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NUR 190 FINAL EXAM 2025 | ALL QUESTIONS
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The experience of being physically restrained can be traumatic. Which nursing intervention would best help the client deal with this experience? A. Administering a tranquilizing medication before applying the restraints B. Talking to the client at brief but regular intervals while the client is restrained C. Decreasing stimuli by leaving the client alone most of the time D. Checking on the client infrequently, in order to meet documentation requirements ---------CORRECT ANSWER-----------------ANS: B. Talking to the client at brief but regular intervals while the client is restrained Restraints are never to be used as punishment or for the convenience of the staff. Connecting with the client by maintaining communication during the period of restraint will help the client recognize this intervention as a therapeutic treatment versus a punishment. There is one bed available on an inpatient psychiatric unit. For which client should a nurse advocate emergency commitment? A. An individual who is persistently mentally ill and evicted from an apartment B. An individual treated in the emergency department (ED) for generalized anxiety disorder C. An individual who is delusional and has a plan to kill his wife D. An individual who rates mood 4/10 and is participating in a no-harm safety plan ---------CORRECT ANSWER-----------------ANS: C. An individual who is delusional and has a plan to kill his wife
The criteria for involuntary emergency commitment include danger to self and/or others. Of the four clients considered, the client who is delusional and has a plan to kill his wife meets this criterion as a danger to others. What is the legal significance of a nurse's action when the nurse threatens a demanding client with restraints? A. The nurse can be charged with assault. B. The nurse can be charged with negligence. C. The nurse can be charged with malpractice. D. The nurse can be charged with beneficence. ---------CORRECT ANSWER-----------------ANS: A. The nurse can be charged with assault. Assault is an act that results in a person's genuine fear and apprehension that he or she will be touched without consent. In the situation presented, which nursing intervention constitutes false imprisonment? A. The client is combative and will not redirect stating, "No one can stop me from leaving." The nurse seeks the physician's order after the client is restrained. B. The client has been consistently seeking the attention of the nurse much of the day. The nurse institutes seclusion. C. A psychotic client, admitted in an involuntary status, runs off the psychiatric unit. The nurse runs after the client and the client agrees to return. D. A client hospitalized as an involuntary admission attempts to leave the unit. The nurse calls the security team and they prevent the client from leaving. ---------CORRECT ANSWER-----------------ANS: B. The client has been consistently seeking the attention of the nurse much of the day. The nurse institutes seclusion. False imprisonment is the deliberate and unauthorized commitment of a person within fixed limits by the use of verbal or physical means.
Identification of a problem is the first step in problem solving and occurs before any other step. The most common cause for failure to resolve problems is the improper identification of the problem/issue; therefore, problem recognition and identification are considered the most vital steps. REF: Page 109 | Page 110 TOP: AONE competency: Knowledge of the Health Care Environment The nurse manager of a rehab unit wants to purchase a new anti-embolic stocking. To make a high-quality decision, the nurse manager would: a. Involve the rehab staff in the decision. b. Involve the sales representative. c. Make the decision alone. d. Involve administration in the decision. ---------CORRECT ANSWER-------- ---------ANS: A. Involve the rehab staff in the decision. In a shared decision model, the decisions are made through an interactive, deliberate process and the staff may express and discuss options and preferences. The shared decision model has been shown to increase work performance and productivity, decrease employee turnover, and enhance employee satisfaction. REF: Page 103 TOP: AONE competency: Communication and Relationship-Building Several nurses on an adolescent psychiatric unit complain that the teens are becoming unmanageable on the 0700-1900 shift. To resolve this problem, the nurse manager decides that the staff should have a brainstorming session. The goal of brainstorming is to: a. Evaluate problem solutions. b. Critique the ideas of others. c. Generate as many solutions as possible. d. Identify only practical and realistic ideas. ---------CORRECT ANSWER---- -------------ANS: C. Generate as many solutions as possible.
Brainstorming encourages creativity when one is beginning to problem-solve and avoids premature shutting down of ideas through early evaluation. The goal is to generate ideas, no matter how seemingly unrealistic or absurd. REF: Page 106 | Page 107 TOP: AONE competency: Communication and Relationship-Building During a fire drill, several psychiatric patients become agitated. The nurse manager quickly assigns a staff member to each patient. This autocratic decision style is most appropriate for: a. Routine problems. b. Crisis situations. c. Managers who prefer a "telling" style. d. Followers who cannot agree on a solution. ---------CORRECT ANSWER-- ---------------ANS: B. Crisis situations. An autocratic style is appropriate when rapid decision making is required, such as in a crisis situation. REF: Page 103 | Page 104 TOP: AONE competency: Leadership After the nurses who work on an adolescent psychiatric unit have had a brainstorming session, they are ready to resolve the problem of teenagers who are unmanageable. To maximize group effectiveness in decision making and problem solving, the nurse manager has: a. Prevented conflict. b. Formed highly cohesive groups. c. Used majority rule to arrive at decisions. d. Encouraged equal participation among members. ---------CORRECT ANSWER-----------------ANS: D. Encouraged equal participation among members. Groups are more likely to be effective if members are involved, the group is cohesive, communication is encouraged, and members demonstrate some understanding of the group process. The nurse
position similar to ours. Kantianism states that decisions should be made based on moral law and that actions are bound by a sense of moral duty. Utilitarianism holds that decisions should be made focusing on the end result being happiness. Ethical egoism promotes the idea that what is right is good for the individual. During a hiring interview, which response by a nursing applicant should indicate that the applicant operates from an ethical egoism framework? A. "I would want to be treated in a caring manner if I were mentally ill." B. "This job will pay the bills, and the workload is light enough for me." C. "I will be happy caring for the mentally ill. Working in Med/Surg kills my back." D. "It is my duty in life to be a psychiatric nurse. It is the right thing to do." -- -------CORRECT ANSWER-----------------ANS: B. "This job will pay the bills, and the workload is light enough for me." The applicant's comment reflects an ethical egoism framework. This framework promotes the idea that decisions are made based on what is good for the individual and may not take the needs of others into account. Without authorization, a nurse administers an extra dose of narcotic tranquilizer to an agitated client. The nurse's coworker observes this action but does nothing for fear of repercussion. What is the ethical interpretation of the coworker's lack of involvement? A. Taking no action is still considered an unethical action by the coworker. B. Taking no action releases the coworker from ethical responsibility. C. Taking no action is advised when potential adverse consequences are foreseen. D. Taking no action is acceptable because the coworker is only a bystander. ---------CORRECT ANSWER-----------------ANS: A. Taking no action is still considered an unethical action by the coworker. The coworker's lack of involvement can be interpreted as an unethical action. The coworker is experiencing an ethical dilemma in which a
decision needs to be made between two unfavorable alternatives. The coworker has a responsibility to report any observed unethical actions. Group therapy is strongly encouraged, but not mandatory, on an inpatient psychiatric unit. The unit manager's policy is that clients can make a choice about whether or not to attend group therapy. Which ethical principle does the unit manager's policy preserve? A. Justice B. Autonomy C. Veracity D. Beneficence ---------CORRECT ANSWER-----------------ANS: B. Autonomy The unit manager's policy regarding voluntary client participation in group therapy preserves the ethical principle of autonomy. The principle of autonomy presumes that individuals are capable of making independent decisions for themselves and that health-care workers must respect these decisions. Which is an example of an intentional tort? A. A nurse fails to assess a client's obvious symptoms of neuroleptic malignant syndrome. B. A nurse physically places an irritating client in four-point restraints. C. A nurse makes a medication error and does not report the incident. D. A nurse gives patient information to an unauthorized person. --------- CORRECT ANSWER-----------------ANS: B. A nurse physically places an irritating client in four-point restraints. A tort is a violation of civil law in which an individual has been wronged and can be intentional or unintentional. A nurse who physically places an irritating client in restraints has touched the client without consent and has committed an intentional tort.
Which client should a nurse identify as a potential candidate for involuntary commitment? A. A client living under a bridge in a cardboard box B. A client threatening to commit suicide C. A client who never bathes and wears a wool hat in the summer D. A client who eats waste out of a garbage can ---------CORRECT ANSWER-----------------ANS: B. A client threatening to commit suicide. The nurse should identify the client threatening to commit suicide as eligible for involuntary commitment. The suicidal client who refuses treatment is a danger to self and requires emergency treatment. A client diagnosed with schizophrenia refuses to take medication, citing the right of autonomy. Under which circumstance would a nurse have the right to medicate the client against the client's wishes? A. When the client makes inappropriate sexual innuendos to a staff member B. When the client constantly demands inappropriate attention from the nurse C. When the client physically attacks another client after being confronted in group therapy D. When the client refuses to bathe or perform hygienic activities --------- CORRECT ANSWER-----------------ANS: C. When the client physically attacks another client after being confronted in group therapy. The nurse would have the right to medicate a client against his or her wishes if the client physically attacks another client. This client poses a significant risk to safety and is incapable of making rational choices. The client's refusal to accept treatment can be challenged because the client is endangering the safety of others.
A psychiatric nurse working on an inpatient unit receives a call asking if an individual has been a client in the facility. Which nursing response reflects appropriate legal and ethical obligations? A. Refusing to give any information to the caller, citing rules of confidentiality B. Refusing to give any information to the caller by hanging up C. Affirming that the person has been seen at the facility but providing no further information D. Suggesting that the caller speak to the client's therapist --------- CORRECT ANSWER-----------------ANS: A. Refusing to give any information to the caller, citing rules of confidentiality. The most appropriate action by the nurse is to refuse to give any information to the caller. Admission to the facility would be considered protected health information (PHI) and should not be disclosed by the nurse without prior client consent. A client requests information on several medications in order to make an informed choice about management of depression. A nurse should provide this information to facilitate which ethical principle? A. Autonomy B. Beneficence C. Nonmaleficence D. Justice ---------CORRECT ANSWER-----------------ANS: A. Autonomy The nurse should provide the information to support the client's autonomy. A client who is capable of making independent choices should be permitted to do so. In instances when clients are incapable of making informed decisions, a legal guardian or representative would be asked to give consent. An inpatient psychiatric physician refuses to treat clients without insurance and prematurely discharges those whose insurance benefits have expired.
D. The client relies on his or her spouse to interpret the information. --------- CORRECT ANSWER-----------------ANS: C. The client incorrectly reports his or her spouse's name, date, and time of day The nurse should question the validity of informed consent when the client incorrectly reports the spouse's name, date, and time of day. This indicates that this client is disoriented and may not be competent to make informed choices. A client diagnosed with schizophrenia receives fluphenazine decanoate (Prolixin Decanoate) from a home health nurse. The client refuses medication at one regularly scheduled home visit. Which nursing intervention is ethically appropriate? A. Allow the client to decline the medication and document. B. Tell the client that if the medication is refused, hospitalization will occur. C. Arrange with a relative to add medication to the client's morning orange juice. D. Call for help to hold the client down while the injection is administered. -- -------CORRECT ANSWER-----------------ANS: A. Allow the client to decline the medication and document. It is ethically appropriate for the nurse to allow the client to decline the medication and provide accurate documentation. The client's right to refuse treatment should be upheld unless the refusal puts the client or others in harm's way. Which situation exemplifies both assault and battery? A. The nurse becomes angry, calls the client offensive names, and withholds treatment. B. The nurse threatens to "tie down" the client and then does so against the client's wishes. C. The nurse hides the client's clothes and medicates the client to prevent elopement.
D. The nurse restrains the client without just cause and communicates this to family. ---------CORRECT ANSWER-----------------ANS: B. The nurse threatens to "tie down" the client and then does so against the client's wishes. The nurse in this situation has committed both assault and battery. Assault refers to an action that results in fear and apprehension that the person will be touched without consent. Battery is the touching of another person without consent. A geriatric client is confused and wandering in and out of every door. Which scenario reflects the least restrictive alternative for this client? A. The client is placed in seclusion. B. The client is placed in a geriatric chair with tray. C. The client is placed in soft Posey restraints. D. The client is monitored by an ankle bracelet. ---------CORRECT ANSWER-----------------ANS: D. The client is monitored by an ankle bracelet. The least restrictive alternative for this client would be monitoring by an ankle bracelet. The client does not pose a direct dangerous threat to self or others, so neither physical restraints nor seclusion would be justified. A brother calls to speak to his sister who has been admitted to the psychiatric unit. The nurse connects him to the community phone and the sister is summoned. Later the nurse realizes that the brother was not on the client's approved call list. What law has the nurse broken? A. The National Alliance for the Mentally Ill Act B. The Tarasoff Ruling C. The Health Insurance Portability and Accountability Act D. The Good Samaritan Law ---------CORRECT ANSWER----------------- ANS: C. The Health Insurance Portability and Accountability Act
The nursing staff is discussing the concept of competency. Which information about competency should a nurse recognize as true? A. Competency is determined with a client's compliance with treatment. B. Refusal of medication can initiate an incompetency hearing leading to forced medications. C. A competent client has the ability to make reasonable judgments and decisions. D. Competency is a medical determination made by the client's physician. - --------CORRECT ANSWER-----------------ANS: C. A competent client has the ability to make reasonable judgments and decisions. A competent individual's cognition is not impaired to an extent that would interfere with decision making. A nursing instructor is presenting content on the provisions of the nurse practice act as it relates to their state. Which student statement indicates a need for further instruction? A. "The nurse practice act provides a list of definitions of important terms including the definition of nursing." B. "The nurse practice act lists education requirements for licensure and reciprocity." C. "The nurse practice act contains detailed statements that describe the scope of practice for registered nurses (RNs)." D. "The nurse practice act lists the general authority and powers of the state board of nursing." ---------CORRECT ANSWER-----------------ANS: C. "The nurse practice act contains detailed statements that describe the scope of practice for registered nurses (RNs)." The nurse practice act contains broad, not detailed, statements that describe the scope of practice for various levels of nursing (APN, RN, LPN), not just for the RN. This student statement indicates a need for further instruction.
Which is an accurate description of a common law? A. A common law would be invoked to deal with a nurse who, without justification, threatens a client with restraints. B. A common law would be invoked to deal with a nurse who touches a client without the client's consent. C. A common law would be invoked to deal with a hospital employee who steals drugs, hospital equipment, or both. D. A common law would be invoked to deal with a nurse's refusal to provide care for a specific client. ---------CORRECT ANSWER----------------- ANS: D. A common law would be invoked to deal with a nurse's refusal to provide care for a specific client. Common laws apply to a body of principles that evolve from court decisions resolving various controversies. Common law may vary from state to state. Assault (threats) and battery (touch) are governed by civil law. Stealing is governed by criminal law.
- In a rural hospital, the unit for which you are charge nurse has a particularly busy morning. A 52-year-old patient is complaining of left-sided chest pain and a multiparous patient is about to deliver. A child with asthma is experiencing early signs of an attack. The other RN on the unit is a recent graduate who has not yet been orientated to the labor room and has limited cardiac nursing experience. An unregulated assistant is also available. You must decide which patient situation you will take and where the RN's skills can best be used. Given the limitations in skills and experience, number of staff available, and time constraints, you must make a decision that involves: a. A higher-order thinking process. b. Selecting the best option for reaching a predefined goal. c. Optimizing. d. Satisficing. ---------CORRECT ANSWER-----------------ANS: D With this approach, the decision maker selects an acceptable solution, one that may minimally meet the objective or standard for a decision. This
REF: Page 111 TOP: AONE competency: Knowledge of the Health Care Environment
- An outpatient surgery manager is evaluating infusion pumps for the operating room. The manager should: a. Select the least expensive brand. b. Use a decision-making tool to evaluate brands. c. Ask the nursing staff which brand they prefer. d. Select the vendor the institution usually buys from. ---------CORRECT ANSWER-----------------ANS: B. Use a decision-making tool to evaluate brands. Decision-making tools such as decision grids and SWOT analyses are most appropriate when information is available and options are known. REF: Page 108 | Page 109 TOP: AONE competency: Knowledge of the Health Care Environment
- Select the statement that best defines the difference between problem solving and decision making: a. Decision-making skills require critical thinking; problem-solving skills do not. b. Problem-solving skills require critical thinking; decision-making skills do not. c. Decision making is a goal-directed effort; problem solving is focused on solving an immediate problem. d. Problem solving is a goal-directed effort; decision making is focused on solving an immediate problem. ---------CORRECT ANSWER----------------- ANS: C. Decision making is a goal-directed effort; problem solving is focused on solving an immediate problem. Problem solving is focused on solving immediate problems, whereas decision making is a goal-directed process that is aimed at selecting appropriate actions from among options. Not all decisions begin with a problem.
REF: Page 101 TOP: AONE competency: Leadership
- Sue, a nurse manager, has a staff nurse that has been absent a great deal for the past three months. A whistleblower gives some information to Sue indicating that the staff nurse will be resigning and returning to school. Because of this, Sue decides to do which of the following? a. Immediately fire the staff nurse. b. Speak to the whistleblower and elicit more information. c. Speak to the staff nurse and ask her to resign. d. Do nothing. ---------CORRECT ANSWER-----------------ANS: D. Do nothing Doing nothing is often warranted because of lack of energy, time, or resources to solve the real problem adequately, and because the benefits are not seen as sufficiently compelling to commit to an action. REF: Page 109 | Page 110 TOP: AONE competency: Leadership
- The maintenance department wishes to have the nursing lounge renovated, so the lounge will be more "user-friendly." The department asks the nursing staff to make a wish list of everything that they would like to see in the new lounge. This process is an example of which part of the decision-making process? a. Assessment/Data collection b. Planning c. Data interpretation d. Generating hypotheses ---------CORRECT ANSWER-----------------ANS: A. Assessment/Data collection In this particular model (a model similar to the nursing model), data collection is the first step toward identifying important alternatives or determining if there is a problem or problems. REF: Page 112 | Page 113 TOP: AONE competency: Leadership
