Which statement by the nurse indicates an understanding of the definition of nursing informatics quizlet?

Informatics Nursing Exam Sample Questions

These sample questions apply to all exams taken on or after March 23, 2018.

The following sample questions are similar to those on the examination but do not represent the full range of content or levels of difficulty. The answers to the sample questions are provided after the last question. Please note: Taking these or any sample question(s) is not a requirement to sit for an actual certification examination. Completion of these or any other sample question(s) does not imply eligibility for certification or successful performance on any certification examination.

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This practice exam is not timed, and you may take it as many times as you wish. Good luck!

Which statement by the nurse indicates an understanding of the definition of nursing informatics?
a. “Nursing informatics is a specialty area of hospital nursing in which management of patient care is done via computers.”
b. “Nursing informatics is the specialty practice of nursing integrating nursing science with computer science and information science.” c. “Nursing informatics includes the input and retrieval of a patient’s complete medical history via electronic data.” d. “Nursing informatics is an area of computer system design and analysis to provide and retrieve patient health data during the period of hospitalization.”

ANS: B The ANA has defined informatics as “a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge and wisdom in nursing practice.

What is the focus or goal of Nursing Informatics?

Focus: is to improve patient care with health care technology that encourages clinicians to make more accurate and timely decisions. 

What are examples of regulatory agencies that will affect health care policy with regard to informatics?
a. Health Insurance Portability and Accountability Act (HIPAA)
b. American Nursing Credentialing Center (ANCC)

c. American Nurses Association (ANA) d. Medicare/Medicaid authorization

ANS: A The Joint Commission (TJC) and the Health Insurance Portability and Accountability Act (HIPAA) are two regulatory and governmental agencies instituting health care policy. The American Nurses Association (ANA) is the professional nursing organization. Medicare and Medicaid are governmental organizations that provide services. They do not regulate health care policy

In 2013 HIPPA created new rules? What changes were made to those Rules? (5)

1. Fines were increased if HIPPA was broken. 2. Patients were able to request there EHR in digital form. 3. When you pay by cash you can refuse information to be shared by your health plan. 4. New limits for marketing and fundraising. ( For Research) 5. You need consent from the patient for research purposes.

Which of the following statements indicates the nurses understanding of the difference between the electronic health record (EHR) and electronic medical record (EMR) is:
a. “EHR provides nursing with a standardized nomenclature of taxonomy to record nursing care.”
b. “EMR is the inclusion of only data collected by the patient (personal health record (PHR).”
c. “EHR is a longitudinal record of the patient’s health information.” d. “EMR allows nurses to document nursing care in a system that is intuitive to their level of computer literacy.”

ANS: C EHR is the longitudinal electronic record of patient health information generated by one or more encounters in any care delivery setting. Included in this information are patient demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data, and radiology reports. The EHR automates and streamlines the clinician's work flow. The EHR has the ability to generate a complete record of a clinical patient encounter—as well as supporting other care-related activities directly or indirectly via interface—including evidence-based decision support, quality management, and outcomes reporting. The EMR is composed of data from multiple software applications used by a facility such as a hospital or provider officer to order, document, and store patient information just as a paper medical record did in the past. The ability of the computer systems to combine data from various EMRs to form a more holistic view of a patient is one of the major benefits of electronic documentation. The inclusion of data collected by the patient into the EHR is called the personal health record (PHR)

____ is Data that is collected by the patient into the EHR.

(PHR) Personal Health Record

What would the Personal Health Record be used for? Examples.. What are the problems with a PHR?

- Inputting family history - A diabetic inputting real time blood glucose - Someone with Hypertension would put in there blood pressure readings. - Someone tracking there Diet or excersie could put in there exercise information.
- Problems 1. who owns it 2. The patients could be with holding data which is critical for the provider to know which could impact the course of treatment of the patient.

_____ is information technologies in prescribing and dispensing medications. Give an Example of this.

-Medication Fulfillment - Example of this is Micromedex being part of the MAR.

____ is entering patient care orders directly into a system that transmits these orders directly into the receiving departments with out any following steps. What are the benefits of this system and What are the benefits of this system?

Answer: Computerized Provider Order Entry System ( CPOE) and Clinical Decision Support.
Benefits: You don't have to read handwriting and Similar drug names, Drug interactions are flagged,  Drug specification Errors such as the Dose is to high. Fast Transmission

Give Examples of Technology-Enabled Medication Administration. (2)

- Bar coding - Dispensing Equipment Pixis machine

Stages of Meaningful use of EHR to patients

1. record demographics and record meds 2. more responsiblities where they can get lab results and record current meds 3. not quite defined at this point

_____ requires hospitals and providers to supply patients with "the capability to electronically view, download, and transmit relevant information from their provider;s electronic health record..

Which action can the nurse take to evaluate an internet resource? a. Assume that the resource is credible if it is on an internet page. b. Determine if the resource provides evidence for claims made. c. Assess the popularity of the resource. d. Determine the date the resource was published; older material is more reliable.

ANS: B To evaluate an internet resource, the nurse should use the CARS checklist developed by Harris (2007). The nurse should assess credibility, accuracy, reasonableness, and support. The nurse assesses support by determining if the source provides evidence for claims made. The nurse should not assume that the resource is credible because it is on the internet, assess popularity, or rely on information that is old or outdated.

What are the 5 Steps in Evaluation of a Website?

1. Authority- Who are the Authors 2. Timeliness- When was the site created and when was it updated. 3. Purpose- Who is the targeted Audience 4. Accuracy- Content Objective, Is there Bias? 5. Structure- is the site secure? and easy to Access.

What is the Tiger initiative? 

T- Technology I- Information G- Guided R- Reform - Nursing Guided principles to make practices safer through technology.

_____ are violent acts including physical assaults and threats or assault, directed at individuals at work or on duty. This can include verbal abuse, Threats, unwanted sexual advances, physical assault, and murder.

What are the signs of escalating violence?

- Pacing - Using foul language - Raising ones fist - Using Threats

After completing a crisis intervention course, the nurse recognizes the signs of escalating violence as: a. pacing and cursing. b. repeatedly pushing the call bell. c. crying and complaining of no pain relief. d. staring out the window and not responding to questions.

ANS: A Signs of escalating violence include pacing, using foul language, cursing, raising of fists, and threats. The other options are typical behaviors that are noted in the hospital setting that do not reflect a situation where the person is escalating out of control.

____ a systematic, health-harming mistreatment of one or more individuals by one or more perpetrators that can be verbal, behavioral, and or sabotage. 

Horizontal Violence - "Bullying" It is fostered in the healthcare environment and it seems to happen over time due to change.

A nurse believes to be bullied at work. Which of the following actions by the perpetrator lead them to believe this? a. Offering to help with their assignment b. Asking them to switch a shift c. Asking them to cover for a break d. Being given the “silent treatment

ANS: D Being given the “silent treatment” is a sign of bullying. Offering to help with an assignment and asking to switch a shift or cover a break are not considered signs of bullying.

A nurse feels bullied at work. Which of the following actions should the nurse take first? a. Ignore the bullying. b. Report the bullying. c. Take action against the bully themself. d. Take time off from work.

ANS: B The nurse should first report the bullying to get the behavior to stop. The next step would be to take time off of work recover from the incident. The nurse should never ignore the bullying or take action against the other person by themself.

The new nurse has an adequate understanding of bullying when stating which of the following? (Select all that apply.)
a. “The purpose of bullying is to control the target.” b. “Bullying can verbal, behavioral, or sabotage.” c. “Bullying usually occurs as a single event.” d. “Bullying is initiated by the perpetrator.” e. “The victim usually deserves the bullying.”

ANS: A, B, D The new nurse has an adequate understanding when stating that the purpose of bullying is to control the target. It can be verbal, behavioral, or sabotage. Bullying is not a single event; rather, it occurs over time. It is initiated by the perpetrator and is not something that the victim deserves to have happen .

The Occupational Safety and Health Administration (OSHA) provides guidelines to protect health care workers from needlesticks. Which action by the nurse manager shows the use of the guidelines in practice?
a. Purchasing safety devices b. Providing a safe working environment c. Working with the local health department d. Establishing guidelines for safe nursing practice

ANS: A OSHA has established guidelines that employers must follow to protect their workers. The Needlestick Safety and Prevention Act became law in November 2000, requiring the use of safer devices to protect workers from sharps injuries. Advocating for workplace safety, the ANA was very instrumental in having this piece of federal legislation passed. This act amends the Blood-Borne Pathogen Standard (administered by OSHA) to require the use of safer devices to protect from sharps injuries. It also requires that employers solicit the input of nonmanagerial employees who are responsible for direct patient care regarding the identification, evaluation, and selection of effective engineering and work-practice controls. Providing a safe working environment is a good option, but it does not specifically address the safety devices required for prevention of needlestick injuries. OSHA does not provide for safe nursing practice guidelines.

The Needlestick Safety and Prevention Act of 2000 was implemented to prevent health care workers from experiencing needlestick injuries. Which of the following is required to be documented regarding a needlestick injury?
a. Notify the patient’s physician. b. Advise the hospital risk management department. c. Document the department or work area in which the exposure occurred.  d. Send the injured staff person to the emergency room for documentation of the incident.

ANS: C The Needlestick Safety and Prevention Act requires documentation of the department and work area in which the needlestick injury occurred. It also requires employers to maintain a sharps injury log to document the type and brand of device involved and an explanation of how the incident occurred. The information is to be recorded and maintained in a way that protects the confidentiality of injured employees. The test question is asking for “required documentation,” so notifying the doctor is not appropriate. More than likely, the person would be sent to the occupational safety department for follow-up and documentation.

What are the benefits of E-prescribing? (2)

1. reduces mistakes that occur with handwritten prescriptions. 2. correlates the prescription with a patients medical history to automatically Check drug allergies, drug-drug interactions , and overly high doses..

What are the benefits of CPOE?

1. Averting problems with hand writing 2. Similar Drug names 3. Drug interactions and Specification errors. Adverse drug events ,drug to drug interaction, multi dosing,  faster transmission, 4. Potential economic savings

What are the signs of escalating violence? (4)

1. Pacing 2. using foul language 3. raising ones fist 4. Using threats.
Remember to always keep yourself between your patient and the door.

_____ goes beyond hazing. The is purpose is to control the target and usually occurs over time.

What are the 4 outcomes with the Needlestick safety Act of 2000

1. Use of safety devices to protect from sharps injuries
2. Tracing and recording work-practice controls

3. Maintain log to document type and brand of device involved in each incident, department where occurred, and explanation of how it happened.
4. Meant to protect confidentiality of employee but to assist to help determine the relative effectiveness and safety of currently used devices and to guide the development of future products.

A nurse manager is educating a coworker on agencies that oversee environmental hazards at ambulatory care centers. The nurse manager judges the teaching to be effective when the coworker states:
a. “National Council of State Boards of Nursing has a role in overseeing any environmental hazard.”
b. “American Nurses Credentialing Center oversees all environmental hazards in the United States.”
c. “Ambulatory Care Nursing Administration and Practice oversees only local environmental hazards.”
d. “ The Occupational Safety and Health Administration oversees all environmental hazards at ambulatory care centers.”

ANS: D The purpose of the Occupational Safety and Health Administration (OSHA) and the state health department is to establish safety and health standards in the work environment. OSHA requires employers to provide a safe work environment for employees. The other options refer to agencies that regulate professional nursing practice (NCSBN) and provide credentialing (ANCC). Ambulatory Care Nursing Administration and Practice is not a recognized agency. There is the American Academy of Ambulatory Care Nursing (AAACN), which is the association of professional nurses and associates who identify ambulatory care practice as essential to the continuum of high quality, cost-effective health care.

____ is concerned with the fair allocation of resources among diverse members of a community. Fair allocation typically takes into account the total amount of goods to be distributed, the distributing procedure, and the pattern of distributation that results.

Is based on the evaluation of outcomes or results of the business relationship.

Conducted to understand the root of the problem and to create solutions for addressing and correction of potential subsequent issues resulting from the identified problem.

___ is the Gold standard of safety  that follows model of excellence, have better patient outcomes, implement shared governance structure. 

____ is something done considered harmful to society as a whole, includes Felonies or misdemeanors. 

____ is a term for private interests and rights between individuals; malpractice, negligence, and informed consent issues.

___ is immunity from malpractice to those professionals who attempt to give assistance at the scene of an accident.

How would a person be sued with the Good Samaritan Law?

If found to have acted in a grossly negligent manner. Is expected that all persons not leave a victim in a position that is more dangerous than when found. After you stop to help, stay until you are given clearance by emergency responders..

4 Elements of Malpractice Liability

1) Duty - that nurse had a duty to the patient to care for them 2) Breach of Duty - nurse failed to meet standard of care 3) Causation - the breach of duty is what caused damages 4) Damages - they suffered some kind of damage

Many nurse practice acts have mandatory reporting obligations. Some states discipline nurses who fail to report an impaired colleague pursant to the mandatory reporting requirement. Allowing an impaired nurse to practice not only puts the nurse and the patient at risk but also negatively impacts the facilitys reputation and the nursing profession as a whole. Report actions through your chain of Command.

What is the purpose of the the Whistle blower statues?

Protects nurses from retaliatory action and may also reward them for reporting concerns: 1. Report concern to the national/ or state agency responsible for regulation of organization. 2 . Put your complaint in writing 3. Take this very seriously

____ is a Moral and Ethical principle with self-determination without outside control.

The ethical principle of doing or actively promoting good; related nursing actions include determining how the patient is best served.

_____is an Moral and Ethical Principle of avoiding doing harm. 

Which ethical principle refers to being faithful and loyal to commitments and agreements made to provide client services as long as they do not cause danger to the client or to others?

____is an Moral and Ethical Principle of treatment of all fairly.

_____is an Moral and Ethical Principle of Telling the Truth.

_____ is a fundamental right but one that can be taken away if personal rights have potential harm to public rights.

____ is a term which Its a Duty focused and centered on rules from which all action is derived. The rules represent beliefs about intrinsic good that are moral absolutes.

Deontological - This approach reasons that all persons are worthy of respect and should be treated the same. - Right and wrong is based on one's duty or obligation to act not on the consequences of one's actions. - Absolute rules that are sometimes seen as ridged or inflexible. but its strength is in its unbending approach to many issues, emphasizing the intent of actions. .

____ is a Ethical theory based on outcome-focused and places emphasis on results.

Teleological/ Utilitarianism. -The end justifies the means. The rights of some may be sacrificed for the majority.

____ is a result of abuse by Experiments conducted without consent resulting in mutilation, disability and death. Identifies need for voluntary informed consent for medical experiments on human beings,  Patients right to autonomy and health cares providers responsibility to be faithful to that right.

-Nuremberg Code
-Delineates limits and restrictions that researchers must recognize and respect.

____ is created to assist with ethical dilemmas in institutional settings. Provides consultation and emotional support in situation in which difficult ethical choices are necessary.

List the group members you would see on a Ethics Committee. Name (6)

1. Provider 2. Nurse 3. Case Manager 4. Social worker 5. Clergy 6. administration 7. business representative 8. legal representative 9 Lay people

What are the 7 steps in the Ethical Decision Making process.

1. Gather Data and identify Conflicting moral claims 2. Identify Key participants 3. Determine Moral Perspective . 4. Determine Desired outcomes 5, Identify options 6. Act on the Choice 7. Evaluate the outcomes of Action.

___ Serves the Following Purpose: 1. It is succinct statement of ethical values, obligations, duties, and professional ideals of nurses individually and collectively.
2. It is the professions nonnegotiable  standard.
3. Its is an expression of Nursing's own understanding of its commitment to society.

What is the purpose of the Nursing Code of Ethics?

It helps set professional standards and its our commitment to society.

What are the six things that you should assess when it comes to spiritual care? (6)

1. Spirit- Enhancing practices or Rituals 2. Experience of God or Transcendence 3.  Sense of meaning 4. Giving and Receiving Love 5. Sources of hope and strength 6. Link between Spirituality and Health

What are the three component it takes to be a good Patient Advocate?

1. Providing information that is useful to the patient 2. Supporting the patients decisions. 3. Collaborative relationship

What are the 4 objectives of the Nurse practice Act?

1. Defines the practice of professional nurse 2. Sets the minimum educational qualifications and requirement for licensure. 3. Determines the legal titles and abbreviations nurses may use. 4. Provides for disciplinary action licensee for certain causes.
Reason: To protect the public.

What is the differnce between libel and slander?

a.      Libel is the written form of exposing someone to ridicule or contempt them

b.      Slander is the spoken form of libel

A nurse manager is teaching the purpose of the nurse’s Code of Ethics to a group of high school students. Which statement by one of the students indicates that the teaching has been effective? The purpose of the nurse’s Code of Ethics is
a. to assist in clarifying the individual nurse’s personal values and goals.” b. “to differentiate between moral and immoral acts.” c. “to guide the behavior of the professional nurse. d. “to identify acts that are legal for the nurse to perform.

ANS: C
The American Nurses Association (ANA) Code of Ethics (2001) is a statement to society that outlines the values, concerns, and goals of the profession. It should be compatible with the values and goals of each nurse. It does not outline moral or immoral acts or make statements regarding legal aspects of nursing

Which statement best describes the Code of Ethics of the American Nurses Association?
a. A moral statement of accountability for practicing nurses and for student nurses b. A legal document describing the responsibilities of the nurse c. A statement regarding nursing care that outlines principles for the hospital to use to evaluate quality of care d. A document that is used as a guide for the nurse to consider in the decision-making process in legal situations

ANS: B The Code of Ethics is a moral statement of accountability for practicing nurses and for student nurses. It is a statement to society that outlines the values, concerns, and goals of the profession, thereby addressing accountability. The code provides direction for ethical decisions and behavior by repeatedly emphasizing the obligations and responsibilities that the nurse–patient relationship entails. It lacks legal enforceability and is not a legal document like licensure laws

A nurse is educating themself on the ANA Code of Ethics. Which action by the nurse would be unethical, according to the ANA Code of Ethics?
a. Joining unions or bargaining units b. Engaging in lobbying related to health care issues c. Reporting an incompetent or impaired colleague d. Refusing to care for a patient who is diagnosed as HIV positive

ANS: D ANA Code 1: The nurse provides services with respect for human dignity and the uniqueness of the patient unrestricted by considerations of social or economic status, personal attributes, or the nature of the health problem. Nurses have the right to engage in collective bargaining and lobbying for health care issues. Nurses have a legal responsibility based on the Nurse Practice Act in their states to report an incompetent of impaired colleague.

A patient who has a terminal illness wants to be able to take a prescription medication to end life when suffering becomes unbearable. The patient asks the nurse for advice. Operating from a deontological point of reference, what action does the nurse take?
a. Advises the patient about local providers willing to participate b. Assesses the patient for more information about the situation c. Determines what kind of insurance the patient has before acting d. Tells the patient that they cannot participate in this action

ANS: D Deontology is rule-bound and inflexible, obtaining moral authority from absolutes revealed by God. To preserve the sanctity of life, the nurse cannot participate in this situation. Advising the patient of providers to see is working from a teleological viewpoint because the end (patient death) might be seen as outweighing the means (helping the patient find a provider to provide a lethal prescription of drugs). Assessing the situation to see how the patient is affected (versus how some other patient would be affected) is situational. Determining financial status is not related to a specific philosophical outlook but might violate the principle of justice.

A nurse is educating a group of nursing on the deontological model of ethical reasoning. The nurse determines that the teaching has been effective when a student states:
a. “All life is worthy of respect.” b. “Abortions are ethical.” c. “Euthanasia is acceptable in certain situations.” d. “Lying is acceptable if it benefits the patient.”

ANS: A The deontological model of ethical reasoning states that all life is worthy of respect. Abortions and euthanasia are never acceptable because they violate the duty to respect the sanctity of all life. Lying is never acceptable because it violates the duty to tell the truth.

A nurse is educating nursing students on the teleological model of ethical reasoning. The nurse judges that the education has been effective when a student states
: a. “Abortion is acceptable because it results in fewer unwanted babies.” b. “Abortion is never acceptable because it violates the sanctity of life.” c. “Euthanasia is never acceptable because it violates the sanctity of life.” d. “The rights on individuals should not be sacrificed for the good of the majority.”

ANS: A The teleological model of ethical reasoning is interpreted as meaning “the end justifies the means.” The rights of some individuals may be sacrificed for the majority. Therefore, abortion may be acceptable because it results in fewer unwanted babies. Euthanasia may be acceptable because it results in decreased suffering.

What ethical principle is implemented, or supported, when the nurse encourages a patient to be involved in planning and implementing self-care?
a. Autonomy c. Justice b. Fidelity d. Veracity

ANS: A A patient’s right to self-determination implies the freedom to make choices and decisions about one’s own care without interference even if those decisions are not in agreement with those of the health care team. Justice is the duty to treat all patients fairly without regard to age, socioeconomic status, or other variables. This principle involves the allocation of scarce and expensive health care resources. Fidelity involves keeping information confidential and maintaining privacy and trust. Veracity is the duty to tell the truth

The ethical principle of autonomy is not applicable in which patient situation?
a. The patient does not speak or understand the English language. b. The patient is unaware of who or where he or she is. c. The patient has been in a long-term care facility for 10 years. d. The patient has values that conflict with the caregiver’s values

ANS: B This principle assumes rational thinking on the part of the individual, and being unaware of who and where the patient is, is not indicative of the ethical principle of autonomy. Autonomy is a patient’s right to self-determination implies the freedom to make choices and decisions about one’s own care without interference even if those decisions are not in agreement with those of the health care team. In the other situations, the patient has rational thinking even though he or she may not understand or speak English because an interpreter could assist

The nurse is very busy caring for a large case load. An adult patient mentions that by having slow mobility, “people just do things for me rather than allowing me to do as much as possible on my own.” To solve the dilemma of needing to conserve time versus supporting the patient’s involvement in self- care, what principle may help the nurse?
a. Veracity c. Justice b. Fidelity d. Autonomy

ANS: D Autonomy implies the freedom to have choices and make decisions about one’s own care without interference. Just because this patient is slow does not mean he or she cannot make choices and participate in self-care. Justice is the duty to treat all patients fairly without regard to age, socioeconomic status, or other variables. This principle involves the allocation of scarce and expensive health care resources. Veracity is the duty to tell the truth. Fidelity involves keeping information confidential and maintaining privacy and trust.

Advance directives such as the health care proxy and living will support what ethical principle?
a. Veracity c. Beneficence b. Advocacy d. Autonomy

ANS: D Autonomy implies the freedom to make choices and decisions about one’s own care without interference even if those decisions are not in agreement with those of the health care team. Veracity is the duty to tell the truth. Beneficence is the duty to actively do good for patients. Speaking out on behalf of the patient is an essential part of the advocacy role of the nurse.

Which action by the nurse shows an understanding of the ethical principle of autonomy?
a. Allowing a patient the right to make decisions regarding his health care even if the nurse does not agree with his decisions. b. Making decisions for the patient regarding his care c. Disregarding the patient’s decisions because they are not “normal” according to society d. Consulting the attending physician to make decisions for the patient

ANS: A
The nurse shows understanding of the ethical principle of autonomy by allowing patients the right to make their own health care decisions even if the nurse does not agree with their decisions. It is not up to the nurse or the attending physician to make health care decisions for patients

The nurse is educating a coworker on the ethical principle of beneficence. The nurse judges the teaching to be effective when her coworker states:
a. “Beneficence involves allowing patient to make their own health care decisions.” b. “Beneficence is the duty to actively do good for patients.” c. “Beneficence is the duty to do no harm.” d. “Beneficence involves treating all patients equally.”

ANS: B Beneficence is the ethical principle of actively doing good for patients. Allowing patients to make their own health care decisions is autonomy. Doing no harm to the patient is nonmaleficence. Justice involves treating all patients equally

A nurse is educating a nurse aide on patient confidentiality. The nurse believes the teaching to be effective when the nurse aide states that confidentiality will be maintained by a nurse who believes in and values the ethical principle of
a. veracity. c. justice. b. autonomy. d. fidelity.

ANS: D
Fidelity involves keeping information confidential and maintaining privacy and trust. Veracity means to tell the truth. Autonomy involves the patient making an informed decision and implies the freedom to make choices and decisions about one’s own care without interference even if those decisions are not in agreement with those of the health care team. Justice is the duty to treat all patients fairly without regard to age, socioeconomic status, or other variables.

Which ethical principle is applied when the nurse acts to safeguard the patient and the public by reporting poor nursing practice?
a. Autonomy c. Justice b. Fidelity d. Veracity

ANS: D
Veracity—the duty to tell the truth—is represented in this situation. Autonomy is the right of the patient to make an informed decision. Fidelity means to act in a way that is loyal, such as keeping information private and confidential. Justice requires the nurse to treat all patients fairly without regard to age, socioeconomic status, or other variables

A nurse is educating nursing students on the teleological model of ethical reasoning. The nurse judges that the education has been effective when a student states:
a. “Abortion is acceptable because it results in fewer unwanted babies.” b. “Abortion is never acceptable because it violates the sanctity of life.” c. “Euthanasia is never acceptable because it violates the sanctity of life.” d. “The rights on individuals should not be sacrificed for the good of the majority.”

ANS: A The teleological model of ethical reasoning is interpreted as meaning “the end justifies the means.” The rights of some individuals may be sacrificed for the majority. Therefore, abortion may be acceptable because it results in fewer unwanted babies. Euthanasia may be acceptable because it results in decreased suffering.

A nurse is caring for a patient who has just been diagnosed with cancer. The patient’s family has requested that the patient not be told at this time because it would be devastating. The patient asks the nurse if the diagnosis is cancer. If the nurse were to uphold the ethical principle of veracity, what would the response be?
a. “No, you do not have cancer.” b. “The physician is unsure of your diagnosis at this time.” c. “Yes, that is the diagnosis. Let me call the doctor so that we can have a discussion.” d. “Yes, but your family told me that I could not talk to you about the diagnosis.”

ANS: C If the nurse were to uphold the ethical principle of veracity, the nurse would inform the patient of the diagnosis and involve the physician in the discussion. The nurse should not lie to the patient or withhold information at the family’s request; the patient has a right to know information regarding his or her health care.

What is a correct statement regarding a nurse who acts beyond the scope of practice?
a. Demonstrates what a good nurse he or she can be b. Provides enriched services to patients who would not otherwise receive them c. May make other nurses angry because of the increased expectations created d. May be disciplined by the board of nursing

ANS: D States may regulate nursing practice by controlling the scope of practice and determining the specific activities for each level of nursing. In most states, the Nurse Practice Act provides definitions and scope of practice for each level of nursing practice. The power of the board to discipline can have an adverse effect on the nurse’s ability to practice. Practicing beyond the scope of practice does not demonstrate what a good nurse the person is and does not provide enriched services. Other nurses would not be angry at increased expectations but at the foolishness of the nurse practicing beyond the scope of practice.

The nurse has an adequate understanding of risk management when stating which of the following? (Select all that apply.)
a. “Risk management becomes involved when incidents occur.” b. “Risk management becomes involved when untoward events occur.” c. “Risk management becomes involved to discipline the nurse.” d. “Risk managers gather evidence surrounding the event.” e. “Risk managers will interview those involved in an event.”

ANS: A, B, D, E
Risk management becomes involved when incidents and untoward events occur. Risk managers gather evidence surrounding the event and interview those involved. Risk management does not become involved to discipline the nurse.

A nurse tells a patient, “If you don’t stop getting out of that chair, I’m going to put some restraints on you.” What may this nurse be accused of?
a. False imprisonment c. Invasion of privacy b. Defamation d. Malpractic

ANS: A
Assault and battery are the legal terms applied to nonconsensual threat of touch (assault) or the actual touching (battery). Use of restraints may also be interpreted as false imprisonment. False imprisonment means making someone wrongfully believe that they cannot leave a place. It is often associated with assault and battery claims. Assault and battery are the legal terms applied to nonconsensual threat of touch (assault) or the actual touching (battery). Malpractice is the improper performance of professional duties, a failure to meet the standards of care that results in harm to another person. Defamation (libel and slander) refers to causing damage to someone else’s reputation. If the means of transmitting the damaging information is written, it is called libel; if it is oral or spoken, it is called slander. Invasion of privacy applies to several behaviors, such as photographing a procedure and showing it without the patient’s consent, going through a patient’s belongings without consent, or talking about a patient’s private life publicly.

A nurse is giving a presentation on malpractice. Which statement indicates the nurse understands malpractice?
a. “The elements of duty, breach of duty, and patient injury must be present for a malpractice claim.”
b. “Negligent nursing care and failure to follow standards must be present for a malpractice claim.”
c. “Failure to report, defamation, and discrimination must be present for a malpractice claim.”
d. “Error in judgment and invasion of privacy must be present for a malpractice claim.”

ANS: A
There are three elements that must be present for a malpractice claim: (1) You must have a duty—there must be a professional nurse–patient relationship. (2) You must have breached a duty that was foreseeable—you must have fallen below the standard of care. (3) Your breach of duty caused patient injury or damages. The other options do not indicate the nurse’s understanding of malpractice.

What is a significant action a nurse can take to prevent being named in malpractice suits?
a. Refuse to care for suit-prone patients. b. Carry professional liability insurance. c. Maintain updated professional knowledge and skills. d. Check with a nursing supervisor before undertaking care

ANS: C
When you become a registered nurse, you will have a license to practice nursing. This license sets certain standards, which you must follow as a nurse in the state. Should you not live up to these standards, your state can take away your ability to practice as a nurse. The best way to maintain those standards to practice professionally is to stay updated on skills and knowledge. Refusing to care for patients does not prevent you from being named in other malpractice suits. Carrying professional liability insurance does not prevent a malpractice suit but may provide assistance and monies in paying out claims. Although it is important to check with a supervisor about questions concerning nursing care, it may not prevent you from being named if you perform a procedure or intervention incorrectly.

A nurse places a heating pad on the lower leg of a patient with peripheral vascular disease. When the heating pad is removed, it is apparent that the patient has sustained partial-thickness burns to the area covered by the pad, and the nurse is sued for malpractice. Which statement is true?
a. All elements are present to find the nurse liable for damages.
b. Proximate cause cannot be established, so the nurse will not be found liable c. The standard of care in such a situation cannot be established, so the nurse will not be found liable.
d. No duty to the patient exists, so the nurse will not be held liable.

A nurse wants to avoid malpractice claims. What action can be taken to greatly reduce the risk of a lawsuit?
a. Reduce work status to part time. b. Implement fall precautions on an older adult patient.
c. Leave clutter on the floor in patient rooms. d. Leave the patient’s bed in the highest position

ANS: B To protect themself from a malpractice claim, the nurse can implement fall precautions on an older adult patient. These include supervising the patient when getting out of bed, keeping the floor clear, and placing the bed in the lowest position. Reducing work status to part time would not guarantee that the nurse wouldn’t be named in a lawsuit.

During a life-threatening emergency, a nurse hurriedly gives the patient a medication by IV push. There is extravasation of medication. Later, necrosis and tissue sloughing take place. The nurse’s behavior may be the basis for what action?
a. Felony charge c. Tort suit b. Misdemeanor charge d. Defamation suit

ANS: C
Unintentional torts are those that usually involve an inadvertent, unreasonable act that causes harm to someone. Civil, as opposed to criminal, actions are also called torts. Remember that civil actions occur when a plaintiff files a lawsuit to receive compensation for damages he or she suffered as a result of a perceived wrong. Unintentional torts are those that usually involve an inadvertent, unreasonable act that causes harm to someone. Defamation (libel and slander) refers to causing damage to someone else’s reputation. If the means of transmitting the damaging information is written, it is called libel; if it is oral or spoken, it is called slander

In a legal suit, what element is necessary to prove a tort has been committed?
a. Intent c. Injury b. Assault d. Malpractice

ANS: C
There are four elements that need to be present in a malpractice case, one of which is patient injury. The patient will have to prove that the specific nursing action caused injury or harm. The nurse, as a defendant, does not have a “burden of proof.”

A new nurse is preparing to start a new job. What actions should the nurse take to be prepared in case workplace violence occurs? (Select all that apply.)
a. Take a crisis intervention course to understand signs of escalating violence. b. Become familiar with the organization’s policy regarding violence. c. Be prepared to handle any violent situation alone.
d. Be aware of procedures that can be used to defuse situations.
e. Appear intimidating so that the violent person will back down.

ANS: A, B, D The nurse should take a crisis intervention course to understand signs of escalating violence, become familiar with the organization’s policy regarding violence, and be aware of procedures that can be used to defuse situations. The nurse should never handle any violent situation alone or try intimidation to make a violent person back down because this could backfire.

A patient with cancer has decided to end treatment and is discussing end-of-life care with family. The nurse notices that the attending physician has just ordered another dose of chemotherapy. What would be the best action for the nurse to take as an advocate for the patient?
a. Send the order to pharmacy so that the chemotherapy can be prepared.
b. Call the attending physician and request a meeting so that there can be open communication between the physician, patient and family.
c. Tell the patient that because the chemotherapy has been ordered, it must be given.
d. Request a meeting with the attending physician, patient, and family so the attending physician can convince the patient to receive the chemotherapy.

Ans: B
As an advocate for the patient, the nurse should advocate for the patient with the attending physician and family by facilitating communication. It would be best for all parties to be in a room together so that a discussion can take place. It would not be appropriate to send the order to pharmacy, try to convince the patient to receive chemotherapy, or to tell the patient that the drug must be given because it was already ordered. 

A nurse is educating students on how to evaluate a website. The nurse judges the teaching to be effective when the students can state:
a. “Internet information must go through careful screening before it can be posted.”
b. “Credibility, accuracy, and reasonableness of the information should be considered.”
c. “It is important to have the hospital librarian verify the authenticity of the website.”
d. “Most Internet information can be downloaded or beamed to a smartphone or handheld device (personal digital assistant [PDA]).

ANS: B
The credibility of the information that you obtain from Internet searches should be challenged. It is important to be skeptical because not all information that is posted on a website is accurate. Information should be evaluated and reevaluated on a regular basis. It is important to remember that Internet information is dynamic and fluid in nature compared with printed information. Although librarians can assist with the verification of the authenticity of the website, nurses need to understand how to evaluate information from various Internet sources. It is true that most information can be downloaded to a smartphone or handheld device; however, the question is asking about evaluating a website.

How can the nurse expect to be impacted by nursing informatics?
a. The nurse would not be directly impacted unless he or she worked in nursing informatics. b. Nurses at the bedside are minimally impacted. c. Nurses are impacted by the use of barcode medication administration. d. Nurse managers are the only hospital staff who are impacted.

ANS: C
Everyone in the health care system is impacted by nursing informatics in one way or another. Nurses are directly impacted by the use of barcode medication administration

The nurse understands the benefits of Computerized Provider Order Entry (CPOE) when stating:
a. “CPOE does not change the process of patient care.”
b. “CPOE averts problems with hand-written orders.”
c. “CPOE benefits only the nurses in the health care system.”
d. “CPOE benefits only the pharmacists in the health care system.

ANS: B Provider Order Entry benefits everyone in the health care system and greatly changes the process of patient care, as well as averts problems with handwritten orders.

After completing a crisis intervention course, the nurse recognizes the signs of escalating violence as:\
a. pacing and cursing.
b. repeatedly pushing the call bell.
c. crying and complaining of no pain relief.
d. staring out the window and not responding to questions.

ANS: A
Signs of escalating violence include pacing, using foul language, cursing, raising of fists, and threats. The other options are typical behaviors that are noted in the hospital setting that do not reflect a situation where the person is escalating out of contro

Which statement by the nurse manager indicates understanding of Magnet status?
a. “Hospitals are granted Magnet status by the National League of Nursing.” b. “The American Nurses Association grants Magnet status.”
c. “Hospitals are granted Magnet status by the American Nurses Credentialing Center.”
d. “The National Council of State Boards of Nursing grants Magnet status.”

ANS: C
The American Nurses Credentialing Center is responsible for judging whether hospitals achieve Magnet status, which is an American Nurses Association subsidiary. The National League of Nursing accredits nursing programs. The National Council State Boards of Nursing is the national regulatory body for nursing practice and nurse licensur