Category 1
A nurse who organizes and establishes a political action committee (PAC) in their local community to address issues relating to the accessibility and affordability of healthcare resources in the community is serving in which capacity and role of the registered nurse?
A. Client advocate
B. Collaborator
C. Politician
D. Entrepreneur
Answer: A
Rationale: A nurse who organizes and establishes a political action committee (PAC) in their local community to address issues relating to the accessibility and affordability of healthcare resources in the community is serving as the client advocate. As you should know, the definition of “client” includes not only individual clients, and families as a unit, but also populations such as the members of the local community.
A nurse makes a significant medication error. Which information should the nurse expect the risk manager to ask about?
A) Any process that was in place that allowed the error to occur
B) If the nurse will agree to have the error reported
C) The hours the nurse worked the previous day
D) Whether the nurse intended to commit the error
Answer: A)Any process that was in place that allowed the error to occur
Rationale - When an error occurs, it should always be reported, whether or not the nurse involved agrees. Reporting of errors should be nonpunitive and should not be considered a negative. Fatigue levels may be considered, but a nurse who is experiencing fatigue should not be allowed to work. It should be assumed that the nurse did not intend to commit the error because this could become a human resources or criminal issue. Reporting of errors is mostly beneficial when safety gaps in processes are identified. Then work can be done to improve processes and prevent future errors.
The nurse is obligated to follow a physicians order unless:
A. The order is a verbal order
B. The order is illegible
C. The order has not been transcribed
D. The order is an error, violates hospital policy, or would be detrimental to the client
Answer: D
Rationale: The order is an error, violates hospital policy, or would be detrimental to the client.
Which of the following best describes Provision 6 of the nursing code of ethics?
A) Accountability, responsibility, and delegation
B) Self-respect, professional growth, character and integrity
C) Accountability, ethical obligations, and professional growth
D) Virtues and values, ethical obligations, and addressing workplace issues
Answer: D) Virtues and values, ethical obligations, and addressing workplace issues
Rationale: Provision 6 of the nursing code of ethics emphasizes virtues and values, ethical obligations, and addressing workplace issues that contribute to sound and ethical nursing practice.
In most ethical dilemmas in health care, the solution to the dilemma requires negotiation among members of the health care team. Why is the nurse's point of view valuable?
A. Nurses understand the principle of autonomy to guide respect for a patient's self-worth.
B. Nurses have a scope of practice that encourages their presence during ethical discussions.
C. Nurses develop a relationship with the patient that is unique among all professional health care providers.
D. The nurse's code of ethics recommends that a nurse be present at any ethical discussion about patient care.
Answer: C. Nurses develop a relationship with the patient that is unique among all professional health care providers.
Rationale - Nurses are unique beings. They can provide professional opinions, while expressing their own opinions, with the ultimate goal of evidence-based patient care and patient advocacy.
A charge nurse is explaining the concept of unionization and collective bargaining to a student nurse. The charge nurse knows that the student nurse has a clear understanding of why nurses join unions when the student nurse states which of the following? (Select all that apply)
1. Nurses join unions to increase their input into organizational decision making.
2. Nurses join unions because they are required to do so as part of employment.
3. Nurses join unions because of fear of lost of income associated with a strike or walkout.
4. Nurses join unions to eliminate discrimination and favoritism.
Answer: 1, 4
Rationale: Unions allow nurses to provide their input on organizational decisions as a unified group. Unions also help nurses create a safe and fair work environment by ensuring fair disciplinary hearings, and standardized grievance mechanisms.
Resolution of an ethical dilemma involves discussion with the patient, the patient's family, and participants from all health care disciplines. Which of the following best describes the role of the nurse in the resolution of ethical dilemmas?
A. To articulate the nurse's unique point of view, including knowledge based on clinical and psychosocial observations.
B. To study the literature on current research about the possible clinical interventions available for the patient in question.
C. To hold a point of view but realize that respect for the authority of administrators and physicians takes precedence over personal opinion.
D. To allow the patient and the physician to resolve the dilemma on the basis of ethical principles without regard to personally held values or opinions.
A. To articulate the nurse's unique point of view, including knowledge based on clinical and psychosocial observations.
Rationale - Nursing plays a unique and critical role in the resolution of difficult ethical situations The nurse is often able to contribute information not available to others on the team, the result of the special relationship that nurses build with patients. In providing this information, it is important to remain aware of one's own values and how they may differ from those of the patient and others on the healthcare team.
Who is responsible for ensuring that the student nurse is qualified and competent for the assigned tasks?
Select all that apply.
A. The healthcare provider
B. The charge nurse
C. The primary nurse
D. The nursing instructor
E. The student nurse
B, C, D, E The charge nurse, primary nurse, and clinical instructor are responsible for ensuring that nursing students under their supervision are assigned nursing responsibilities that are within the student nurse's scope. The student nurse is also responsible for ensuring s/he does not work outside of his/her qualifying scope.
You are acting as a preceptor for a newly graduated RN during her second week of orientation. You would assign the new RN under your supervision to provide care to which patients? Select all that apply
A. A 38-year-old with moderate persistent asthma awaiting discharge.
B. A 63-year-old with a tracheostomy needing tracheostomy care every shift.
C. A 56-year-old with lung cancer who has just undergone left lower lobectomy.
D. A 49-year-old just admitted with a new diagnosis of esophageal cancer.
Answer: A. A 38-year-old with moderate persistent asthma awaiting discharge.
B. A 63-year-old with a tracheostomy needing tracheostomy care every shift.
Rationale - A patient who is waiting for discharge may be stable enough for the care of the student nurse. The new RN is at an early point in her orientation. The most appropriate patients to assign to her are those in stable condition who require routine care.
A registered nurse arrives at work and is told to "float" to the ICU for the day because the ICU is understaffed and needs an additional nurse to care for the clients. The nurse has never worked in the ICU. Which of the following is the most appropriate nursing action?
A. refuse to float in the ICU
B. call the hospital lawyer
C. call the nursing supervisor
D. report to the ICU and identify tasks that can be safely performed
Answer: D
Rationale - floating is acceptable and legal practice. The nurse floated to a unit until will be given orientation; be assigned to care for stable patients or those with conditions similar to her training experience.