Fundamentals of Nursing Final Practice Questions and answers with complete solutions.

Which medication administration situations should be documented in a healthcare facility's incident reporting system? A. Medication errors and adverse drug reactions only B. Medication errors that cause patient harm C. Near misses and medication errors only D.near misses, medication errors, and adverse drug reactions D. Near misses, medication errors, and adverse drug reactions must all be documented in the facility's incident reporting system. The patient self-determination act of 1990 requires all of the hospitals to do which of the following? A. Collect data on contagious diseases B. Collect data on patient falls C. Inform patients about advanced directives D. Inform patients about medication side effects C. The patient self-determination act of 1990 requires all hospitals to inform patients about advanced healthcare directives upon admission to a hospital 00:02 01:23 A nurse is assessing his patients in the morning and finds that a frail a 85 year-old female patient is soiled in bed. The patient reports that she has been asked to cleaned numerous times and has been ignored. Of the following, which demonstrates appropriate documentation in the patient's chart. A. The patient was found soiled in bed by this RN. she reports being left alone all night by the night shift RN, who did not clean her before the change of shift. She was given a bed bath and provided skin care. Her skin was reddened on her buttocks; emollient applied. B. The patient was found soiled in bed by this RN. She was incontinent of urine and feces and she said she was "ignored for hours" by the night shift RN. She was given a bed bath and provided skin care. Her skin was reddened on her buttocks; emollient applied. C.The patient was found soiled; incontinent of urine and feces. She was given a bed bath and provided skin care. Her skin was reddened on the buttocks; Emollient applied. Incident report made. D. The patient was found soiled; incontinent of urine and feces. She was given a bed bath and provided skin care. Her skin was reddened on the buttocks; emollient applied. D. The patient was found soiled; incontinent of urine and feces. She was given a bed bath and provided skin care. Her skin was reddened on the buttocks; emollient applied. **Documentation Must stick to objective descriptions of what happen in any assessments and interventions performed. Personal biases or information that applies misconduct should never be documented in the patient's chart A home health nurse makes weekly visits to an 87-year-old client who lives with her son. When home alone, the client is talkative and friendly, but when the son is home, the client is observed to be withdrawn and appears anxious. The client has bruises, which she states is from "bumping into things" and a weight-loss of 10 pounds in the past month. With these objective findings, the nurse is required to do which of the following? select all that apply. A. ask the client if she has any concerns about her living situation, maintaining an objective, non-accusatory role. B. Confront the son about the abuse, demanding that he turn himself in to seek help for the abusive pattern of behavior. C. Question the client's son privately about the suspicions of his mother's condition and about possible abuse or neglect. D. Report suspected abuse to adult protective services so investigation into the clients welfare can be performed. C, D All states have statutes requiring mandatory reporting by nurses and other healthcare workers of any suspected abuse of children, disabled, and the elderly. The nurse should probably discuss with the client any concerns about the client safety The nurse is also required by law to report any suspected abuse or neglect because the nurses are mandated reporters. The nurse understands the following about informing and obtaining consent for an eight-year-old patient who is undergoing a heart transplant: Select all that apply. A. Since the child is a minor, he does not need to be informed about the surgery B. The child must be informed about the surgery. C. The child must sign the informed consent form along with their parent D. The child only needs to know the risks of the surgery. E. The parent/guardian must be informed of the risks and benefits of the procedure and sign the informed consent on behalf of the child B, E The child must be informed about the surgery and the parent/guardian must be informed of the risks and benefits of the procedure and sign the informed consent on the half of the child The patient refuses chemotherapy based on religious beliefs. The hospital staff must follow his decision based on which patient right? A. The right to counsel B. The right to informed consent C. The right to refuse treatment D. The right to suffer C. The right to refuse treatment A nurse notices at the start of the shift that the patient's IV anabiotic scheduled to be given six hours ago is still hanging on the patient's IV pole. The pump is turned off and the tubing is not connected to the patient. The antibiotic is documented as given on the MAR by the previous nurse. What is the first thing that the nurse should do? A. Document findings in the facilities incident reporting system B. Document physician notification in the medical record C. Notify the charge nurse of the missed dose D. notify the physician of the missed dose and seek orders for the next dose timing D. Notify the physician of the missed dose and seek orders for the next dose timing The first action the nurse should take is to ensure the patient receives the order therapy by notifying the physician and seeking orders for the timing of the next dose of antibiotic. Antibiotics are most effective when there is a therapeutic level in the patient's system. The most important thing the nurse can do in this situation is to make sure the physician is aware of the missed dose so that the antibiotic schedule can be adjusted if needed. ** After notifying the physician and adjusting the dosing schedule, the nurse should document physician notification, notify the charge nurse, and complete an incident report. A nurse on the medical surgical floor is caring for an elderly patient with dementia. The patient's adult child is staying with the patient during the hospital stay. The patient's dementia and confusion is worse at night in a phenomenon known as "sundowners" the doctor has order for the patient to receive alpralozam 1mg PO q hs as needed for anxiety. The patients child called the nurses station at 7:30 PM requesting that the patient be given the medication early because the patient will not stay in bed. The nurse knows which of the following about this request? A. Alpralozam can be used as a chemical restraint since it is ordered by the doctor B. Giving the alpralozam early to keep the patient in bed is using it as a chemical restraint C. The alpralozam can be given at 7:30 PM since the patient will be in bed. D. The alprazolam order can only be given after 10 PM. B. Giving the Alpralozam early to keep the patient in bed is using it as a chemical restraint Medications ordered by the doctor to be used for anxiety as needed are only to be administered as directed for anxiety. Using these anxiolytics as a means to keep a patient in bed is considered a chemical restraint A patient was mistakenly given 40 mg of propranolol instead of her scheduled levothyroxine. After assessing the patient and reporting this to the physician, the nurse makes a written report that the medication was given in error to the patient due to a mixup in the med room. Where does this report go? A. The report goes in the patient's MAR ( medication administration record) only B. The report goes in the patient's chart C. The report goes to the charge nurse D. The report is sent to risk prevention D. The report is sent to risk prevention Report is made to risk prevention, a part of the hospital management responsible for investigating the root causes a potential or actual errors on patient injuries This report should not be included in the patient's an MAR or medical record The patient was recently admitted to hospice care for lung cancer. After filling out his advanced directive, the patient says that he worries his physician will be uninterested in his care. Which of the following statements made by the nurse best addresses the patient's concerns? A. "After you fill out an advance directive, the physician plays a limited role to allow you space and time to be with your family." B."Once you are admitted to hospice, the physician plays a passive role." C. "Your physician is required by law to help you, so don't worry." D. "Your physician will continue to take care of you. The advanced directive just states what type of care you want, so we can provide that care even when you cannot tell us too." D. "Your physician will continue to take care of you. The advanced directive just states what type of care you want, so we can provide that care even when you cannot tell us too." A nurse on the cardiovascular step down unit is caring for a patient who is post operative day two after arterial bypass surgery. The patient has a PCA with Hydromorphone infusion and has hydrocodone 10 mg PO Q4 hours ordered for breakthrough pain. During morning assessment, the patient complains of pain rated 10 on a scale of 0 to 10. The nurse offers the patient the hydrocodone for breakthrough pain. The patient states, "I asked for pain medication from the other nurse and was told no because I have a PCA." On further questioning the patient stated that the other nurse there and to disconnect the PCA if the patient continued to complain. The nurse knows that the next appropriate action is which of the following? A. Call the other nurse at home to confront them about the patients accusations. B. Discuss the accusations with the Charge nurse and complete an incident report C. Ignore patient claims since the patient should have adequate pain control with the PCA. D. investigate the patient's past medical history for possible substance abuse D. discuss the accusations with the charge nurse and complete an incident report Pain is a subjective experience, and all patients will experience pain individually from others. When a patient complains of pain, it is the nurses duty to address the pain. If a patient has a PCA pump and orders for breakthrough pain medication, this is because pain medications provided through a PCA are shorter acting while breakthrough pain medication are longer acting to help achieve better pain control A nurse witnesses another nurse slap a patient. The patient has been very difficult to manage and often very rude, observed screaming obscenities at other patients and staff. What action should the nurse take after witnessing this? A. ask the charge nurse reported to the bureau of adult protective services B. Call the patient's family to tell them about the incident. C. Reported to the bureau of adult protective services D. Tell the other nurse that it will be reported if it happens again. C. Report it to the bureau of adult protective services Abuse is against the law, and the nurse is a mandated reporter. This means that the nurse is required to report such events directly to the appropriate authorities.