Question 1

A police officer has accompanied an apparently intoxicated client to the emergency room. After blood work results come back, the officer asks for a copy of the results. What is the nurse's most appropriate response?
A)Give the officer a copy as requested.
B)Ask the doctor if it is ok to give the officer a copy of the results.
C)Tell him he is not entitled to the results.
D)Advise him that he must present a warrant in order to obtain the blood results.

Accepted Answer

Although you may want to help the police officer in carrying out his own professional duties, you must follow the accepted rules. By law, the officer must present a warrant requesting blood results for any client. If you gave him the results, you might be liable for breach of confidentiality.

Question 2

Which of the following sites should be avoided when selecting a peripheral site for Intravenous insertion?
A)An arm with several tattoos.
B)The arm opposite the side where a complete mastectomy was performed.
C)An arm that has an arterial-venous shunt.
D)An arm with scars from a previous burn injury.

Accepted Answer

When selecting a site for a peripheral I.V., it is best to avoid an arm that has an arterial-venous shunt. You may damage the shunt or interfere with its capabilities.

Question 3

You have come to the end of a very long and busy twelve-hour shift, and after giving report to the on-coming nurse you ask her to leave space for you in the client's chart. You tell the nurse you plan on to finishing your charting in the morning. What would be the on-coming nurse's most appropriate response to you?
A)"I know you are tired, but it is your professional responsibility to complete your charting before you go home."
B)"Why don't you leave me your notes and I will do the charting for you?"
C)"If you leave without charting, I will report you to the supervisor."
D)"We are all tired, but you can't leave until you're done."

Accepted Answer

A twelve-hour shift can easily become much longer, but charting is a professional responsibility. It must be completed before you leave work. The other responses are inappropriate and not supportive of one's peers.

Question 4

You are performing a sterile surgical dressing change. You accidently drop a sterile piece of gauze on the table, outside the sterile field. What should you do?
A)Pick up the gauze with your sterile forceps and continue the dressing.
B)Get a new sterile gauze piece.
C)Use the gauze anyway. The client is on antibiotics, so it will fight any infectious agent that may be introduced.
D)Get a whole new dressing tray and start the procedure over again.

Accepted Answer

If a piece of gauze from your sterile dressing tray falls outside the sterile field, you must replace it with a new, sterile one. It is not necessary to start the procedure over.

Question 5

An Occupational Health Nurse is teaching staff nurses of a medical unit how to identify a positive Mantoux test result. Which of the statements below is correct?
A)An area of redness around the injection site larger than 10mm indicates a positive test.
B)An area of redness around the injection site larger than 15mm indicates a positive test.
C)10mm or more of in duration around the injection site indicates a positive test.
D)15mm or more of in duration around the injection site indicates a positive test.

Accepted Answer

In Canada, an in duration of 10mm or more around the injection site of a Mantoux sub-dermal injection indicates exposure to TB (Tuberculosis). Further tests, such as an x-ray, would be needed to confirm any presence of active disease.

Question 6

Which of the following is the major cause of an acute hemolytic reaction during a blood transfusion?
A)The wrong type and cross match (wrong RH and blood type).
B)Failure to identify the correct client by reading the arm band prior to the infusion.
C)Allowing the blood to warm before the transfusion takes place.
D)Not allowing the blood to warm up before administering the transfusion.

Accepted Answer

Failure to properly identify the client before transfusion of blood is the major cause of acute hemolytic reactions. Giving the incorrect blood type to a client is a mistake that can easily be prevented by using proper identification processes.

Question 7

You are preparing to administer medication through a nasogastric tube. Which of the following medications should not be administered this way?
A)A crushed enteric coated tablet mixed with 30cc of water.
B)An emptied encapsulated medication mixed in t30cc of water.
C)Liquid Dilantin
D)Crushed low dose aspirin mixed with 30cc of water.

Accepted Answer

An enteric coated tablet is enteric coated for a reason; either to protect the stomach lining or to ensure the medication is absorbed in the small intestine. If you are faced with this situation, it would be best to speak with the client's doctor regarding a substitute medication.

Question 8

The nurse is preparing to administer an antibiotic via the intravenous route. The client has an I.V. line currently running at 30cc/hour. Which of the following is the correct way to hand the medication bag?
A)Hang both I.V. bags at the same height.
B)Hang the medication bag higher than the primary I.V bag.
C)Hang the primary I.V. bag higher than the medication bag.
D)Start a new and separate I.V. site for the administration of the I.V. antibiotic.

Accepted Answer

When you need to run antibiotics through an already existing intravenous line, you simply need to hang the medication I.V. bag higher than the primary I.V. bag. There is no need to start a second intravenous site to deliver antibiotics.

Question 9

A client is receiving intravenous heparin therapy. What is the antidote that should be available in case of bleeding?
A)Protamine sulphate
B)Narcan
C)Dilantin
D)Vitamin K

Accepted Answer

If a client receiving heparin therapy should experience sudden excessive bleeding, the immediate antidote would be protamine sulphate. Narcan is used for a narcotic overdose, and dilantin is used to control seizures. Vitamin K helps to prevent blood clotting.

Question 10

Many institutions have risk management policies in place. What is the primary purpose of these risk management policies?
A)To ensure only qualified staff are hired.
B)To protect clients, ensuring they receive high quality and safe care.
C)To protect nursing staff from being sued by clients or their families.
D)To ensure that minimal health care required, by law, is provided to all clients.

Accepted Answer

Risk management is an important policy, and program, that is addressed in every health care facility to ensure that clients receive the best quality and safest care possible.

Question 11

Adeleis a nurse in a long term care facility. She has only been working there for six months but has seen aspects of care she feels is unethical and demoralizing to the residents. Angela decides to go to the local newspaper and write a letter to the editor. How would this action be seen?
A)An act of revenge
B)An act of whistle blowing
C)As a citizen's right to freedom of speech
D)Investigative reporting

Accepted Answer

Going public, whether internally or externally (outside the health care facility) with concerns or complaints about a health care institution is known as an act of whistle blowing.

Question 12

Angela is called in to her supervisor's office after writing a letter to the editor of a local paper about aspects of care in her workplace that she finds unethical. The newspaper has published her letter, and the supervisor has read it. She tells Angela she will have to dismiss her from her job, pending an investigation. What should be Angela's next step?
A)Call her own lawyer and sue the health care facility.
B)Threaten her supervisor.
C)Refuse to leave her job because she has done nothing wrong.
D)Contact the Canadian Nurse's Protective Society

Accepted Answer

Whistle blowing has been addressed not only in the media but also by health care facilities and the Canadian Nurses Association. Guidelines have been set up to help nurses report practices they feel are unsafe for clients and to protect whistleblowers from any possible backlash from an employer. In this instance, these guidelines would probably not protect Angela, so she would be best to contact the Canadian Nurse's Protective Society for legal guidance.

Question 13

Your client has been scheduled for knee surgery, but he has changed his mind and does not wish to go ahead with the surgery. He states that he wants to be discharged from the hospital. What is your best response to his request?
A)Convince him that he really needs this surgery.
B)Understand that he has the right to decide about his own care and contact his doctor regarding his request.
C)Ignore his request and go ahead with the preoperative care and paperwork.
D)Have another nurse try and talk him in to having the surgery.

Accepted Answer

If a client decides to cancel their care, including surgery, the nurse must respect that the client has the right to do so. It would be prudent to check that he understands to pros and cons of both having the treatment and not having it. This way the client is making an informed decision.

Question 14

Your client asks you for some information regarding a specific disease for which you have little knowledge. How can you answer the client?
A)Tell the client whatever comes to mind. After all, you are a nurse and the client will believe anything you tell them.
B)Ignore their request, pretending you did not hear them. Perhaps they will ask someone else.
C)Tell the client you are not familiar with the illness but you will attempt to find the information for them.
D)Ask them to talk to their doctor; you are too busy to do any research on the subject.

Accepted Answer

Though you have learned much in school you will undoubtedly run in to situations where you are asked about a subject you have little knowledge on. Telling the client that you will find information for them shows professionalism and caring. Nurses need to continue to learn and educate themselves at every opportunity.

Question 15

The doctor writes an order for the insertion of a nasogastric tube in a client you are caring for. You have never inserted a nasogastric tube before. What is your best course of action at this point?
A)Go to the policy and procedure manual, read up on the procedure and then go ahead and attempt the nasogastric tube insertion.
B)Ask the education coordinator (if available) or supervisor to walk you through the insertion process.
C)Leave the procedure for the nurse coming on the next shift.
D)Ask another nurse to do the procedure for you.

Accepted Answer

Every nurse has the responsibility to know the limits of his or her own knowledge base. They must also seek out learning opportunities and assistance to learn things that are expected as part of duties.

Question 16

The RN is extremely busy and needs to delegate the taking of vital signs for her clients to a Nursing Assistant. The Nursing Assistant reports back that one of the client's has an elevated pulse. The RN goes and rechecks the client's vital signs. What would this action be called?
A)A mistrust of the NA ability to check vital signs accurately
B)Accountability for care
C)A nuisance
D)A reverse of delegation

Accepted Answer

Registered Nurses may delegate care to other providers, provided those health care workers, such as NAs and CNAs have been taught to do the delegated task. However, the Registered Nurse still has a professional obligation, and accountability for care, and should always follow up on abnormal findings reported to her/him.

Question 17

In the cafeteria you notice the smell of alcohol on a nurse who works in your unit. You and this coworker are close friends. After lunch, you notice the same nurse drawing up an injectable medication for a patent. Her movements seem awkward and uncoordinated. What action should you take at this time?
A)Help the nurse draw up the medication.
B)Approach her and accuse her of drinking while on duty.
C)Draw up the medication yourself and go give it to her client.
D)Take the medication from her and tell her you must report her to the supervisor immediately.

Accepted Answer

A nurse under the influence of alcohol, or drugs, while on duty must immediately be reported to the supervisor. This nurse must not be allowed any further contact with clients. Afterward, you will need to fill out an incident report based on your factual findings.

Question 18

The parents of an eighteen year old client are upset because their daughter has been admitted to hospital and they have not been given a diagnosis. What is the nurse's best response to their demands to be informed about their daughter's condition?
A)"Your daughter is of legal age and we are not obliged to give you that information."
B)"Your daughter has the right to keep any information from you that she wishes."
C)"I'm not really supposed to tell you but your daughter…."
D)"I understand your frustration. Why don't we see if your daughter would like to discuss her condition with you? If she gives me permission, I could also explain."

Accepted Answer

The nurse must relay to the parents that their daughter is of legal consenting age for care and to tell them anything without her permission would be a breach of confidentiality.

Question 19

Medication errors can occur easily and happen far too frequently. Nursing shortages and heavy workloads add to a nurse's stress in completing her/his tasks on time. All of the following are ways to help ensure medication errors do not occur, except:
A)Right dose
B)Right patient
C)Right time
D)Right nurse

Accepted Answer

The four "R's" that can help ensure medication errors do not occur are right dose, right patient, right time and right drug. If a nurse is diligent in taking the time to ensure all four of these steps, then it is likely that medication errors, on the part of the nurse, will not occur.

Question 20

Which of the following factors has most influenced the trend of early discharges of clients from hospitals in Canada?
A)Better home care services.
B)Government efforts to contain health care costs.
C)People are healthier these days, recovering faster and able to care for themselves at home.
D)The nursing shortage.

Accepted Answer

Over the last several years, clients are being discharged earlier from hospitals in an attempt to contain rising health care costs. There are still many gaps in home care services due to funding and care staff shortages.

Quiz 3: Professionalism

A police officer has accompanied an apparently intoxicated client to the emergency room. After blood work results come back, the officer asks for a copy of the results. What is the nurse's most appropriate response?

Which of the following sites should be avoided when selecting a peripheral site for Intravenous insertion?

You are performing a sterile surgical dressing change. You accidently drop a sterile piece of gauze on the table, outside the sterile field. What should you do?

An Occupational Health Nurse is teaching staff nurses of a medical unit how to identify a positive Mantoux test result. Which of the statements below is correct?

Which of the following is the major cause of an acute hemolytic reaction during a blood transfusion?

You are preparing to administer medication through a nasogastric tube. Which of the following medications should not be administered this way?

The nurse is preparing to administer an antibiotic via the intravenous route. The client has an I.V. line currently running at 30cc/hour. Which of the following is the correct way to hand the medication bag?

A client is receiving intravenous heparin therapy. What is the antidote that should be available in case of bleeding?

Many institutions have risk management policies in place. What is the primary purpose of these risk management policies?

Adeleis a nurse in a long term care facility. She has only been working there for six months but has seen aspects of care she feels is unethical and demoralizing to the residents. Angela decides to go to the local newspaper and write a letter to the editor. How would this action be seen?

Your client has been scheduled for knee surgery, but he has changed his mind and does not wish to go ahead with the surgery. He states that he wants to be discharged from the hospital. What is your best response to his request?

Your client asks you for some information regarding a specific disease for which you have little knowledge. How can you answer the client?

The doctor writes an order for the insertion of a nasogastric tube in a client you are caring for. You have never inserted a nasogastric tube before. What is your best course of action at this point?

The RN is extremely busy and needs to delegate the taking of vital signs for her clients to a Nursing Assistant. The Nursing Assistant reports back that one of the client's has an elevated pulse. The RN goes and rechecks the client's vital signs. What would this action be called?

The parents of an eighteen year old client are upset because their daughter has been admitted to hospital and they have not been given a diagnosis. What is the nurse's best response to their demands to be informed about their daughter's condition?

Medication errors can occur easily and happen far too frequently. Nursing shortages and heavy workloads add to a nurse's stress in completing her/his tasks on time. All of the following are ways to help ensure medication errors do not occur, except:

Which of the following factors has most influenced the trend of early discharges of clients from hospitals in Canada?