Health Care Ethics, Law, and Policy

A multiple-gunshot victim is brought by EMS to the emergency department, and subsequently expires. Which action by the nurse is completed first?

The unlicensed assistive personnel (UAP) performs a delegated task after failing to complete the yearly mandatory education and skills check-off and an adverse event occurs. Who is most responsible for the adverse event?

The bedside nurse asks the unlicensed assistive personnel (UAP) to help a stable patient to the bedside commode. Upon standing, the patient complains of being dizzy and lightheaded, but insists on using the commode. The UAP calls out to the bedside nurse for help, but the nurse had left the floor with another patient. The patient falls and sustains a mild head injury. Which individual is most responsible for the patient’s injury?

The nurse calls the provider with this report: “Hi, Dr. Smith, the patient Mrs. Welch is complaining of an 8/10 pain in her lower abdomen. Her abdomen is distended but is soft with positive bowel sounds in all four quadrants. I have tried ambulation, warm compresses, and position changes, to no avail. Could you please come assess her?” Which component of SBAR communication does the nurse need to elaborate for this patient?

A fire has started in one of the medical surgical units, and the staff has been instructed to perform a horizontal evacuation. Which action does the nurse take first?

The nurse is assigned to care for a 65-year-old male patient who is diagnosed with atrial fibrillation. The nurse realizes during the shift report that six hours ago she administered 0.6 mg of this patient’s antiarrhythmic medication instead of 6.0 mg. Which action does the nurse perform first?

A terminally ill patient has attempted to commit suicide by swallowing an entire bottle of opioid pain medication.The patient is brought to the emergency department and found to have a “Do Not Resuscitate” tattoo on her chest along with a handwritten note that states that she is tired of suffering and wishes her life to end. Which next step by the medical team is most appropriate?

The nurse is assigned to care for a 45-year-old G2P1 female at 35 weeks estimated gestational age who is admitted with preeclampsia. On morning rounds, the patient says she is having considerable abdominal pain, so the provider writes multiple medication orders for her. Which medication order can the nurse carry out without clarification?

A nurse is assigned to care for a 45-year-old male who is admitted for alcohol withdrawal. On the second day of admission, the patient becomes disoriented and combative, and the provider places him in bilateral wrist restraints. Which physical exam finding is most important for this patient?

A nurse is assigned to care for a 28-year-old patient with seizures and neuropsychiatric symptoms secondary to cocaine abuse. The patient is combative and prone to hurting himself despite a 24-hour bedside sitter, so the provider writes for physical restraints. Which options are included in this order? Select all that apply.

The nurse would like to institute a process improvement project to improve the cleanliness of the patient rooms. Which key stakeholders does the nurse include? Select all that apply.

The nurse is admitting a patient positive for human immunodeficiency virus (HIV). A fellow nurse states, “This patient is on contact precautions for his HIV status. You need to wear an isolation gown in addition to your gloves.” Which response by the nurse is most appropriate?

The patient who is scheduled for a cardiac catheterization is unable to read or write. How does the medical team obtain informed consent for the procedure? 

Prior to transporting a patient to surgery, the nurse ensures which items are in the patient's chart? Select all that apply. 

The patient who is scheduled for an elective surgery in 2 hours asks the nurse, “What time do the maids typically come to clean the hotel room?” Further questioning reveals the patient believes the hospital in the United States is a hotel in Paris, France, and the year is 20 years prior. The nurse notes that the patient signed a consent form for the procedure just minutes ago. Which action does the nurse take first?

Which statement by the novice nurse requires correction by the charge nurse?

Which patient must be treated first in the emergency department following a mass shooting?

Which process improvement project will be most effective in improving patient satisfaction?

Which observation prompts the nurse manager to implement a process improvement project on alarm fatigue in the unit?

Patients with which characteristics are at an increased risk for falls? Select all that apply.

Which situation in the hospital unit requires the most immediate attention?

Which patient is appropriate to assign to a licensed practical/vocational nurse (LPN/LVN)?

Which task in the care of a patient newly diagnosed with diabetes is appropriate to delegate to an unlicensed assistive personnel?

The nurse is caring for the patient who was admitted to the hospital after a fall at the nursing home. Which intervention does the nurse implement in order to reduce the patient’s fall risk?

After receiving report, which patient does the nurse see first?

The nurse is providing education to a patient with localized shingles. Which statement by the patient indicates the teaching was effective?

A fire develops in the nurses’ station kitchen. Which action does the nurse take first?

The off-duty nurse passes a car accident. Which statement is true regarding this situation?

Which statement by the unlicensed assistive personnel (UAP) indicates an understanding of the proper way to transfer patients?

The nurse holds the transfusion and contacts the blood bank if which anemic patient is sent B negative packed red blood cells for transfusion?

Which is an example of the mitigation phase of disaster planning?

The 8-year-old presents with a generalized rash. The patient's mother reports that some areas of the rash have developed into pimples that are oozing clear fluid. The nurse places this patient on which type of precaution(s)? Select all that apply.

The novice nurse is transferring a patient from the floor to the intensive care unit. Which statement, if made by the novice nurse, indicates a need for further teaching about SBAR (Situation, Background, Assessment, Recommendation) communication?

Which action by the intensive care unit (ICU) nurse is most appropriate following the resolution of an active shooter emergency in the emergency department?

Which statement by a patient with mumps indicates an understanding of the diagnosis?

Following a motor vehicle accident, the patient is unable to make his wishes known and is close to death without immediate and extensive treatment. The patient’s girlfriend, who he has been living with for the last five years, wants the medical team to do everything possible to save him. The patient’s wife, who he left when he moved in with his girlfriend, states she would not like any lifesaving measures and will sign the Do-Not-Resuscitate (DNR) paperwork. The medical team looks to which entity for decision-making?

The 15-year-old patient is hospitalized after harming herself when her mother would not let her use her cell phone. While she is awaiting inpatient psychiatric placement, she repeatedly expresses a desire to leave. Which intervention is most helpful to prevent the patient from eloping?

The nurse is assisting with the development of a tool in the electronic medical record to prompt providers to screen appropriate individuals for hypothyroidism. The nurse provides which characteristics to the informatics team to include in the tool? Select all that apply.

The registered nurse asks the unlicensed assistive personnel to obtain the patient’s vital signs and to assist the patient to ambulate in the hallway. Which term is used to describe this nursing function?

The nurse is involved in a motor vehicular accident in which a minor injury from the seatbelt was sustained. Which action does the nurse take first in helping the other victims?

A local celebrity is admitted to hospital following rupture of the appendix. The charge nurse submits an incident report if which individual accesses the patient’s chart?

The nurse learns that a fellow nurse is viewing the electronic chart of a patient with whom she went to high school. Which action does the nurse take first?

The grandparents of a baby in the newborn intensive care unit (NICU) ask the nurse about the age of another baby. Which response by the nurse is most appropriate?

The nurse delegates a pre-prandial blood sugar check to the unlicensed assistive personnel who fails to perform it before the patient’s food tray arrives and the patient eats breakfast. Who is most at fault?

Which task is most appropriate for the nurse to delegate to an unlicensed assistive personnel (UAP)?

The patient from India tells the nurse that, in addition to his conventional medical treatment, he would also like to be treated according to the principles of Ayurvedic medicine. The nurse plans care based on which understanding of the focus of Ayurvedic medicine?

The nurse is assigned to care for a patient who speaks minimal English but is fluent in Farsi. Which is the best practice for the nurse to take when communicating with this patient?

The nurse is providing discharge instructions and education to a patient with stomach cancer who is interested in alternative/complementary medicine. Which low-risk therapies does the nurse include in the discussion? Select all that apply.

The patient reports an interest in using a herbal supplement to help with his depression. The nurse discusses herbal supplements with the patient based on which understanding of the nurse’s role in alternative and complementary medicine?

A medical-surgical floor nurse is asked to float to the intensive care unit (ICU) to alleviate understaffing. Which reason for refusing the assignment is legal?