Exam 2 Practice Questions P2 Questions
and Correct Answers | Latest Update
A school nurse notices that a student is losing weight and decides to perform a focused
nutritional assessment to rule out an eating disorder. What is the nurse's best action?
Perform the focused assessment as this is an independent nurse-initiated intervention.
Request an order from Jill's physician since this is a physician-initiated intervention.
Request an order from Jill's physician since this is a collaborative intervention.
Request an order from the nutritionist since this is a collaborative intervention.
Perform the focused assessment as this is an independent nurse -initiated
intervention.
Performing a focused assessment is an independent nurse-initiated intervention; thus the nurse
does not need an order from the physician or the nutritionist.
Nurses use the NIC Taxonomy structure as a resource when planning nursing care for patients.
What information is found in this structure?
Case studies illustrating a complete set of activities that a nurse performs to carry out nursing
interventions
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Nursing interventions, each with a label, a definition, and a set of activities that a nurse
performs to carry it out, with a short list of background readings
A complete list of nursing diagnoses, outcomes, and related nursing activities for each nursing
intervention
A complete list of reimbursable charges for each nursing intervention
Nursing interventions, each with a label, a definition, and a set of
activities that a nurse performs to carry it out, with a short list of
background readings
The NIC Taxonomy lists nursing interventions, each with a label, a definition, a set of activities
that a nurse performs to carry it out, and a short list of background readings. It does not
contain case studies, diagnoses, or charges.
A new RN is being oriented to a nursing unit that is currently understaffed and is told that the
UAPs have been trained to obtain the initial nursing assessment. What is the best response of
the new RN?
Allow the UAPs to do the admission assessment and report the findings to the RN.
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Do his or her own admission assessments but don't interfere with the practice if other
professional RNs seem comfortable with the practice.
Tell the charge nurse that he or she chooses not to delegate the admission assessment until
further clarification is received from administration.
Contact his or her labor representative to report this practice to the state board of nursing.
Tell the charge nurse that he or she chooses not to delegate the admission
assessment until further clarification is received from administration.
The nurse should not delegate this nursing admission assessment because only nurses can
perform this intervention. The nurse should seek clarification for this policy from the nursing
administration.
A nurse is about to perform pin site care for a patient who has a halo traction device installed.
What is the FIRST nursing action that should be taken prior to performing this care?
Administer pain medication.
Reassess the patient.
Prepare the equipment.
Explain the procedure to the patient.
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Reassess the patient.
Before implementing any nursing action, the nurse should reassess the patient to determine
whether the action is still needed. Then the nurse may collect the equipment, explain the
procedure, and, if necessary, administer pain medications.
A student nurse is on a clinical rotation at a busy hospital unit. The RN in charge tells the
student to change a surgical dressing on a patient while she takes care of other patients. The
student has not changed dressings before and does not feel confident performing the
procedure. What would be the student's best response?
Tell the RN that he or she lacks the technical competencies to change the dressing
independently.
Assemble the equipment for the procedure and follow the steps in the procedure manual.
Ask another student nurse to work collaboratively with him or her to change the dressing.
Report the RN to his or her instructor for delegating a task that should not be assigned to
student nurses.
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