Question 1

The most common cause of gastrointestinal bleed is:
A)Trauma
B)Endoscopy procedures
C)Peptic ulcer
D)Alcohol intake

Accepted Answer

The most common cause of gastrointestinal bleed is peptic ulcer. A peptic ulcer, also known as ulcus pepticum, PUD or peptic ulcer disease, is an ulcer (defined as mucosal erosions equal to or greater than 0.5 cm) of an area of the gastrointestinal tract that is usually acidic and thus extremely painful.

Question 2

What is the leading cause of shock in newborns?
A)Dehydration
B)Third-spacing of fluids
C)Hypovolemia
D)Bradycardia

Accepted Answer

The leading cause of shock in newborns is hypovolemia. Hypovolemia can result from third-spacing fluids, hemorrhage, and dehydration. Manage with airway management, oxygenation, and IV fluid replacement with Ringer's lactate or saline at 10mL/kg.

Question 3

You are caring for a patient in the emergency department. The patient has been drinking alcohol and is asking for medication. When you instruct the patient that they have to wait to be seen by the doctor, the patient becomes verbally abusive. You then obtain a set of restraints and instruct the patient if they do not calm down you will restrain them. What can you be charged with?
A)Assault
B)Battery
C)Negligence
D)Invasion of privacy

Accepted Answer

You as the nurse can be charged with assault for threatening to restrain the patient. You as the nurse have put the patient in fear of harmful or offensive contact. In order for this to be a chargeable offense, the patient must be aware of the threat.

Question 4

You as the nurse are working on the unit. You enter the medication room and find another nurse taking intravenous medication and administering it to him- or herself. What should your next action be?
A)Call the police.
B)Call security.
C)Lock the nurse in the medication room.
D)Call the nursing supervisor.

Accepted Answer

You should call the nursing supervisor and report the nurse for taking medications from the unit. The nurse practice act requires that all impaired nurses be reported. The nursing supervisor should then report to the board of nursing who will develop a plan for treatment and supervision for the nurse.

Question 5

You are on break in the nursing lounge when a nursing assistant enters to tell you that what she just heard about the secretary. She then proceeds to tell you that the secretary's husband is a drug addict and she needs to be watched very carefully on the unit. You ask her what makes her think the secretary might take drugs, and she states that she heard it from someone else. What legal tort has the nursing assistant violated?
A)Slander
B)Libel
C)Assault
D)Negligence

Accepted Answer

Slander is when something untrue is said about a person that results in injury to that person's good name. Libel would be when something untrue is written about a person that results in injury to the person's good name. The nursing assistant was spreading gossip, not fact, about the secretary, leading to injury to her good name.

Question 6

You have been assigned to triage patients today. Which patient would get the highest priority?
A)A patient who ate spicy pizza who is now complaining of chest pain
B)A patient who injured their finger while cutting vegetables
C)A patient with a headache, fever and nasal congestion
D)A patient who complains of ankle pain when ambulating

Accepted Answer

A patient who is complaining of chest pain should get the highest priority. Patients with trauma, chest pain, respiratory distress and cardiac arrest would get the highest priority on the list. Patients with minor injuries, cold symptoms or sprains would fall next.

Question 7

You are planning the assignment for the day. Which of the following would be the most appropriate assignment for the nursing assistant?
A)A patient receiving a continuous tube feeding
B)A patient who needs a urine culture sent to laboratory
C)A patient who needs a colostomy changed
D)A patient who is having problems swallowing

Accepted Answer

The most appropriate assignment for the nursing assistant would be a urine culture collection for the laboratory. The nurse must choose the most appropriate assignment for each staff member on the unit. In this case the nursing assistant should have the appropriate skills to collect urine and send it to the laboratory.

Question 8

You have received reports on the patients that you are assigned to. After assessing each of your patients, which would you want to provide care for first?
A)An ambulatory patient who will be discharged today
B)A patient who has begun to run a fever and is anxious and diaphoretic
C)A patient who will receive physical therapy today
D)A patient who has been given pain medication

Accepted Answer

The patient who is now feverish, anxious and diaphoretic should be your first priority. This patient has the most immediate need. The other three patients do not have priority in the Maslow's hierarchy of needs.

Question 9

You are caring for a patient who needs to go to surgery. The patient is unable to sign consent due to narcotic analgesic administration. Who should sign the consent for surgery?
A)The family members should provide consent, and two witnesses will be necessary.
B)A court order will be needed.
C)The patient should go to surgery without consent.
D)The hospital chaplain should sign consent.

Accepted Answer

The nurse should call the family and get consent for the procedure. The nurse will need to have two witnesses available to sign. In emergency cases the physician is allowed to take a patient to surgery without consent if every effort has been made to contact the family.

Question 10

You are working with a child and suspect physical abuse. What is your primary legal responsibility?
A)Document your assessment thoroughly and accurately.
B)Report the abuse to local authorities.
C)Refer the family to support groups.
D)Assist the family in identifying resources and support systems.

Accepted Answer

The nurse should report her suspicions to the local authorities so they can investigate. The law makes it mandatory to report any suspected child abuse. All other options are important in dealing with patient and the family, but they would not be the priority of the nurse.

Question 11

There is a patient on the unit with herpes zoster. Which staff member would you avoid assigning to this patient?
A)A nurse who has never had mumps
B)A nurse who has never had chicken pox
C)A nurse who has never had roseola
D)A nurse who has never had German measles

Accepted Answer

The nurse who has never had chicken pox should not be assigned to this patient. Herpes zoster is caused by the same virus that causes chicken pox; therefore, assigning this nurse to this patient would increase her chances of contracting chicken pox from the patient.

Question 12

You are preparing an in-service for the staff on delegation. What would you want to include on how delegation impacts safety and quality of patient care?
A)It prevents staff from becoming ineffective and nonproductive.
B)It utilizes appropriate resources, getting the job done in the most effective way.
C)It gives nursing tasks to the staff members who can best understand the goals of treatment,
D)It creates team work on the unit,

Accepted Answer

Delegation is a way of getting the job done in the most effective way, while utilizing appropriate resources. The job must be delegated to the staff member who can accept the responsibility of the goal and achieve it. The other three options are incorrect.

Question 13

Which of the following patients would the nurse want to delegate to unlicensed assistive personnel?
A)A patient whose husband died and needs to talk
B)A patient with a nasogastric feedings and foley catheter
C)A patient with leakage from an ostomy
D)An ambulatory patient who has been on the unit for 3 days

Accepted Answer

The unlicensed assistive personnel should be assigned to the ambulatory patient who has been on the unit 3 days. The patient in D is the least complicated patient and does not have procedures that require licensed staff to complete. The other three patients require a high level of care and need a licensed staff member to provide this care.

Question 14

You are preparing the assignment for the day. You have one licensed practical nurse (LPN) and one unlicensed assistive staff member. Which of the following assignments would you not want to make?
A)LPN to reinforce discharge instruction with a patient
B)Unlicensed personnel to take vital signs and to document and report any changes
C)Unlicensed personnel to assess effectiveness of pain medication
D)LPN to remove dressing from an abdominal wound on a postoperative patient

Accepted Answer

The unlicensed personnel should not be assigned to assess the effectiveness of pain medication; it is the responsibility of the RN to assess. LPNs can perform dressing changes and reinforce discharge instructions. Unlicensed personnel can take vital signs and document and report any changes.

Question 15

When a registered nurse (RN) decides to delegate care to unlicensed personnel, what should the RN take into consideration when delegating care?
A)Amount of support from RN
B)Complexity of nursing tasks
C)Amount of time the staff member will need to complete care
D)Capability of the staff member to perform assessments

Accepted Answer

The RN needs to take the complexity of the nursing tasks into consideration when delegating care to unlicensed personnel. The nurse would need to consider the amount of education, skill, knowledge, and judgment of the unlicensed staff. The nurse would not consider the amount of support, but rather the amount of supervision that the staff member would need.

Question 16

You are observing one of the RNs on the unit administer medication. What action by the nurse would lead you to conclude there is a risk for a medication error?
A)Answering a physician's page while giving medication
B)Documenting in military time
C)Asking for help with calculations
D)Holding a medication that the patient questions

Accepted Answer

Answering the phone during medication administration puts the nurse at risk for making an error. It is important not to interrupt the process of administering medications to prevent error. All other options are correct ways of handling medication administration.

Question 17

You are delegating to a licensed practical nurse (LPN) to wound care on a patient. The LPN has never performed this type of wound care before. What component of delegation have you neglected?
A)Authority
B)Competency
C)Communication
D)Responsibility

Accepted Answer

You neglected to ensure that the LPN was competent to perform this skill. Therefore the RN must complete the care herself or find someone else who is competent to do so.

Question 18

You are caring for a patient with gastroesophageal reflux disease (GERD). You have an unlicensed staff member working with you. Which activity can you delegate to the unlicensed staff?
A)Teach the patient about weight loss.
B)Explore any concerns about managing the disease.
C)Explain why the patient needs eat several small meals a day.
D)Instruct the patient to remain upright for 2 hours following a meal.

Accepted Answer

The unlicensed staff member can instruct the patient to remain upright for 2 hours following a meal. Therapeutic counseling and communication are not within the scope of practice of unlicensed staff members. Assessment and teaching are the responsibility of the RN and can not be delegated.

Question 19

You will be working with an unlicensed staff member this shift. Which of the following should be priority before delegating care to the staff member?
A)Assessing whether the staff member is competent to perform the skill
B)Preparing written instructions on how to perform skill
C)Gathering supplies
D)Informing the patient that an unlicensed staff member will perform the care

Accepted Answer

The nurse should assess the unlicensed staff member's competency to complete the task assigned to them before delegating. Written instructions are not necessary if the staff is competent to complete the skill. Supplies will need to be gathered once an assignment is made. The staff member performing the procedure needs to give his or her name and title to the patient before performing the task.

Question 20

A nurse from the surgical care unit has been floated to your unit for the day. Which of the following patients would you want to assign to this nurse?
A)Exacerbation of heart failure
B)Diabetes Type II, new onset
C)Emergency appendectomy
D)Thyrotoxicosis

Accepted Answer

The nurse from the surgical care unit should be comfortable taking care of an emergency appendectomy patient. This nurse should be most comfortable with pre- and post-operative patients; therefore, the nurse should choose to give him or her those patients if available.

Quiz 3: PCCN, Pediatrics and Obstetrics, and Professionalism

The most common cause of gastrointestinal bleed is:

What is the leading cause of shock in newborns?

You as the nurse are working on the unit. You enter the medication room and find another nurse taking intravenous medication and administering it to him- or herself. What should your next action be?

You have been assigned to triage patients today. Which patient would get the highest priority?

You are planning the assignment for the day. Which of the following would be the most appropriate assignment for the nursing assistant?

You have received reports on the patients that you are assigned to. After assessing each of your patients, which would you want to provide care for first?

You are caring for a patient who needs to go to surgery. The patient is unable to sign consent due to narcotic analgesic administration. Who should sign the consent for surgery?

You are working with a child and suspect physical abuse. What is your primary legal responsibility?

There is a patient on the unit with herpes zoster. Which staff member would you avoid assigning to this patient?

You are preparing an in-service for the staff on delegation. What would you want to include on how delegation impacts safety and quality of patient care?

Which of the following patients would the nurse want to delegate to unlicensed assistive personnel?

You are preparing the assignment for the day. You have one licensed practical nurse (LPN) and one unlicensed assistive staff member. Which of the following assignments would you not want to make?

When a registered nurse (RN) decides to delegate care to unlicensed personnel, what should the RN take into consideration when delegating care?

You are observing one of the RNs on the unit administer medication. What action by the nurse would lead you to conclude there is a risk for a medication error?

You are delegating to a licensed practical nurse (LPN) to wound care on a patient. The LPN has never performed this type of wound care before. What component of delegation have you neglected?

You are caring for a patient with gastroesophageal reflux disease (GERD) . You have an unlicensed staff member working with you. Which activity can you delegate to the unlicensed staff?

You will be working with an unlicensed staff member this shift. Which of the following should be priority before delegating care to the staff member?

A nurse from the surgical care unit has been floated to your unit for the day. Which of the following patients would you want to assign to this nurse?