Question 1

The nurse is frustrated by the number of single mothers who receive medical services at no cost. What is the greatest danger of this frustration?&#10;A) The nurse may unintentionally neglect to educate patients on services available.&#10;B) The nurse may be rude to these mothers.&#10;C) This frustration may increase the likelihood that the nurse elects to leave this job position.&#10;D) The frustration may increase the nurse's job stress.&#10;

Accepted Answer

Rationale 1: This type of frustration may raise ethical issues in allowing this nurse to continue to provide care to this group of patients. While the nurse might be rude, have increased stress, or elect to quit this job, the greatest danger is that the nurse will unintentionally neglect to educate the patients regarding all services that are available.
Rationale 2: Rudeness may occur but this is not the greatest danger for this nurse.
Rationale 3: The nurse may elect to leave this job. If frustration is extreme, leaving the job may be the best choice. This is not the biggest danger.
Rationale 4: Job stress will likely increase, but this is not the greatest danger.

Question 2

The correctional nurse has drawn blood from an inmate who has experienced gastrointestinal bleeding. While performing the venipuncture, the nurse told the inmate the blood was being drawn for the purposes of evaluating the inmate's hemoglobin and hematocrit. Can the blood also be used to screen the inmate for drug usage?

A) No, the blood can be used only for the determination of medical diagnosis.
B) Yes, the inmate signs away all rights to privacy when incarcerated.
C) Yes, as long as the nurse suspects the inmate of drug use.
D) No, the laboratory will not accept this blood drawn and will insist that the blood be drawn again by a laboratory technician.

Accepted Answer

Rationale 1: This blood can only be used to determine medical diagnosis.
Rationale 2: Inmates retain their rights to privacy, so if blood is being drawn for a drug screen the inmate must be informed.
Rationale 3: If the nurse suspects the inmate of drug abuse, an order for additional blood draw and screen is necessary.
Rationale 4: The correctional nurse often draws blood that is sent to the laboratory, so there is no indication that there will be need to redraw blood by the technician.

Question 3

Which person would likely be provided for under the Social Security Act of 1935?&#10;A) A 16-year-old whose father died in a motor vehicle accident&#10;B) A 70-year-old man who is retired from a job he held for 30 years&#10;C) A 45-year-old woman who suffered a myocardial infarction&#10;D) A 34-year-old person who files for unemployment after losing her job&#10;E) A 30-year-old woman who has become blind secondary to diabetic retinopathy&#10;

Accepted Answer

Rationale 1: As a dependent child this person is provided for by the Social Security Act of 1935.
Rationale 2: The Social Security Act of 1935 provided for the federal welfare by establishing a system of federal benefits for the aged population.
Rationale 3: Despite having a cardiovascular history, there is no indication the 45-year-old woman meets the criteria for inclusion.
Rationale 4: State unemployment compensation laws are part of the Social Security Act of 1935.
Rationale 5: Blind persons are provided for by the Social Security Act of 1935.

Question 4

Nurses in which health care settings are required to comply with the Patient Self-Determination Act of 1991?&#10;A) In home health care settings only if they have a validly executed advanced directive when care is first rendered&#10;B) Solely in formal institutional settings, such as hospitals&#10;C) In all health care settings, including home health care settings, if federal funds are received&#10;D) In all health care settings except home health care settings&#10;

Accepted Answer

Rationale 1: This act requires that the facility inquire about advance directives. It is not limited to patients who have already executed these directives.
Rationale 2: Adherence to this act is not limited to formal institutional settings.
Rationale 3: Any agency that receives federal funds, which includes home health care settings, is to abide by the federal legislation of the Patient Self-Determination Act of 1991.
Rationale 4: Home health setting also has to adhere to this act in certain situations.

Question 5

Which nurse is exposed to the greatest risk of liability for malpractice because of the nature of the employment relationship?&#10;A) The hospital-based staff nurse&#10;B) The home health care nurse&#10;C) The federally employed nurse&#10;D) The occupational health nurse&#10;

Accepted Answer

Rationale 1: Hospital-based staff nurses do not face the same amount of liability as do nurses in this specialty.
Rationale 2: The home health care nurse does not face the same amount of liability as nurses in this specialty.
Rationale 3: Federally employed nurses do not face the same amount of liability as those in this specialty.
Rationale 4: The practice of occupational health nurses is greatly influenced by a variety of federal and state laws, particularly workers' compensation laws, mandatory-reporting laws, and occupational safety and health laws.

Question 6

What is the most significant professional qualification necessary for a nurse who practices as a school nurse?&#10;A) The nurse's ability to exercise independent judgment in emergency situations&#10;B) The nurse's ability to properly counsel students about medical concerns&#10;C) The nurse's ability to work closely with school officials&#10;D) The nurse's ability to effectively teach students about their health&#10;

Accepted Answer

Rationale 1: School nurses practice with no other care provider present and are often called upon as the first person to respond to provide care in emergency situations. Therefore, they must possess the ability to think independently and use critical thinking and judgment.
Rationale 2: Providing counseling is an important aspect of school nursing, but is not the most important skill this nurse can possess.
Rationale 3: The school nurse must work closely with school officials, but this is not the most critical attribute of this nurse.
Rationale 4: The nurse must be able to teach students about health, but this is not this nurse's most important skill.

Question 7

After analyzing assessment data, the home health care nurse determines that a change is necessary in the medical care of a patient. The nurse makes the change without consulting the physician. Under which circumstance is this a legal action by this nurse?

A) If the nurse is experienced and sure the change will not harm the patient
B) If there is a signed, standing order for the change
C) If the nurse is certain the physician will agree with the change
D) If the patient's family agrees that the action is necessary

Accepted Answer

Rationale 1: The nurse is licensed to practice nursing which does not include alteration of the medical plan of care with orders.
Rationale 2: Standing orders are legal orders once they are signed by the physician. These orders require astute assessment and analysis by the nurse.
Rationale 3: The nurse's certainty that the physician will agree with the change will not make this a legal action.
Rationale 4: The family's approval of the action does not make it legal.

Question 8

The school nurse is leaving campus after work when an accident occurs on the playground. The nurse responds and treats the injured students. Which standard of care would most likely determine liability?

A) The reasonably prudent pediatric nurse
B) The reasonably prudent general duty hospital nurse
C) The reasonably prudent school nurse
D) The reasonably prudent nurse in an emergency situation

Accepted Answer

Rationale 1: The primary focus of these nursing actions is more specifically in the scope of care of a different specialty.
Rationale 2: General duty hospital nurses do not routinely provide emergency care, so this is not the standard used for this situation.
Rationale 3: Since these injuries have occurred outside of school hours, this nurse may be functioning outside the usual scope of employment.
Rationale 4: Because of the emergency nature of this situation the most likely standard would be that of a reasonably prudent nurse in an emergency situation.

Question 9

The home health care agency that receives federal funds desires to hire a new home health care aide. This aide will provide direct and hands-on care to patients. Which person would meet federal requirements for that position?

A) A nursing assistant who has on-the-job training at a nursing home
B) A nursing assistant who completed a training and competency evaluation program
C) A nursing assistant who has on-the-job training at a hospital
D) A second-semester student enrolled in a registered nursing program

Accepted Answer

Rationale 1: On the job training at a nursing home is not sufficient for employment in a home health agency that receives federal funds.
Rationale 2: The Omnibus Budget Reconciliation Act of 1986 sets strict criteria of qualifications for home health care aides who have a predominant role in direct, hands-on contact with patients. Under this provision, the agency may not use any individual who is not a licensed health care professional, unless the individual has successfully completed a training and competency evaluation program that meets minimum federal standards and the individual is actually competent to provide the services assigned.
Rationale 3: On the job training at a hospital is not sufficient training for a nursing assistant who will work in a home health agency receiving federal funds.
Rationale 4: Just because a student has some experience in nursing school does not qualify the student as a nursing assistant in this situation.

Question 10

The nurse presenting a community education session about community health would include information about which foundational federal laws?&#10;A) Social Security Act of 1935&#10;B) 1947 Taft Hartley Amendment&#10;C) Civil Rights Act of 1991&#10;D) Americans with Disabilities Act of 1990&#10;E) Public Health Service Act of 1994&#10;

Accepted Answer

Rationale 1: The Social Security Act of 1935 established the means for states to make provisions for establishing public health services. Community health nurses play a significant role in providing care through the programs established by the public health service.
Rationale 2: The Taft Hartley Amendment is a federal law that monitors the activities and power of labor unions. It is not associated with the development of community health.
Rationale 3: The Civil Rights Act of 1991 deals with the right of employees in regard to discrimination by employers. It did not help to establish community health.
Rationale 4: The Americans with Disabilities Act of 1990 was passed to provide equality for people with disabilities. It did not help to establish community health.
Rationale 5: The Public Health Service Act of 1994 consolidated all existing public health legislation under one law and became the major piece of health legislation for the country.

Question 11

A nurse responds to help provide care at the scene of a disaster. Which nursing action will help to reduce the chance of lawsuit?&#10;A) Do not perform any actions outside of the scope of nursing care.&#10;B) Take breaks to rest when needed.&#10;C) Keep detailed notes on every action taken.&#10;D) Maintain certifications that will support care provided during emergencies.&#10;E) Be honest about one's capabilities.&#10;

Accepted Answer

The answer of A nurse responds to help provide care...

Question 12

In which situations would the home health nurse likely be considered to have abandoned a client?&#10;A) The nurse and patient decided together that home health care was no longer needed.&#10;B) The home health nurse no longer provides care for the patient when reimbursement amounts change.&#10;C) The nurse stops making home visits without giving the patient notice that this would occur.&#10;D) The nurse fails to assess the patient on a daily basis.&#10;E) The nurse left the patient's home when a grandchild threatened the nurse.&#10;

Accepted Answer

The answer of In which situations would the home health...

Question 13

The nurse preparing to complete an Outcome and Assessment Information Set (OASIS) would expect to collect which information?&#10;A) Medication history&#10;B) Insurance information&#10;C) Living arrangements&#10;D) Demographic information&#10;E) Financial information&#10;

Accepted Answer

The answer of The nurse preparing to complete an Outcome...

Question 14

The occupational nurse has sponsored and taught first aid classes to workers throughout the factory. If a person, taught by the nurse, makes an error in providing first aid that causes further injury, does the nurse hold any liability?

A) No, the liability is on the person who caused the original accident causing the need for first aid.
B) No, all liability is on the person who made the error.
C) The nurse holds all the liability.
D) The nurse may hold liability depending upon circumstances.

Accepted Answer

The answer of The occupational nurse has sponsored and taught...

Question 15

A school nurse negligently administered an overdose of medication to a student, causing the student to suffer a severe reaction that necessitated hospitalization. Should a lawsuit result from this case, the nurse would be held to what standard?

A) The reasonably prudent advanced nurse practitioner
B) The reasonably prudent general duty hospital nurse
C) The reasonably prudent pediatric nurse
D) The reasonably prudent school nurse

Accepted Answer

The answer of A school nurse negligently administered an overdose...

Deck 19: Public and Community Health Care