Exam 4 Almost done

Pregunta 1 de 45

1

The team at PRH has decided to implement a new discharge class for all patients newly diagnosed with diabetes. After starting the program, several patient's wind up having complications relating to not recieving their insulin on time and it is determine that the reason was because the discharge class was during the 10:00am med pass and their insulin was delayed. The nurse manager would be demonstrating transformational leadership style by doing which of the following?

Selecciona una de las siguientes respuestas posibles:

Ask nurse who made the suggestion to have the discharge class from 10am-12am why she suggested it and ask the team for better suggestions.
Use the sandwich method to find out why the nurses did not administer the insulin before the patient's were brought to the discharge class.
Take responsibility for this negative outcome and work with team to rectify it.
Reassign the workload so that an RN could be at the class to give insulin.

Explicación

Pregunta 2 de 45

1

A hospital is instituting a new safety measure at thel, the nurses will now being using a fingerprint scanner to enter the dispensing machine that contains narcotics. The machines have been sent to replace 5 machines on med-surg floors out of the hospitals total of 70 dispensing machines. Which stage of Lewin's theory of change is taking place?

Selecciona una de las siguientes respuestas posibles:

Force field anlysis
refreezing
unfreezing
movement

Explicación

Pregunta 3 de 45

1

Incentives provided by CMS & HCAHPS would be directly effected by all of the following except?

Selecciona una de las siguientes respuestas posibles:

TJC pt. safety goals
Clinical core measures
improvement & consistency
pt. survey measuring satisfaction with care

Explicación

Pregunta 4 de 45

1

Select from the following, those two items most involved in safeguarding the public from nurses.

Selecciona una o más de las siguientes respuestas posibles:

Nurse Practice Act
National Council of State Boards of Nursing (NCSBN)
National League of Nursing
Board of Nursing (BON)
American Nurses Association (ANA)

Explicación

Pregunta 5 de 45

1

A traveling nurse arrives in Texas to begin her work at a community health clinic. She is told that they have a needle exchange facility on the hospital campus where nurses teach patient's harm reduction strategies to safely inject heroin. After deciding that she would be competent to complete the task, the best resource to find out if this is task is within the nursing scope of practice is?

Selecciona una de las siguientes respuestas posibles:

Texas BON
NCSBSN
ANA
NPA

Explicación

Pregunta 6 de 45

1

The charge nurse notes that Kim left her patient on the commode for 35 minutes while going to obtain a suppository. The pt. was then given the suppository and got back in bed but had significant pain for the rest of the day. What is the best way for the charge nurse to communicate his feedback?

Selecciona una de las siguientes respuestas posibles:

"Kim you probably were just busy but why did 304 get left on the commode for 35 minutes?"
" Kim, you have been overall very attentive to Mrs J. in 304. I did notice and am concerned that she was on the commode for 35 minutes earlier. It makes me uncomfortable that this happened because it is a safety issue. You are one of my most timely and attentive nurses. Tell me about what happened and how i can support you.
"Do you want me to give Mrs. J to someone else? I noticed she was on the commode for 35 minutes. That really makes me concerned and uncomfortable, it is a safety issue with her being elderly."
"Kim, leaving Mrs. J on the commode for such a long time is a safety issue and I can not have nurse's putting patient's at risk. Tell me why she was left there ?"

Explicación

Pregunta 7 de 45

1

The best approach to problem solving to use for conflict negotiation is?

Selecciona una de las siguientes respuestas posibles:

Compromise
Win-win
Closed-loop
sandwich method

Explicación

Pregunta 8 de 45

1

A nurse you work with has been refusing to have a meaningful conversation with you, she also will not cosign any of your medications when you have asked. Today in handoff she said "Just write your handoff down and hand it to me, it will probably be easier to understand without you saying like every other word." This is an example of?

Selecciona una de las siguientes respuestas posibles:

dominant style of interaction
bullying
contentious communication
Lateral violence

Explicación

Pregunta 9 de 45

1

A nurse educator is going to be providing teaching on the root cause analysis. She is assessing nurses for knowledge regarding the theory, which nurse requires further teaching?

Selecciona una de las siguientes respuestas posibles:

"It establishes cause and effect."
" It allows us to understand the problem, then we come up with a solution and implement Lewin's change theory."
"It includes assessing Equipment, process, and people."
"It is a STEP situation monitoring effort."

Explicación

Pregunta 10 de 45

1

All of the following are clinical criteria for diagnosing Substance abuse in the DSM 5 except?

Selecciona una de las siguientes respuestas posibles:

Repeated use leading to failure to fufill role obligations
desire to cut down
continued use despite social or interpersonal problems
repeated use leading to physically hazardous situations

Explicación

Pregunta 11 de 45

1

A nurse is assessing the A in the CAGE tool when asking which question?

Selecciona una de las siguientes respuestas posibles:

Do you feel alone because of your drinking problem?
Do you have access to supports to help you stop drinking?
Do you feel annoyed when people ask about your drinking?
Do you always drink more than you planned?

Explicación

Pregunta 12 de 45

1

A patient who has made the statement "That is it, I don't want to drink anymore. I have lost my family, my life, my home. I am ready to not be a god damn drunk anymore, I need to be sober by Christmas." is in what stage of change?

Selecciona una de las siguientes respuestas posibles:

Precontemplation
Preparation
Action
Maintenance
Relapse
Contemplation

Explicación

Pregunta 13 de 45

1

What are the 5 As

Selecciona una de las siguientes respuestas posibles:

Ask, assess, adapt, advise, arrange
Ask, allow, adapt, arrange, admit
Ask, assess, advise, arrange, admit
ask, advise, assess, assist, arrange

Explicación

Pregunta 14 de 45

1

A pt. was brought to the ER by family, they say that the pt's last drink was at midnight. When should the nurse expect withdrawal symptoms to begin?

Selecciona una de las siguientes respuestas posibles:

24 hrs later
noon
4am-6am
6am-12pm

Explicación

Pregunta 15 de 45

1

The inpatient psych nurse has been assigned a patient who is a longterm alcohol abuser with severe cirrhosis. The patient is on day 1 of detox and has a bp of 165/101, HR: 96, LFTs are elevated but all other vital signs are WNL. Which intervention should the nurse perform ?

Selecciona una de las siguientes respuestas posibles:

Instruct the patient about completing 90 meetings in 90 days
Administer lorazepam (ativan) as ordered
Administer oxazepam (serax) as ordered
Encourage the pt to attend all groups
roleplay just say no activities

Explicación

Pregunta 16 de 45

1

All of the following are assessed on the CINA based on observation except

Selecciona una de las siguientes respuestas posibles:

goosebumps
nasal congestion
yawning
delirium tremens

Explicación

Pregunta 17 de 45

1

Out of the patial agonist/antagonist's used for opiod addiction which medication has the least potential for OD?

Selecciona una de las siguientes respuestas posibles:

Buprenex
Subutex
Suboxone

Explicación

Pregunta 18 de 45

1

Risk factors for aggressive behaviors include all of the following except?

Selecciona una de las siguientes respuestas posibles:

Past history of violence
Diagnosis
insomnia
Current behavior: prodromal

Explicación

Pregunta 19 de 45

1

A client is very angry because staff can not locate an item that has been locked up when he was admitted. The best response by the nurse is?

Selecciona una de las siguientes respuestas posibles:

"We put everything in the same place for each patient yours was not there."
"I know it mustbe frustrating that we can't find your things, I'm sorry we haven't been able to find it yet. Can you remember any details about when you came in so that i can help you more?"
"You really need to come down before i can continue looking. I can't help you when you are yelling at me."
"I'm sorry your so angry but we have done everything we can and need to get back to the other patients."

Explicación

Pregunta 20 de 45

1

An instructor asks the class to yell out answers for characteristics of victims of intimate partner violence. The teacher selects which of the following to write on the board as correct answers?

Selecciona una o más de las siguientes respuestas posibles:

grew up in abusive homes
pathologically jelous
pregnancy & moves towards independence increases violence
low self esteem
inadequate supports
likely to abuse drugs

Explicación

Pregunta 21 de 45

1

Sheila tells the community nurse that her boyfriend has been abusive and she is afraid of him, but she doesn’t want to leave. The client asks the nurse for assistance. Which nursing interventions are appropriate in this situation? Select all that apply.

Selecciona una de las siguientes respuestas posibles:

Help Sheila to develop a plan to ensure safety, including phone numbers for emergency help.
Reinforce concern for Sheila’s safety and her right to be free of abuse
Report the abuse to the authorities
Tell her to leave because things will not improve

Explicación

Pregunta 22 de 45

1

A 19 year old male patient arrives on the unit he is in college and is catholic. He has a diagnosis of MDD and has no previous attempts of suicide in his history. He lives with his parents and has a diagnosis of cystic fibrosis. He has positive SI with a plan to hang himself with a belt, pt stated "just like Robin Williams, my favorite actor" How many risk factors for suicide does this patient exhibit?

Selecciona una o más de las siguientes respuestas posibles:

5
7
3
4

Explicación

Pregunta 23 de 45

1

A pt. who is being discharged the next day from the unit starts giving away a lot of his clothing and books to the other patients, he appears much happier than he has the last couple days. When asked about his plans for when he returns home by another pt. you hear him respond "dont worry about me George im going to a better place." What is the best response by the nurse?

Selecciona una de las siguientes respuestas posibles:

Your not feeling suicidal with your discharge coming up are you?
Are you feeling okay Henry?
Henry it really looks like the medicine is working, you are so cheerful and giving. I am so happy you are doing better, good for you.
Sometimes people who are feeling suicidal give away things that matter to them, and their mood improves Henry, Do you feel this way? Tell me about it.

Explicación

Pregunta 24 de 45

1

The most dangerous complication of bed rest is?

Selecciona una de las siguientes respuestas posibles:

disuse osteoporosis
atelectasis
DVT
renal calculi & UTI
Decubitus ulcers

Explicación

Pregunta 25 de 45

1

The mother of a pediatric patient with a congenital hip dysplasia shows that she needs further teaching when she states?

Selecciona una de las siguientes respuestas posibles:

My baby will need to wear the pavlick harness continuously for 3-6 months
Im so glad that my baby had the barlow and ortolani tests before 3 months so that she could be diagnosed
If she needs surgery I want to wait till she is older and understands whats going on
I know its not my fault, its probably due to the fact that she was breech and a twin

Explicación

Pregunta 26 de 45

1

Pts at risk for osteoporosis include all but who?

Selecciona una de las siguientes respuestas posibles:

65 year old asian male 30 pack year history
70 year old thin sedentary white female
Obese 30 year old female pot smoker
Pt. on long term steroids for IBD, malabsorption

Explicación

Pregunta 27 de 45

1

You would diagnose the condition that teriparatide (forteo) treats by all of the following except?

Selecciona una de las siguientes respuestas posibles:

ANA
increased serum Ca
bone density scan
crush fractures in vertebrae, hip fractures, colles fractures

Explicación

Pregunta 28 de 45

1

Gout diets exclude all of the following except?

Selecciona una de las siguientes respuestas posibles:

red meat
seafood
leafy greens
alcohol

Explicación

Pregunta 29 de 45

1

A pt. who has been chronically immobile would be at risk which complication related to mineral imbalance?

Selecciona una de las siguientes respuestas posibles:

UTI
renal calculi
DVT
orthostatic hypotension

Explicación

Pregunta 30 de 45

1

The hospitalist continues Mrs. M.'s risedronate (Actonel) from her home medications. He writes the order : 5mg with water at least 30 min before dinner daily. You know the incorrect part of this order to be?

Selecciona una de las siguientes respuestas posibles:

30min
5mg
before
dinner

Explicación

Pregunta 31 de 45

1

A client was infected with TB 10 years ago but never developed the disease. He’ began cancer treatment over 9 weeks ago. Which signs and symptoms would be indicative of active infection? Select all that apply (4)

Selecciona una o más de las siguientes respuestas posibles:

initial dry cough that started 6 weeks ago and has grown productive
restlessness/apprehension
fatigue & malaise
CO2 retaining
low grade fever & night sweats
hemoptysis

Explicación

Pregunta 32 de 45

1

You are providing teaching to a patient who had a 19mm PPD skin test and positive chest xray. He is being admitted to the hospital to obtain sputum cultures and start antibiotics immediately after. You know the patient needs further teaching when he says?

Selecciona una de las siguientes respuestas posibles:

I will need to take four drugs must likely; isoniazid, rifampin, pyrazinamide, ethambutol
I will be on four drugs for the initial 8 weeks and then some other combination for 18 weeks.
I will be in a special room in the hospital and everyone that takes care of me will be wearing masks
as long as i take my meds i won't have the active disease and need to spit into the cup again

Explicación

Pregunta 33 de 45

1

A pt. is on the med-surg floor after an esophagectomy and hemigastrectomy. This morning he was ambulating well in the halls, required only his scheduled pain medication and received a visitor. When you assess the patient after your lunch break he is exhibiting a heart rate of 135, respiratory rate of 40 with shallow depth and is complaining of chest pain and difficulty breathing. What is the very first thing the nurse should do being concerned that this patient has a tension pneumothorax?

Selecciona una de las siguientes respuestas posibles:

check clamps on the chest tubes
call physician
call code blue
place pt in semifowlers to optimize expansion

Explicación

Pregunta 34 de 45

1

When admitting a patient the nurse will assess the patient for all of the following risk factors for pulmonary embolism except?

Selecciona una de las siguientes respuestas posibles:

pneumonia
DVT
smoking
Clotting d/o
oral contraceptives
surgery

Explicación

Pregunta 35 de 45

1

When communicating in an SBAR to a resident about a pt with a positive D-Dimer. What should the nurse recommend?

Selecciona una de las siguientes respuestas posibles:

I think we need to start IV heparin right away
We really should get a spiral ct scan
Would you like me to go ahead and book the V/Q scan?
I think we should do an ultrasound of the lower extremities and a spiral CT

Explicación

Pregunta 36 de 45

1

All of the following are true about COPD except?

Selecciona una de las siguientes respuestas posibles:

Lung sounds are often diminished in the absence of infection
emphysema and chronic bronchitis usually often coexist
blood vessels thicken
air flows in with difficulty but flows out with ease
PFTs can diagnose and monitor the progression of COPDS
AAT deficiency will make a pt present much earlier with COPD
O2 therapy 2-4L/min via NC or 40% venturi (retainers 1-2L/min)

Explicación

Pregunta 37 de 45

1

Appropriate nursing interventions for a pediatric pt with Cystic fibrosis to optimize the clearance of secretions includes?

Selecciona una de las siguientes respuestas posibles:

Working with respiratory therapy to schedule Chest PT before meals during the pt's favorite TV show
administering clindamycin via PICC line
placing the two CF patients at opposite ends of the unit to decrease transmission of super bugs
providing pancreatic enzyme replacement before each meal
offering frequent high calorie snacks of the child's favorite foods

Explicación

Pregunta 38 de 45

1

A pt with COPD admitted for exacerbation has become short of breath at rest. Baseline blood gas show
ph: 7.34
paco2: 60
HCo3: 49.3
02: 79
What update in patient data would the nurse need to address first?

Selecciona una de las siguientes respuestas posibles:

Patient in tripod position
Increased productiveness of cough
Arterial pH of 7.26
Arterial PaCO2 of 50

Explicación

Pregunta 39 de 45

1

The nurse is monitoring a client who is receiving IV theophylline (aminophylline) for control of an acute episode of his chronic respiratory condition. What nursing observations would cause the nurse the most concern?

Selecciona una de las siguientes respuestas posibles:

Blurred vision, halos surrounding lights, and diplopia
Hypokalemia, diarrhea, and bradycardia
Bradycardia, pulse oximetry of 90%, irregular respirations
Restlessness, tachycardia, nausea, and vomiting

Explicación

Pregunta 40 de 45

1

On the first postoperative day after a right lower lobe (RLL) lobectomy, the client deep-breathes and coughs but has difficulty raising mucus. What nursing observation would indicate the client is not adequately clearing secretions?

Selecciona una de las siguientes respuestas posibles:

Chest x-ray film showing right-sided pleural fluid
A few scattered crackles on RLL on auscultation
Increase in PaCO2 from 35 to 45 mm Hg
Decrease in forced vital capacity

Explicación

Pregunta 41 de 45

1

What source of data provides the nurse with the most accurate assessment of the pulmonary status of a client being treated with a water-sealed chest drainage system?

Selecciona una de las siguientes respuestas posibles:

volume of fluid drained
quality of breath sounds
chest xray
client's level of SOB

Explicación

Pregunta 42 de 45

1

A client is confined to bed with a fracture of the left femur. He begins receiving subcutaneous heparin injections. What is the purpose of this medication?

Selecciona una de las siguientes respuestas posibles:

prevent thrombophlebitis and pulmonary emboli associated with immobility
To decrease the incidence of fat emboli associated with long bone fractures
To prevent venous stasis, which promotes vascular complications associated with immobility
To promote vascular perfusion by preventing formation of microemboli in the left leg

Explicación

Pregunta 43 de 45

1

The nursing instructor realizes that the teaching was effective about the differences between osteoarthritis and gouty arthritis when the student states?

Selecciona una de las siguientes respuestas posibles:

Gouty arthritis requires immediate methotrexate therapy while osteoarthritis is treated just by symptom control
Osteoarthritis is autoimmune, gout is not
Gout is caused by increased uric acid levels and osteoarthritis is just a normal part of aging
Gouty arthritis has a pattern of acute attacks while osteoarthritis is a gradual onset involving weight bearing joints primarily

Explicación

Pregunta 44 de 45

1

Thiamine, which is often ordered with folate would be ordered to prevent/ treat what condition in a chronic alcohol abuser?

Selecciona una de las siguientes respuestas posibles:

Korsakoff's syndrome
Delirium tremens
Wernicke's encephalopathy
seizures

Explicación

Pregunta 45 de 45

1

A patient on which drug must avoid substances such as hand sanitizer, nail polish remover, mouthwash, cold medicine as well as warfarin, metronidazole and cephalosporins while on the medication and for 2 weeks after d/c

Selecciona una de las siguientes respuestas posibles:

chlordiazepoxide hydrochloride (librium)
disulfiram (antabuse)
acamprosate (campral)
naltrexone (revia)

	Creado por Tess Nicholson hace más de 8 años

Nursing great bay exam 4

Exam 4 Almost done

Pregunta 1 de 45

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 2 de 45

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 3 de 45

Incentives provided by CMS & HCAHPS would be directly effected by all of the following except?

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 4 de 45

Select from the following, those two items most involved in safeguarding the public from nurses.

Selecciona una o más de las siguientes respuestas posibles:

Explicación

Pregunta 5 de 45

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 6 de 45

The charge nurse notes that Kim left her patient on the commode for 35 minutes while going to obtain a suppository. The pt. was then given the suppository and got back in bed but had significant pain for the rest of the day. What is the best way for the charge nurse to communicate his feedback?

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 7 de 45

The best approach to problem solving to use for conflict negotiation is?

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 8 de 45

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 9 de 45

A nurse educator is going to be providing teaching on the root cause analysis. She is assessing nurses for knowledge regarding the theory, which nurse requires further teaching?

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 10 de 45

All of the following are clinical criteria for diagnosing Substance abuse in the DSM 5 except?

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 11 de 45

A nurse is assessing the A in the CAGE tool when asking which question?

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 12 de 45

A patient who has made the statement "That is it, I don't want to drink anymore. I have lost my family, my life, my home. I am ready to not be a god damn drunk anymore, I need to be sober by Christmas." is in what stage of change?

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 13 de 45

What are the 5 As

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 14 de 45

A pt. was brought to the ER by family, they say that the pt's last drink was at midnight. When should the nurse expect withdrawal symptoms to begin?

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 15 de 45

The inpatient psych nurse has been assigned a patient who is a longterm alcohol abuser with severe cirrhosis. The patient is on day 1 of detox and has a bp of 165/101, HR: 96, LFTs are elevated but all other vital signs are WNL. Which intervention should the nurse perform ?

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 16 de 45

All of the following are assessed on the CINA based on observation except

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 17 de 45

Out of the patial agonist/antagonist's used for opiod addiction which medication has the least potential for OD?

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 18 de 45

Risk factors for aggressive behaviors include all of the following except?

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 19 de 45

A client is very angry because staff can not locate an item that has been locked up when he was admitted. The best response by the nurse is?

Selecciona una de las siguientes respuestas posibles:

Explicación

Pregunta 20 de 45

An instructor asks the class to yell out answers for characteristics of victims of intimate partner violence. The teacher selects which of the following to write on the board as correct answers?

Selecciona una o más de las siguientes respuestas posibles:

Explicación

Pregunta 21 de 45

Sheila tells the community nurse that her boyfriend has been abusive and she is afraid of him, but she doesn’t want to leave. The client asks the nurse for assistance. Which nursing interventions are appropriate in this situation? Select all that apply.