Linton And Matteson S Medical Surgical Practical Nursing In Canada 1St Edition Poser Test Bank

Test Bank - Chapter 01

Q1: Which item in a medical record provides direction for individualized care and assures the delivery of accurate, safe care through a definitive pathway that promotes the patient’s and the support persons’ progress toward positive outcomes?

A. Physician’s orders

B. Progress notes

C. Nursing care plan (Correct)

D. Client health history

Rationale: The nursing care plan provides direction for individualized care and assures the delivery of accurate, safe care through a definitive pathway that promotes the patient’s and the support persons’ progress toward positive outcomes. DIF: Cognitive Level: Understanding OBJ: 1 TOP: Nursing Care Plan KEY: Nursing Process: Planning

Q2: The nurse is performing behaviours and actions that assist patients and significant others in meeting their needs and the identified outcomes of the plan of care. Which term is correct for these nursing behaviours?

A. Assessments

B. Interventions (Correct)

C. Planning

D. Evaluation

Rationale: Care interventions are those nursing behaviours and actions that assist patients and significant others in meeting their needs and the identified outcomes of the plan of care. DIF: Cognitive Level: Remembering OBJ: 1 TOP: Interventions KEY: Nursing Process: Planning

Q3: The nurse understands the importance of being answerable for all actions and the possibility of being called on to explain or justify them. Which term best describes this concept?

A. Reliability

B. Maturity

C. Accountability (Correct)

D. Liability

Rationale: Accountability means that a person is answerable for their actions and may be called on to explain or justify them. DIF: Cognitive Level: Remembering OBJ: 1 TOP: Accountability KEY: Nursing Process: N/A

Q4: Which action is an example of an RPN/LPN exhibiting beneficence?

A. Removes defective equipment from the patient’s room (Correct)

B. Willingly works extra shifts during a staff shortage

C. Adheres to agency policy

D. Joins the National Association for Practical Nurse Education and Service (NAPNES) and attends educational seminars

Rationale: Beneficence means promoting good and reducing harm. Removing defective equipment demonstrates that the RPN/LPN is reducing possible harm to the patient. Working extra shifts, adhering to policy, and joining NAPNES are personal values, not beneficence. DIF: Cognitive Level: Understanding OBJ: 3 TOP: Ethical Considerations KEY: Nursing Process: N/A

Q5: An LPN/LVN is educating a group of nursing students regarding values demonstrated in their nursing practice. Which area of the RPN/LPN’s life identifies where the base of these values is derived?

A. Nursing school education

B. Family influence (Correct)

C. Peer relationships

D. Agency policies

Rationale: The family shapes values that are demonstrated in later life. These values may be enhanced or challenged by life experiences, but the base is forged in the family. DIF: Cognitive Level: Remembering OBJ: 3 TOP: Ethical Considerations KEY: Nursing Process: N/A

Q6: One obstetrical nurse remarks, “I don’t see how these young single women can keep on having babies without being married. Everyone knows a child needs a father.” Which term identifies what this nurse is exhibiting?

A. Ethnocentrism (Correct)

B. Moral uncertainty

C. Values clarification

D. Professional concern

Rationale: Ethnocentricity is the belief that one’s own culture and values are superior to those of another. Such statements are based on values clarification and, perhaps, on moral outrage. DIF: Cognitive Level: Understanding OBJ: 3 TOP: Ethical Considerations KEY: Nursing Process: N/A

Q7: Which of the following indicate the correct steps in solving an ethical dilemma?

A. Plan an approach, visualize the consequences, take action, evaluate the outcome, identify the problem

B. Take action, visualize the consequences, identify the problem, plan an approach, evaluate the outcome

C. Evaluate the outcome, plan an approach, visualize the consequences, take action, identify the problem (Correct)

D. Visualize the consequences, identify the problem, take action, evaluate the outcome, plan an approach

Rationale: To solve an ethical dilemma, one must clearly identify the problem, plan an approach, visualize the consequences, take action, and evaluate the outcome. DIF: Cognitive Level: Understanding OBJ: 3 TOP: Resolution of an Ethical Dilemma KEY: Nursing Process: N/A

Q8: An RPN/LPN charts that “the patient is drunk and acting in a crazy manner.” The team leader cautions the RPN/LPN that this documentation is not appropriate. Which charges of commission of the intentional tort is this an example of?

A. Assault

B. Wrongful publication

C. Defamation of character (Correct)

D. Invasion of privacy

Rationale: Charting or saying unsupported defamatory statements can lead to tort litigation. DIF: Cognitive Level: Remembering OBJ: 4 TOP: Legal Considerations KEY: Nursing Process: N/A

Q9: An RPN/LPN trimmed the toenails of a patient with diabetes too short, which results in a toe amputation from infections. Which term identifies what the RPN/LPN guilty of ?

A. Unintentional tort

B. Intentional tort

C. Negligence

D. Malpractice (Correct)

Rationale: Malpractice occurs when an unintentional tort causes an injury to a patient. DIF: Cognitive Level: Understanding OBJ: 4 TOP: Legal Considerations KEY: Nursing Process: N/A

Q10: In which situation must an RPN/LPN ensure acquiring a signature on a surgical informed consent document?

A. The patient is not sedated. (Correct)

B. The physician is present.

C. The family member is a witness.

D. The signature is in ink.

Rationale: Before surgery, the consent form must be signed before any preoperative sedation is administered. A sedated person cannot give a valid consent. DIF: Cognitive Level: Understanding OBJ: 5 TOP: Accountability KEY: Nursing Process: N/A

Q11: A physician has written an order for Synthroid, 137 mg. The RPN/LPN is aware that the drug is measured in micrograms. Which action should the nurse implement?

A. Transcribe the order as if it were written in micrograms.

B. Notify the nursing supervisor.

C. Transcribe the order as written.

D. Call the prescribing physician. (Correct)

Rationale: The RPN/LPN may call the physician to clarify the order but may not alter the written order in any way. The order for the correct dose will be written as a new order. DIF: Cognitive Level: Creating OBJ: 5 TOP: Accountability KEY: Nursing Process: N/A

Q12: A physician has written an order for morphine sulphate, 100 mg. The RPN/LPN inquires if they meant to write 10 mg. The physician confirms that they meant 100 mg. Which action should the RPN/LPN implement?

A. Call a member of the hospital administration.

B. Refuse to transcribe the order.

C. Call the pharmacist.

D. Notify the nursing supervisor. (Correct)

Rationale: In the event of a physician’s refusal to clarify a questionable order, the LPN/LVN should notify the nursing supervisor to intervene. DIF: Cognitive Level: Creating OBJ: 5 TOP: Accountability KEY: Nursing Process: N/A

Q13: On which principles are health care ethics based? (Select all that apply.) (Select all that apply.)

A. Autonomy (Correct)

B. Fidelity (Correct)

C. Professionalism

D. Justice (Correct)

E. Nonmaleficence (Correct)

Rationale: Health care ethics are based on autonomy, fidelity, beneficence, justice, and nonmaleficence. DIF: Cognitive Level: Remembering OBJ: 3 TOP: Ethical Considerations KEY: Nursing Process: Implementation

Q14: Which elements describe how values clarification support nursing practice? (Select all that apply.) (Select all that apply.)

A. Guides decision making (Correct)

B. Gives insight to patients (Correct)

C. Enhances peer relationships

D. Helps a person understand themselves (Correct)

E. Gains the confidence of supervisors

Rationale: Values clarification gives a person a foundation for moral decisions and insight into self and others. DIF: Cognitive Level: Understanding OBJ: 3 TOP: Ethical Considerations KEY: Nursing Process: N/A

Q15: Which modes of conflict resolution should be addressed when providing an in-service workshop about conflict resolution? (Select all that apply.) (Select all that apply.)

A. Suppression

B. Accommodation (Correct)

C. Compromise (Correct)

D. Avoidance (Correct)

E. Collaboration (Correct)

F. Competition (Correct)

Rationale: The modes of conflict resolution include accommodation, collaboration, compromise, avoidance, and competition. DIF: Cognitive Level: Remembering OBJ: 5 TOP: Conflict Resolution

KEY: Nursing Process: N/A

Q16: Which characteristics describe an effective leader? (Select all that apply.) (Select all that apply.)

A. Effective communication (Correct)

B. Rigid rules and regulations

C. Delegates appropriately (Correct)

D. Acts as a role model (Correct)

E. Consistently handles conflict (Correct)

F. Focuses on individual development

Rationale: Characteristics of an effective leader include effective communication, consistency in managing conflict, having knowledge of and competency in all aspects of delivery of care, being an effective role model for staff, using a participatory approach in decision making, showing appreciation for a job well done, delegating work appropriately, setting objectives and guiding staff, displaying caring, understanding, and empathy for others, motivating and empowering others, being proactive and flexible, and focusing on team development. DIF: Cognitive Level: Understanding OBJ: 5 TOP: Leadership KEY: Nursing Process: N/A

Q17: An RPN/LPN arrives on duty at 0700 and is faced with the ethical dilemma of inadequate staffing for the day shift. Which actions describe how the RPN/LPN should invoke a “safe harbour”? (Select all that apply.) (Select all that apply.)

A. Immediately file a written protest with administration. (Correct)

B. Leave duty.

C. Refuse the assignment.

D. Call hospital administration.

E. Suggest that the unregulated care provider (UCP) file a written protest. (Correct)

Rationale: Filing a written protest relative to short staffing provides the “safe harbour” for the RPN/LPN and protects their license. Nonacceptance of the assignment or leaving duty is considered abandonment. Suggesting that the UCP file a similar protest is an effective action. DIF: Cognitive Level: Creating OBJ: 7 TOP: Conflict Resolution KEY: Nursing Process: N/A

Q18: __ is defined as the process by which information is exchanged between individuals verbally, nonverbally, and/or in writing or through information technology. (Fill in the blank)

Answer: Communication

Rationale: Communication is defined as the process by which information is exchanged between individuals verbally, nonverbally, and/or in writing or through information technology. DIF: Cognitive Level: Remembering OBJ: 2 TOP: Communication KEY: Nursing Process: N/A

Q19: __ is the collection and processing of relevant data for the purpose of appraising the client’s health status. (Fill in the blank)

Answer: Assessment

Rationale: Assessment is the collection and processing of relevant data for the purpose of appraising the client’s health status. DIF: Cognitive Level: Remembering OBJ: 1 TOP: Assessment KEY: Nursing Process: N/A

Q20: __ is concerned with the ethical questions that arise in the context of health care. (Fill in the blank)

Answer: Bioethics

Rationale: Bioethics is concerned with the ethical questions that arise in the context of health care. DIF: Cognitive Level: Remembering OBJ: 3 TOP: Bioethics KEY: Nursing Process: N/A

Q21: The values that direct human behaviour and are concerned with defining right from wrong are known as __. (Fill in the blank)

Answer: ethics

Rationale: An individual’s ability to define right from wrong is based on a value system called ethics. DIF: Cognitive Level: Remembering OBJ: 3 TOP: Ethical Considerations KEY: Nursing Process: N/A

Review Questions - Chapter 01

Q1: Which document further defines the role of the RPN/LPN in each province?

A. Scope of practice

B. Standards for nursing practice (Correct)

C. Nursing practice guidelines

D. Educational competencies

Rationale: The roles that RPNs/LPNs may assume are specified by their provincial regulatory body. Some roles require collaboration with a registered nurse; others require specialized training or certification. Each regulatory body establishes the scope of practice and sets the standards for nursing practice. The standards of practice and educational competencies of graduates of practical/vocational nursing programs define the RPN/LPN’s range of capabilities, responsibilities, rights, and relationship to other health care providers.

Q2: The standards for nursing practice and educational competencies of graduates of RPN/LPN programs include professional behaviours, communication, assessment, planning, caring interventions, and managing. Which competency demonstrates proficiency in planning?

A. Document data collection, do assessment, and communicate findings to appropriate members of the health team.

B. Utilize knowledge of normal values to identify deviation in health status to plan care. (Correct)

C. Provide and promote the patient’s dignity.

D. Assist the patient and significant support persons to access available resources and services.

Rationale: Planning encompasses the collection of health status information to formulate nursing care plans and actions. Assessment is the collection and processing of relevant data for the purpose of appraising the client’s health status. Providing and promoting dignity is an example of a caring intervention. Assisting the patient and support persons to access available resources is an example of a competency for managing care.

Q3: Which health care team member is responsible for collaborating with and supervising the RPN/LPN with regard to nursing assessment, planning, intervention, and evaluation?

A. Registered nurse (Correct)

B. Nursing assistant

C. Physician

D. Pharmacist

Rationale: The RPN/LPN collaborates with the registered nurse. While nursing assistants, physicians, and pharmacists are important members of the health care team, nursing care provided by the RPN/LPN must be in collaboration with the RN responsible for the patient.

Q4: Which ethical principle is being demonstrated when the nurse respects a patient’s decision to stop dialysis even though it will lead to the patient’s death?

A. Autonomy (Correct)

B. Beneficence

C. Justice

D. Veracity

Rationale: The nurse is practicing autonomy—the respect of individual rights. Beneficence is acting in the patient’s best interest. Justice is the consideration of fairness, equity, and appropriateness, and veracity is being truthful and honest.

Q5: Which competency is exemplified when providing relevant, accurate, and complete information in a manner that protects patient confidentiality?

A. Communication (Correct)

B. Planning

C. Managing

D. Caring interventions

Rationale: Competencies demonstrating effective communication include providing relevant, accurate, and complete information in a manner that maintains both organizational and patient confidentiality. Planning is demonstrated by utilizing information to prioritize care needs of the patient. Demonstration of managing is an effective use of human, physical, financial, and technological resources to achieve a patient outcome. Caring interventions are nursing behaviours and actions that assist the patient in meeting identified outcomes.

Q6: Which RPN/LPN competency is associated with the prioritization of nursing care needs?

A. Communication

B. Assessment

C. Planning (Correct)

D. Managing

Rationale: Planning is demonstrated by utilizing information to prioritize care needs of the patient. It encompasses the collection of health status information, accessing information, and using information to formulate care actions. Communication includes providing relevant, accurate, and complete information in a manner that maintains both organizational and patient confidentiality. Assessment is the collection of data for the purpose of appraising the health status of an individual. Demonstration of managing involves effective use of human, physical, financial, and technological resources to achieve a patient outcome.

Q7: Which action by the RPN/LPN demonstrates care management?

A. Identifying personal capabilities

B. Creating an environment of hope and trust

C. Collecting data relevant to the health status of the patient

D. Delegating aspects of care to unregulated care providers (Correct)

Rationale: The RPN/LPN demonstrates care management when they direct aspects of care to unregulated care providers (UCPs). Identification of personal capabilities is an aspect of accountability and professionalism. Caring interventions occur when the RPN/LPN creates an environment of hope and trust. Collecting data relevant to the health status of the patient is related to assessment.

Q8: Which term identifies the belief that one’s own culture and its values are superior to others?

A. Bioethics

B. Ethnocentrism (Correct)

C. Values conflict

D. Values clarification

Rationale: Ethnocentrism is the belief that one’s own culture and its values are superior to others. Bioethics is concerned with the ethical questions that arise in the context of health care. Values conflict occurs when the values of individuals or institutions, or both, are different. Values clarification is the process of becoming aware of personal values and how those values affect behaviour.

Q9: Which approach to conflict resolution focuses on shared higher goals with a commitment to work together for the benefit of the patient?

A. Accommodation

B. Collaboration (Correct)

C. Compromise

D. Avoidance

Rationale: Collaboration is a conflict resolution strategy that generates commitment to work together, focusing on shared higher goals instead of individual immediate needs. Accommodation occurs when an agreement is reached between parties. Compromise can produce mutually acceptable solutions where both parties have achieved what they wanted. Avoidance allows both parties to “cool off” until a reasonable approach can be considered.

Q10: Which conditions must be met for the nurse to be found liable for malpractice? (Select all that apply.) (Select all that apply.)

A. The nurse owed a duty to the patient. (Correct)

B. The patient was injured. (Correct)

C. The nurse carried out a duty that was owed to the patient.

D. The patient’s injury was caused by the nurse failing to carry out a duty to the patient. (Correct)

E. The patient signed consent for the treatment.

Rationale: To be found liable for malpractice, the following conditions must be met: the nurse owed a duty to the patient, the nurse did not carry out that duty, the patient was injured, and the injury was caused by the nurse’s failure to carry out that duty. Liability for malpractice can be determined without a signed consent for treatment.