NUR 3030 Exam 1

A client admitted to the inpatient medical-surgical unit has suffered sudden respiratory failure. The client's condition is getting worse; the client is cyanotic (turning blue) with periods of labored breathing. Which action should the nurse take first?
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A client admitted to the inpatient medical-surgical unit has suffered sudden respiratory failure. The client's condition is getting worse; the client is cyanotic (turning blue) with periods of labored breathing. Which action should the nurse take first?
Look for an advance directive.
A hospital uses a source-oriented medical record. What is a major disadvantage of this charting system?
Data may be fragmented and scattered throughout the chart.
A student nurse makes the following comments to the preceptor: "I love getting information from the chart. Everything related to the patient's problem is together and addressed by various members of the healthcare team." The student nurse has been introduced to which type of charting system?
Problem-oriented
The department of nursing at a local hospital is considering changing to charting by exception (CBE). Which example would be a major disadvantage of CBE?
Can increase the risk of omissions in client care
Which prescription would the nurse question since it is inconsistent with the standards established by The Joint Commission?
Administer Lasix 10.0 mg PO daily at 1000
A patient with a history of hypertension and rheumatoid arthritis is admitted for surgery, a colon resection, for colon cancer. Which integrated plan of care (IPOC) would be priority for the nurse to implement?
Postoperative colon resection
The nurse notifies the primary care provider that the patient is experiencing pain. The provider gives the nurse a telephone prescription for morphine 4 mg intravenously every hour as needed for pain. How should the nurse document this telephone order?
09/02/19 0845 morphine 4 mg intravenously q 1 hour prn pain. TO Dr. D. Kelly/Kay Andrews, RN
A patient refuses a dose of medication. How should the nurse document the event?
Patient refuses the 0900 dose of digoxin
At 1000 on 11/14/19, the nurse takes a telephone prescription for "metoprolol 5 mg intravenously now." What is the latest date and time the nurse will expect the prescriber to countersign the order?
11/15/19 at 1000
The nurse takes a telephone order from a primary care provider for 40 mEq potassium chloride in 100 mL of sterile water for injection to be infused over 4 hours. Which action must the nurse take to ensure the accuracy of the order?
Repeat the order to the prescriber, even if the nurse believes the order was understood correctly.
A resident being admitted to a long-term care facility is unable to provide self-care due to dementia and is receiving Medicare funds. At which time must the Resident Assessment and Care Screening be completed?Within 2 weeksWhich charting entry would the nurse use for the "A" in SOAP charting?Intractable painA client is admitted to a long-term care facility. The nurse would use which form to follow federal law?The Minimum Data Set (MDS) for assessmentThe surgeon enters a computerized order for a patient in the postoperative period after a unilateral thoracotomy for lung cancer. The order states: OOB in AM. Which action indicates the nurse is following the surgeon's order?Assists the patient out of bedWhich instruction by a registered nurse should the student nurse clarify with the clinical instructor about transcribing the provider's orders?"Use apothecary units—instead of metric units."The nursing instructor is teaching the student about occurrence reports. Which statement by the student indicates correct understanding of the purpose of occurrence reports?These reports track problems and identify areas for quality improvementWhich aspect is the most beneficial for electronic documentation systems when compared with written documentation systems?Improves legibilityThe unlicensed assistive personnel (UAP) informs the nurse that a patient has fallen out of bed and is in pain. The nurse assesses the patient and provides care. Identify the correct documentation of the fall.Patient found on floor by UAP Smith and verbalizing (L) hip painWhich set of topics makes up a handoff report given in a recommended format?Situation-background-assessment-recommendation (SBAR)What is one advantage of problem-intervention-evaluation (PIE) charting?Establishes an ongoing plan of care for the clientA client is admitted to the birthing unit to rule out preterm labor. The nurse charts only abnormal findings. Which type of charting is the nurse using?Charting by exceptionAt the end of a 12-hour shift, the nurse gives a verbal report to the oncoming nurse. This face-to-face reporting, using the acronym "CUBAN," does which of the following?Provides a guide for the nurse's report to the oncoming nurseThe instructor is teaching the nursing students about electronic health records (EHRs). Which student statement indicates the need for further instruction?"I am proficient with a computer; therefore, I am completely prepared to use the EHR in any institution."A medical provider has prescribed milk of magnesia (magnesium hydroxide) 30 mL, PO bid. What does bid mean?2 times a dayWhy might a healthcare provider choose narrative charting instead of using forms or checklists?Narrative charting tracks the client's changing health status as it occurs.Which statements by the student nurse indicates a correct understanding of the nursing Kardex? Select all that applyIt pulls data from multiple areas of the patient's chart "It summarizes the plan of care and guides nursing care."Which actions by the nurse breach patient confidentiality? Select all that apply.Leaving patient data displayed on a computer screen where others may view it Remaining logged on to the computer system after documenting patient careA wise person once said, "Literature is a reflection of life." Nowhere is this more evident than in the seemingly simple fables penned by the immortal Aesop centuries and centuries ago. One fable has particular relevance in my own life: "The Ant and the Grasshopper." The moral of this tale has direct application to an episode from my own experience. There is an ant and grasshopper who live out in a field. The ant is very focused and dedicated to his work. All summer long, the ant toils, pulling grain and corn back and forth to his nest. Unlike the ant, the grasshopper is not a determined worker. He chooses to enjoy his time playing music the entire summer instead of preparing for winter and storing food like the ant. As the grasshopper is playing music and watching the ant exhaust himself, he asks the ant, "Why not come and chat with me, instead of toiling and moiling in that way. Why bother about winter?" said the Grasshopper. ''We have got plenty of food at present." The ant explains that winter is approaching, and he must have food stored for then, not now. The ant recommends he does the same. Later on, winter comes, and the grasshopper is starved with no food while the ant lays comfortably with plenty. The grasshopper begged the ant for some food, claiming he had no time to gather food during summer because he was too busy playing music. The ant says, "Very well, now dance!" and leaves the grasshopper to starve. The moral of the fable is to not play when it is time to work; there will be consequences. Throughout my young adult life and even now, I continue to remind myself of the moral of this fable. In my life, I am the ant. In high school, I never really did any of the typical fun social activities that kids my age did. I can count on one hand how many times I went to the mall, the movies, or a party with any friends. Instead, I spent all four years dedicating myself to my schoolwork, standardized test prepping, and extracurricular activities with the hopes that I was preparing myself to have a successful future. My peers thought I was wasting my time stressing over academics because they claimed college was a scam. They believed they were more mature and ahead in life than me because they had jobs, a car, and lived like young adults while all I did was go to school. Now in college, I have secured myself on a path toward a rewarding career in nursing. The straight As I earned in high school allowed me to receive full-ride scholarships that provide me with a comfortable life today. Most of my peers currently struggle financially in college because they did not apply or qualify for many scholarships. Likely due to an evident lack of academic effort. In reference to the fable, my peers play the grasshopper, and their recreational activities represent his music. I, as the ant, did not stop my hard work to listen to the grasshopper's music. As a teen, I did not stop preparing for my future to have fun in the present. The grasshopper claimed to have no time to store food for the winter because he was playing music, like my peers had time for recreational activities, but not school. The grasshopper starves in the winter, while the ant lives comfortably. Likewise, my peers are left struggling to manage their finances and careers, where I stand secure in both. Aesop's fable "The Ant and the Grasshopper '', like many others, is an ancient form of teaching insights and life lessons through storytelling that is still relevant to our lives today. Telling fables is especially a great way to instill these morals into children because they are very brief, have simple characters, and clear plots. These lessons are not limited to children, but continue to be relevant to us throughout our lives. Furthermore, even though these fables were written during a time when society has little resemblance to ours today, the moral of the story continues to apply to my overall experience as a student. The moral of the story is essentially cause and effect. Earning what you worked for, and receiving the consequences of your actions. My work as a student, like the ant, will continue to place me in a comfortable position in life, while my peers may wind up like the grasshopper.