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Leadership Exam 2 A nurse should initiate discharge planning for a client at what time period? A client who is admitted for suspected abuse is quiet and withdrawn. Which of the following should the nurse implement to promote client communication? A nurse manager is explaining the importance and guidelines for use of incident reports to new graduate RNs during their orientation. In assessing their understanding of what she has told them, which of the following statements would indicate that more explanation/reinforcement is needed about incident reports? A client has just joined a health care maintenance organization (HMO) and asks for information about the payment obligations with this plan. The most accurate description of health care costs is that the client will be charged in which manner? Immediately after a client's condition is stabilized on the assigned unit When the client or family demonstrate readiness to learn self-care modalities Upon admission to a hospital unit or the emergency room When a date for discharge has been determined Invite a family member to be present for the nursing history Provide basic wound care for obvious physical injuries Probe the client to offer an actual account of the abuse Provide privacy and be direct and honest when communicating with the client A manager usually reviews the incident report and investigates the incident before sending it on to the risk manager for follow-up. Incident reports should not be shared with the client and the family. A copy of the incident report should be made by the person who initiates the report for future reference if there is a lawsuit. Only a factual description of the event should be documented in the client's health care record without any mention of an incident report. A pre-determined fee for all services The usual and customary fee for services
What area of a healthcare organization's budget generally accounts for largest portion of expenditures? A client is brought into the ED with a history of alcohol abuse. The client presents confused and disoriented. Wrist restraints were placed on the patient. After six hours had passed, the client requested to leave. The nurse refused to remove the wrist restraints. The client informed the nurse that he was going to report her to her supervisor. Which term below best describes the intentional tort that the client will be reporting? Only for services provided by specialists One flat rate for each service rendered Capital Budget Supplies Budget Contingency Budget Personnel Budget Following change of shift report, which client should the RN see first? A client who has threatened a lawsuit regarding his call light not being answered in a timely manner. A client who is to be discharged in one hour who needs additional information about managing his new gastrostomy tube at home. A client who is complaining of incisional pain 9/10. A client who has sudden left sided weakness and slurred speech after getting up to the commode. Assault Invasion of privacy Battery False imprisonment
A nurse who keeps her promise and returns to a patient's room to answer the patient's questions on her next rounds is demonstrating the ethical principle of: A nurse has received morning report on the following four clients. Which client should the nurse see first? These reports help to document incident details/persons involved that could be used for legal purposes at some future time should an organization be involved in a lawsuit. Fidelity Veracity Autonom y Paternali sm The expense of buying a new MRI machine would most likely be included in which type of a budget? contingency budget operating budget capital budget minor equipment budget A healthcare worker anonymously reports through his organization's Corporate hotline that coworkers are steeling supplies and taking them home for their own use. This reporting would be called: Lateral Whistle Blowing External Whistle Blowing Vertical Whistle Blowing Internal Whistle Blowing A client who has blood glucose of 68 mg/dL and reports mild sweating and is hungry.
What is the primary purpose of laws and legislation? A charge nurse receives a phone call from the emergency room where a client is being admitted. The admission diagnosis of the client is renal failure. The client is also confused and restless. Which is the safest room assignment for this client? Which statement best describes the value of clinical pathways (also known as care paths or critical pathways)? The nursing staff of a Medical- Surgical unit is asked to make a recommendation regarding an installation of a computer work station. Which factor is a priority for staff ergonomics? A client who has acute glomerulonephritis and reports reddish-brown urinary output. A client who has a calcium level of 10 mg/dL and reports having a headache. A client who has cellulitis of the left lower leg and reports pain in the affected area. To protect the nurse and the patient To guarantee patient privacy To ensure nursing compliance with the law To prevent medical errors A semi-private room 50 feet from the nurse's station. A small, private room at the end of the hallway. A seclusion room that is monitored by a camera for client safety. A large private room within view of the nurse's station. They provide a means of standardizing care for clients with similar diagnoses. They determine justifiable differences/variances among clients. They decrease the amount of paperwork required for reimbursement. They reduce administrative costs. Availability of the chart rack and dictation equipment for healthcare providers. Distance from clients' rooms and number of chairs
There are two types of torts. These are intentional and unintentional. Which of the following is an example of an unintentional tort? An RN accidentally sticks her hand with the syringe needle after administering an IM injection to a client. Which one of the following should the nurse do first? Nursing staff sometimes need support and guidance when facing challenging patient care ethical dilemmas. Nurse Managers can support staff in working through ethical dilemmas by consulting which of the following? An elderly client who has a documented history of dementia is intermittently alert and can currently tell you her name. Who should sign the client's informed consent for an invasive diagnostic procedure? Distance to the nearest hospital/ emergency care Family's understanding of the client's needs False imprisonment Assault and battery Professional negligence Defamation of character Notify the charge nurse of the incident. Go to employee health services. Complete an incident report. Wash hand thoroughly with soap and water. American Nurses Association (ANA) Social Policy Statement Joint Commission Standards Patient Bill of Rights Hospital/Healthcare Agency's Ethics Committee The client's husband, who is blind. The client herself, who has an advance directive.
A client is receiving patient-controlled analgesia (PCA). The client complains to a RN that the button has been pushed several times but there is no pain relief. The RN checks the pump and determines it is programmed correctly. It appears, however, that no analgesic has been delivered for 3 hours. Which is the safest action for the RN to take? Information technology makes client care easier as well as more challenging for nurses. Which action by the nurse demonstrates compliance with HIPAA? A nurse is convicted for false representation and illegal practice as a nurse practitioner. The nurse is sentenced to five years in a state penitentiary. Which of the following courts has processed this nurse's sentence? Which one of the following characteristics describes a "reasonable and prudent RN"? The client's friend who has durable power of attorney for health care for the client. The client's daughter, who is competent and visiting her mother from out of state. Call the Central Service Department to replace the old pump with a new one. Place the old pump in the soiled utility room. Place a sign on the old pump to inform Biomedical Engineering about the nature of the equipment malfunction. Remove/isolate the old pump so no one else can use it. Call the PCA Pump vendor to remove the pump in question and have them bring you a new one that functions properly. Report the pump malfunction to the supervisor and have him/her call Biomedical Engineering to pick up. Log-in with user name and password and log-out once every shift. Allow a physician to use the nurses' computer access information to read lab data only. Minimize a computer screen with patient health information when speaking with someone not authorized to view it. Allow clergy to visit all patients on the nursing unit. Criminal Court Civil Court Administrative Court Board of Registered Nursing Court At least 5 years of applicable RN experience Specialized RN skills for the assigned nursing area.
Where can a nurse manager find standards of ethical behavior specifically written for the nursing profession? A client voluntarily admits himself to a hospital's mental health unit with the diagnosis of suicidal ideation, but is not on a legal hold. The client has been on the unit for two days and states, "I demand to be released now!" The appropriate response from the RN should be which of these statements? A RN in the emergency department is assessing an elderly client. The client's son states that the client has glaucoma, is extremely hard of hearing, and has been experiencing severe abdominal cramping and diarrhea for the past 24 hours. Which of the following actions is most appropriate for the nurse to do FIRST? Which phrase best describes the meaning of the standard of care? Assess the patient and review current laboratory data. The Joint Commission Department of Health Services American Nurses Association Centers for Medicare/Medicaid Services (CMS) "Let's discuss your decision to leave and then we can prepare you for discharge." "You have a right to sign out as soon as we get the health care provider's discharge order." "You cannot be released because you are still at risk of being suicidal." "You can be released only if you sign a no suicide contract before you leave." Ask the client if he is wearing or has with him a hearing aid. Ask the patient if he has taken any medication for the diarrhea in the past 24 hours. Using a numeric 1-10 rating scale, ask the client to rate his abdominal pain. Ask the client if he has talked to his physician yet about his condition. The directive that ensures that all nurses will act prudently The minimal level of expertise that may be delivered to a patient
An RN overhears two care providers discussing a hospitalized client while getting coffee at the coffee bar in hospital lobby where many visitors can hear them. Which nursing action below is most appropriate for the RN to take first? An RN notes that the toes on the casted left foot of her post-surgical client are cold and turning blue. The RN has notified the healthcare provider's answering service every hour for the past two hours, yet the healthcare provider has not yet responded to the calls. The client is now complaining of extreme pain. What is the most important action for the nurse to take right now? A RN is assessing four clients on a Medical-Surgical unit. Which one of the following clients should the RN attend to first? Which behavior is a priority to minimize an RN's risk for a malpractice claim? The intentions that the nurse will behave in a prudent manner The law that states that a nurse shall do no harm Report the incident to their nurse manager. Quickly engage them in a different conversation to change the subject. Quietly pull the two staff members aside and remind them about client confidentiality. Wait until they get their coffee and head back to the nursing lounge; then tell the care providers that the conversation was not appropriate. Continue to call the healthcare provider's answering service every 15 minutes until a response is obtained. Report the situation to the nursing supervisor so she can elevate the patient's situation to the appropriate head/chief physician for the service. Continue to record the assessment findings, the time of each phone call and content reported each time to the healthcare provider. Have the family file an immediate complaint with the Medical Staff Office against the physician. A client who has diarrhea and requests clear liquids for breakfast. A client who has type 1 diabetes mellitus and has a blood glucose level of 280mg/dL. A client who has a cast on her left forearm and reports numbness and paresthesia in her fingers. A client who has pneumonia and has an axillary temperature of 38 degrees Centigrade ( degrees Fahrenheit). Maintain positive nurse-patient relationships.
An RN witnesses an assistive personnel (AP) under her supervision reprimand an elderly client for spilling urine from his urinal on the bed sheets. The AP verbally threatens to put a diaper on the client if he does not use the urinal more carefully next time. Which one of the following wrong doings is the AP committing? The nurse is caring for a combative patient who has been placed in soft wrist restraints. The nurse notes that the client has been cooperative and non-combative for the past two hours. Which of the following measures will the nurse take next? When a RN receives what he/she feels is an unsafe assignment, which of the following actions is most appropriate to do initially? What statement made by a new nurse manager would indicate to her nursing director that he/ she needs more budget training/coaching? False Imprisonment Assault Invasion of Privacy Slander Continue to assess the patient's wrists every 15 minutes Compliment the patient for cooperating and return in 4 hours Remove one wrist restraint at a time and assess the patient's behavior Maintain the restraints for the next 24 hours File a written complaint regarding unsafe staffing with the appropriate hospital administrator (Assignment Despite Objection). Bring the inappropriate assignment to the attention of the charge nurse and negotiate a new assignment. Place a call to the nursing director to discuss the unsafe staffing situation. Do not accept the assignment and inform your supervisor that you are going home. A budget contains an estimate of both income and expenses for a year. A budget followed exactly as prepared will always achieve a good financial outcome. A budget allows for an institution to plan for the effective use of its resources.
