Question 1

When the nurse receives a telephone order from the healthcare provider's office,which guidelines are used to ensure the order is correct? Select all that apply.

Accepted Answer

A)  Ask the prescriber to repeat or spell out medication. 
B)  Read the order back to the prescriber. 
C)  Ask the prescriber to speak slowly. 
D)  Know agency policy for telephone orders. 
E)  Sign the prescriber's name and credentials.

Question 2

The nurse is assigned to provide care to a client who is diagnosed with chronic obstructive pulmonary disease (COPD).Overnight,the client's oxygen saturation levels decreased and the client was placed on oxygen by the respiratory therapist.To review specific information about the care received from the respiratory therapist,which portion of the medical record will the nurse review?

Accepted Answer

A)  The consultation report 
B)  The nurses' notes 
C)  The medication record 
D)  The diagnostic report

Question 3

A novice nurse is working with a client who is admitted to a medical-surgical unit.The nurse is establishing a therapeutic relationship with the client by conveying empathy.Which statement by the nurse best exemplifies empathy?

Accepted Answer

A)  "I wouldn't be afraid, if I were you." 
B)  "You shouldn't have done it that way." 
C)  "You seem to be frightened by the procedure. Tell me how you are feeling." 
D)  "I know just how you feel, as my mother has the same illness."

Question 4

The nurse is providing care to a client diagnosed with end-stage renal disease.When planning a care plan conference for this client,who does the nurse invite to participate?

Accepted Answer

A)  Family members 
B)  The psychiatrist 
C)  The oncologist 
D)  The hospital CEO

Question 5

The nurse is caring for a school-age client who is scheduled to have major heart surgery the next morning.The nurse enters the room to administer a medication and finds the client crying.Which response by the nurse is most therapeutic?

Accepted Answer

A)  "Would you like some toys from the playroom?" 
B)  "I'm going to go get the doctor." 
C)  "You shouldn't cry. You are not in pain." 
D)  "It is okay to cry. I know this is scary."

Question 6

A nurse manager is working with staff nurses regarding the types and frequency of documentation required for clients being cared for in long-term care facilities.Which laws contribute to the specific documentation required for client's in long-term care facilities? Select all that apply.

Accepted Answer

A)  Kardex 
B)  Omnibus Budget Reconciliation Act (OBR
A)  
C)  Health Care Financing Administration Act 
D)  Minimum Data Set (MDS) 
E)  Charting by exception (CB
E)

Question 7

The nurse is caring for a client who is having difficulty understanding the wound care dressing changes that need to be completed in the home after discharge.The client asks the nurse to demonstrate the procedure again and allow the client's spouse to perform the procedure while the nurse watches.Which is the most likely outcome of this assertive request by the client?

Accepted Answer

A)  A slightly increased chance that the wound will become infected due to exposure during dressing changes. 
B)  Less compassionate care for the client due to the spouse's irritation by the request. 
C)  A greater likelihood that the wound will heal appropriately. 
D)  A guarantee that the spouse will change the dressings correctly.

Question 8

The nurse is caring for a client with a new colostomy.The client has been taught care and has been successful with return demonstration to the staff.Although the client is able to perform care independently,and has asked to do so,the charge nurse has instructed the nursing staff to continue performing colostomy care for this client.When addressing this issue directly with the charge nurse,which statement by the nurse is the most appropriate?

Accepted Answer

A)  "The client will change the apparatus whether you like it or not." 
B)  "The client has been trained to change the apparatus and has expressed interest to continue doing so." 
C)  "You have no right to continue delegating this task to nursing when the client has been trained to change the apparatus." 
D)  "I will report you to the nurse manager for not allowing the client to change the apparatus independently."

Question 9

The nurse is providing care to a client who is diagnosed with hypertension.Which response by the nurse is an appropriate example of informational confrontation with the client?

Accepted Answer

A)  "I noticed you rubbing your head and your eyes, are you hurting? Let's take your blood pressure." 
B)  "I heard raised voices when I was coming down the hall to your room. Are you upset?" 
C)  "It is 3 p.m. and time to take your blood pressure before I give you your medication." 
D)  "Is the blood pressure medication making your head hurt?"

Question 10

The nurse is caring for a client who received analgesic medication via central line to treat pain associated with cancer.After reassessing the client's response,which section of PIE will the nurse use when documenting the client's care?

Accepted Answer

A)  Evaluation 
B)  Progress notes 
C)  Problem 
D)  Intervention

Question 11

The healthcare provider prescribes digoxin for a client who is to be discharged in the morning.When documenting the order in the medical record,which action by the nurse is the most appropriate?

Accepted Answer

A)  Write digoxin, .0125 mg QD 
B)  Write digoxin, 0.0125 mg QD PO 
C)  Write digoxin, 0.0125 mg, once daily. 
D)  Write digoxin, 1 pill each day.

Question 12

The clinic nurse is faxing a client's medical record to the local hospital.Which actions by the nurse are appropriate to ensure the client's confidentiality is maintained? Select all that apply.

Accepted Answer

A)  Using a fax cover sheet 
B)  Having signed client consent from the client 
C)  Conducting a check of the fax number prior to transmitting 
D)  Including identifiable client information on the cover sheet 
E)  Signing an employee consent form

Question 13

The nurse is providing care to a visually impaired client who is scheduled for a colonoscopy.The client requires a bowel prep prior to the diagnostic test.Which approach will the nurse use to facilitate the client's understanding of the material?

Accepted Answer

A)  Use layman's term and ask the client to describe the procedure afterwards. 
B)  Explanation the procedure to the client using medical terms for clarity. 
C)  Focus on intonation when teaching the client. 
D)  Speak slowly to the client.

Question 14

A nurse is providing care for a nonverbal client.The nurse wants to implement strategies that will promote communication with this client.Which interventions would be appropriate for the client in this situation? Select all that apply.

Accepted Answer

A)  Facing the client when speaking 
B)  Having pen and paper on hand for the client 
C)  Making sure that the language spoken is the client's dominant language 
D)  Using a picture board to facilitate communication 
E)  Employing an interpreter

Question 15

The nurse is caring for a young adult client after a cervical biopsy.The client has expressed anxiety about the results.The healthcare provider peeks into the client's room and says,"The biopsy is negative." The nurse later finds the client sobbing.Which response by the nurse is appropriate?

Accepted Answer

A)  "What did the healthcare provider tell you about the biopsy?" 
B)  "You seem upset. Do you want to talk to me about the test results?" 
C)  "Why are you crying with such good news?" 
D)  "The term 'negative' in this case is good!"

Question 16

The nurse is conducting a health history on a client who is being admitted to a medical-surgical unit for the treatment of chronic pain.The client is concerned about privacy and asks why it is necessary for the nurse to ask for private information and then document it in the medical record.Which response by the nurse is most appropriate?

Accepted Answer

A)  "You will be able to read the record and review your care." 
B)  "Documentation decreases the likelihood that you will have to repeat this information to others who will care for you." 
C)  "Your family can review the record and ensure that care is appropriate." 
D)  "A record ensures there are no breaches of confidentiality."

Question 17

A new nurse on a unit asks to speak to the nurse manager as several clients have complained because family members were able to hear the verbal report outside the room during nursing rounds.The nurse manager asks the nurse for suggestions that could enhance client privacy.Which suggestion by the new nurse is appropriate?

Accepted Answer

A)  Nursing rounds should take place in each client's room. 
B)  The unit should be closed to family and visitors during rounds. 
C)  Nurses should tape-record their reports outside the room. 
D)  Clients should be allowed to choose whether a written or oral report is used.

Question 18

The nurse on third shift is handing off clients to the nurse on first shift.Which key element is most important for the third shift nurse to report during this handoff?

Accepted Answer

A)  The nurse reports, "The client in room 312 continues to complain about a headache unrelieved by pain medication. I am awaiting a call from the physician for orders." 
B)  The nurse reports on the clients in no apparent order of acuity or room number. 
C)  The nurse reports, "The client in room 315 received an enema at 2100." 
D)  The nurse reports, "The client in room 311 was transferred from 212."

Question 19

The nurse is caring for a client with cancer who is struggling with chronic pain.The nurse tells the client,"It is normal to feel frustrated about the discomfort." Which skill associated with the working phase of the nurse-client relationship does the nurse's statement best reflect?

Accepted Answer

A)  Confronting 
B)  Respect 
C)  Concreteness 
D)  Genuineness

Question 20

The nurse is preparing to provide care for a client who is newly admitted to the unit.Prior to assessing the client,which should the nurse review to determine care that may be needed?

Accepted Answer

A)  The written care plan 
B)  The client's medical record 
C)  The Kardex 
D)  The medication administration record (MAR)

Exam 38: Communication