ANSWER AND RATIONALE LEADERSHIP, MANAGEMENT RESEARCH WITH PROFESSIONAL ADJUSGEMENTS

Level II-Comprehen !ve Rev!e" Novem#er $%%&

1. A client arrives in the emergency room and is assessed by the nurse. The client is staggering, confused and verbally abusive. The client complains of a headache from drinking alcohol and is asking for medication. The nurse explains to the client that the physician will have to perform an assessment before the administration of medication. When the client becomes verbally abusive, the nurse obtains the leather restraints and threatens to place the client in restraints. With which of the following can the client legally charge the nurse as a result of the nursing action? a. Assault c. egligence b. !attery d. "nvasion of #rivacy $. The nurse calls the physician regarding a new medication order dosage because the dosage prescribed is higher than the recommended dosage. The nurse is unable to locate the physician and the medication is due to be administered. Which of the following actions would the nurse take? a. %old the medication until the physician can be contacted b. Administer the prescribed dose c. Administer the recommended dose until the physician is located d. &ontact the nursing supervisor '. A nursing graduate is employed as a staff nurse in a local hospital. (uring orientation, the new graduate asks the nurse educator about the need to obtain a professional liability insurance. The most appropriate response by the nurse educator would be) a. *The hospital+s liability insurance will cover your actions, b. *"t is very expensive and not necessary, c. * urses are encouraged to have their own malpractice insurance, d. *The ma-ority of suits are filed against physicians and hospitals,

1. Answer: A, an assault occurs when a person puts another person in fear of a harmful or offensive contact. For this intentionable tort to be actionable, the patient must be aware of the threat of harmful or offensive contact. Battery is the actual contact with ones body. Negligence involves actions below the standards of care. nvasion of privacy occurs with unreasonable intrusion into the clients private affairs

!. Answer: D, if the physician writes an order that re"uires clarification, the nurses responsibility is to contact the physician for clarification. f there is no resolution regarding the order because the physician cannot be located or because the order remains as it was written after tal#ing with the physician, the nurse should then contact the nurse supervisor or the nurse manager for further clarification as to what the ne$t step should be. %nder no circumstances should the nurse proceed to carry out the order until obtaining clarification &. ANSWER: C, nurses need their own liability insurance for protection against malpractice law suits. Nurses erroneously assume that they are protected by the agencys professional liability policies. %sually, when a nurse is sued, the employer is also sued for the nurses actions or inactions. 'ven though this is the norm, nurses are encouraged to have their own malpractice insurance

.. The registered nurse arrive at work and is told to work /float0 in the intensive care unit /"&10 for the day because the "&1 is understaffed and needs additional nurses to are for the clients. Which of the following is the most appropriate nursing action? a. 2efuse to float to the "&1 b. &all the hospital lawyer c. &all the nursing supervisor d. 2eport to the "&1 and identify tasks that can be performed safely 3. The nurse gives an inaccurate dose of a medication to the client. 4ollowing assessment of the client, the nurse completes an incident report. The nurse notifies the nursing supervisor and of the medication error and calls the physician to report the occurrence. The nurse who administered the inaccurate medication understands that the) a. 5rror would be in suspension b. "ncident report is a method promoting 6uality care and risk management c. "ncident will be reported to the !oard of ursing d. "ncident will be documented in the personnel file 7. A nurse who works on the night shift enters the medication room and finds a co8 worker with a tourni6uet wrapped around the upper arm. The co8 worker is about to insert a needle, attached to a syringe containing a clear li6uid, into the antecubital area. The most appropriate initial action by the nurse is which of the following? a. &all the police b. &all security c. 9ock the co8 worker in the room until help is obtained d. &all the nursing supervisor :. A hospitali;ed patient tells the nurse that a living will is being prepared and that a lawyer will be bringing the will to the hospital today for witness signatures. The client asks the nurse for assistance in obtaining a witness for the will. The most appropriate response to the client is which of the following? a. *" will sign as a witness to your signature., b. *<ou will have to find a witness on your own., c. *" will seek the nursing supervisor to provide assistance to your re6uest, d. *Whoever is available at that time will sign as a witness for you,

.. ANSWER: D, floating is an acceptable legal practice used by hospitals to solve their understaffing problems. (egally, a nurse cannot refuse a float unless a union contract guarantees that nurses can only wor# in a specified area or the nurse can prove the lac# of #nowledge for the performance of assigned tas#s. )hen encountering this situation, nurses should set priorities and identify potential areas of harm to the client.

3. ANSWER: B, documentation of unusual occurrences, incidents, and accidents and the nursing actions ta#en as a result of the occurrence is internal to the institution or the agency and allows the nurse and administration to review the "uality of are and determine nay potential ris#s present. Based on the information provided in the "uestion, the nurses error will not result in suspension nor will it be documented in the personnel file. *he error and the situation presented in the "uestion are not a reason for notifying the board of nursing

7. ANSWER: D, Nurse +ractice acts re"uire reporting impaired nurses. *he board of nursing has ,urisdiction over the practice of nursing and may develop plans of treatment and supervision of the impaired nurse. this incident needs to be reported to the nursing supervisor, who will then report to the board of nursing and the other authorities, such as the police as re"uired. -ption . is inappropriate and unsafe. *he nurse may call security if a disturbance occurs, but no data in the "uestion supports this need, and therefore is not the immediate action

:. ANSWER: C, living wills are re"uired to be in writing and signed by the client. *he clients signature either must be witnessed by specified individuals or notari/ed. 0any states prohibit any employee, including the nurse of a facility where the client is receiving care, from being a witness. -ption B is non1 therapeutic and not a helpful response. *he nurse should see# the assistance of a nursing supervisor

=. The nurse has made an error in documenting an assessment finding on a client and obtains the client+s record to correct the error. The nurse corrects the error by) a. Trying to erase the error for space to write in the correct data b. 1sing whiteout to delete the error and writing in the correct data c. (rawing a line through the error, initialing and dating the line, and then documenting the correct information d. (ocumenting a late entry into the client+s record >. The nurse employed in the hospital is waiting to receive a report from the laboratory via the facsimile machine. The facsimile machine activates and the nurse expects the report but instead receives a sexually oriented photograph. The most appropriate nursing action is to) a. &ut up the photograph and throw it away b. &all the laboratory and ask for the individual+s name that sent the photograph c. &all the police d. &all the nursing supervisor and report the incident 1?. The nursing instructor provides a lecture to the nursing students regarding the issue of client rights. The instructor asks a nursing student to identify a situation that represents an example of invasion of client privacy. Which of the following, if identified by the student, indicates an understanding of this client right? a. #erforming a procedure without his consent b. Telling a client that he@ she cannot leave the hospital c. Threatening to give a client a medication d. Abserving care given to a client without asking for client+s permission 11. The nursing staff is sitting in the lounge taking their morning break. A nursing assistant tells the group that she thinks that the 1nit secretary has ac6uired immunodeficiency syndrome. The nursing assistant proceeds to tell the staff that the secretary has probably contracted the disease from her husband who is supposedly a drug addict. Which legal tort has the nursing assistant violated? a. Blander c. Assault

b. 9ibel

d. egligence

=. ANSWER: C, if the nurse ma#es an error in documenting in the clients record, the nurse should follow agencys policies to correct the error. *his includes drawing one line through the error, initialing and dating the line, and then documenting the correct information. 'rasing data from the clients record and the use of whiteout are prohibited. A late entry is used to document additional information not remembered at the initial time of documentation

>. ANSWER: D, se$ual harassment in the wor#place is prohibited by state and federal laws. 2e$ually suggestive ,o#es, touching, pressuring a co1 wor#er for a date, and open displays of se$ually oriented photographs or posters are e$amples of conduct that can be considered se$ual harassment by another wor#er. f the nurse believes that she or he is being sub,ected to unwelcome se$ual conduct, these concerns should be reported to the nursing supervisor immediately. -ption . is unnecessary at this time. -ptions A and B are not the most appropriate options. 1?. ANSWER: D, nvasion of privacy occurs with unreasonable intrusion into an individuals private affairs. *elling the client that the client cannot leave the hospital constitutes false imprisonment. *hreatening to give a client medication constitutes assault. +erforming a procedure without consent is considered battery

11. ANSWER: A, defamation occurs when something untrue is said 3slander4 or written 3(ibel4 about a person, resulting to in,ury to that persons good name and reputation. An assault occurs when a person puts another person in fear of harmful or offensive contact. Negligence involves the actions of professionals that fall below the standard of care for a specific professional group.

1$. The nurse hears a client calling out for help. The nurse hurries down the hallway to the client+s room and finds the client lying on the floor. The nurse performs a thorough assessment and assists the client back to bed. The nurse notifies the physician of the incident and completes an incident report. Which of the following would the nurse document on the incident report? a. The client was found lying on the floor b. The client climbed over the side rails c. The client fell out of bed d. The client became restless and tried to get out of bed 1'. A client is brought to the emergency room by the emergency medical services after being hit by a car. The name of the client is not known. The client has sustained a severe head in-ury, multiple fractures, and is unconscious. An emergency craniotomy is re6uired. 2egarding informed consent for the surgical procedure, which of the following is the best action? a. &all the police to identify the client and locate the family b. Abtain a court order for the surgical procedure c. Ask the emergency medical services team to sign the informed consent d. Transport the victim to the operating room for surgery 1.. An =:8 year old woman is brought to the emergency room for treatment of a fractured arm. An physical assessment, the nurse notes old and new ecchymotic areas on the client+s chest and legs. The nurse asks the client how the bruises were sustained. The client, although reluctant, tells the nurse that her son fre6uently hits her if supper is not prepared on time when he arrives home from work. Which of the following is the most appropriate nursing response? a. *Ah really, " will discuss the situation with your son., b. *(o you have any friends that can help you out until you resolve these important issues with your son., c. *9et+s talk about the ways that you can manage your time to prevent this from happening., d. *This is a legal issue, and " need to let you know that " will need to report it,

1$. ANSWER: A, *he incident report should contain the clients name, age and diagnosis. *he report should contain a factual description of the incident, any in,uries e$perienced by those involved and the outcome of the situation. -ption A is the only option that describes the facts as observed by the nurse. -ptions !, &, and 5 are interpretations of the situation and are not factual data observed by the nurse.

1'. ANSWER: D, generally, only two instances is the informed consent of an adult is not needed. -ne instance is when an emergency is present and delaying treatment for the purpose of obtaining informed consent would result to in,ury of death to the client. *he second is when the client has waived the right to informed consent. -ption B will delay the emergency treatment and option . is inappropriate. Although option A may be pursued, it is not the best action.

1.. ANSWER: D, .onfidential issues are not to be discussed with non1 medical personnel or the persons family or friends without the patients permission. .lients should be assured that information is #ept confidential, unless it places the nurse under a legal obligation. -ptions A, B and . do not address the legal implication of the situation and do not assure a safe environment for the client.

13. The nurse is working in a long8 term care facility and is administering medications to assigned clients. A client refuses to take

the prescribed medication, and the nurse threatens the client and tells the client that if the medication is not taken orally, then restraints will be applied and the medication will b given by in-ection. This statement by the nurse constitutes which legal tort? a. "nvasion of #rivacy c. Assault b. egligence d. !attery 17. The nurse is reviewing the critical paths of the clients in the nursing unit. "n performing a variance analysis, which of the following would indicate the need for further action and analysis? a. A client+s family attending a diabetic teaching lesson b. &ancelling physical therapy sessions on the weekend c. ormal Cital Bigns and absence of wound infection in a post8 operative client d. A client demonstrating accurate medication administration after teaching 1:. A new nursing graduate is attending an agency orientation regarding the nursing model of practice implemented in the facility. The nurse is told that the nursing model is a team nursing approach. The nurse understands that planning care delivery will be based on which characteristic of this type of nursing model practice? a. A task approach method is used to provide care to the clients b. A single registered nurse is responsible for providing care to a group of clients c. Danaged care concepts and tools are used in providing care d. ursing personnel are led by an 2 leader in providing care to a group of clients 1=. The nurse manager has implemented a change in the method of nursing delivery system from functional to team nursing. A nursing assistant is resistant to the change and is not taking an active part in facilitating the process of change. Which of the following would be the best approach in dealing with the nursing assistant? a. "gnore the resistance b. 5xert coercion with the nursing assistant c. #rovide a positive reward system for the nursing assistant d. &onfront the nursing assistant to encourage verbali;ation of feelings regarding the change

13. ANSWER: C, An assault occurs when a person puts another person in fear of a harmful or offensive contact. For this intentional tort to be actionable, the victim must be aware of the threat of harmful or offensive contact. Battery is the actual contact with the clients body. Negligence involves actions below the standards of care. nvasion of privacy occurs with unreasonable intrusion into the individuals private affairs

17. ANSWER: B, variances are actual deviations or detours from the critical paths. 6ariances can be positive or negative, avoidable or unavoidable, and can be caused by a variety of things. +ositive variance occurs when the client achieves ma$imum benefit and is discharged earlier than anticipated. Negative variance occurs when untoward events prevent a timely discharge. 6ariance analysis occurs continually to anticipate and recogni/e negative variance early so that appropriate action can be ta#en

1:. ANSWER: D, n team nursing, nursing personnel are lead by a registered nurse leader in providing care to a group of clients. -ption A identifies functional nursing. -ption B, identifies primary nursing, and option . identifies a component of case management.

1=. ANSWER: D, confrontation is an important strategy to meet resistance head1 on. Face1 to1 face meetings to confront the issue at hand will allow verbali/ation of feelings, identification of problems and issues, and development of strategies to solve the problem. -ption A will not address the problem. -ption B may cause additional resistance. -ption . may provide a temporary solution to the resistance but will not address the concern specifically

1>. The registered nurse is planning the client assignments for the day. Which of the

following is the most appropriate assignment for the nursing assistant? a. A client with difficulty swallowing foods and fluids b. A client who re6uires urine specimen collection c. A client re6uiring a colostomy irrigation d. A client receiving continuous tube feedings $?. The registered nurse employed in a long8 term care facility is planning assignments for the clients on a nursing unit. The 2 needs to assign four clients and has a licensed practical /vocational0 nurse and three nursing assistants on a nursing team. Which of the following clients would the nurse most appropriately assign to the licensed practical nurse? a. A client who re6uires a bedbath b. An older client re6uiring ambulation c. A client who re6uires a fleet enema d. A client with an abdominal wound re6uiring wound irrigations and dressing changes every ' hours $1. The 2egistered nurse has received the assignment for the day shift. After making initial rounds and checking all the assigned clients, which client will the 2 plan to care first? a. A client who is ambulatory b. A client who has fever, is diaphoretic and restless c. A client scheduled for physical therapy at 1 pm d. A post8 operative client who has -ust received pain medication $$. The nurse is assigned to care for four clients. "n planning client rounds, which client would the nurse assess first? a. A client receiving oxygen via nasal cannula who had difficulty breathing during the previous shift b. A post8 operative client preparing for discharge c. A client scheduled for a chest E8 ray d. A client re6uiring daily dressing changes

this case, the most appropriate assignment for a nursing assistant would be to care for the client who re"uires urine specimen collections. *he nursing assistant is s#illed in this procedure. *he client with difficulty swallowing is at ris# for aspiration. .olostomy irrigations and tube feedings are not performed by unlicensed personnel

$?. ANSWER: D, when delegating nursing assignments, the nurse needs to consider the s#ills and educational level of the nursing staff. .ollecting a !51 hour urine sample, giving a bedbath, and assisting with fre"uent ambulation and the administering enemas can be provided most appropriately by the nursing assistant. *he licensed practical 3vocational4 nurse is s#illed in wound irrigations and dressing changes and most appropriately would be assigned to the client who needs this care.

$1. ANSWER: B, the 7N would plan to care for this client who has fever, is diaphoretic and restless first because this clients needs are the priority. )aiting for pain medication to ta#e effect before providing care to the post1 op client is best. *he client who is ambulatory and the client scheduled for physical therapy later in the day do not have priority needs related to care

$$. ANSWER: A, airway is the priority and the nurse would attend to this client who has been e$periencing an airway problem first. *he clients described in options B, . and 8 have needs that would be identified as intermediate priorities

1>. ANSWER: B, the nurse must determine the most appropriate assignment based on the s#ills of the staff members and the needs of the clients. n

$'. The nurse is giving a bedbath to an assigned client. A nursing assistant enters the client+s room and tells the nurse that another assigned client is in pain and needs pain medication. The most

appropriate nursing action is which of the following? a. 4inish the bedbath and then administer the pain medication to the other client b. &over the client, raise the side rails, tell the client that you will return shortly and administer the pain medication to the other client c. Ask the nursing assistant to tell the client in pain that medication will be administered as soon as the bedbath is complete d. Ask the nursing assistant to find out when the last pain medication was given to the client $.. The home health nurse is planning client visits for the day. The nurse is assigned to admit a client who was discharged yesterday from the hospital following a diagnosis of pneumonia. The nurse also is scheduled to visit a client re6uiring twice daily abdominal dressing changes. The third client to be seen is a client whose spouse is performing daily dressing changes, and the nurse needs to supervise the spouse in performing the dressing change. The fourth client to be seen will be visited by a home health aide at 1? am, and the nurse needs to orient the aide and provide supervision of client care. The nurse begins the visits at > am. All the clients live within a 38 mile radius. %ow would the nurse plan the order of the assignments for the day? a. &lient being visited by the home health aid, the client re6uiring admission, the client regarding supervision of the dressing change, client re6uiring twice daily dressing changes, the client re6uiring the second twice daily dressing change b. The client re6uiring admission, the client re6uiring supervision of the dressing change, client re6uiring twice daily dressing changes, client being visited by the home health aide, client re6uiring the second twice daily dressing change
c. &lient being visited by the home health aide, client re6uiring twice daily dressing changes, the client re6uiring admission, the client regarding supervision of the dressing change, client re6uiring second twice daily dressing change

$'. ANSWER: B, the nurse is responsible for the care provided to the assigned clients. *he most appropriate action is to provide safety to the client receiving the bedbath and prepare to administer the pain medication. -ptions A and . delay the administration of the medication to the client in pain. -ption 5 is not a responsibility of the nursing assistant

!5. ANSWER: D, the nurse would plan to see the client re"uiring twice daily dressing changes first because the dressing changes should be spaced as far apart a possible. *he nurse ne$t would plan to see the client being visited by the home health aide and provide instructions and directions to the home health aide regarding care of the client. *he nurse would then visit the client regarding supervision of the dressing change and would perform the admission last because that may ta#e more time than the other clients. *he nurse would then return to the client regarding the second twice daily dressing

d. &lient re6uiring twice daily dressing changes, client being visited by the home health aide, the client re6uiring supervision of the dressing change, the client re6uiring admission, client re6uiring second twice daily dressing change

$3. A nurse employed in an emergency department is assigned to triage clients arriving to the emergency room for

treatment on the evening shift. The nurse would assign the highest priority to which of the following clients? a. A client with chest pain who states that he -ust ate pi;;a with a very spicy sauce b. A client with a minor laceration on the index finger sustained while cutting an eggplant c. A client complaining of muscle aches, a headache and malaise d. A client who twisted her ankle when she fell while rollerblading

cardiac arrest, limb amputation, acute neurological deficits, and those who sustained chemical splashes to the eyes are number 1 priority. .lients with conditions such as a simple fracture, asthma without respiratory distress, fever, hypertension, abdominal pain, or the client with a renal stone have urgent needs and are classified as number ! priority. .lients with conditions such as minor lacerations, sprain or cold symptoms are classified as non1 urgent and are the number & priority.

$7. Which of the following agencies is the accrediting body of the "ntravenous Training #rogram? a. Association of ursing Bervice Administrators of the #hilippines b. #rofessional 2egulation &ommission c. #hilippines urses Association d. "ntravenous Training &ommission

$7. ANSWER: A, the AN2A+ is the accrediting body of the 6* program and has formulated the ntravenous standards of Nursing +ractice. -ption B is responsible for the assessment and licensure of aspiring professionals, -ption . is not involved in the 6* program whilst -ption 8 is a fictional agency and does not e$ist

$:. The role of the nurse is seen more broadly today. The &lient+s well8 being is more likely to be observed if health team members have awareness of the) a. %uman !ill of 2ights b. #atient !ill of 2ights c. Dagna &arta for %ealth Workers d. #rofessional &ode of 5thics for urses

$:. ANSWER: B, in order to effectively care for client, the nurse should be aware of clients needs and rights and on the nurses responsibility to these clients as stated in the patients bill of rights

$=. Which of the following statements below is the expanded role of nurses today and in the future? a. %ealth insurance nursing care service b. Danaged care at home c. %ealth maintenance organi;ation d. %ospital nursing services

$=. ANSWER: B, nurses may care for the clients but nurses should encourage N8'+'N8'N.' such as the client being able to manage care at home. Also, this enables the nurse to reach clients in areas that cannot be easily reached by the 9ealth .are 8elivery 2ystem

$3. ANSWER: A, n an emergency department, triage is classifying clients according to their need for care and includes establishing priorities of care. *he #ind of illness, the severity of the problem, and the resources available govern the process. .lients with trauma, chest pain, severe respiratory distress,

$>. Which of the following is the core strategy that the (epartment of %ealth formulated to make health care more accessible to clients? a. (eregulation of health services b. 2egionali;ation of health services c. Apening !aranggay wellness clinics d. #rimary health care

'?. As a nurse, how will you promote the role of nursing in the health care team? a. "nterprets nursing to the health team b. Acts as change agent c. Abserves standards of nursing practice d. &learly specifies nursing contribution to health care

'1. Which of the following is the ultimate goal of The ational %ealth "nsurance !ill ? a. "ncrease health source availability b. %ealth services for those insured c. %ealth coverage for all 4ilipinos d. %ealth services for the poor

Situation: As a registered nurse, Ms. Hannah dela Cruz was placed as nurse-incharge of the unit shes working in. She noted that a lot of confusion occurred in her unit due to certain disorganization and so she has decided to impro e work performance !" altering the areas that ma" need impro ement. '$. This refers to the intentional course of action that results in alteration of something different in a nursing unit) a. #lanned change c. 2e8education b. "mprove systems d. ursing process ''. "n implementing changes in the unit to reorgani;e it, urse %annah may encounter resistance. When resistance threatens needed change, what intervention should %annah use to address the resistance? a. Bend a memorandum of change b. 1se a problem8solving strategy c. "nstitute measures to gain support from staff d. &onduct staff re8education

'$. AN2)'7: A, planned change refers to the

intentional course of action that results in alteration of something different in a nursing unit

''.

'.. Which of the following factors would increase or influence the staff to accept the change that nurse %annah wishes to impose in the unit? a. 5xternally imposed b. Bhare its benefits c. #articipation in decision making d. #lanned ahead

'3. As the nurse is charge of the unit, urse %annah will have to delegate and

supervise unit activities. Which is the main purpose of supervision and delegation? a. To enhance the delivery of 6uality nursing care b. To improve staff compliance to policy F procedure c. To assign appropriate work tasks to the best 6ualified individual d. To influence the organi;ation+s approach in recruitment, promotion F personnel evaluation '7. 8 '7. Which best defines *Btandards of &are,? a. 9egally mandated minimal re6uirement for care. b. &onsumer8directed expectation for care delivery. c. Dedically focused level of excellence in delivery of care. d. #redetermined model of level of performance that is to be followed. ':. ':. A couple of days before ew <ear, Genny, the nurse supervisor motivate her staff nurses to work for an extended period that day. "n collaboration with the staff, they develop a contingency plan to better provide 6uality8nursing care for the firecracker victims. Genny is exemplifying what type of leadership? a. Authoritarian c. (emocratic b. !udgetary d. 9ai;;es8faire

'=.

'.. AN2)'7: ., +articipation in decision1 ma#ing

encourages the members of the team to share their opinions and fosters the feeling of importance among the members

'3. AN2)'7: A, to enhance the delivery of "uality

nursing care as the nurse1 in1 charge is able to divide the tas#s among the members according to their s#ills and e$pertise, thus ma#ing sure that client care is effective

urse Dinette is a community health nurse is working with disaster relief team following a typhoon. urse Dinette+s goal is to prevent further in-uries F deaths and plans to find temporary housing, provide psychological support, organi;e the community F secure physical care for affected victims. The nurse+s actions are examples of which type of prevention? a. #rimary level c. Tertiary level b. Becondary level d. Aggregate level '>. While you conducting a research in a nearby area, one of the participants told the nurse that she wants to withdraw from the study. The nurse should perform which of the following actions? a. &onvince the participant not to withdraw. b. Hive her the permission to withdraw.

c. Bue her since she already signed a contract. d. Allow her to withdraw a for her in the study. .?. The first step in the change process is facilitating change. This is called) a. free;ing c. Doving b. free;ing d. Btatus 6uo .1. An understanding of the usefulness of scientific findings is more and more essential for 6uality nursing practice. As a nurse, you decided to do a review of literature. The nurse would do so in order to) a. "mprove your library reading skills b. Het ideas on interpretation of findings c. 4ormulate a conceptual framework for the study d. (ecide on a sampling method .$. The sampling method where each member of the study population has an e6ual chance to be selected as sub-ect is termed as a@ an) a. 2andom sampling b. &onvenient sampling c. Belective sampling d. #urposive sampling .'. (r. Bantos is a chemist who employs human volunteers in his clinical trials for a drug that he believes would cure cancer. %owever, some of the sub-ects in the experiment may be harmed. !ut, he believes that his action can not be considered wrong because many people would gain when the cure for cancer is developed. What ethical theory is (r. Bantos utili;ing to -ustify his action as good? a. 1tilitarian theory b. Holden rule theory c. (eontological theory d. (ivine theory '=.

.?.

.1.

.$.

.'. AN2)'7: A, this theory states that an act is ethical if it benefits the ma,ority of people.

... (r. 4a-ardo on the other hand, thinks that the act of (r. Bantos is wrong because the act itself is wrong. What ethical theory is (r. 4a-ardos employing? a. Teleological theory b. Holden rule theory c. (eontological theory d. (ivine theory .3. "n what instances may a &lient+s "nformed &onsent for treatment not re6uired? a. in emergencies b. when the patient is incompetent c. when there is a waiver d. all of the above

'>.

.7. urse Hina noted that after she has rendered tepid sponge bath, the client+s temperature remained elevated and thus, she would have to continue doing TB!. %owever, she still had another client to attend to, so urse Hina documented a normal temperature reading so that she would not have to continue the TB!. Which of the following ethical principles did she violate? a. confidentiality b. veracity c. autonomy d. -ustice .:. urse &laven hates his patient, a :3 year old cardiac patient who was Hreek in origin. %e attempted to electrocute the patient. Bhe asked her friend !illy 4ernande; to be the look8out during the killing. After &laven killed his patient, %e asked her sister !arona to help her bury the body to prevent its discovery. "f those involved will be charged legally, who is considered as the principal? a. &laven c. !arona b. !illy d. one of the them .=. Who is considered as accomplice to the crime? a. &laven c. !arona b. !illy d. one of the them

.7. AN2)'7: B, veracity means truthfulness. *he nurse has violated this ethical principle by falsifying a 62 result

.:. AN2)'7: A, he instigated the crime

.=. AN2)'7: B

.>. Who is the accessory? a. Daria c. !arona b. Willy d. one of them ...

.3.

3?. A patient has been in the "&1 for $ weeks. The relatives have consented to a *do not resuscitate, order. When the client develops a cardiac arrest the nurse will carryout which of the following actions? a. only medication will be given b. all ordinary measures will be stop c. basic and advance life support will not be given d. mechanical ventilation and HT will be stopped

31. Dr. de 9eon is in the terminal stage of 9ung malignancy and he tells the nurse that he has a living will. The nurse knows that the client+s living will involve which one of the following? a. A document signed by the client+s family for the provider to withhold medical treatment when death is eminent b. The medical treatment a client chooses to withhold if he is rendered unable to make decisions c. "t is confidential and not part of the client+s medical records d. #rovides the client+s wishes need not be followed if life can be prolonged 3$. <ou understand that as the nurse, maintaining privacy and confidentiality is an important aspect of which of the following? a. %ospital policy b. urse code of ethics c. What all client expect d. "t is an accepted practice

31. AN2)'7: B, the living will is made by the client and is to be followed if the client is deemed no longer able to ma#e decisions

3$. AN2)'7: B

3'. AN2)'7: B, veracity means truthfulness 3'. Which of the follow of profession nurses is considered when one tells truth about medication errors committed? a. privacy c. maleficence b. veracity d. beneficence 3.. The #hilippines is a hot pot of various ethical groups and cultures. Which of the following must the nurse perform to effectively care for her clients from various ethnic settings? a. study the ethnic culture of each of her client b. determine patient+s personal beliefs and values c. work with on ethnic folk healer d. minimi;e transcultural communication 33. "f a client is asking the nurse about the cost of treatment at the healthcare facility where care is being received. The nurse refers to a document when needing information about the client+s 6uery. The patient+s right to this information is based on? a. &ode for urses b. &lient+s bill of rights c. %ospital+s policy manual d. urses practice act

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3?. AN2)'7: ., All basic and e$traordinary means will be stopped

37. Hringo, a nurse working in an ambulatory surgery unit fre6uently signs as a witness on consent for surgery forms. !y signing as a witness, urse Hringo is? a. legally responsible to verify the client+s understanding of the proposed procedure b. stating that the client+s has been informed of the risks and benefits of the procedure c. verifying that the client signed the consent form d. verifying that the physician thoroughly informed the client about the risks and benefits of the surgery 3:. The legal permission obtained from the client before any invasive procedure, involvement in research or administration of experimental medication and intervention is a. Affidavit c. informed consent b. contract d. power of attorney 3=. Dang !erto, a #ulmonary Tuberculosis patient, fre6uently buys drugs from Dercury (rug Btore. "n our country, senior citi;ens are given discounts in purchase of their medicines. %ow much is the discount? a. $?I b. 13I c. 1?I d. $3I

37. AN2)'7: A, the nurse needs to verify if the client was able to understand the procedure

:;.AN2)'7: ., the informed consent id the legal permission obtained prior to any invasive procedure

3=. AN2)'7: A, !<=

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3>. An institution or organi;ation that is responsible for approving the certificate to operate as a nursing school in the #hilippines is the) a. !oard of ursing b. # A c. &ommission on %igher 5ducation d. #2&

33.

7?. According to the new #hilippine ursing 9aw of $??$, each professional nurse must be legally accountable for all his actions, which involves proper monitoring and recording. Which of the following are the legal implications of the said nursing actions? a. that regardless if the nurse recorded his observation or not, he shall still be accountable and liable b. if the nurse did not document anything, he shall not be liable c. if it was not written although it was performed, it is considered as not having been done at all

d. because a chart needs to be completed by handwritten words 71. 71. Which of the following persons cannot legally give consent to any medical or surgical treatment? 1. a person accused of civil interdiction $. a minor person '. an unconscious or imbecile person .. emancipated minor a. 1,$,' b. $,',. c. 1,',. d. 1,$,. 7$.

7$. Which of the following does the nurse commit "f the nurse allows the publication of a picture of a malformed baby without the consent of the parents? a. defamation b. invasion to right of privacy c. false imprisonment d. battery 7'. A nurse has made an error in documenting an assessment finding on client and obtains the client+s record to correct the error. The nurse corrects the error by) a. Trying to erase the error to provide space to write in the correct data b. 1sing whiteout to delete the error and writing in the correct data c. (rawing one line through the error, initialing and dating line, and then documenting the correction d. (ocumenting a late entry into the client+s record 7.. 9egally, nursing care that is not documented) a. is care provided even if not recorded b. may be recorded soon alter done c. may be recorded during the next shift d. is care not done 73. 5thics is defined by the following, !1T) a. protects the rights of other like patients and co8workers b. refers to the human conduct itself8which is good c. warrants no legal right d. standards of conduct becoming a professional 77. A physician does not want a patient to be informed of the possibility of hysterectomy although it is indicated on the consent

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form. Which is the appropriate action of the nurse? a. the nurse is obligated to do as told by the physician b. to make such a decision is the physician+s right c. patient has the right to receive information from the physician which are necessary to give informed consent d. *&onsult your physician for any 6uestion., "s the advise of the nurse to the patient after obtaining the signature 7:. A patient was informed that he needs a ma-or surgery or his life will be in danger. The patient refused the procedure. Which does not conform to the patient+s !ill of 2ight? a. the patient has the right to know that his life is in danger b. the patient has the obligation to submit himself to the treatment c. the patient has the right to refuse treatment to extent permitted by law d. the patient recogni;es the expertise of the physician and agree to the surgery 7'. AN2)'7: ., this is the correct procedure for error correction if the clients documents

7:. AN2)'7: .

7=. The Btandards of nursing practice serve as guide forJ a. safe nursing care and management b. varied areas of nursing practice c. proper nursing approaches and techni6ues d. evaluation of care rendered

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7>. The 6ualification of a chief nurse under 2A :17. are the following but one) a. two/$0 years experience in nursing service administration b. master+s degree holder in nursing service administration c. 4ilipino citi;en d. Dember of the accredited professional organi;ation of nurses

73. AN2)'7: 8

:?. The law is an essential component of nursing practice. The following concepts are true about laws, 5E&5#T) a. laws tent to remain constant b. laws and ethics are closely related c. laws are principles and processes that resolve disputes without resorting to physical force d. laws govern a particular field or activity

77. AN2)'7: ., the informed .onsent is a testament that the client has understood all the ris#s and benefits of a procedure, withholding information from the client indicates that the client is not legible to sign the informed consent

:1. ew graduate Karen has to apply for the ursing 9icensure 5xamination, the

applicant must meet which of the following re6uirements) 1. holder of a !B degree $. "n good health and of good moral character '. citi;en of #hilippines .. at least $1 years of age a. 1,$,' c. ',.,1 b. $,',. d. 1,',. :$. Bcreening the applicants for the nurse licensure examination is a legitimate exercise of the police power of the states which belongs to the) a. !oard of ursing b. #rofessional 2egulation &ommission c. #hilippine urses Association d. (eans of the &olleges of ursing

:$. AN2)'7: B

7=. AN2)'7: .

:'. When the member of the !oard of ursing studied and reviewed the provisions of 2A :17. and subse6uently adopted the implementing guidelines, it was an exercise of their power called) a. discretionary c. 6uasi8-udicial b. ministerial d. 6uasi8legislative

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:.. A professional license is a legal document necessary for the practice of a profession. "t is best described as) 1. a privilege $. a permanent right '. a temporary right .. an evidence that one has the basic skill, knowledge and attitude to 6ualify for the practice 3. a proof of expertise in the delivery of health care to people a. 1,$,3 b. $,.,3 c. 1, ', . d. ',.,3

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:3. "f one+s license is to be renewed every three /'0 years and the renewal date falls on one+s birth month of the year $??7, when is the year of it+s expiration? a. $??3 b. $??7 c. $??> d. $?1?

:1. AN2)'7: A,

:7. 5very nurse is responsible for his own acts which include all of these but one) a. performances while on duty or off duty b. primary, secondary and tertiary care c. providing first aid and emergency d. %ealth care service only to those belonging to his race, creed, social status, etc.

::. When the patient gets in-ured, which should not be done in order to protect the nurse from liability? a. relieve first your anxiety, then apologi;e and explain to the patient in-ured b. notify the attending physician c. when charting, concentrate on the incident d. focus on the physician+s order :=. Cincent, a 13 year old out of school youth robbed a bank, killing two /$0 security guards with his unlicensed gun. Which concept on crimes will be most applicable to Cincent+s case? a. consummated, gray felony, exempting circumstances consummated, less grave felony, mitigating b. circumstance c. grave felony, consummated, mitigating circumstances d. less grave felony, consummated, exempting circumstance :>. Dang Kardo is a 3.8 year old stroke patient broke his leg when he fell out of bed while being turned to side by an aide. The in-ury sustained by the patient is a sufficient evidence of negligence using the doctrine of) a. force ma-eure b. 2es ipsa lo6uitor c. Btare decisis d. *let the master answer, =?. urse 2yan is having a hard time reading the latest (octor+s orders. The proper procedure to observe when a nurse cannot decipher a physician+s written order is to) a. wait for the physician who gave the order b. 6uestion the physician before transcribing the order c. call the pharmacist to ac6uire about the usual dosage of the drug d. transcribe the order according to normal dosage =1. urse Kim has received a phone call from a physician who wishes to give a telephone order. Which circumstances may -ustify a nurse+s decision to accept an order by phone? 1. the nurse knows how to carry out the orders $. the orders are clear and specific

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:.. AN2)'7: ., a professional license it temporarty and may be suspendedor revo#ed as deemed by a recogni/ed authority

:3. AN2)'7: .

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'. the orders are within the areas of nursing practice .. the physician is out of reach 3. any unnecessary delay in treating the patient will result to a serious in-ury a. 1,$,' b. $,',. c. ',.,3 d. 1,',3 =$. "n the medical ward, urse Dike is reviewing the hospital+s policies. 1nder what condition will warrant the need for detention of a patient in the hospital? a. when underage and the parents have not settled the hospital bills b. with no accompanying relative c. if mentally ill and no responsible watcher d. when illness presents a danger to the public ='. The statement of a dying patient is considered as) a. hearsay evidence b. testimony of opinion c. competent evidence in civil proceedings d. acceptable in court when made by a victim of a crime S!'()'!on* urse 9uisa is newly appointed by the local government to lead the program integrated management of childhood illnesses in the Dunicipality of Ban Gacinto. Bhe knows that as a young and inexperienced nurse, she needs to update her competence in the legal aspects of professional practice. =.. As a nurse, 9uisa should be guided by the nursing law in the #hilippines. Which of the following is not a stipulation of this law? a. "ncrease the composition of the board from five to seven representing nursing education, service and community health nursing. b. 2e6uires those nurses who have been away from practice to undergo one month of didactic training and five months of practicum before returning to the workforce c. 2ecognition of nursing specialty organi;ation in coordination with the accredited professional organi;ation d. #rovides for incentives and benefits for nurses and their dependents. =3. urse 9uisa is trying to perform an assessment of a three year old boy for fever, but the boy does not want to go near her. Which of the following remarks of #amela would constitute an assault? a. *<ou don+t want to have your temperature taken? " will call the guard

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:>. AN2)'7: B, 7es psa (o"uitor means >the thing spea#s for itself?, this means even if the client tries to e$plain himself, the conse"uences of his actions are already evidence of his negligence

=?. AN2)'7: B, the one who gave the order should be the one "uestioned before transcribing the order

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to hold you and give you an in-ection instead., b. *alright, -ust tell me when you are ready to have your temperature taken, c. *this will not hurt you -ust put it under your tongue, d. *if you will let me take you temperature your fever will be gone, =$.

=7. A . year old patient assessed to have severe dehydration needs an intravenous infusion of (3 BB. urse 9uisa has not attended training in "C therapy yet so she would perform which of the following? a. Btart the "C with the goal of saving the patient from further in-ury b. 2efer the case to the doctor who can come in less than one hour c. 2efer the patient to the nearest hospital facility, which can be reached in '? minutes d. Hive A25BA9 while waiting for help =:. Dr. !lack, a !ritish national,is terminally ill and instructed the hospital staff to abstain from giving him revival in the event that he goes into cardiac arrest. Which of the following actions of nurse 9uisa is least likely to be legally sound? a. #repare the form for advanced directives and ask Dr. Hibson to sign b. Ask other persons who are 6ualified to be witnesses of the signed directive c. 5xplain to Dr. Hibson that this is not yet a practice in the #hilippines d. Attached the advance directives to the patient+s chart ==. Dr. Bimpson, a canadian who is a BA2B suspect is advised to be confined in a negative pressure room with strict protective gadgets of the health workers taking care of him. %e vehemently resented being confined in that room. Doreover, he was denied visitors. %e tried to sue the hospital. Which case will Dr. Bimpson most likely file? a. illegal detention c. "ncompetence b. (efamation d. !attery =>. "n addition to the prescribed period, the following are the other conditions for which the revoked certificates can be re8issued. Which one is AT included? a. 2easons of e6uality and -ustice b. &ause for the revocation has disappeared or has been cured and corrected c. 1pon the application thereof and payment of re6uired fees d. 1pon the completion of one month didactic training and ' months practicum

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=3. AN2)'7: A, A, an assault occurs when a person puts another person in fear of a harmful or offensive contact. For this intentionable tort to be actionable, the patient must be aware of the threat of harmful or offensive contact. Battery is the actual contact with ones body. Negligence involves actions below the standards of care. nvasion of privacy occurs with unreasonable intrusion into the clients private affairs

>?. The screening of applicants by the #rofessional 2egulation &ommission for the urse 9icensure 5xamination is a legitimate exercise of what kind of power? a. #olice power c. "mplied power b. 5xpress power d. #olitical power =7.

>1. A client+s who is a member of the Gehovah+s witnesses refuses a blood transfusion based on his religious beliefs and practices. %is decision must be followed based on which ethical principle? a. The right to die b. Advance directive c. The right to refuse treatment d. Bubstitute -udgment >$. A nurse practitioner who gives any false evidence to the !A in order to obtain a certificate of registration will be liable for) a. Disdemeanor b. Disfeasance c. 4raudulent misrepresentation d. #rofessional misconduct

=:. >'. The #resident of the #hilippines may reappoint members of the !A . The !oard must meet the 6ualifications set forth by the nursing law. Appointment by virtue of 6ualification refers to) a. %old8over c. Derit system b. 5xpress d. Tenure >.. Which of the following behaviors of a nurse constitutes negligence? a. do not answer a call at $ A.D. of a town mate to help his wife who has severe abdominal pain b. failure to diagnose the case of ailment c. ignoring a complaint made by a patient d. maintaining patient airway during the acute stage of a cord in-ury >3. The bulk of responsibility is on the head nurse when he supervises ancillary workers based on which of the following statutes) a. 2es ipsa lo6uitor b. 1nity of command c. 2espondeat superior d. 9egitimate authority >7. The health care system often deals with people and thus often experiences ethical dilemmas. %ealth care issues often become an ethical dilemma because of which of the following) a. (ecision must be made 6uickly often under s stressful condition b. (ecision must be made based on individual system c. The choices involved do not appear to be clearly right or wrong

==. AN2)'7: A

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d. &lient+s legal right co8exists with a health profession >1. AN2)'7: ., a client has the right to refuse treatment

>:. <ou have -ust been promoted as a head nurse in a newborn unit. Which of the following actions is !5BT for you to do? a. 5stablish authority by sounding firm and knowledgeable b. (elegate responsibility to staff nurses according to their abilities c. Talk to the team leader of the staff nurses and give her the best schedule d. 2ead present hospital policies for possible modification

@!. AN2)'7: . >=. Which of the following is ma-or managerial responsibility of the head nurse? a. Bee to it that the ward is clean b. Goin the doctors during their rounds c. Bet standard of performance among the staff nurses d. #rovide bedside nursing care to selected patients

@&. AN2)'7: .,

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>>. Assessment of staff performance is a regular activity in your unit. As a new head nurse, which of the following is expected of you? #erform an outcome evaluation a. Hive the staff a good evaluation so that they will evaluate you fairly b. Hive the nurse average scores to make room for improvement c. 5valuate the nurses performance according to their -ob description 1??. With the rapid turnover of nurses nowadays as a head nurse you are sometimes called to interview applicants for a staff nurse position. Which of the following 6uestions is most appropriate to ask in order to get an idea of the applicant+s competence? a. *Are you willing to do overtime?, b. *Where did you take up your !.B. .?, c. *(o you plan to go abroad?, d. *What was your last nursing experience?,

>3. AN2)'7: .

>7.

Nothing will ever be attempted if all possible objections must first be overcome.
Samuel Johnson

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