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Nurs 251 End of Chapter Questions with complete solutions 2024/2025( A+ GRADED 100% VERIFIED).
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NURS 251 End of Chapter Questions with complete solutions 2024/2025( A+ GRADED 100% VERIFIED).
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Nurs 251 End of Chapter QuestionsAs a patient is admitted to the ICU, the nurse documents that the skin is intact. The patient is in
the unit for nearly a month, and a chart audit discovers that no wound care was charted and the
wound care nurse consultation was not done until the patient was transferred to a
medical-surgical unit. At this time, the patient's skin is documented as having a stage II pressure
ulcer on her coccyx. What does this lack of documentation indicate?
A. Appropriate admission assessment
B. Wound care was not done daily
C. Medicare reimbursement will be possible
D. The nursing role of care planning is not apparent
d. Documentation of the nursing process within this record provides essential data related to
assessment, interventions, and goals. Clear, accurate, and up-to-date patient documentation is
a cornerstone for safe care delivery providing flow of information between providers of care. If a
patient record or portions of it are unavailable or inaccurate, a vital line of communication is
blocked. Medicare and Medicaid stopped reimbursement in 2008 for some hospital-acquired
complications, including pressure ulcers. The admission assessment is not an issue of lack of
documentation.
Which of the following are elements that improve documentation when using an electronic
health record? (Select all that apply.)
A. Nurses are "tasked" to perform scheduled assessments.
B. Reassessment of pain medications is scheduled depending on administration route.
C. Computerized order entry to directly communicate orders legibly and timely.
D. Access codes to track patient care and compare to established standards of care.
E. Prevention of use of all abbreviations to improve clarity.
a, b, c, d. All characteristics mentioned in statements A through D improve nursing
documentation, patient safety, and tracking of patient care. Only certain abbreviations are
prohibited.
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A group of nurses are discussing a patient case in the elevator when a group of people enter
the elevator. Which aspect of HIPAA is most directly in violation?
A. Patient education on privacy protection
B. Patient recourse if privacy protections are violated
C. Minimal disclosure of protected health information
D. Limit use of information to accomplish intended purpose
c. Disclosure of protected health information is at issue when patient cases are discussed in
public. Patient education on privacy protection, patient recourse if privacy protections are
violated, and limiting use of information to accomplish the intended purpose are also aspects of
HIPAA but are not discussed in this scenario.
Two nurses are performing a change-of-shift handoff at the bedside of a patient with a recent
abdominal surgery who is receiving a constant infusion of opioids via a patient-controlled
analgesia (PCA) IV pump. The off-going nurse provides a thorough report including the plan of
care and the biggest safety risks. What else should these nurses do as part of their handoff?
A. In-depth neurologic assessment
B. List of all medications ordered
C. In-depth medical history
D. Double-check of high-alert infusion rates
d. Double-check of all high-alert infusions should be performed by both the off-going and
oncoming nurses. Acute changes or interventions (e.g., neurologic status) may be indicated by
patient status but are not relevant for this patient scenario. A complete list of medications is not
needed since this is available as part of the patient's medical record. Similarly, a complete past
medical history is not needed and is available in the patient's chart.
A nurse calls a provider regarding a patient's increased output from a surgical Jackson-Pratt
(JP) drain. She relays the following information: "The patient has had 600 mL of
serosanguineous drainage from his JP drain over the last 2 hours; the previous 8-hour shift had
a total of 160 mL. He is post-op day #1 for a prostatectomy. He has had no increase in pain but
is now hypotensive with a BP of 100/64 and a HR of 98. I think he has a urine leak." What is
missing from this SBAR communication?
A. Situation
B. Background
,C. Assessment
D. Recommendation
d. A recommendation is missing from this SBAR, answering the question of "What should we do
to correct the problem?" Situation, Background, and Assessment are all included in the
scenario.
A nurse is charting the application of medication and dressing change on the patient's pressure
ulcer. Which purpose of health record-keeping requires the nurse to provide a meticulous
recording using the guidelines of the Centers for Medicare and Medicaid?
A .Legal document
B. Quality assurance
C. Reimbursement
D. Research
c. Medicare and Medicaid regulations require specific criteria to be met to receive
reimbursement for specific health-related expenses. The patient chart is used for litigation,
auditing patient care practices, and research, but those purposes do not require the need to
follow the specific Medicare or Medicare guidelines.
The nurse, who has an assignment of five patients for the shift, follows a routine of getting
bedside report from the outgoing nurse, assessing the patients, and providing immediate care
as needed. What is the best practice for documenting?
A. After finishing the shift
B. At the nurse's station after passing scheduled medications
C. When there is an unexpected occurrence with a patient
D. While in the patient's room performing each procedure
d. The nurse should be documenting after each procedure because timely reporting is
necessary. Documenting after busy hours of work or at the end of the shift could result in errors
or forgetting to document important information. Unexpected occurrence reporting is not part of
the patient's medical record; it is used by the hospital for risk management to prevent a repeat
of the incident.
A nurse's brother is admitted to the hospital. The nurse opens and reads the brother's laboratory
report in the electronic health record, per the mother's request, without the patient's permission.
What will most likely happen to the nurse?
A. The nurse will be criminally prosecuted.
B. The nurse will be fined a minimum of $50,000.
C. The nurse will be jailed for 10 years.
D. The nurse will be retrained or terminated.
, d. The nurse has committed a HIPAA violation and will most likely be terminated or retrained.
Civil prosecution is more likely than criminal prosecution for HIPAA violations. Financial
penalties are reserved for the most serious violations, such as those resulting in patient
suffering.
A nurse is teaching a postoperative patient how to change the leg bag prior to discharge. This
skill demonstration by the patient displays which type of learning?
A. Cognitive
B. Affective
C. Psychomotor
D. All of the above
c. Psychomotor learning refers to the muscular movements learned to perform new skills and
procedures. This type of knowledge is easiest to measure because it can be physically
demonstrated. Cognitive learning refers to rational thought and may involve learning facts,
reaching conclusions, solving problems, making decisions, or using critical thinking skills.
Affective learning changes beliefs, attitudes, or values. Sensitivity and emotional climate
influence all types of learning but are especially important in the affective domain.
A nurse is assisting a postoperative patient with effective use of the incentive spirometer (IS).
The nurse states that using the IS 10 times every hour while awake will help prevent atelectasis,
enabling the patient to regain her baseline health and return home sooner to be with her
children. Together, the patient and nurse develop a practice schedule that allows the patient to
take a break for visitors in the afternoon. Then, the patient verbalizes to the nurse what she has
learned and demonstrates her skill with the IS. Which patient education practices are evident in
this scenario?
Select all that apply:
A. Developing patient rapport
B. Individualizing education to patient
C. Negotiation of plan of care
D. Interactive education technique
a, b, c, d. All patient education practices are evident in this scenario. Patient education should
aim to include these as well as holistic consideration of the whole person rather than focusing
on just specific content.
A patient has just received a new cancer diagnosis after being hospitalized for fatigue and
anemia (low red blood cell levels). The nurse has information about how to improve red blood
cell counts through appropriate nutrition. What is the most important thing that the nurse should
know prior to conducting this education?
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