Professional Nursing
A nurse is caring for a patient who is recovering from surgery. During a conversation, the patient expresses concern about their ability to afford the prescribed medications after discharge. Which of the following actions BEST demonstrates the nurse's role as a patient advocate?
A. Assuring the patient that most insurance plans cover post-surgical medications.
B. Providing the patient with information on different pharmacies in the area.
C. Collaborating with the healthcare provider and social worker to explore options for medication assistance programs.
D. Encouraging the patient to discuss their financial concerns with family members.
Answer: C
Rationale: Patient advocacy involves actively working to support the patient's well-being and access to care. Exploring medication assistance programs directly addresses the patient's stated concern about affordability.
A nurse is preparing to conduct a patient interview. Which of the following actions is most important for the nurse to take to establish trust and rapport with the patient?
A) Asking a series of closed-ended questions to gather data quickly.
B) Ensuring privacy and explaining the purpose of the interview.
C) Reviewing the patient's medical record in detail while the patient is present.
D) Focusing on taking detailed notes and avoiding eye contact to maintain objectivity.
Answer: B
Rationale: Establishing trust and rapport is essential for an effective interview. Ensuring privacy and explaining the purpose of the interview helps the patient feel comfortable and understood.
An older adult patient is experiencing increased difficulty with dividing their attention, such as trying to listen to the television while cooking. Which age-related cognitive change is the most likely cause of this?
A. Decline in short-term memory
B. Decrease in information processing speed
C. Decline in long-term memory
D. Preservation of language skills
Answer: B
Rationale: The presentation states that with normal age-related change, the ability to divide or switch attention becomes more difficult and information processing speed decreases. While long-term memory also declines with age, it's the attention deficit that directly relates to the patient's symptom.
A nurse is participating in a multidisciplinary team meeting to plan care for a patient with chronic heart failure. Which action demonstrates effective interprofessional collaboration?
A. The nurse independently adjusts the patient's medication dosage based on their assessment.
B. The nurse communicates the patient's needs and preferences to the team and works with them to set shared goals.
C. The nurse focuses primarily on completing their tasks without seeking input from other team members.
D. The nurse defers all decisions to the physician and does not actively participate in the discussion.
Answer: B
Rationale: Effective interprofessional collaboration involves valuing the expertise of all team members, communicating openly, and working together to achieve patient-centered goals.
A nurse is caring for a patient who is facing a life-altering diagnosis. Which action best demonstrates the nurse's understanding of spirituality according to Pargament's definition?
A. Providing the patient with information about their treatment options.
B. Contacting the hospital chaplain to visit the patient.
C. Exploring with the patient what gives their life meaning and purpose.
D. Assessing the patient's coping mechanisms and support systems.
Answer: C
Rationale: Pargament's definition emphasizes the search for the sacred or transcendent. Exploring meaning and purpose aligns with this search for what is ultimately important to the patient, which goes beyond just religious affiliation (B) or practical support (A, D)
A nurse on a medical-surgical unit is assigned to four patients. Which of the following actions, if performed by the nurse, demonstrates integrity?
A. Administering pain medication to a patient before completing their head-to-toe assessment to save time.
B. Documenting a dressing change before actually performing it to keep up with charting.
C. Sharing personal opinions about a patient's lifestyle choices with other staff members.
D. Reporting a colleague's error in medication administration, even if it might lead to disciplinary action.
Answer D
Integrity involves honesty and adherence to moral principles. Reporting a medication error, despite potential consequences, is the action that best exemplifies integrity.
During a health assessment, a patient reports a history of hypertension. Which of the following blood pressure readings would the nurse identify as consistent with hypertension?
A) 118/78 mm Hg
B) 120/80 mm Hg
C) 130/85 mm Hg
D) 142/92 mm Hg
Answer: D
Rationale: Hypertension is defined as a blood pressure greater than 140 systolic or greater than 90 diastolic
A nurse is assessing a patient with a suspected neurological condition. Which assessment finding would indicate a potential issue with intracranial regulation?
A. Intact language skills
B. Stable vital signs
C. Headache or change in consciousness
D. Glasgow Coma Scale score of 15
Answer: C
Rationale: Changes in mental function, such as headache or altered consciousness, are common findings in patients with intracranial regulation problems. A high Glasgow Coma Scale score indicates intact consciousness, and while language skills can be affected, a headache or change in consciousness is a more direct indicator of a potential intracranial issue.
A nurse is preparing to hand off a patient to the oncoming shift using the ISBARR communication tool. Which component of SBARR focuses on what the nurse thinks the patient needs?
A. Situation
B. Background
C. Assessment
D. Recommendation
Answer: D
Rationale: The "R" in SBARR stands for Recommendation, which includes the nurse's suggestions for what needs to be done for the patient.
A patient recovering from surgery expresses a lack of interest in activities they used to enjoy and states, "I feel so disconnected." Which concept attribute is most likely being affected?
A. Self-transcendence
B. Meaning and purpose
C. Connectedness
D. Faith and hope
Answer: C
Rationale: The patient's statement of feeling "disconnected" directly points to an issue with connectedness. While meaning and purpose (B) might be related, the explicit mention of disconnection makes connectedness the most direct answer. Self-transcendence (A) involves going beyond oneself, and faith and hope (D) are related but not the primary issue described.
A nurse is caring for a patient with a terminal illness who is experiencing significant existential distress. The patient questions the meaning of their suffering and expresses a desire for peace and acceptance. Which of the following interventions BEST demonstrates a holistic approach that promotes human flourishing?
A. Administering prescribed pain medication and focusing solely on physical comfort.
B. Engaging in active listening, exploring the patient's values and beliefs, and facilitating spiritual care resources.
C. Encouraging the patient to focus on positive thinking and avoid discussing their fears about death.
D. Providing the patient with detailed information about the stages of grief and the dying process.
Answer: B
Rationale: This question requires the nurse to go beyond physical care and address the patient's existential and spiritual needs.
A nurse is assessing a patient’s pulse and notes an irregularity. Which action should the nurse take first?
A) Document the finding and continue with the assessment.
B) Assess the patient's radial pulse.
C) Assess the patient's apical pulse.
D) Notify the healthcare provider immediately.
Answer: C
Rationale: If an irregular pulse is detected, the nurse should assess the apical pulse to accurately assess the heart rate. The radial pulse may not accurately reflect the heart rate due to decreased peripheral perfusion.
The nurse is educating a family about interventions to support a family member with mild cognitive impairment. Which of the following strategies would be appropriate to include?
A. Encourage the patient to avoid social interaction to minimize confusion.
B. Establish a consistent daily routine
C. Discourage the use of memory aids like lists and calendars.
D. Rearrange furniture frequently to stimulate cognitive flexibility
Answer: B
Rationale: Establishing routines is a helpful strategy for patients with cognitive impairment. Social interaction should be encouraged, not avoided, and memory aids are beneficial. A stable environment is preferred to reduce confusion
The nurse is caring for a patient who is anxious and having difficulty understanding discharge instructions. Which nursing actions would demonstrate effective communication in this situation?
A. Speak quickly and provide detailed information to ensure all points are covered.
B. Use medical terminology to ensure accuracy and avoid misinterpretation.
C. Acknowledge the patient's anxiety and use clear, simple language to explain the instructions.
D. Avoid repeating information, as this may frustrate the patient.
Answer: C
Rationale: Effective communication involves considering the patient's emotional state and adapting communication to their needs. Using clear, simple language and acknowledging the patient's feelings can improve understanding.
A nurse is planning care for several patients. Which factor, if present in a patient's situation, would most likely require the nurse to prioritize addressing spiritual needs?
A. A patient who is newly admitted and anxious about their diagnosis.
B. A patient who is experiencing chronic pain and limited mobility.
C. A patient who is facing a terminal illness and expressing fear of death.
D. A patient who is scheduled for elective surgery and is concerned about recovery.
Answer: C
Rationale: While all patients have spiritual needs, the patient facing a terminal illness and expressing fear of death has the most urgent need. Spirituality often becomes a primary concern when individuals confront mortality and look for meaning and comfort.
A nurse is working in a fast-paced emergency department. A patient presents with altered mental status, and the family is demanding immediate attention, exhibiting escalating anxiety. The department is short-staffed. Which of the following actions by the nurse demonstrate courage and advocacy? (Select all that apply)
A. Prioritizing the patient based on acuity while acknowledging the family's concerns and providing regular updates.
B. Delegating the family's concerns to the unit secretary to minimize disruption to patient care.
C. Assertively communicating the patient's critical needs to the healthcare team and advocating for timely intervention.
D. Documenting the staffing challenges and their potential impact on patient care.
A, C, and D
Rationale: This question requires the nurse to balance multiple priorities, advocate for the patient, and address systemic issues.
A nurse is taking a health history and wants to gather data about the patient’s psychosocial health. Which of the following questions or assessments would be appropriate? (Select all that apply)
A) “Can you tell me about your exercise and sleep habits?”
B) “What prescription medications are you currently taking?”
C) Using the CAGE-AID questionnaire.
D) Observing the patient's posture and emotional reaction.
Answer: A, C, and D
Rationale: Psychosocial assessment includes behavioral, social, and environmental factors. Questions about exercise and sleep habits, using the CAGE-AID questionnaire (for substance abuse), and observing posture and emotional reaction are all relevant to psychosocial health. Prescription medications are part of the patient's health history, but not psychosocial assessment.
Which of the following are potential consequences of cognitive impairment? Select all that apply.
A. Increased risk for injury
B. Decreased need for assistive services
C. Financial hardship
D. Complicated disease management
Answer: A, C, D
Rationale: Cognitive impairment can lead to an increased risk for injury, complicate disease management, and cause financial hardship. It increases the need for assistive services, not decreases it.
Which of the following are attributes of effective interprofessional collaboration? (Select all that apply)
A. Shared governance
B. Values and ethics
C. Roles and responsibilities
D. Teams and teamwork
Answer: B, C, and D
Rationale: The four attributes necessary for effective interprofessional collaboration are values and ethics, roles and responsibilities, communication, and teams and teamwork. Shared governance is a type of nurse-to-nurse collaboration, not interprofessional collaboration.
Which of the following are reasons nurses may neglect providing spiritual care? (Select all that apply)
A. Belief that spiritual care is solely the responsibility of clergy.
B. Feeling unprepared or lacking education on how to provide spiritual care.
C. Discomfort discussing topics that lack concrete answers.
D. A lack of awareness of the patient's spiritual needs.
Answer: B, C, D
Rationale: The presentation explicitly states that reasons nurses neglect spiritual care include: feeling inadequate, insufficient education, discomfort with lack of concrete answers, and failure to recognize spiritual needs. Option A is incorrect because while clergy can be a resource, nurses also have a role in spiritual care.
A nurse is part of an interdisciplinary team caring for a patient with a complex chronic condition. The team members have differing opinions on the best course of treatment. The patient is becoming overwhelmed by the conflicting information. Which actions by the nurse demonstrate humility and promote patient-centered care? (Select all that apply)
A. Asserting the nursing perspective as the most important due to the 24/7 nature of nursing care.
B. Facilitating a team meeting to discuss the different perspectives and collaboratively develop a unified plan of care.
C. Acknowledging the limitations of one's own expertise and seeking input from other team members.
D. Providing the patient with unbiased information about each treatment option, including potential benefits and risks.
Answer: B, C, and D
Rationale: Humility involves recognizing one's limitations and valuing the contributions of others.
When conducting a patient interview, which of the following techniques promote effective communication? (Select all that apply)
A) Using medical jargon to ensure accuracy.
B) Allowing sufficient time for the patient to respond.
C) Maintaining eye contact and sitting at the same eye level.
D) Using open-ended questions to explore the patient's concerns.
Answer: B, C, and D
Rationale: Effective communication involves allowing response time, maintaining eye contact, using open-ended questions, and sitting at the same eye level. Medical jargon is a barrier to communication.
When caring for a patient with increased intracranial pressure (ICP), which nursing interventions are essential to optimize intracranial regulation? Select all that apply.
A. Position the head of the bed at 10 degrees.
B. Maintain the patient's neck in a midline position
C. Hyperventilate the patient to decrease CO2 rapidly.
D. Elevate the head of the bed to greater than 30 degrees
Answer: B, D
Rationale: Elevating the head of the bed to greater than 30 degrees and maintaining the neck in a midline position are crucial to facilitate venous drainage and help lower ICP. Hyperventilation can be used cautiously in specific situations but is not a general recommendation and should be avoided for prolonged periods.
A nurse is working to improve communication within the healthcare team. Which strategies could the nurse implement to foster effective communication? (Select all that apply)
A. Use SBARR when communicating patient information.
B. Document patient information accurately and timely in the electronic health record.
C. Focus primarily on linguistic communication to ensure clarity.
D. Recognize the influence of context on communication.
Answer: A, B, and D
Rationale: SBARR is an effective communication technique. Accurate and timely documentation is essential for communication. Contextual factors significantly impact communication. Effective communication includes linguistic, paralinguistic, and metacommunication.
Which of the following concepts are interrelated with spirituality, according to the presentation? (Select all that apply)
A. Culture
B. Cognition
C. Professional Communication
D. Nutrition
Answer: A, B, C
Rationale: The presentation identifies Culture, Family Dynamics, Development, Cognition, and Professional Communication as interrelated concepts. Nutrition is not mentioned as a core interrelated concept.