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The nurse is caring for a client who is asking about advanced directives. Many documents fall under the category of an advanced directive. The nurse knows that one of the most common legal papers is called 'Durable Power of Attorney for Health Care' and works to:
- A. Review a person's personal preferences for medical care in the future.
- B. Authorize another person to make medical decisions for a person if they become unable to on their own.
- C. Assign a legal authority in making medical decisions while honoring the spoken word of the family.
- D. Define what care should be administered or withheld by health care professionals, no matter which medical facility the patient finds themselves in.
Correct Answer: B
Rationale: A Durable Power of Attorney for Health Care (B) authorizes a designated person to make medical decisions if the client is incapacitated. Reviewing preferences (A) describes a living will. Honoring family wishes (C) is not legally binding, and defining care across facilities (D) overstates its scope.
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Which statements about an electronic medical record (EMR) system are true for the nurse working in a hospital? Select all that apply.
- A. Allows for efficient and centralized documentation of patient information.
- B. Enhances communication among healthcare providers by facilitating the sharing of patient data.
- C. Improves patient safety by reducing the risk of errors in medication administration and treatment plans.
- D. Supports evidence-based practice by providing access to medical research and clinical guidelines.
- E. Eliminates the need for physical storage of paper records, reducing clutter and saving space.
Correct Answer: A, B, C, D, E
Rationale: All statements are true: EMRs centralize documentation (A), enhance provider communication (B), reduce medication and treatment errors (C), support evidence-based practice with research access (D), and eliminate paper record storage (E). These features improve efficiency, safety, and care quality in hospitals.
The nurse is researching evidence-based practice and needs related literature. The nurse understands that the best source of reliable writing is:
- A. Systematic review and meta-analysis studies
- B. Expert opinions
- C. Qualitative studies
- D. Case studies
Correct Answer: A
Rationale: Systematic reviews and meta-analyses (A) provide the highest level of evidence by synthesizing multiple studies, per evidence-based practice hierarchies. Expert opinions (B), qualitative studies (C), and case studies (D) are less reliable due to subjectivity or limited scope.
The nurse has received the following information about assigned clients. The nurse should first assess the client with
- A. chronic obstructive pulmonary disease (COPD) and has respiratory acidosis on the most recent arterial blood gas (ABG).
- B. atrial fibrillation taking prescribed warfarin and reports black, tarry stools.
- C. diabetes mellitus who refuses to eat following the administration of glargine insulin.
- D. acute pancreatitis and reports nausea with epigastric pain rated as a 3 on the Numerical Rating Scale.
Correct Answer: B
Rationale: Black, tarry stools in a client on warfarin (B) suggest gastrointestinal bleeding, a life-threatening complication requiring immediate assessment. Respiratory acidosis (A) is concerning but less acute if stable. Refusing to eat post-insulin (C) risks hypoglycemia but is less urgent. Pancreatitis pain (D) rated 3/10 is manageable.
The nurse manager is completing an annual performance evaluation of a staff nurse. Which elements should the nurse manager include when completing the evaluation? Select all that apply.
- A. The nurses’ bar-code medication administration scan rate
- B. The number of times the nurse has been absent or tardy
- C. The nurse achieving a national certification
- D. The nurses’ performance compared to other staff nurses
- E. The number of medication errors the nurse has self-reported.
Correct Answer: A, B, C, E
Rationale: Bar-code scan rate (A), absences/tardiness (B), national certification (C), and self-reported errors (E) are objective metrics for evaluation. Comparing to other nurses (D) is subjective and biased, inappropriate for inclusion.
The registered nurse (RN) is observing licensed practical/vocational nurses (LPN/VN) care for assigned clients. Which of the following actions by the LPN would require the RN to intervene? Select all that apply.
- A. Positions an unconscious client semi-Fowlers for oral care
- B. Administers a bronchodilator to a client with chronic asthma
- C. Irrigates an indwelling urinary catheter with 30 ml of sterile saline
- D. Removes and reapplies weight to a client's skin traction every two hours
- E. Administers intramuscular (IM) ketorolac to a client with osteoarthritis
Correct Answer: A
Rationale: Positioning an unconscious client in semi-Fowler’s for oral care (A) risks aspiration, requiring intervention. Bronchodilator (B), catheter irrigation (C), traction adjustment (D), and ketorolac administration (E) are within LPN scope if per protocol.