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Med Surg 3 Exam 1 questions and answers latest [100% correct answers]
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- Med Surg Hesi
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- Bj Medical College
Med Surg 3 Exam 1 questions and answers latest [100% correct answers]
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Med Surg 3 Exam 12023 Questions and Answers (Verified Answers)
1. A client is referred to a surgeon by the healthcare provider. After meeting
with the surgeon, the client decides to consult with a different surgeon
about treatment options. The nurse supports the client's action, utilizing
which eth- ical principle?: Autonomy
Autonomy is the right of individuals to take action for themselves
2. A nurse forgets to administer a dose of a client's diuretic drug and the
client experiences an episode of pulmonary edema. The nurse should
consider that this error constitutes negligence because the situation
contains which element?: Unintentional failure to perform a healthcare
procedure
Negligence is the unintentional failure of an individual to perform or
not perform an act that a reasonable person would or would not do in
the same or similar circumstances.
,3. A client asks why a diagnostic test has been prescribed and the nurse
replies, "I'm unsure but will find out for you." When the nurse later returns
and provides an explanation, the nurse is acting under which principle?:
Fidelity
Fidelity means being faithful to agreements and promises. This nurse is
acting on the client's behalf to obtain needed information and report it
back to the client
4. An individual falls and fractures a hip while walking down the street. A
companion notices a nurse drive past without stopping to assist. The indi-
vidual sues the nurse for negligence but fails to win a judgement for
which reason?: The nurse had no duty to the individual
To be guilty of negligence, the nurse must have a relationship with
the client that involves a duty to provide care
5. A client who is taking warfarin is given aspirin for a headache while
visiting a neighbor, who is a nurse. The client subsequently has a bleeding
episode caused by interaction of these drugs. The legal nurse consultant
interprets which necessary elements of malpractice are missing from this
case? Select all that apply: Duty owed
Intent to cause harm or injury
,There was no nurse-client relationship because the nurse was acting as a
neighbor and not in an employment capacity. Thus, there can be no duty
owed.
6. A client with cancer has decided to discontinue further treatment.
Although the nurse would like the client to continue treatment, the nurse
recognizes the client is competent and supports the client's decision using
which ethical
,principle?: Autonomy
Autonomy refers to the right to make one's own decisions, which is the
principle supported in this situation
7. The healthcare provider prescribes a medication in a dose that is consid-
ered toxic. The nurse administers the medication to the client, who later
suffers a cardiac arrest and dies. What consequence can the nurse expect
from this situation. Select all that apply: The healthcare provider who
prescribed the drug can be charged with negligence
The nurse can be charged with negligence for administering the toxic
dose
Healthcare providers who prescribe incorrect dosages of medications
are liable for their errors. The nurse is open to a charge of negligency
for failing to verify and question the incorrect dose
8. A nurse and teacher are discussing legal issues related to the practice of
their professions. The teacher asks about the functions of the Nurse
Practice Act (NPA). The nurse should include which elements in a response?
Select all that apply: Protect the public
Define the scope of nursing practice
A NPA serves to protect the public by setting minimum qualifications
for nursing in relation to skills and competencies. One way it fulfills
,responsibility to protect the public is by defining the scope of nursing
practice in that state or province
9. A staff nurse concerned about maintaining client
confidentiality would take which action while carrying
out
assigned duties?: Share information about the client with those directly
involved in that client's care
Client confidentiality is maintained when the nurse shares client
information only with those currently involved in the plan of care
10.The nurse working in an acute care environment would utilize which
strate- gies to reduce the risk of malpractice litigation? Select all that apply:
Maintain expertise in practice
Report unsafe staffing levels to supervisor
Maintaining expertise in practice by maintaining up to date knowledge
and skills aids in reducing the risk of malpractice claims by fostering
continued competence in practice. Unsafe staffing levels can result in a
higher incidence rate of errors, which
,could later lead to charges of malpractice. Thus, reporting such
situations so they can be prevented should be beneficial.
11.Unintentional torts: Negligence and malpractice
12.Intentional torts: Assault and battery, invasion of privacy (false
imprisonment, exposure of a person, defamation), fraud
13. What types of procedures should be assigned to professional nurses?: -
Sterile or invasive procedures
14.Negligence is measured by reasonableness. What question might the
nurse ask when determining such reasonableness?: Would a reasonable
and prudent nurse act in the same manner under the same
circumstances?
15.List the four elements that are necessary to prove malpractice
(profession- al negligence): Duty: failure to protect client against
unreasonable risk
Breach of duty: failure to perform according to established
standards Causation: a connection exists between conduct of the
nurse and the resulting damage
Damages: damage is done to the client, whether physical or mental
,16.Define an intentional tort, and give one example: Conduct causing
damage to another person in a willful or intentional way without just
cause. Example: hitting a client out of anger, not in a manner of self-
protection
17. List five activities a person who is declared incompetent cannot perform
: Vote
Make contracts or
wills Drive a car
Sue or be sued
Hold a professional license
18.Name three legal requirements of a surgical permit: Voluntary,
informed, written
19.Who may give consent for medical treatment?: Alert, coherent, or
otherwise competent adults; a parent or legal guardian; a person in loco
parentis of minors or incompetent adults
20.What law protects the nurse who provides care or gives aid in an
emer- gency situation?: The Good Samaritan Act
21.The patient with a pacemaker shows pacemaker spikes that are not
fol- lowed by a QRS. The nurse interprets this as:: Failure to capture.
When the pacemaker generates an electrical impulse (pacer spike) and
,no depo- larization is noted, it is described as failure to capture. Failure
to pace or fire occurs when the pacemaker fails to initiate an electrical
stimulus when it should fire. The problem is noted by absence of pacer
spikes on the rhythm strip. Failure to sense manifests as pacer spikes
that fall too closely to the patient's own rhythm, earlier than the
programmed rate. The demand mode paces the heart when no intrinsic
or native beat is sensed
22.The nurse is speaking with the patient when the monitor shows that the
patient is in ventricular fibrillation (VF). The nurse should:: Assess the
patient and check the patient's monitor leads.
Ventricular fibrillation (VF) is a chaotic rhythm characterized by a
quivering of the ventricles, which results in total loss of cardiac output
and pulse. Because this patient was in the process of speaking with the
nurse, there is evidence of cardiac output being present, which would
not be the case with VF. Because a loose lead or electrical interference
can produce a waveform similar to VF, it is always important to
immediately assess the patient for pulse and consciousness. The issue
here is more likely a loose lead. Immediate BLS and ACLS interventions
would only be required if the patient was truly in VF
23.The nurse notices ventricular tachycardia on the heart monitor. The
nurse's first action should be to:: Determine patient responsiveness and
presence of a pulse.
Determine whether the patient has a pulse. If no pulse is present,
,provide emergent basic and advanced life-support interventions,
including defibrillation. If a pulse is present and the blood pressure is
stable, the patient can be treated with intravenous amiodarone or
lidocaine. Cardioversion is used as an emergency measure in pa- tients
who become hemodynamically unstable but continue to have a pulse. It
may also be used in nonemergency situations, such as when a patient
has asymptomatic VT.
24.The patient has a temporary transvenous, demand-type ventricular pace-
maker. The rate on the pacemaker is set at 60 beats/min. Which of the
following situations would be of concern?: A pacemaker spike is seen on
the T wave of the preceding beat.
, Failure to sense manifests as pacer spikes that fall earlier than the
programmed rate. This can cause an artificial R-on-T phenomenon
similar to when a PVC occurs during the T wave, and ventricular
tachycardia may occur.
25.The patient is complaining of midsternal chest discomfort and nausea.
The nurse calls for a 12-lead ECG and notices that the ST segment is newly
elevated in two related leads. The nurse should:: Call the provider because
the ST segment may indicate myocardial injury.
A displacement in the ST segment can indicate myocardial ischemia or
injury. If ST displacement is noted and is a new finding, a 12-lead ECG is
performed and the provider notified. The patient is assessed for signs
and symptoms of myocardial ischemia.
26.The nurse is interpreting the rhythm strip of a patient and measures the
QRS complex as being three small boxes in width. The nurse interprets
this width as:: 0.12 seconds.
ECG paper contains a standardized grid in which the horizontal axis
measures time and the vertical axis measures voltage or amplitude.
Larger boxes are circumscribed by darker lines and the smaller boxes by
lighter lines. The larger boxes contain 5 smaller boxes on the horizontal
line and 5 on the vertical line for a total of 25 per large box.
Horizontally, the smaller boxes denote 0.04 seconds each or 40
milliseconds; the larger box contains five smaller boxes and thus equals
10 /
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