Palmer Nursing sample discussion PDF

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PALMER MASTER CLASSPrepared by:Prof. ALEXIS JOHN S. CASTRO, RNTop 5, May 2015 NLEClass Valedictorian (UPang Class of 2015)Cum Laude (BSN, 2015) Which of the following is true about the Code of Ethics for Nurses? a. A nurse who has accepted to take care of a patient should render the service diligent...

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d. 5.

PALMER MASTER CLASS Prepared by: Prof. ALEXIS JOHN S. CASTRO, RN Top 5, May 2015 NLE Class Valedictorian (UPang Class of 2015) Cum Laude (BSN, 2015) 1. Which of the following is true about the Code of Ethics for Nurses? a. A nurse who has accepted to take care of a patient should render the service diligently and effectively b. A nurse is duty bound by professional ethics to reveal any information given by her patient c. A practicing nurse may receive a commission for referral of patient made by her d. A nurse working in a health care facility should join a health team only at her own discretion 2. At the front door of X-ray rooms , there is a common instruction poster that informs client to tell the radiologist if they are pregnant because it has teratogenic effects. What ethical principle does the situation represents? a. Autonomy b. Fidelity c. Beneficence d. Nonmaleficence 3. Mrs. Gomez who has cancer of the uterus submits to hysterectomy will not be able to bear a child. If she does not have the operation, she will die. It is the gynecologist’s intension to help the mother and not to harm her. What ethical principle will explain the situation? a. Two-folded effect b. Totality c. No one is obliged to betray himself d. If one is willing to cooperate, no injustice is done to him 4.

Mr. Raul, a diabetic man with gangrenous foot consented to an amputation. Amputation will save the patient’s life and he can still walk through the aid of crutches or artificial limbs. What ethical principle is involved? a. Two-folded effect b. Totality c. Epikia

Prepared by: Prof Alexis John Solomon Castro, RN 10

a. b. c. d.

Golden rule

When Hermione, a manic patient went berserk, she was restrained because the doctor cannot be contacted. Which moral principle applies to the situation? Two-folded effect Totality Epikia Golden rule

6. A research study is being conducted by a group of nurse researchers, Aileen, 25 years old patient confined in the medicalsurgical ward subject herself willingly to an experimental drug after she has been told of the possible side effects of the same. The research did not violate any principle of human rights. The moral principle used is: a. One who acts though an agent is himself responsible b. No one is obliged to betray himself c. The end does not justify the means d. If one is willing to cooperate in the act, no injustice is done to him 7. During an epidemic, immunization against communicable disease is administered to the people. Although there may be some who may have slight reactions to the vaccine, the greater majority of the populations shall be considered rather than the isolated few. a. No one is held to the impossible b. The greatest good for the greatest number c. A little more or less does not change the substance of an act d. The end does not justify the means nurse 8. Joan is assisting in a research study calculates the risk-benefit ratio and concludes that there were no harmful effects associated with a survey of diabetic clients. This researcher was applying which principle? A. Human dignity B. Human rights C. Beneficence D. Utilitarianism 9.

Which of the following statements concerning nursing liability is true? A. A physician may assume personal liability for the negligent acts of the nurse B. The nurse is responsible for her own negligent acts (ACCOUNTABILITY)

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C. The doctrine of respondent superior always protects the nurse D. Malpractice insurance will always cover the damages assessed against the nurse 10. A nurse speaking in support of the best interest of a vulnerable client reflects the nurse’s on duty of A. Caring B. Veracity C. Advocacy D. Confidentiality

SITUATION: As what the Constitution says, “Ignorance to the law excuses no one.” A nurse must be aware of her ethico-legal and moral responsibilities to her patient. 11. A patient, G8P5 refused to be injected with her third dose of Depo-provera. The nurse forcibly injected the contraceptive inspite of the patient’s refusal. She can be sued for which of the following? a. Misrepresentation b. Assault c. Malpractice d. Negligence 12. All of the following are standard parameters to test if negligence is present in a case. Which is not included? a. There is an existence of duty b. There is failure to perform the duty c. Such failure resulted to injury d. Such failure was committed with intent ANS: D – negligence is Unintentional 13. Nurse Lee juggles 50 patients at a time. She always gets confused with what to do when she was starting. After 3 years of experience, Nurse Lee felt no intimidation to anyone or what so ever. One Friday the 13th, Dr. Jayvee ordered for hot compress on left arm of post stroke patient name Louie. Louie was already hemiplegic which affected the left hemisphere of his brain. Lee then instructed the wife of Louie to apply hot compress. Around 2:30 pm, the wife was crying hard and told Lee that she burned his husband’s right arm. Who was really accountable? a. Nurse Lee b. Wife and Louie c. Dr. Jayvee d. Louie 14. Based from the question above, what is the person liable to? a. Malpractice b. Force majeure c. Reps ipsa Loquitor

Prepared by: Prof Alexis John Solomon Castro, RN 10

d.

Negligence

15. The nurse carries out a medication order, incorrectly written by the physician and subsequently filled by the pharmacist. Who, in this situation, is legally liable for the action? a. Physician b. Pharmacist c. Hospital d. Nurse 16. If a nurse admits her guilt in a crime she committed, her liability will be: a. Justified b. Aggravated c. Mitigated d. Exempted 17. Which of the following is an example of crime with an aggravating circumstance? a. The nurse attended an delivery and the mother died because of heart attack b. The nurse was not able to attend to the home delivery because she was sick c. The nurse attended a delivery and the baby died because of congenital heart disease d. The nurse performed an induced abortion for a fee 18. A hospital receives notice of being sued for an action performed by a nurse. The nurse realizes that which doctrine is being implemented in this case? a. Contractual relationship b. Stare decisis c. Respondeat superior d. Res ipsa loquitur 19. Nurse Jenna Cole and three other staff nurses are subjects of an administrative cases filed with the BON because of negligence. The relatives claimed that there was a failure to render proper nursing management when the client was having a panic attack. Jenna and the other staffs are considered? a. Accessories b. Accomplices c. Plaintiffs (LITIGANT/ACCUSER) d. Respondents (DEFENDANT/ACCUSED) 20. Based on the previous situation, the family of the dead patient who filed an administrative cases against the nurses is considered which of the following? a. Accessories

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b. c. d.

Litigant Defendant Accomplices

profession, a nurse must be guided by the Code of Ethics for Nurses. Documentation, is one of the most important nursing responsibility as it is the hallmark of nursing accountability according to Article III, Section 6.

21. The doctor assigned to the patient was also sued together with the nurses. When it was his turn to take the stand during the next hearing, he was told to bring him a copy of the patient’s chart. The hearing officer will have to issue what legal order to bring the patient’s chart? a. Warrant of arrest b. Subpoena ad testificandum c. Subpoena duces tecum d. Injunction

26. Which of the following documentation entries is most accurate? a. Patient walked up and down hallway with assistance, tolerated well. b. Patient up, out of bed, walked down hallway and back to room, tolerated well. c. Patient up, walked 50 feet and back down hallway with assistance from nurse. Spouse also accompanied patient during the walk. d. Patient walked 50 feet and back down hallway with assistance from nurse; HR 88 and regular before exercise, HR 94 and regular following exercise.

22. Ms. Leilanie de Lima has declining condition after being revived yesterday from cardiopulmonary arrest. Dr. Rody Dutwenti wrote a DNR order. This order implies that: a. The patient need not be given food and water b. The nurses and the attending physician should not do any heroic or extraordinary measures for the patient c. The patient need not be given ordinary care so that his dying process is hastened. d. The nurse need not give due care to Joshua even giving bed bath

27. Label each line of documentation with the appropriate SOAP category [Subjective (S), Objective (O), Assessment (A), and Plan (P)]. __P__1. Repositioned patient on the right side. Encourage patient to use patientcontrolled analgesia (PCA) device. __S__2. The pain increases every time I try to turn on my left side. __A__3. Acute pain related to tissue injury from surgical incision. __O__4. Left lower abdominal surgical incision, 3 inches in length, closed, sutures intact, no drainage. Pain noted on mild palpation.

23. The nurse must observe the principle of privileged communication. Confidentiality of information can be revealed only in which case? a. When the attending physician allows b. When the patient consents c. In any court case involving the client d. Civil case 24. If your patient is a case of rape, which among these legal responsibilities would you give priority? a. Let somebody inform immediate adult relatives 3rd b. Protect her from potential harm c. Report the case to the police authorities 2nd d. Notify the legal officer 4th 25. During the investigation, it was decided to call the chief nurse to testify on what she knows about the case. The chief nurse can be compelled to be present in the next hearing if the investigation body issues which of the following? a. Subpoena duces tecum b. Subpoena ad testificandum c. Warrant d. Injunction SITUATION: Since the culture in nursing profession is continuously changing, the Philippine Board of Nursing wants to emphasize that in the practice of the

Prepared by: Prof Alexis John Solomon Castro, RN 10

3. 4.

28. The nurse is transferring a patient to a longterm, skilled care facility and has just and given a telephone report to a registered nurse who works at that facility and how she will be receiving the date and time the report was given and the name of the RN taking the report. Which of the following pieces of information does the nurse include in the documentation of this telephone call? 1. The patient’s name, age, and admitting diagnoses. 2. The discussion of any allergies to food and medications that the patient has That the nurse receiving the report was advised that the patient is “needy” and “on the call light all the time” That the patient’s pain rating went from 8 to 2 on a scale of 1 to 10 after receiving 650 mg of Tylenol 5. Description of any unresolved problems and current interventions in place. a. b. c.

1, 2, 3, 4 2, 3, 4, 5 1, 3, 4, 5

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d.

1. 2. 3. 4. 5.

1, 2, 4, 5

29. The nurse is supervising a beginning nursing student and allowing the student to complete the documentation of care under direct observation. Which of the following actions are not appropriate and would require intervention? The nursing student: Documents medications given by another nursing student. Includes the date and the time of the entry into the medical record. Enters assessment data into the electronic medical record using the computer mounted on the wall in the patient’s room. Leaves a slip of paper with her user name and password in the patient’s room. Starts to enter “Docusate sodium 100 mg ordered at 08:00 held. Patient declined to take the dose stating, “I had several loose stools yesterday, and I’m afraid if take this dose the problem will get worse,” as a narrative comment. a. 1, 2, & 3 only b. 3, 4, & 5 only c. 1 & 4 only d. 2 & 4 only 30. A preceptor observes a new graduate nurse discussing changes in a patient’s condition with a physician over the phone. The new graduate nurse accepts telephone orders for a new medication and for some laboratory tests from the physician at the end of the conversation. During the conversation the new graduate writes the orders down on a piece of paper to enter them into the electronic medical record can be viewed by hospital pharmacists, and hospital policy states that all new medications must be reviewed by a pharmacists before being administered to patients. Which of the following actions requires the preceptor to intervene? The new nurse: (THE WRONG) a. Read the orders back to the health care provider to verify accuracy of transcribing the orders after receiving them over the phone. b. Documents the date and the time of the phone conversation, the name of the physician, and the topics discussed in the electronic record. c. Gives a newly ordered medication before entering the order in patient’s medical record. d. Asks the preceptor to listen in on the phone conversation. 31. As the nurse enters a patient’s room, the nurse notices that the patient is anxious. The patient quickly states, “I don’t know what’s going on; I can’t get an explanation from my doctor about my test results. I want something done about this.” Which of the following is the most appropriate way for

Prepared by: Prof Alexis John Solomon Castro, RN 10

a. b. c. d.

the nurse to document this observation of the patient? “The patient has a defiant attitude and is demanding test results.” “The patient appears to be upset with the nurse because he wants his test results immediately.” The patient is demanding and is complaining about the doctor. The patient stated feeling of frustration from the lack of information received regarding test results. (fac method)

32. The nurse is reviewing the Health insurance Portability and Accountability Act (HIPAA) regulations with the patient during the admission process. The patient states, “I’m not familiar with the HIPAA regulations. How will they affect my care?” Which of the following is the best response? a. HIPAA allows all hospital staff access to your medical record. b. HIPAA limits the information that is documented in your medical record. c. HIPAA provides you with greater protection of your personal health information. d. HIPAA enables health care information to release all of your personal information to improve continuity of care. 33. A patient states, “I would like to see what is written in my medical record.” What is the nurse’s best response? a. Only your family can read your medical record b. You have the right to read your record c. Patients are not allowed to read their records d. Only health care workers have access to patient records. 34.

a. b. c. d.

A manager is reviewing the nursing documentation entered by a staff nurse in a patient’s electronic medical record and finds the following entry, “Patient is difficult to care for, refuses suggestion for improving appetite.” Which of the following statements is most appropriate for the manager to make the staff nurse who entered this information? (FOC METHOD) “Avoid rushing when documenting an entry in the medical record.” “Use correction fluid to remove the entry.” “Draw a single line through statement and initial it.” “Enter only objective and factual information about a patient in the medical records.”

35. While reviewing the pulmonary assessment entered by a nurse in a patient’s electronic medical record (EMR), a physician notices

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a. b. c. d.

that the only information documented in that section is “WDL” (within defined limits). The physician also is not able to find a narrative description of the patient’s respiratory status in the nurse’s progress notes. What is the most likely reason for this? The nurse caring for the patient forgot to document on the pulmonary system. The EMR uses a charting-by-exception format. The computer shut down unexpectedly when the nurse was documenting the assessment. Because of HIPAA regulations, physicians are not authorized to view the nursing assessment. 36. What is the appropriate way for a nurse to dispose of information printed out from a patient’s electronic health record? a. Rip the papers up into small pieces and place the pieces into a standard trash can. b. Place all papers in the flip top binder designated for that patient that is located in the nurse’s station on the patient care unit c. Place papers with patient information in a secure canister marked for shredding d. Burn documents with patient information in the steel sink located within the dirty supply room on the patient care unit

37. A nurse manager has identified a problem on the nursing unit and holds unit meetings for all shifts. The nurse manager presents an analysis of the problem and proposals for actions to team members and invites the team members to comment and provide input. Which style of leadership is the nurse manager specifically employing? a. Situational b. Laissez-faire c. Participative d. Authoritarian 38. Your head nurse in the unit believes that staff nurses are not capable of decision making so he makes the decision for everyone without consulting anybody. This type of leadership is? a. Democratic leadership b. Autocratic leadership c. Managerial leadership d. Laissez-faire leadership 39. A charge nurse observes that a staff nurse is not able to meet client needs in a reasonable time frame, does not problem-solve situations, and does not prioritize nursing care. The charge nurse has the responsibility to: a. supervise the staff nurse more closely so that tasks are completed

Prepared by: Prof Alexis John Solomon Castro, RN 10

b. c. d.

ask other staff members to help the staff nurse get the work done provide support and identify the underlying cause of the staff nurse’s problem report the staff nurse to the supervisor so that something is done to resolve the problem

SITUATION: Like death and taxes, change is inevitable. Change can result into both success and failure of an organization. Therefore, nurse managers must be knowledgeable in dealing with change. 40. Which of the following is true about conflict? a. Seldom occurs as part of the change process in healthcare settings b. It highlights differences in values, beliefs or actions c. It is automatically negative d. It discourages creativity and innovation 41. The final step needed to complete the change process is called: a. Assessment b. Planning c. Implementation d. Stabilization 42. With this method of conflict resolution, each side gives up something as well as gets something: a. Negotiating b. Competing c. Avoiding d. Compromising 43. When people in control enforce changes in an organization and others in the organization have no input into these changes, what change strategy is being implemented? a. Normative-Reeducative b. Power-Coercive c. Change-Stabilization d. Rational-Empirical 44. The change strategy which assumes that people act more in accordance with social values and less likely to change based on information or rational arguments: a. Stabilization-Evaluation strategy b. Power-Coercive strategy c. Normative-Reeducative strategy d. Rational-Empirical strategy

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45. Martyr Nieverra, hospital X’s medical director, is lobbying for majority rule within the group to decide on what new equipment will be purchased for every department. This decision making model is called: a. Collegial b. Political c. Garbage can d. Swallow hard

b. c. d.

SITUATION: Management of nurse practitioners is done by qualified nursing leaders who have had identical clinical experience. 51. An example of management function of a nurse is a. Directing and evaluating the staff nurses b. Performing nursing procedures for clients c. Teaching patient do deep breathing and coughing exercises d. Preparing for a surprise party for a client

SITUATION: Phoqy Kho is the chief nurse of the Vachina Medical Center. To be guided accordingly with her roles,...