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NUR 171 Final review
NUR 171 Final review
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1
Which assessment finding would be most alarming if found on an 82 yr old admitted for a UTI?
O2 Sat of 96% on room air without dyspnea
A diastolic pressure of 62 mm Hg
Hypoactive bowel sounds
Presence of an S3 heart sound
2
Discharge planning should be initiated at which point in a pt's hospital stay?
After the pt has been an inpatient for 24 hours
During the admission process
Before the pt is admitted to the hospital
Immediately before discharging the pt
3
In order to help build rapport and trust with a patient which action could the nurse take?
Reinforce the importance of treatment to a pt who speaks a foreign language
Fulfill a promise by allowing a pt to visit with family members
Use clinical terminology to help the pt better understand their diagnosis
Minimize contact with the pt that is angry
4
A technique to alleviate pain that involves pressure and kneading of the body is what?
Biofeedback
Aqua therapy
Massage therapy
Guided imagery
5
This is a common modifiable risk factor of many illnesses. It is a response of the body to a demand made of it.
Stress
Smoking
High fat diet
Anxiety
6
While caring for a pt with suspected untreated/uncontrolled diabetes what is the best action for the nurse to take?
Refer the pt to an endocrinologist to address the diabetes
Treat the symptoms and give the pt medication to take home
Suggest the pt go home and return if symptoms get worse
Begin test while asking about other social concerns
7
Which of the following resources are considered reliable tools for obtaining pt teaching?
City or County health department
You-Tube
Google MD
Foundations
Wikipedia
Associations
8
What factors help guide decisions about pt care to ensure they get the care they need at the appropriate place?
Medical necessity and reasonable delivery of care
Medical necessity and appropriate level of care
Managed care and critical access
Medical necessity and interprofessional collaboration
9
Which definition best describes the allopathic philosophy of health care?
Disease is a result of nerve dysfunction
Giving small doses of a substance that creates the disease symptoms
Remedies that produce effects different from what caused them
Illness is the result of falling out of balance with nature
10
Which of Maslow's hierarchy of needs represents the highest level of human need
Homeostasis
Self-actualization
Feeling safe
Feeling loved
11
This type of charting provides a continual description of a pt's care from admission through discharge
Narrative charting
Focused charting
Charting by exception
PIE charting
12
Which of the following describes a team of mental health professionals who work together to provide client care?
A professional organization
Intra-professional team
A shared governance
Inter-professional team
13
A pt who refuses invasive treatments is practicing which pt right?
Right of confidentiality
Right to autonomy
Right of justice
Right to medical records
14
To develop cultural competence, a nurse should understand which of the following characteristics of their pt's
Professional roles
Self-esteem
Diversity
Social status
15
Which nurse was instrumental in establishing modern nursing. She founded the school of nursing
Florence Nightingale
Dorothea Dix
Clara Barton
Linda Richards
16
Pt is back from an EGD & is c/o sob, abd & shoulder pain that increases with movement of the torso. What do you suspect?
Myocardial infarct
Hematoma
A perforation
Pulmonary embolism
17
Which cause would you suspect if a pt has hypoactive bowel sounds, c/o nausea and refuses to eat 12 hours after surgery
Anesthesia
Paralytic ileus
Peritonitis
Obstruction
18
Which pt finding would necessitate a CT scan
without
contrast?
BUN 10 mg/dL
Allergy to eggs
Allergy to shellfish
GFR of 90 or below
19
Which of the following examples demonstrates adherence to HIPAA
Taking a photo of a patient for Instagram
Discussing a pt's status with a friend
Logging out of a computer after documenting pt care
Posting details about the pt without using their name on Facebook
20
This Act was implemented to provide confidential maintenance of protected health information
Health Security Act
Health Privacy Act
Health Insurance Portability and Accountability Act
Health Information Technology for Economic and Clinical Health Act
21
Which of the following assessments is considered subjective?
Respiratory rate of 26 bpm
Cough producing green sputum
Patient reports shortness of breath
Coarse lung sounds billaterally
22
When teaching a pt who is cognitively impaired which of the following actions should the nurse include in the plan?
Avoid making eye contact
Involve the pt's family in the education
Speak quickly
Provide long educational sessions
23
Which of the following has had the greatest impact on the ability of obtaining health insurance?
The Affordable Care Act (ACA)
Medicare Prescription Drug, Improvement, and Modernization Act (MMA)
The Children's Health Insurance Program (CHIP)
Medicaid
24
What lab result would you expect to find on a pt that is dehydrated
Increased hematocrit
No abnormalities
Increased red blood cells
Decreased hemoglobin
25
Who is responsible for determining the scope of practice for LPN's
Federal legislators
US Dept of Health and Human Services
State legislators
American Nurses Association
26
Why is evidence based nursing important?
It helps ensure nurses can demand more pay
Guides nursing decisions to optimize effective care
Helps validate the difference nurses really make
It makes nursing more professional
27
Which patient is eligible to receive health insurance under the Medicare program?
A pt who does not have any other kind of health insurance
A pt whose income is below the poverty line
A pt who is below the age of 18
A pt who is age 65 or older
28
This is a form of rude, disrespectful, or intimidating behavior that violates social norms of mutual respect?
Incivility
Harassment
Anger
Abuse
29
This type of learner prefers to learn through physical activity or learning though doing?
Auditory
Verbal
Kinesthetic
Visual
30
Any abnormal assessment finding should be reassessed within what time frame of an intervention
In 15 minutes
In 1-2 hours
Every 4 hours
At the beginning of the next shift
31
Which documentation method is used when the nurse only documents the unexpected findings related to the pt's condition?
Focus charting (DAR)
SOAP charting
Charting by exception
Problem-oriented medical record
32
What term would you use to document a pt who is having difficulty verbalizing due to a stroke
Aphasia
Dyspneic
Dysphagic
Dysphasia
33
Which of the following interprofessional team members can help a pt with a mental illness find housing?
Social worker
Behavioral therapist
Psychologist
Psychiatrist
34
What statement best describes the major effects the Affordable Care Act (ACA) had on health inequities
Allows for quality performance measures to be used to reimburse hospitals
Has enabled pt's with pre-existing conditions to obtain health insurance
Allows hospitals to receive less reimbursement for preventable re-admits
Has improved quality and safety in hospitals
35
Which of the following areas is an example of an environmental risk factor of health
Age
Sexual practices
Work Stress
Ethnicity
36
Which statement is most accurate when accessing a pt's medical records?
A nurse can share information about a pt with the pt's who have the same dx
A nurse can only access the records of a pt within the facility
A nurse can only access the records of pts they are actively caring for
pt information can only be shared with the immediate family
37
This designates legal written permission to appoint another person responsible for medical decisions on your behalf
Advance directives
Durable medical power of attorney
Emancipation
Civil law
38
When a pt is actively dying and the nurse is performing a shift assessment which action should take priority?
Provide oral care
Auscultate lung fields
Observe for cyanosis
Obtain a pulse ox reading
39
A nurse who fails to recognize vital symptoms of a decline in a pt's condition is guilty of what?
Tort
Liability
Malpractice
Negligence
40
Which statement accurately describes an alternative modality?
Only hippies use alternative modalities
They are not effective
They are used in addition to a conventional modality
It is a therapy used instead of conventional modalities
41
Which statement about the legal guidelines for documentation is false?
Any information recorded in the chart must be accurate and true
It should be organized and completed in a timely fashion
It should include the nurse's interpretation of the situation
A medical record can be used as evidence in a court of law
42
What are indications of cold therapy?
Vasodilation
Increased blood flow to the site
Hemostasis
Pain relief
Decrease edema
Reduction of muscle spasms
43
In which step of the nursing process would you formulate goals?
Evaluation
Implementation
Planning
Data collection
44
Which definition best describes a subculture?
An appreciation of someone from another culture
Differences that occur in race, color, ethnicity, and national origin
A variation within an ethnic or cultural group
An ability to practice openness to new ways of thinking
45
When total protein values are significantly below normal what physical manifestation would you expect the pt to have?
Dry mucous membranes
Pallor
Edema
Poor skin turgor
46
Reflecting on unconscious feelings towards a pt is an example of what concept of cultural competence?
Implicit bias is
Color discrimination
Explicit bias
Sterotyping
47
This quick pt reference summary is updated each shift and used to provide pt report and summarize pt care
Personal notes
Medication administration record (MAR)
Narrative chart note
Kardex
48
Which type of assessment should a nurse perform upon starting their shift?
Vital signs and bowel sounds
Focused assessment of the system related to the pt's primary diagnosis
Complete head to toe assessment
A neuro assessment
49
What is the most appropriate nursing intervention when you enter a pt's room and find them to have a drooping right eye?
Auscultate the lungs
Assess the pt for pain
Check the pt's blood pressure
Palpate the abdomen
50
When performing a neuro exam on a 65 yr old pt which finding is considered a normal based on the pt's age?
Drooping smile
Limited ability to fully extend right leg
Inability to distinguish certain tones or voices
Uneven grip strength of arms
51
When reviewing a pt's plan of care you determine that they have not met the goal what is the most appropriate plan?
Assess for patient noncompliance
Add more interventions
Collect additional assessment data
Review the plan of care
52
What factor places immigrant populations at an increased risk for negative health outcomes
Poverty
Genetics
Language barriers
Transporation access
53
You witness a co-worker put a pain pill in their pocket before leaving the hospital. What should you do?
Confront the co-worker about what happened
Ask an RN what to do
Notify the nurse manager of the unit
Call the police and report the incident
54
A 16 year old pt is admitted to the hospital. Which situation allows the pt to sign admission papers?
The pt states they understand informed consent
The pt has a baby of their own
The pt's family is out of town
The pt is an emancipated minor
55
Which type of teaching method asks the pt to explain the information received in their own words back to the nurse?
Teach back
Role play
Question and answer
Lecture
56
In order for a hospital to receive reimbursement for services rendered a nurse must do what?
Notify the pt's insurance of the pt's admission
Document care and appropriate interventions provided during hospitalization
Tell the pt his care will not be covered by insurance
Be careful not to mention adverse reactions in the documentation
57
To threaten a pt with harm is an example of what type of offense?
Negligence
Harassment
Assault
Battery
58
When working with a pt to set goals for an identified problem it is important for the nurse to remember what?
Only the adults in the family should set the goals
Family input is important for goals to be realistic and
Only a provider should set the goals for the family
the nurse needs to take the lead
59
A nurse experiencing moral conflicts when providing pt care places them at risk for which of the following actions?
Initiating inclusion when planning care for the pt
PBecoming too involved with the pt
Using nonverbal cues when caring for pt's
Providing a lower quality of care to the pt
60
When assessing a pt with a head injury you find that the GCS was initially 13 and is now 10. What do you do?
Contact the physician
Assess the pt for pain
Raise the head of the bed
Continue to monitor for any changes
61
Which function is the nurse assessing when asking a pt to focus on an object close up and moving it farther away
Direct pupil response
Consensual pupil reflex
Accommodation response
Anisocoric pupil response
62
Presenting infor about the prevention of STD's to a group of high school kids is an example of which type of prevention
Secondary prevention
Tertiary prevention
Quaternary prevention
Primary prevention is
63
Which statement is most true regarding the electronic medical record is it...
increases the number of medication errors
provides evidence of care provided
allows less time for direct pt care
Decreases the amount of paperwork
64
This law serves to protect citizens from legal liability when rendering emergency care to someone outside a hospital
Statute
Good Samaritan
tort
Liability
65
This nurse has completed a 4-year degree at a university and sits for the NCLEX-RN
LPN
RN diploma nurse
Doctorate nurse
RN bachelors degree nurse
66
If a nurse delegates a task to a pt care tech and it doesn't get completed who is held accountable?
The pt care tech
The charge nurse
The nurse that delegated the task
The primary physician
67
Which pt would you assess first?
A pt who has a respiratory rate of 22
A pt who reports a pain level of 2
A pt with a blood glucose of 42 mg/dL
A pt who has just received a diagnosis of cancer
68
Which of the following plans would help to elicit accountability to a pt wanting to increase daily exercise?
The pt provides a list of exercises that they are interested in
The pt will share their exercise log with an identified support person
The pt will exercise daily for the next 2 weeks
The pt will mark a calendar on the days they exercise
69
Which of the following statements is true regarding the cultural care theory?
The nurse should be fair and treat everyone the same
It is possible for the nurse to separate a pt's culture from their care
The nurse should aim to provide culturally competent and congruent care
The nurse should know everything about the client's culture
70
Which action by the nurse would cause concern when performing a head-to-toe assessment?
Perform bilateral comparison of the extremities
Inspect the scalp using gloved hands
Examine the genitalia last
Palpate both carotid pulses simultaneously
71
A pt with a low hemoglobin is at risk for what?
Poor nutrition
Altered tissue perfusion
Alteration in skin integrity
Infection
72
Which of the following
would not
be submitted in an incident report?
Visitor falling in the hallway
Patient lost dentures
Patient given the wrong medication
Patient complaints about dietary services
73
Using the ABC priority framework which pt should be seen first?
A pt who has early dementia and awoke confused to their location
A pt who has pneumonia and has developed difficulty breathing and stridor
A postop pt with a urine output of 50 ml over the last 3 hrs
A pt scheduled for discharge who has a 101.1 temp this morning
74
What is a normal finding when assessing an older pt's eyes?
Opaque white ring around cornea
Cloudy appearance
Yellow tint to sclera
Bloodshot appearance
75
You enter a pt's room and find they are apneic and pale. should your first response be?
Call a rapid response
Auscultate the lung sounds
Notify the Dr
Check the chart for a code status
76
A pt care tech reported a pts temperature as 102.2 F. What is the
next
action the nurse should take?
Continue to monitor
Check for an order and administer Tylenol
Encourage the pt to drink more fluids
Retake the temperature for yourself to verify it was done correctly
77
You are caring for a pt immediately after a paracentesis. Which finding is most concerning?
Pt c/o discomfort at the puncture site
A blood pressure of 92/60
Blood sugar of 102 mg/dL
Oxygen saturation of 92% with a poor waveform
78
What strategy would you enforce to help decrease health care disparities among vulnerable groups
Compile a list of resources available in the community
Update pt's charts to reflect socioeconomic status
Provide low-cost medications
Teach staff to recognize discrimination in vulnerable populations
79
Which statement by the nurse reflects an attempt to minimize judgment and bias when caring for pt's
"I will reflect on my responses and thoughts when meeting new pt's"
"I will watch for evidence of bias by members of the health care team"
"I will review my actions at the end of the day in the team huddle"
"I will make all comments in a private setting away from pt's"
80
this is set in place by each state to define the scope of nursing practice. It is regulated by the Board of Nursing
Nurse Practice Act
Health Insurance Portability And Accountability Act
The National Council of State Boards of Nursing
American Nursing Association
81
This type of nursing care empowers the pt to take control of and manage their health care
Patient centered care
Primary care nursing
Team nursing
Case management
82
Which wound complication is more serious?
Sinus tracts
Dehiscence
Evisceration
Fistula
83
Which of the following actions demonstrates active listening skills?
Interrupt the pt's statement to clarify thoughts or ideas
Show emotion when a pt is disclosing sensitive information
Keep direct eye contact to a minimum
Avoid looking at other pt's on the unit
84
What assessment finding would be most alarming if found on a pt who is on diuretic therapy?
Pulse rate of 100
Respiratory rate of 24
Weight gain of 2 pounds
BP 130/80
85
This initiative was developed to provide science-based health goals to improve health and prevent disease.
The Nursing Practice Act
The Affordable Care Act
Healthy People 2030
The Office of Disease Prevention and Health Promotions
86
When making a correction in a pt's paper chart what is the appropriate action to take?
Write over the incorrect letters with a different color ink
Draw a line through the entry, write error and initial just above the entry
Scribble over the information so no one else can read it
Use "white out" to blank out the mistaken entry
87
When auscultating breath sounds which position is best?
Low Fowler's
High Fowler's
Supine
Semi Fowler's
88
A wound that was surgically made and is not infected but has more potential to become infected due to it's location
Colonized
Contaminated
Infected
Clean-contaminated
89
When documenting in a pt's EMR which statement is most appropriate?
Quantify statements using the words "average" or "normal"
Copy and paste pertinent data from the previous note
Avoid using abbreviations within the note
Document N/A or "not observed" to prevent any blank entries
90
This type of facility can perform minor surgical procedures in which the pt is discharged home the same day
Rehabilitation facility
Health department
Ambulatory surgery center
Ambulatory care clinic
91
While providing care to a pt from a different culture what action indicates cultural competence?
Assesses the pt for chronic illness
Speaks a different language
Develops communication skills
Interacts effectively in a multicultural context
92
Which of the following is
not
a nursing diagnosis?
Altered sensory perception related to surgery
Pain related to abdominal incision
Chronic fatigue syndrome related to poor diet
Altered nutrition related to nausea and vomiting
93
Which type of goals would you expect to be completed by time of discharge from the hospital?
Short term goals
Teaching goals
Long term goals
Long term and short term goals
94
When assessing the respiratory system which finding is consistent with normal respiratory function?
Equal thoracic excursion
Barrel-shaped chest
Productive cough
Circumoral cyanosis
95
Which of the following actions by the nurse exemplifies compassion?
Providing care that demonstrates caring service
Providing care that uses knowledge development from scientific advances
Providing care that affirms and upholds a code of ethics
Care that collaborates with other health professions and disciplines
96
Which of the following statements best represents the government's legal responsibilities for health care?
the government pursues investors for funding
The government provides a health care savings account
The government produces an anual budget
The government provides unlimited funding for health care programs
97
All are contraindications to heat application
except
what?
Bleeding wound
Phlebitis
Suspected appendicitis
Newly injured joints
98
Which intervention best represents the planning step in the nursing process?
Weight loss to be achieved
Trending lab results
Reviewing medication record
Obtaining blood pressure reading
99
while reviewing lab results of a pt with a known bacterial infection you would expect to find what?
Increased neutrophils
Decreased white blood cells
Increased lymphocytes
Decreased monocytes
100
This physical change associated with the dying process often causes a pt's family distress and concern
Conjunctival dryness that causes tearing of the eyes
Pallor and circumoral cyanosis
Restlessness and difficulty sleeping
Accumulation of secretions in the trachea
101
When performing a focused assessment which condition provides the best information through the use of palpitation?
Rebound tenderness
Hyperinflated lungs
Cardiac arrhythmia
An enlarged heart
102
According to the law, you must initiate resuscitative measures if this order is not provided
Consent
Advance directives
Durable medical power of attorney
DNAR
103
This type of communication is pt centered and promotes a greater understanding of the pt's needs, concerns and feelings
Assertive communication
Passive communication
Aggressive communication
Therapeutic communication
104
This protective response triggers the endocrine glands to pump cortisol and adrenaline into the blood stream.
Stress response
Exacerbation
Fight-or-flight response
Adaptation response
105
When caring for a pt who has reported experiencing abuse at home the nurse should do what?
Instruct the pt on how to leave the relationship
Implement a safety plan
Assess the pt's risk for immediate harm
Refer the pt to a community support group
106
Which statement is the best example of therapeutic communication?
'You feel like you have the support needed to be successful?"
"Do you need any more resources of information?"
"Tell me what kind of coping skills you have"
"Do you understand your next step in the treatment?"
107
What statement best describes a tort?
Assault is a tort that only occurs if a pt is physically harmed
False imprisonment does not apply to the use of chemical restraints
Battery occurs when a person verbally threatens to harm another person
Negligence is the most common unintentional tort