Download NU 311 Nursing Final Exam Questions with complete solutions. Graded A+ and more Exams Nursing in PDF only on Docsity!
NU 311 Nursing Final Exam Questions
with complete solutions. Graded A+
What are professional characteristics? - CORRECT ANSWER --extensive
education -theoretical body of knowledge -specific service -autonomy in decision making -code of ethics
Define Nursing - CORRECT ANSWER -The protection, promotion, and
optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations.
parts to the nursing process - CORRECT ANSWER -assess, diagnose, plan,
implement, evaluate
prioritizing nursing process - CORRECT ANSWER -o Safety
o Airway o Breathing o Circulation o Pain
What is the ANA? - CORRECT ANSWER -American Nurses Association (ANA)
What is the ANA code of ethics provision 9? - CORRECT ANSWER -The
profession of nursing, collectively through its professional organizations, must articulate nursing values, maintain the integrity of the profession, and integrate principles of social justice into nursing and health policy.
What is the ANA code of ethics provision 6? - CORRECT ANSWER -the nurse
participates in establishing, maintaining, and improving health care environments and conditions of employment conducive to the provision of quality health care and consistent with the values of the profession through individual and collective action
What is the ANA code of ethics provision 7? - CORRECT ANSWER -The Nurse,
in all roles and settings, advances the profession through research and scholarly inquiry, professional standards of development, and the generation of both nursing and health policy."
What is the ANA code of ethics provision 8 - CORRECT ANSWER -The nurse
collaborates with other health professionals and the public in promoting community, national, and international efforts to meet health needs.
What is the ANA code of ethics provision 5 - CORRECT ANSWER -duties to self
and others -INTEGRITY is an aspect of wholeness of character and is primarily a self-concern of the individual nurse. -Nurses have a responsibility to remain consistent with both their personal and professional values
What is the ANA code of ethics provision 4 - CORRECT ANSWER -The nurse
has authority, accountability, and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to promote health and to provide optimal care
What is the ANA code of ethics provision 3? - CORRECT ANSWER -Promotes,
advocates for, and strives to protect the health, safety, and rights of the patient This means: -Participate in review and development of policies -Reporting errors and near misses per facility policy (whether you or other made error) -Disclosing errors to patients -Use the Chain of Command
What is the ANA code of ethics provision 2? - CORRECT ANSWER -professional
boundaries The nurse's primary commitment is to the patient, whether an individual, family, group, or population. When acting within one's role as a professional, the nurse recognizes and maintains boundaries that establish appropriate limits to relationships.
- Offering approval or disapproval
- Offering advice
- Avoid yes or no questions
- Stereotyping- conclusions are influenced based on personal beliefs or biases
- Using patronizing language- "you know better than that"
What are the state nurse practice acts? - CORRECT ANSWER --defined as the
scope of practice in each state -protected by the public -law that regulates the practice of nursing: to have a nursing licensure and pass the NCLEX-RN exam in order to practice. (RN, LPN, APN) -establishes the Alabama Board of Nursing (ABON) and gives the board authority over nursing practice. They have the right to give and take away nursing liscense
How do you be assertive? - CORRECT ANSWER -use a nonthreatening tone,
respect others,use direct statements of feeling What is the difference between assigning, delegating, and supervising? -
CORRECT ANSWER -Assigning - transferring the authority, accountability, and
responsibility of client care to another Delegating - transferring the authority and responsibility to another team member to complete a task, while retaining the accountability Supervising - directing, monitoring, and evaluating the performance of tasks by another. RNs are responsible for supervising delegated tasks to an LPN or AP
What is an appropriate delegation? - CORRECT ANSWER --The transfer of
responsibility for the performance of a task from one individual to another while retaining accountability and authority for the outcome -The individual receiving the assignment is responsible for the performance of the task The individual delegating the task retains accountability for the outcome.
Can you delegate responsibility? - CORRECT ANSWER -yes
Can you delegate accountability? - CORRECT ANSWER -no
Can a nurse say "no" to an assignment? - CORRECT ANSWER -Yes... if
assignment is unsafe for patients
-Talk with charge nurse -Take up the Chain of Command -Document Practice Situation and file with Administration -Failure to follow the steps above may result in a charge of patient abandonment - reportable to the BON
Five rights of delegation - CORRECT ANSWER --Right direction/communication
-Right supervision -Right circumstances -Right task -Right person
Delegation: Right direction/communication - CORRECT ANSWER -Clear,
concise, correct, and complete initial and ongoing directions. (Include time, expectations, follow-up communication etc.)
Delegation: Right Supervision - CORRECT ANSWER -Oversee
assigned/delegated tasks (Huddles/checkpoints - solicit team members opinion; credit team for accomplishments
Delegation: Right circumstance - CORRECT ANSWER --Long term vs. acute vs
home health? -Knowledge and skill of delegatee -Verification of clinical competence -Stability of patient's condition -Availability of resources (including human)
Delegation: Right task - CORRECT ANSWER -is it safe? Does it require little
supervision?
Delegation: Right person - CORRECT ANSWER -License, certification and role
description; strengths, experience, competence?
An RN on a medical-surgical unit is making assignments at the beginning of the shift. Which of the following tasks should the nurse delegate to the LPN? A. Obtaining vital signs for a client who is 2 hr. post-procedure following a cardiac catheterization B. Administering a unit of packed red blood cells (RBCs) C. Instructing a client in the performance of wound care
D. Developing a plan of care for a newly admitted client. - CORRECT ANSWER -
C. Because it is reinforcing client teaching from the standard care plan
What is best evidence? - CORRECT ANSWER -EVIDENCE-up to date
information from relevant, valid research -BEST evidence is comes from well designed, systematically conducted research studies Other sources (non-research): -General literature review -Quality improvement data -Risk management data -Infection control data -Chart reviews -Clinician's expertise
What is EBP? - CORRECT ANSWER -Evidence based practice is a problem-
solving approach to clinical practice that combines the best available evidence in combination with a clinician's expertise, patient preferences and values, and available health care resources in making decisions about patient care
What are the 6 steps of EBP? - CORRECT ANSWER -1. Ask a clinical question
- Collect the most-relevant and best evidence
- Critically appraise the evidence you gather
- Apply or integrate evidence along with your clinical expertise, patient preferences, and values in making a practice decision or change
- Evaluate the practice decision or change
- Communicate your results
How to form a PICOT statement? - CORRECT ANSWER -P: patient, population,
or problem I: intervention or issue of interest C: comparison with the intervention O: Outcome (measurable) T: Time (an optional component of a clinical question)
Example of a PICOT - CORRECT ANSWER --In abdominal surgery patients (P),
does epidural analgesia (I) compared to patient-controlled analgesia (C)affect pain severity(O) in the first 48 hours after surgery (T)? -Is an adult patient's (P) blood pressure more accurate (O) while measuring with the patient's legs crossed (I) versus the patient's feet flat on the floor (C)?
What databases contain searchable Scientific Literature - CORRECT
ANSWER --CINAHL:
Cumulative Index of Nursing and Allied Health Literature. Includes studies in nursing, allied health, and biomedicine Cochrane Database of Systematic -Cochrane Collaboration. Includes completed reviews: Full text of regularly updated systematic reviews prepared by the and protocols. -PubMed: Health science library at the National Library of Medicine. Offers free access to journal articles. -MEDLINE: US National Library of Medicine; bibliographical database that contains more than 22 million references to journal articles in the life sciences with a concentration in biomedicine -EMBASE:
Most common way for pt to become infected with an HAI? - CORRECT
ANSWER -a health care provider's hands
Chain of infection - CORRECT ANSWER -Transmission, Portal of entry, Host
susceptibility, infectious agent, reservoir, portal of exit
What is Medical Asepsis and Sterile Technique? - CORRECT ANSWER -Medical
Asepsis: clean technique that reduces organisms and prevents the transfer of them as well -HAND HYGEINE!!!, barrier techniques, routine environment cleaning Sterile Technique: eliminates pathogenic organisms used in surgery or other invasive procedures A nursing assistive personnel (NAP) arrives to assist the nurse with a dressing change by opening sterile packages. The NAP states that she does not need to perform hand hygiene before assisting the nurse because she is not going to touch the patient. Is the NAP correct? A. True
B. False - CORRECT ANSWER -B. False
Rationale: The nursing assistive personnel (NAP) is incorrect in saying that hand hygiene does not need to be performed before she assists the nurse. Although she may not touch the patient, she is still participating in patient care. Hand hygiene is performed by all caregivers.
Isolation Precautions - CORRECT ANSWER -(This may lead to loneliness or
changes in self-concept or body image. Know cultural views and preferences of your patients. When a patient from another culture requires isolation, use caution to be sure that the patient and family understand the therapeutic purpose of isolation.) -PPE required (gown, goggles, mask, gloves) -leave equipment in the room
Order in which you don and remove PPE - CORRECT ANSWER -Donning:
gown, mask, goggles, gloves Removing: gloves, goggles, gown, mask
Donning/Removing Sterile Gloves - CORRECT ANSWER -review checkoff
What should you always do before donning sterile gloves? - CORRECT
ANSWER -assess pt for latex allergy
When donning sterile gloves, you take your non-dominant hand to touch which part of
the glove? - CORRECT ANSWER -edge of the cuff
How should you hold your hands when sterile gloves are completely - CORRECT
ANSWER -interlock fingers and above your waist
How should you adjust your sterile gloves after donning? - CORRECT
ANSWER -do not adjust until both gloves are on. Only adjust fingers, NEVER adjust
the cuffs How should you hold your gloved thumb to avoid touching the skin when donning
gloves? - CORRECT ANSWER -away from your body (hitch hike)
How do you remove gloves? - CORRECT ANSWER -glove to glove and then
skin to skin away from other people and downward towards the trashcan
Hand Hygiene - CORRECT ANSWER -pg. 244
(Review Check-Off) -soap and water are required for VISIBLY soiled hands or C.diff -Alcohol-based can be used for non-visible germs
How much soap should be applied when washing hands? - CORRECT
ANSWER -3-5ml
How long should you lather and apply friction to your hands for when washing hands? -
CORRECT ANSWER -15 seconds
When washing hands, you should interlace fingers and rub your palms how? -
CORRECT ANSWER -in a circular motion at least 5 times
How do you dry your hands off after washing them? - CORRECT ANSWER -
wiping from fingers up to wrists and forearms
-CAUTI's -retained objects -VAP
IOM - CORRECT ANSWER -The Quality of Health Care in America Committee
of the Institute of Medicine (IOM) concluded that it is not acceptable for patients to be harmed by the health care system that is supposed to offer healing and comfort--a system that promises, "First, do no harm." prevention of medical errors
2017 Hospital National Patient Safety Goals - CORRECT ANSWER --Identify
patient correctly -Improve staff communication -Use medications safely -Use alarms safely -Prevent infection -Identify patient safety risks -Prevent mistakes in surgery
Patients rights provided for by CMS - CORRECT ANSWER -1. Notice of rights
- Exercise of rights
- Privacy and Safety
- Confidentiality of pt record
- Restraint or seclusion
Notice of rights - CORRECT ANSWER --A hospital must protect and promote
each patient's rights. -A hospital must inform each patient whenever possible or, when appropriate, the patient's representative, of the patient's rights in advance of furnishing or discontinuing patient care. -The hospital must have a process for prompt resolution of patient grievances and must inform each patient about whom to contact to file a grievance
Exercise of rights - CORRECT ANSWER --The patient has the right to participate
in the development and implementation of his or her plan of care.
-The patient or his or her representative has the right to make informed decisions regarding his or her care. -The patient's rights include being informed of his or her health status, involved in care planning and treatment, and able to request or refuse treatment. This right must not be construed as a mechanism to demand the provision of treatment or services deemed medically unnecessary or inappropriate -The patient has the right to formulate advance directives and to have hospital staff and practitioners who provide care in the hospital comply with these directives. -The patient has the right to have a family member or representative of his or her choice and his or her own health care provider notified promptly of his or her admission to the hospital.
Privacy and safety - CORRECT ANSWER --The patient has the right to personal
privacy. -The patient has the right to receive care in a safe setting. -The patient has the right to be free from all forms of abuse or harassment.
Confidentiality of patient record - CORRECT ANSWER --The patient has the
right to the confidentiality of his or her clinical records. -The patient has the right to access within a reasonable time frame information contained in his or her clinical records.
Restraint or seclusion - CORRECT ANSWER --The patient has the right to be
free from physical or mental abuse and corporal punishment. -The patient has the right to be free from restraints or seclusion of any form that is not medically necessary or is used by staff as a means of coercion, discipline, convenience, or retaliation. A restraint is any manual method or physical or mechanical device, material, or equipment attached or adjacent to the patient's body that he or she cannot easily remove that restricts freedom of movement or normal access to one's body. A drug used as a restraint is a medication used to control behavior or to restrict the patient's freedom of movement and is not a standard treatment for the patient's medical or psychiatric condition. Seclusion is the involuntary confinement of a patient alone to a room or area from which the patient is physically prevented from leaving. -A restraint or seclusion can be used only if needed to improve the patient's well-being and if less restrictive interventions have been determined to be ineffective.
A. True
B. False - CORRECT ANSWER -B. False
Do not delegate admission vital signs, because a nurse must conduct the baseline assessment. The nurse can delegate some tasks to nursing assistive personnel (NAP), such as preparing the patient's room and collecting specimens; however, the actual assessment must be performed by the nurse. The nurse admits to the unit a 4-year-old child who is experiencing separation anxiety from her parents. What age-appropriate behavior related to separation anxiety might this child exhibit? A. Having difficulty sleeping B. Throwing items C. Screaming at the nurse
D. Urinating in bed - CORRECT ANSWER -A. Having difficulty sleeping
Rationale: This is the only age-appropriate behavior. The other behaviors may be seen as well; however, a 4-year-old child should not be exhibiting these. The patient tells the nurse she will not cooperate this evening with the physical therapist to perform exercises because she was in pain the entire time during exercise last evening. What question should the nurse ask the patient? A. Do you like the therapist who was assigned to you? B. Why are you trying to be difficult tonight? C. Have you ever liked to exercise in the past?
D. Did you receive pain medication before exercise? - CORRECT ANSWER -D.
Did you receive pain medication before exercise? Pain may reduce a patient's motivation to perform isometric exercises. Pain relief before attempts at exercise may enhance the patient's participation; it may be appropriate to medicate the patient 30 to 60 minutes before exercise.
Can the skill of promoting early activity and exercise for patients be delegated to a
NAP? - CORRECT ANSWER -yes
In the outpatient setting, education regarding activity and exersize CANNOT be delegated to a NAP A. True
B. False - CORRECT ANSWER -A. true
An 82-year-old man with a rotator cuff tear is not a candidate for surgery. Which of the following exercises can the nurse teach the patient to do to assist with range of motion? A. Lift 15-pound weights, raising the arm slowly to shoulder height. B. Perform 5-count sets of push-ups 3 times daily. C. Reach to the bedside table to lift a book.
D. Perform household chores of changing overhead lightbulbs. - CORRECT
ANSWER -C. Reach to the bedside table to lift a book.
Rationale: Reaching sideways to a bedside table is performing ROM activity without putting more stress on the shoulder.
What is used to prevent DVT's? - CORRECT ANSWER -Compression (elastic)
stockings Sequential compression devices (SCDs) pump blood into deep veins, thus removing pooled blood and preventing venous stasis. Another venous plexus foot pump promotes circulation by mimicking the natural action of walking.
S/S of DVT - CORRECT ANSWER -swelling in infected leg, warm to touch,
cyanotic skin, pain Common risk factors that include conditions that influence virchow's triad -
CORRECT ANSWER --hyper-coagulability
-venous wall abnormalities -blood flow stasis (all these contribute to developing a DVT)
What would do if the pt ambulating began to fall? - CORRECT ANSWER -fall
with them. Let them slide down your knee"
How to apply SCD hose - CORRECT ANSWER -turn stocking inside out, hold
heel, pull through. slide over the pt's calf until sock is completely extended making sure there are no rough ridges. make sure to measure pt's leg when selected sizes. you can also apply powder or cornstarch to legs
Pressure Injury - CORRECT ANSWER -a localized area of injury to the skin
and/or underlying tissue, usually over a bony prominence, as a result of pressure or pressure in combination with shear (a never event)
Most common site of pressure injuries - CORRECT ANSWER -over bony
prominences
What type of pt's are more susceptible to acquiring a pressure injury? - CORRECT
ANSWER --incontinent
-immobile -pt's with loss of sensory and perception -pt's who are malnourished -anemia -age -heavy sedation and anesthesia -fever -circulatory changes -dehydration -hx of pressure ulcers
Pressure Injury stages - CORRECT ANSWER -Stage 1: non-blanchable erythma
of intact skin Stage 2: partial thickness skin loss with exposed dermis. wound bed is pink and moist Stage 3: full thickness skin loss in which adipose and granulation tissue is visible Stage 4: full thickness and tissue loss with exposed palpable fascia, muscle, tendon, or bone. slough and eshcar may be visible
How do you assess for pressure injuries on a dark-pigmented person? - CORRECT
ANSWER -assessment of temperature, edema, change in sensation, and change in
tissue consistency is compared to surrounding skin. localized area may be purple-ish instead of red
Braden Scale for predicting pressure ulcer risk include - CORRECT ANSWER -
sensory perception, moisture, activity, mobility, nutrition, fiction and shear
How often should you rotate a pt to avoid a pressure injury? - CORRECT
ANSWER -q2h
A 49-year-old woman is recovering from a pressure injury on her left hip. The patient refuses lunch and tells the nurse that she fasts at lunchtime as part of her weight loss plan. How should the nurse respond to this patient? A. The nurse should explain to the patient that fasting is against the hospital policy . B. The nurse should scold the patient for her choice of diet. C. The nurse should inform the patient that fasting will hinder her healing progress.
D. The nurse should respect the patient's choice and not say anything. - CORRECT
ANSWER -C. The nurse should inform the patient that fasting will hinder her healing
progress. Rationale: Adequate nutrition helps to prevent and treat pressure ulcers. A diet high in protein with enough calories, vitamins, and minerals helps maintain normal tissue status and promotes healing. With tissue injury, the body needs more calories for healing; nutrient deficiencies may result in impaired or delayed healing. Do not EVER massage redness areas because doing so may cause additional tissue trauma A. True
B. False - CORRECT ANSWER -A. True
Positional ways to prevent pressure ulcers - CORRECT ANSWER --30-degree
lateral position -pillow bridging
Deep tissue pressure injury - CORRECT ANSWER -persistant, nonblanchable,
deep red, purple or maroon discoloration
