f f f f f f f f f
th Edition By Eleanor J. Sullivan 9780134153117 Chapter 1-
f f f f f f f f
28 Complete Guide . f f f
1.fAfregisteredfnursefisfassignedftoffivef(5)fclientsfforfafshift.fWhichftasksfarefbestfdelegatedftofafLPN?fSel
ectfallfthatfapply.
a.fRepositioningfafNGftubefonfafclientfwhofhasfhadfafsmallfbowelfobstruction
b.fIrrigatingfafurinaryfcatheterfonfafclientffromfafskilledfnursingffacility
c.fRecheckfvitalfsingsfonfaf40fy/ofasymptomaticfclientfwithfafbloodfpressurefoff100/64
d.fChangingfafdressingfonfafclientfwithfafdiabeticffootfulcerfinfthefmetatarsalfarea
e.fAdministerfRBCftofafclientfwithfafHgbfoff10.2g/dLf-fANSWER:fAnswer:fA&B
Rationale:fScopefoffpracticefforfLPNsfallowsfthemftofirrigatefcathetersfandfchangefdressingsfonfdiabeticf
ulcers.fRegisteredfnursesfshouldfrepositionfNGftubes.fMeasuringfbloodfpressurefdoesn'tfrequirefLPNfex
perience.fRBCsfshouldfneverfbefdelegatedftofanfLPN.f(Hogan,f2012.fPgf48)
2.fThefchargefnursingfinfaflargefoutpatientfclinicfnoticesfthefstafffisfarguingfandfirritablefwithfonefanother
fandfthefatmospherefhasfbeenfveryfintensefforfthefpastfweek. fWhichfactionfshouldfthefchargefnursefimpl
ement?
a.fWaitfforfanotherfweekftofseefwhetherfthefsituationfresolvesfitself
b.fWritefafmemoftellingfallfstafffmembersftofstopfarguing
c.fSchedulefafmeetingfwithfthefstaffftofdiscussfthefsituation
d.fTellfthefstaffftofstopfarguingforfstafffwillfbefterminatedf-fANSWER:fAnswer:fC
Rationale:fThefchargefnursefshouldfattemptftofdeterminefwhatfisfcausingfthefproblemfandftheftensefatm
ospherefdirectly.fThefchargefnursefcouldfthenfproblemfsolve,fthefgoalfbeingftofhavefafrelaxedfatmosphe
refinfwhichftofwork.f(ClientfLeadershipfandfManagementf2009,fpgf128)
3.fThefnursefpreceptorfobservesfthefnewfRNfadministeringfmedications.fThefpreceptorfconcludesftherefi
sfafriskfforfmedicationferrorsfwhenfthefnewfRNftakesfwhichfaction?
a.fAnswersfafphysician'sfpagefwhilefgivingfmedications
b.fUsesfmilitaryftimefforfdocumentation
c.fAsksfforfhelpfwithfafdosagefcalculation
d.fDoesfnotfgivefafmedicationfthatfthefclientfquestionsf-fANSWER:fAnswer:fA
Rationale:fThefnursefshouldfneverfinterruptfthefmedicationfadministrationfprocessfbecausefthisfincreas
esfthefriskfoffmedicationferrors.f(Hogan,f2012.fPgf62)
4.fThefRNfmustfdelegatefcarefoffanfassignedfclientftofanfUAPfforfthefshift.fWhichfclientfwouldfbefbestftofd
elegateftofthefUAP?
a.fAfclientfwhofwouldfbenefitffromftalkingfaboutfthefrecentfdeathfoffherfhusband
b.fAfclientfwithfurinaryfdrainagefcatheterfandfNGftubeffeedingsfwhofisfonfbedrest
c.fAfclientfwithfanfostomyfwhofhasfpersistentfproblemsfwithfleakage
d.fAfclientfwhofwasftransferredffromfthefICUf3fdaysfagofandfisfambulatoryf-fANSWER:fAnswer:fD
Rationale:fThefambulatoryfclientfisfbestftofdelegatefbecausefthefclientfisflikelyftofbefstablefwithfaflowflev
elfoffunpredictability.f(Hogan,f2012.fPagef47)
5.fWhatfisfconsideredfthefmostfeffectivefmeansfforfresolvingfconflicts?
a.fNegotiation
b.fConfrontation
c.fAccommodation
d.fCollaborationf-fANSWER:fAnswer:fB
Rationale:fConfrontationfisfthefmostfeffectivefmeansfforfresolvingfconflictsf(Sullivan,f2013.fPagef166)
6.fThefnursefeducatorfisfdiscussingffirefsafetyfwithfnewfemployees.fListfinforderfoffperformanceftheffollo
wingfactionsfthefnursefshouldfteachftofensurefthefsafetyfoffclientsfandfemployeesfinfthefcasefoffaffirefonf
thefunit
,a.fExtinguish
b.fRescue
c.fConfine
d.fAlertf-fANSWER:fAnswer:fBDCE
Rationale:fRACEfisfthefrecognizedfstandardfforffirefsafetyfinfhealthcareffacilitiesf(Hargrove-
Huttelf&fColgrove,f2009.fPGf33)
7.fThefclientfhasfjustfbeenftoldfthefmedicalfconditionfcan'tfbeftreatedfsuccessfullyfandfthefclientfhasfaflife
fexpectancyfoff6fmonths.fWhichfreferralfwouldfthefnursef makefatfthisftime?
a.fHomefHealthfnurse
b.fTofthefclient'sfpastor
c.fTofafhospicefagency
d.fTofthefsocialfworkerf-fANSWER:fAnswer:fC
Rationale:fOnefoffthefguidelinesfforfadmissionftofafhospicefagencyfisfafterminalfprocessfwithfaflifefexpect
ancyfoff6fmonthsforfless.fTheseforganizationsfworkftofassistfthefclientfandffamilyftofliveflifeftofitsffullestfw
hilefprovidingfforfcomfortfmeasuresfandfafpeaceful,fdignifiedfdeathf(Hargrove-Huttlef&fColgrove,f2009)
8.fTheffemalefvolunteerfonfafmedicalfunitftellsfthefnursefthatfonefoffthefclientsfonfthefunitfisfherfneighbo
rfandfasksfaboutfthefclient'sfcondition.fWhichfinformationfshouldfthefnursefdiscussfwithfthefvolunteer?
a.fDetereminefhowfwellfshefknowsfthefclientfbeforeftalkingftofthefvolunteer
b.fTellfthefvolunteerfthefclient'sfconditionfinflayman'sfterms
c.fAskfthefclientfiffit'sfalrightftoftalkftofthefvolunteer
d.fExplainfthefclientfinfofisfonfafneedftofknowfbasisf-fANSWER:fAnswer:fD
Rationale:fThefnursefshouldfremindfthefvolunteerfoffthefHIPAAfandfconfidentialityfrulesfthatfgovernfanyf
informationfconcerningfclientsfhealthcarefwillfbefsharedfonfafneedftofknowfbasisf(Hargrove-
Huttle,fColgrove,f2009)
9.fThefchargefnursefonfthefnightfshiftfreportsfthatfthefnarcoticfcountfisfincorrect.fThefnursefhasfspokenft
ofthefresponsiblefstafffnursefandfbelievesfthatfsubstancefabusefbyfthefnursefisfthefcause.fIffsubstancefab
usefisfthefcasefoffthefincorrectfcount.fWhatfisfthefappropriatefnextfstep?
a.fRecountfthefnarcoticsfwithfthefstafffnursefandftakefdisciplinaryfaction
b.fAskfthefstafffnurseftofleavefthefunitfandfreportfthefincidentftofthefANA
c.fCompletefandfincidentfreportfandfreportftheffindingsftofthefpharmacyfandfnursingfadministration
d.fSubmitftheffindingsftofthefcouncilfonfnursingfpracticef-fANSWER:fAnswer:fC
Rationale:fAnfincidentfreportfmustfbefcompletedfbecausefoffinaccuratefcountfoffnarcoticsforfcontrolledf
substancesffallfunderffederalflawfandfregulationf(Hogan,f2012.fPGf27)
Accordinglyfauditfisfnowfdueftofevaluatefimplementationfoffelectronicfmedicalfrecordf(EMR)fonfthefunit.
fAsfthefunitfrepresentativefwhofsupervisedfthefadaptationfoffthisfdocumentationfhowfcanfthefnursefbest
fdeterminefiffthefnursingfstafffhavefacceptedfthisfchange
a.fNursingfstafffusesfthefEMRfdailyfinfroutinefdocumentation
b.fNursingfstafffverbalizingfneedfforfEMRfbutfstillfhandfwritefnursingfnotesfintofthefclient'sfchart
c.fNursingfstafffusefthefEMRfsporadicallyftofmonitorfclient'sfprogress
d.fNursingfstaffflikefthefEMRfbecauseftheyfbelievefitfsavesfinftimef-fANSWER:fAnswer:fA
Rationale:fWhenfpeoplefacceptfchangefandfintegratefitfintofthefdailyfactivity,fthefchangefisfmaintainedf(
Hogan,f2012.fPGf47)
11.fAfnursingfinstructorfdeliversfaflectureftofnursingfstudentsfregardingfthefissuefoffclient'sfrightsfandfask
sfafnursingfstudentftofidentifyfafsituationfthatfrepresentsfanfexamplefoffinvasionfoffclientfprivacy.fWhichf
situation,fiffidentifiedfbyfthefstudent,findicatesfanfunderstandingfoffafviolationfoffthisfclientfright?
a.fPerformingfafprocedurefwithoutfconsent
b.fThreateningftofgivefafclientfafmedication
c.fTellingfthefclientfthatfheforfshefcannotfleavefthefhospital
d.fObservingfcarefprovidedftofthefclientfwithoutfthefclient'sfpermissionf-fANSWER:fAnswer:fD
Rationale:fInvasionfoffprivacyfoccursfwithfunreasonablefintrusionfintofanfindividual'sfprivatefaffairsf(Sau
nders,f2014)
, 12.fThefprimaryfnursefoverhearsfthefUAPftellingfaffamilyfmemberfoffafclient,f"Onefoffthefclientsfatfthefre
habfunitfwillfbefgoingftofprisonfbecausefthatfpersonfwasfchargedfwithfvehicularfmanslaughterfbecauseft
wofpeoplefinfafmotorfvehiclefaccidentfdied."fWhatfactionfshouldfthefprimaryfnursefimplementffirst?
a.fApologizeftoftheffamilyfmemberfforfthefUAPsfcomments
b.fTellfthefUAPfthatfthefcommentfisfafviolationfoffHIPAA
c.fAllowfthefUAPftofcompletefthefconversationfthenfdiscussfthefsituation
d.fInterruptfthefconversationfandftellfthefUAPftofgoftofthefnurses'fstationf-fANSWER:fAnswer:fD
Rationale:fThefisfafviolationfoffHIPAAfandfisfgossipingfaboutfanotherfclientf(Hargrove-
Huttelf&fColgrove,f2009)
Staffingfneedsfarefdeterminedfbyfwhichfofftheffollowing:f
a.fNurse-patientfratios
b.fNurse-shiftfratios
c.fStafffmixfratios
d.fAllfoffthefabovef-fANSWER:fAnswer:
a.fNurse-patientfratios
b.fNurse-shiftfratios
c.fStafffmixfratios
Rationale:fItfisfthefresponsibilityfoffthefnursefmanagerftoftakefintofconsiderationfthefnumberfoffpatients,
fnurses,fandfstaffftofdeterminefhowfmanyfstafffarefneededftofconductfsafefnursingfcaref(Monahan,f2010
.fPGf47)
1.fStafffassignmentsfhavefbeenfmadefforfthefshiftfandfbedsidefreportingfisfcomplete.fAfterfmorningfmedf
pass,faf51fyear-
oldffemalefpatientfincontinentfoffbowelfandfbladder,ftellsfthefUAPfthatfshefisfuncomfortablefhavingfafma
lefnurse.fThefUAPfinformsfthefnursefandfthefchargefnurse.fWhatfdoesfthefchargefnursefdofregardingfreas
signmentfoffthefpatient?
a.fInformsfthefpatientfthatfallfpersonalfcarefneedsfwillfbefperformedfbyfthefUAP,fsofhavingfafmalefnursefi
sfnotfanfissue
b.fCollaboratesfwithfthefmalefnursefandfaffemalefnursefregardingfchangingfpatientsfandfreassignsfaccor
dingly
c.fContactsftheflegalfdepartmentftofseefiffthefpatientfcanfbefforcedftofkeepfthefmalefnurse
d.fTellsfthefpatientfthatftherefarefplentyfoffmalefnursesfinftoday'sfsocietyfandfthatfshefshouldffindfwaysft
ofcopefwithfherfprejudicef-fANSWER:fAnswer:fB
Rationale:fBeneficence
1.fAfnursefentersfafclient'sfroomftofadministerfferrousfsulfatef324mg.fWhenfthefnursefchecksfthefMARfa
gainstfthefmedication,ftheyfnoticefthatfthefdosagefonfthefpackagefindicatesfferrousfsulfatef300mg.fWhic
hfactionfwouldfbefthefmostfappropriate?
a.fNotifyfthefpharmacistfoffthefdosageferrorfandfrequestfthefcorrectfdosage
b.fAdministerfthefmedicationfoffthefdosageferrorfandfrequestfthefcorrectfdosage
c.fHoldfthefmedicationfuntilfthefphysicianfcanfbefnotified
d.fAskfthefnursefwhofcaredfforfthefclientfyesterdayfwhatfheforfshefadministeredftofthefclientf-
fANSWER:fAnswer:fA
Rationale:fThefnursefshouldfphonefthefpharmacistffirstftofrequestfthefcorrectfdosagefforfthefclientfbefor
efitfisfadministeredf(Monahan,f2010.fPGf1100)
Thefnursefarrivesfatfworkfandfisftoldftofreportf(float)ftofthefICUfforfthefdayfbecausefthefICUfisfunderstaffe
dfandfneedsfadditionalfnursesftofcarefforfthefclients.fThefnursefhasfneverfworkedfinfthefICU.fThefnursefsh
ouldftakefwhichfactionffirst?
a.fCallfthefhospitalflawyer
b.fRefuseftoffloatftofthefICU
c.fAllfthefnursingfsupervisor
d.fIdentifyftasksfthatfcanfbefperformedfsafelyfinfthefICUf-fANSWER:fAnswer:fD
Rationale:fFloatingfisfanfacceptableflegalfpracticefusedfbyfhospitalsftofsolvefunderstaffingfproblems.fWh
enfencounteringfthisfsituation,fthefnursefshouldfsetfprioritiesfandfidentifyfpotentialfareasfoffharmftofclie
ntf(Saunders,f2014).