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NUR 190 Final Exam D. Utilitarianism - Correct Answer ANS: B. Christian ethics C. Ethical egoism individual. being happiness. Ethical egoism promotes the idea that what is right is good for the duty. Utilitarianism holds that decisions should be made focusing on the end result should be made based on moral law and that actions are bound by a sense of moral as we do when they occupy a position similar to ours. Kantianism states that decisions demand of Christian ethics is to treat others as moral equals by permitting them to act The charge nurse is operating from a Christian ethics framework. The imperative applicant operates from an ethical egoism framework? During a hiring interview, which response by a nursing applicant should indicate that the Answer ANS: B. "This job will pay the bills, and the workload is light enough for me." D. "It is my duty in life to be a psychiatric nurse. It is the right thing to do." - Correct C. "I will be happy caring for the mentally ill. Working in Med/Surg kills my back." B. "This job will pay the bills, and the workload is light enough for me." A. "I would want to be treated in a caring manner if I were mentally ill." may not take the needs of others into account. promotes the idea that decisions are made based on what is good for the individual and The applicant's comment reflects an ethical egoism framework. This framework Without authorization, a nurse administers an extra dose of narcotic tranquilizer to an
NUR 190 FINAL
EXAM STUDY
QUESTIONS AND
ANSWERS 2025
GRADED A+
In response to a student's question regarding choosing a psychiatric specialty, a charge nurse states, "Mentally ill clients need special care. If I were in that position, I'd want a caring nurse also." From which ethical framework is the charge nurse operating? A. Kantianism B. Christian ethics
agitated client. The nurse's coworker observes this action but does nothing for fear of repercussion. What is the ethical interpretation of the coworker's lack of involvement? A. Taking no action is still considered an unethical action by the coworker. B. Taking no action releases the coworker from ethical responsibility. C. Taking no action is advised when potential adverse consequences are foreseen. D. Taking no action is acceptable because the coworker is only a bystander. - Correct Answer ✔ANS: A. Taking no action is still considered an unethical action by the coworker.
refusal when a client is actively suicidal or homicidal. A suicidal or homicidal client who The nurse should understand that health-care professionals can override treatment commitment? Which client should a nurse identify as a potential candidate for involuntary threatening to commit suicide. D. A client who eats waste out of a garbage can - Correct Answer ANS: B. A client C. A client who never bathes and wears a wool hat in the summer B. A client threatening to commit suicide A. A client living under a bridge in a cardboard box and requires emergency treatment. involuntary commitment. The suicidal client who refuses treatment is a danger to self The nurse should identify the client threatening to commit suicide as eligible for client against the client's wishes? autonomy. Under which circumstance would a nurse have the right to medicate the A client diagnosed with schizophrenia refuses to take medication, citing the right of C. When the client physically attacks another client after being confronted in group B. When the client constantly demands inappropriate attention from the nurse A. When the client makes inappropriate sexual innuendos to a staff member Which statement should a nurse identify as correct regarding a client's right to refuse treatment? A. Clients can refuse pharmacological but not psychological treatment. B. Clients can refuse any treatment at any time. C. Clients can refuse only electroconvulsive therapy (ECT). D. Professionals can override treatment refusal if the client is actively suicidal or homicidal. - Correct Answer ✔ANS: D. Professionals can override treatment refusal if the client is actively suicidal or homicidal. refuses treatment may be a danger to self or others. This situation should be treated as therapy D. When the client refuses to bathe or perform hygienic activities - Correct Answer ✔ANS: C. When the client physically attacks another client after being confronted in group therapy. The nurse would have the right to medicate a client against his or her wishes if the client physically attacks another client. This client poses a significant risk to safety and is incapable of making rational choices. The client's refusal to accept treatment can be challenged because the client is endangering the safety of others. an emergency, and treatment may be performed without informed consent.
and should not be disclosed by the nurse without prior client consent. caller. Admission to the facility would be considered protected health information (PHI) The most appropriate action by the nurse is to refuse to give any information to the facilitate which ethical principle? choice about management of depression. A nurse should provide this information to A client requests information on several medications in order to make an informed D. Justice - Correct Answer ANS: A. Autonomy C. Nonmaleficence B. Beneficence A. Autonomy representative would be asked to give consent. when clients are incapable of making informed decisions, a legal guardian or is capable of making independent choices should be permitted to do so. In instances The nurse should provide the information to support the client's autonomy. A client who of an ethical principle should a nurse recognize in this situation? prematurely discharges those whose insurance benefits have expired. Which violation An inpatient psychiatric physician refuses to treat clients without insurance and C. Nonmaleficence B. Beneficence A. Autonomy A psychiatric nurse working on an inpatient unit receives a call asking if an individual has been a client in the facility. Which nursing response reflects appropriate legal and ethical obligations? A. Refusing to give any information to the caller, citing rules of confidentiality B. Refusing to give any information to the caller by hanging up C. Affirming that the person has been seen at the facility but providing no further information D. Suggesting that the caller speak to the client's therapist - Correct Answer ✔ANS: A. Refusing to give any information to the caller, citing rules of confidentiality. D. Justice - Correct Answer ✔ANS: D. Justice The nurse should determine that the ethical principle of justice has been violated by the physician's actions. The principle of justice requires that individuals should be treated equally regardless of race, sex, marital status, medical diagnosis, social standing, economic level, or religious belief. Which situation reflects the ethical principle of veracity? A. A nurse provides a client with outpatient resources to benefit recovery.
monitored by an ankle bracelet. D. The client is monitored by an ankle bracelet. - Correct Answer ANS: D. The client is C. The client is placed in soft Posey restraints. B. The client is placed in a geriatric chair with tray. A. The client is placed in seclusion. restraints nor seclusion would be justified. The client does not pose a direct dangerous threat to self or others, so neither physical The least restrictive alternative for this client would be monitoring by an ankle bracelet. the nurse broken? nurse realizes that the brother was not on the client's approved call list. What law has nurse connects him to the community phone and the sister is summoned. Later the A brother calls to speak to his sister who has been admitted to the psychiatric unit. The Portability and Accountability Act D. The Good Samaritan Law - Correct Answer ANS: C. The Health Insurance C. The Health Insurance Portability and Accountability Act B. The Tarasoff Ruling A. The National Alliance for the Mentally Ill Act not have provided any information without proper consent from the client. by revealing that the client had been admitted to the psychiatric unit. The nurse should The nurse has violated the Health Insurance Portability and Accountability Act (HIPAA) D. The nurse restrains the client without just cause and communicates this to family. - Correct Answer ✔ANS: B. The nurse threatens to "tie down" the client and then does so against the client's wishes. The nurse in this situation has committed both assault and battery. Assault refers to an action that results in fear and apprehension that the person will be touched without consent. Battery is the touching of another person without consent. A geriatric client is confused and wandering in and out of every door. Which scenario reflects the least restrictive alternative for this client? An inpatient client, whom the treatment team has determined to be a danger to self, gives notice of intention to leave the hospital. What information should the nurse recognize as having an impact on the treatment team's next action? A. State law determines how long a psychiatric facility can hold a client. B. Federal law determines if the client is competent. C. The client's family involvement will determine if discharge is possible. D. Hospital policies will determine treatment team actions. - Correct Answer ✔ANS: A. State law determines how long a psychiatric facility can hold a client.
privacy. When admitted to an inpatient psychiatric facility, a client gives implied consent Basic to the psychiatric client's hospitalization is his or her right to confidentiality and competency should a nurse recognize as true? The nursing staff is discussing the concept of competency. Which information about decisions. Answer ANS: C. A competent client has the ability to make reasonable judgments and D. Competency is a medical determination made by the client's physician. - Correct C. A competent client has the ability to make reasonable judgments and decisions. medications. B. Refusal of medication can initiate an incompetency hearing leading to forced A. Competency is determined with a client's compliance with treatment. decision making. A competent individual's cognition is not impaired to an extent that would interfere with A. "The nurse practice act provides a list of definitions of important terms including the Most states commonly cite that in an emergency a client who is dangerous to self or others may be involuntarily hospitalized. A client is concerned that information given to the nurse remains confidential. Which is the nurse's best response? A. "Your information is confidential. It will be kept just between you and I." B. "I will share the information with staff members only with your approval." C. "If the information impacts your care, I will need to share it with the treatment team." D. "You can make the decision whether your physician needs this information or not." - Correct Answer ✔ANS: C. "If the information impacts your care, I will need to share it for information to be shared with health-care workers specifically involved in the client's A nursing instructor is presenting content on the provisions of the nurse practice act as it relates to their state. Which student statement indicates a need for further instruction? definition of nursing." B. "The nurse practice act lists education requirements for licensure and reciprocity." C. "The nurse practice act contains detailed statements that describe the scope of practice for registered nurses (RNs)." D. "The nurse practice act lists the general authority and powers of the state board of nursing." - Correct Answer ✔ANS: C. "The nurse practice act contains detailed statements that describe the scope of practice for registered nurses (RNs)." with the treatment team." care.
escorted to an emergency department by police. The client threatens suicide. Which After disturbing the peace, an aggressive, disoriented, unkempt, homeless individual is will be touched without consent. Assault is an act that results in a person's genuine fear and apprehension that he or she In the situation presented, which nursing intervention constitutes false imprisonment? the day. The nurse institutes seclusion. ANS: B. The client has been consistently seeking the attention of the nurse much of nurse calls the security team and they prevent the client from leaving. - Correct Answer D. A client hospitalized as an involuntary admission attempts to leave the unit. The nurse runs after the client and the client agrees to return. C. A psychotic client, admitted in an involuntary status, runs off the psychiatric unit. The The nurse institutes seclusion. B. The client has been consistently seeking the attention of the nurse much of the day. leaving." The nurse seeks the physician's order after the client is restrained. A. The client is combative and will not redirect stating, "No one can stop me from unsuccessfully attempted. emergency situation to prevent harm after least restrictive means have been fixed limits by the use of verbal or physical means. Seclusion should only be used in an False imprisonment is the deliberate and unauthorized commitment of a person within The criteria for involuntary emergency commitment include danger to self and/or others. Of the four clients considered, the client who is delusional and has a plan to kill his wife meets this criterion as a danger to others. What is the legal significance of a nurse's action when the nurse threatens a demanding client with restraints? A. The nurse can be charged with assault. B. The nurse can be charged with negligence. C. The nurse can be charged with malpractice. D. The nurse can be charged with beneficence. - Correct Answer ✔ANS: A. The nurse criteria would enable a physician to consider involuntary commitment? (Select all that apply.) A. Being dangerous to others B. Being homeless C. Being disruptive to the community D. Being gravely disabled and unable to meet basic needs E. Being suicidal - Correct Answer ✔ANS: A. Being dangerous to others D. Being gravely disabled and unable to meet basic needs can be charged with assault.
d. Identify the problem. - Correct Answer ANS: D. Identify the problem. c. Use institutional research. b. Obtain support from the 7 - 3 shift. a. Use creativity. considered the most vital steps. identification of the problem/issue; therefore, problem recognition and identification are other step. The most common cause for failure to resolve problems is the improper Identification of a problem is the first step in problem solving and occurs before any TOP: AONE competency: Knowledge of the Health Care Environment REF: Page 109 | Page 110 c. Make the decision alone. b. Involve the sales representative. a. Involve the rehab staff in the decision. To make a high-quality decision, the nurse manager would:
- The nurse manager of a rehab unit wants to purchase a new anti-embolic stocking. decrease employee turnover, and enhance employee satisfaction. decision model has been shown to increase work performance and productivity, process and the staff may express and discuss options and preferences. The shared In a shared decision model, the decisions are made through an interactive, deliberate E. Being suicidal The physician could consider involuntary commitment when a client is being dangerous to others, is gravely disabled, or is suicidal. If the client is determined to be mentally incompetent, consent should be obtained from the legal guardian or court-approved guardian or conservator. A hospital administrator may give permission for involuntary commitment when time does not permit court intervention.
- The risk manager informs the nurse manager of an orthopedic unit that her unit has had an increase in incident reports about patients falling during the 11 - 7 shift. The nurse manager knows that the best way to resolve the problem is to: d. Involve administration in the decision. - Correct Answer ✔ANS: A. Involve the rehab REF: Page 103 TOP: AONE competency: Communication and Relationship-Building
- Several nurses on an adolescent psychiatric unit complain that the teens are becoming unmanageable on the 0700 - 1900 shift. To resolve this problem, the nurse manager decides that the staff should have a brainstorming session. The goal of brainstorming is to: a. Evaluate problem solutions. b. Critique the ideas of others. c. Generate as many solutions as possible. staff in the decision.
decisions and may be the most appropriate when lack of time is an issue. minimally meet the objective or standard for a decision. This approach allows for quick With this approach, the decision maker selects an acceptable solution, one that may d. Satisficing. - Correct Answer ANS: D c. Optimizing. b. Selecting the best option for reaching a predefined goal. a. A higher-order thinking process. available, and time constraints, you must make a decision that involves: skills can best be used. Given the limitations in skills and experience, number of staff available. You must decide which patient situation you will take and where the RN's labor room and has limited cardiac nursing experience. An unregulated assistant is also The other RN on the unit is a recent graduate who has not yet been orientated to the patient is about to deliver. A child with asthma is experiencing early signs of an attack. morning. A 52 - year-old patient is complaining of left-sided chest pain and a multiparous
- In a rural hospital, the unit for which you are charge nurse has a particularly busy REF: Page 103 TOP: AONE competency: Knowledge of the Health Care Environment ANS: D. Assess the risk to the client and the agency before proceeding. d. Assess the risk to the client and the agency before proceeding. - Correct Answer c. Fill out a notification form (incident report). b. Inform the nursing supervisor. a. Stay out of it. wound care. The best approach for the clinic nurse to take is to:
- A clinic nurse has observed another nurse deviating from agency policy in performing d. Evaluation of the effectiveness of problem resolution. - Correct Answer ✔ANS: C. Accurate identification of the problem. To proceed effectively, it is important to determine if a problem exists and to accurately identify a problem. Failure to resolve problems is most often linked to improper identification of the problem. REF: Page 109 | Page 110 TOP: AONE competency: Knowledge of the Health Care Environment If the situation is subjective, non-routine, and unstructured or if outcomes are unknown or unpredictable, the nurse leader and manager may need to take a descriptive or behavioral approach. More information (such as degree of risk to the client and to the agency) needs to be gathered to address this situation effectively. REF: Page 103 TOP: AONE competency: Knowledge of the Health Care Environment
- The risk manager wants to evaluate the reasons for an increased number of falls on the rehab unit. The risk manager devises a fishbone diagram. A fishbone diagram is a useful tool to:
decision-making tool to evaluate brands. d. Select the vendor the institution usually buys from. - Correct Answer ANS: B. Use a c. Ask the nursing staff which brand they prefer. b. Use a decision-making tool to evaluate brands. a. Select the least expensive brand. The manager should:
- An outpatient surgery manager is evaluating infusion pumps for the operating room. when information is available and options are known. Decision-making tools such as decision grids and SWOT analyses are most appropriate TOP: AONE competency: Knowledge of the Health Care Environment REF: Page 108 | Page 109 effort; problem solving is focused on solving an immediate problem. immediate problem. - Correct Answer ANS: C. Decision making is a goal-directed d. Problem solving is a goal-directed effort; decision making is focused on solving an immediate problem. c. Decision making is a goal-directed effort; problem solving is focused on solving an b. Problem-solving skills require critical thinking; decision-making skills do not. a. Decision-making skills require critical thinking; problem-solving skills do not. decision making:
- Select the statement that best defines the difference between problem solving and Problem solving is focused on solving immediate problems, whereas decision making is a. Identify the root causes of problems. b. List possible solutions to problems. c. Help leaders select the best options. d. Evaluate the outcomes of decisions made. - Correct Answer ✔ANS: A. Identify the root causes of problems. A fishbone diagram, also known as a cause-and-effect diagram, is useful for determining the reasons (causes) for an effect (falls). REF: Page 111 TOP: AONE competency: Knowledge of the Health Care Environment a goal-directed process that is aimed at selecting appropriate actions from among options. Not all decisions begin with a problem. REF: Page 101 TOP: AONE competency: Leadership
- Sue, a nurse manager, has a staff nurse that has been absent a great deal for the past three months. A whistleblower gives some information to Sue indicating that the staff nurse will be resigning and returning to school. Because of this, Sue decides to do which of the following? a. Immediately fire the staff nurse.
among options. defined as a purposeful, goal-directed effort that uses a systematic process to choose problem centered. Decision making does not always begin with problems, but rather is phase of decision making, and solving a problem refers to problem solving, which is d. Generate ideas. - Correct Answer ANS: B. Choose between alternatives. c. Reflect on a certain situation. b. Choose between alternatives. a. Solve a problem.
- Decision making is described by the nursing educator as the process one uses to: REF: Page 101 TOP: AONE competency: Leadership d. Satisficing model - Correct Answer ANS: C. Optimizing model c. Optimizing model b. Objective model a. Subjective model following decision-making models did Justin use in making his decision? who can best provide high-quality care and who will fit well with the team. Which of the interview candidates carefully because he recognizes that it is important to hire staff Despite his need for staff, Justin decides to review each application thoroughly and high turnover rate among rehab-assistants because of the heavy work assignments.
- Justin is a nurse manager in a rehabilitation unit in a small urban center. There is a Optimizing is a decision style in which the decision maker selects the option that is best, c. High-level cognitive process that includes creativity, problem solving, and decision making. d. Discussion that guides the nursing process. - Correct Answer ✔ANS: C. High-level cognitive process that includes creativity, problem solving, and decision making. It is generally accepted by many authors and researchers that this statement best defines critical thinking. REF: Page 101 | Page 102 TOP: AONE competency: Business Skills The hallmark of decision making is choosing among options. Generating options is one based on an analysis of the pros and cons associated with each option. A better decision is more likely when using this approach, although it takes longer to arrive at a decision. REF: Page 103 TOP: AONE competency: Business Skills
- Justin is a nurse manager in a rehabilitation unit in a small urban center. There is a high turnover rate among rehab-assistants because of the heavy work assignments. Despite his need for staff, Justin decides to review each application thoroughly and interview candidates carefully because he recognizes that it is important to hire staff
staff, the unit manager decided the staff needed to take some time off. He scheduled
- When confronted with the controversy and the apparent poor morale of the evening REF: Page 101 | Page 112 | Page 113 TOP: AONE competency: Business Skills solving needs to begin with "why?" The unit manager did not begin with an accurate identification of the problem. Problem REF: Page 109 | Page 110 TOP: AONE competency: Business Skills
- John Smith, one of three managers at BSG Labs, drafted a policy that would allow who can best provide high-quality care and who will fit well with the team. Which of the following decision-making solutions should Justin consider to have a more efficient department a. Replace staff only with qualified applicants. b. Determine what the problem or problems are before hiring new staff. c. Consult with the human resources department and develop a plan for hiring new staff. d. Consider all the options listed. - Correct Answer ✔ANS: D. Consider all the options listed. Decision making involves a goal-oriented consideration of many options that are holidays for the staff without consulting them. A couple of the staff nurses approached the manager and indicated that the problem was not scheduling, but rather the team his department to do more testing in his lab. This policy included the times for regular collection as well as a new process for emergency laboratory testing. The policy and procedures were never followed. The reason was that: a. The policy was too lengthy and inundated readers with too much detail. b. The policy made decisions for other departments in the company. c. The staff did not believe that the new policy would be effective. d. Testing should not be done in the lab. - Correct Answer ✔ANS: B. The policy made decisions for other departments in the company. instance, all of the options listed might be considered and weighed. feasible and satisfactory and has the fewest undesirable consequences. In this the desired goals or objectives. The solution selected should be the one that is most outcomes. The options should be ranked in the order in which they are likely to result in objectively weighed according to their possible risks, consequences, and positive identification d. Incorrect problem identification - Correct Answer ANS: D. Incorrect problem c. Poor evaluation of outcomes b. Not considering a number of alternatives a. Not using a problem-solving model problem solving? leader and her patient assignments. What was the unit manager's first missed step in
concerned about the decision and went to the administration with a number of the staff was to give them a monetary bonus rather than time off. The staff was very
- In a busy rehabilitation unit, the team manager decided that the best way to reward d. Informative. - Correct Answer ANS: D. Informative. c. Reasoned b. Shared. a. Paternalistic. decision-making style is known as: them to advise you if they have any feedback, concerns, or alternative solutions. This receive services at all. You provide this information on this decision to the staff and ask agency is facing a decline in funding and without restructuring, some clients might not clients in the agency can receive appropriate care from PN staff. Furthermore, the number of RN positions in favor of PN positions because agency data suggest that the
- The agency in which you are a nursing leader makes a decision to reduce the REF: Page 103 TOP: AONE competency: Leadership has been shared and without the active involvement of the manager. The informative model offers the staff the ability to make a decision after the information d. Post a blank schedule, and ask staff members to fill in their times by a given date. - Correct Answer ✔ANS: D. Post a blank schedule, and ask staff members to fill in their times by a given date. This is based on a decision-making model that allows experience and knowledge to predict whether a decision will or will not work. The experience of the head nurse suggests that it is important to involve staff in decisions that affect them the most. REF: Page 101 | Page 102 TOP: AONE competency: Knowledge of the Health Care Environment complaints. Critical thinking is a process that entails a number of steps. What steps did A. Identified what assumptions were underpinning the issues. B. Considered why it was important to make this change or the context for the change. C. Considered how this change might affect staff relationships. Taking a majority consensus is not a step in the critical thinking process. Points A, B, and C are "what," "why," and "how" questions that are part of effective critical thinking processes. REF: Page 101 | Page 102 TOP: AONE competency: Leadership d. Attained a majority consensus of all staff. - Correct Answer ANS: c. Considered how this change might affect staff relationships. b. Considered why it was important to make this change or the context for the change. a. Identified what assumptions were underpinning the issues. the manager omit? She should have (select all that apply):
b. Responsible. a. Accountable. a task, a nurse manager should: patient on the unit, who is going to require more care than the others. Before delegating The nurse manager is setting up the room assignments for the unit. She has one critical Assess the amount of guidance and support needed in a particular situation. d. Create a task analysis of critical behaviors for the individual. - Correct Answer C. c. Assess the amount of guidance and support needed in a particular situation. b. Review the employee's performance assessment for the most recent period. a. Delegate the admission assessment to the LPN. A key advantage that a nurse manager has in terms of delegating is that: used more effectively. d. Team skills can be used more effectively. - Correct Answer D. Team skills can be c. Administration can predict overtime more accurately. b. Nurses report less pressure to perform necessary tasks themselves. care. a. Clients receive less attention because too many staff make it difficult to coordinate personnel (UNP) employee. The night nurse should remain: The nurse on the 7 - 7 shift is assigning a component of care to an unlicensed nursing You are a member of a team assigned to care for 15 general medical/surgical clients. You have all worked well together in the past in this same type of care. If you are assigned to coordinate this team's work, your best strategy, based on the Hersey and Blanchard model, would be to: a. Have a list of tasks to be accomplished and tell each member of the team what he or she must do. b. Encourage people to discuss their frustrations in providing this care. c. Ignore them—they've done it before. d. Provide minimal direction and let them come to you with questions. - Correct Answer ✔D. Provide minimal direction and let them come to you with questions. c. Authoritative and liable. d. Responsible and task-oriented. - Correct Answer ✔A. Accountable. The night nurse understands that certain factors need to be considered before delegating tasks to others. These factors include the: a. Complexity of the task and the age of the delegatee. b. Potential for benefit and the complexity of the task. c. Potential for benefit and the number of staff.
