Question 1

Which of the following best describes the "minimum standard of care" required by Registered Nurses in Canada?
A)The minimum number of Registered Nurses needed to provide safe care.
B)The minimum number of registered Practical Nurses in any health care facility to ensure safe care
C)The minimum number of nursing hours needed to ensure safe care
D)The care that any reasonable, prudent nurse would provide in a comparable situation.

Accepted Answer

According to the Canadian Nurses Association, the minimum standard of care required by Registered Nurses is the care "that any reasonable, prudent nurse would provide in a comparable

Question 2

The Canadian Nurses Association Code of Ethics explains the nursing values and ethical responsibilities of all Registered Nurses. The primary nursing values include all of the following EXCEPT:
A)A nurse's right to be represented by a union.
B)Providing safe, compassionate, competent and ethical care.
C)Promoting justice.
D)Being accountable.

Accepted Answer

The primary nursing values expressed in the Canadian Nurse's Code of Ethics are providing safe, compassionate, competent and ethical care; promoting health and well-being; promoting and respecting informed decision making; preserving dignity; maintaining privacy and confidentiality; promoting justice; and being accountable.

Question 3

A community nurse is helping a small farming town secure a location for an indoor walking group. The nurse is following the principles of primary health care to assist the community in their endeavors. All of the following are principles of primary health care, except:
A)Public participation
B)Health promotion
C)Appropriate technology
D)Accountability

Accepted Answer

According to the World Health Organization (WHO) there are five recognized principles of primary health care. They are accessibility, public participation, health promotion, inter-sectoral cooperation, and appropriate technology.

Question 4

There are four major roles identified within the profession of nursing: administrator, educator, practitioner, and researcher. Although the setting of practice and the level of expertise influence the level of focus, which of the following is the most fundamental role to nursing?
A)Practitioner
B)Educator
C)Administrator
D)Researcher

Accepted Answer

The practitioner role is the most fundamental role to nursing. All the other roles within the nursing practice exist to maintain and support the practitioner role of a nurse. As a practitioner, a nurse is responsible for day to day care of clients. The nurse is expected to work as a noble professional to promote health, prevent or treat clients with the rest of a health care team, and empower clients to care for themselves.

Question 5

A medical facility utilizes case management to organize work, deploy nursing staff, and provide organization of rules and structures that define responsibility and accountability. Which of the following is the advantage of case management over the other nursing care delivery systems?
A)Decision-making is centralized.
B)It promotes multidisciplinary collaboration.
C)It emphasizes continuity of care.
D)It promotes each member to function independently and make independent decisions.

Accepted Answer

Case management is a type of delivery care system that promotes multidisciplinary collaboration. It also emphasizes quality and cost-effective care. This system assesses, plans, implements, coordinates, monitors, and evaluates the care and services received by clients provided by the entire health care team. In team nursing, the team leader maintains a centralized decision-making role. Primary nursing emphasizes continuity of care. In interdisciplinary model, team members function independently and make independent decisions.

Question 6

The Public Health Agency of Canada announces an Escherichia coli outbreak in the city. The chief nurse in a medical facility activates the organization's communicable, infectious disease outbreak management plan. The chief nurse also understands that outbreak management can quickly escalate to disaster management. Disaster management needs to be implemented when:
A)The outbreak causes a serious threat to 50% of the city's population.
B)The outbreak is caused by a Category A agent.
C)The number of clients exceeds the capability and resources of the responders.
D)Officials determine that the outbreak is caused by an internal disaster

Accepted Answer

An outbreak management can quickly escalate to disaster management if the number of clients exceeds the capacity and responses of the responders. The health care providers must be able to make rapid assessments for the interventions to be successful. It is important to identify the immediate and potential health hazards and to prioritize the health needs of a population to prevent an outbreak management from becoming a disaster management.

Question 7

Every client has the right to expect that he or she will be treated with respect, provided with adequate information, and have his or her confidentiality maintained. A nurse respects a client's right to autonomy in which of the following situations?
A)After a female client refused to take her medication, the nurse documents this in the client's chart.
B)A nurse respects the worth and uniqueness of her clients and colleagues.
C)A nurse asks an adult client with intact physical and mental abilities to sign an informed consent form.
D)A nurse provides compassionate care to a client who practices another religion.

Accepted Answer

Allowing a client to refuse treatment demonstrates respect for the client's autonomy. Autonomy is the right to self-determination. A professional nurse must respect the client's right to make decisions about and for himself/herself. B and D are examples of dignity, the right to receive compassionate nursing care. A nurse should not ask a client to sign an informed consent.

Question 8

Principles are applied when deciding on the facility's organizational structure, which is the basis of the organization's goals and the department's philosophy and objectives. Which of the following accurately describes the principle of continuing responsibility?
A)An individual can have more resources and available materials when he or she interacts directly with more individuals.
B)When a superior delegates a responsibility to a subordinate, the superior's responsibility for the function does not diminish.
C)When a certain responsibility is delegated to a subordinate, the subordinate should be given authority over the resources needed to perform and succeed with a task.
D)An employee should only be responsible to one supervisor.

Accepted Answer

Continuing responsibility indicates that when a superior delegates a task to a subordinate, the act of delegation does not diminish the superior's responsibility to accomplish the task. Option A describes organizational centrality. Option C describes requisite authority. Option D refers to unity of command.

Question 9

A Registered Nurse is assigned to care for five clients during the shift. The RN works with a nursing team consisting of one licensed practical nurse and two certified nursing assistants. To accomplish more tasks, the RN decides to delegate specific tasks to each team member. Which of the following is the first and most important step during the delegation process?
A)Reach mutual agreement about the task; validate that each team member understands the task.
B)Monitor and evaluate the results.
C)Determine whom to delegate; ask questions such as: Is the person in mind qualified to accomplish the task?
D)Define the complexity of the task and its elements.

Accepted Answer

The first step of the delegation process is to define the complexity of the task and its elements. After evaluating the difficulty of the task, determine whom to delegate the task. The next step is to provide clear communications about expectations. After clarifying, reach a mutual agreement about the task. The sixth step to monitor and evaluate the results.

Question 10

A methodical and careful planning process is essential to the success of any health care institution or organization. One of these types is called strategic planning. Which of the following statements best describes strategic planning?
A)It considers the availability of qualified staff and the acuity levels of the clients.
B)It takes consideration of the organization's mission, vision, and core value statements to identify future goals.
C)It creates a system that will help the organization analyze, plan and deliver services that meet the needs of its target markets and consumers
D)It attains the vision and mission of the organization through specific work plans that lead to shared responsibility and accountability.

Accepted Answer

Strategic planning takes into consideration the organization's mission, vision, and core value statements. Strategic planning is a proactive process that aims to bring the entire organization together to work toward the same future vision of success. Option A refers to staffing process. Option C refers to marketing planning. Option D refers to operational planning.

Question 11

An indwelling urinary catheter was inserted into the bladder of an elderly male due to urinary symptoms during the admission. A day before discharge, a nurse receives an order to remove the client's urinary catheter. The nurse pulls out the catheter without first deflating the balloon that anchors it inside the bladder. The client complains of severe pain. Examination and tests reveal damaged internal structures. The nurse will be most likely charged with:
A)Negligence
B)Malpractice
C)Misdemeanor
D)Defamation of character

Accepted Answer

The nurse will be most likely charged with malpractice. Malpractice is present when a nurse commits an act of negligence when performing of one of his or her responsibilities. A nurse can be charged with malpractice if s/he had a professional duty toward the client receiving the care. Negligence is the act of doing or refraining from doing something that any reasonable health care professional would do in the same situation. A misdemeanor is a crime lesser than felony and is punished by imprisonment of less than a year. Defamation of character occurs when a nurse writes or speaks something that can damage another person's reputation.

Question 12

Michelle, a female client, is re-admitted to the nursing unit after a diagnostic surgical procedure. The findings indicate that she has cancer. The physician informs the nursing staff not to inform the client about the diagnosis. It is noted that the Michelle has a history of suicide attemps. As soon as Michelle regains consciousness, she asks the nurse if she has cancer. Which of the following is the best response made by the nurse?
A)"I am sorry, but I do not have any information about your diagnosis."
B)"I am not in the position to tell you about the diagnosis. It is best to ask your family members about the results."
C)"The initial findings of the surgeon suggest you have cancer. It is best if you talk to the surgeon to determine your treatment options."
D)"I will contact the surgeon and have him speak with you as soon as he can."

Accepted Answer

The best response is: "I will contact the surgeon and have him speak with you as soon as he can." It is only the physician who is responsible for informing the client about the results of the tests. By contacting the physician, the nurse is not violating the principles of fidelity or veracity. Option A violates veracity. The family is not responsible for informing the client about the diagnosis. C violates fidelity, or professional loyalty to the profession.

Question 13

A client is rushed to the emergency department after a motorcycle accident. The client complains of severe pain in the hip area. The physician decides not to prescribe narcotic analgesics after learning that the client has a history of narcotic abuse. The nurse feels that the physician is not addressing the client's chief complaint. As a client advocate, which of the following is the most appropriate action of the nurse caring for the client?
A)Inform the nurse supervisor about the physician's decision not to prescribe narcotic analgesics to a client in pain.
B)Inform the ethics committee about the physician's action.
C)Discuss administering another type of pain medication with the physician.
D)Document the physician's decision, and look for another physician who can assess the client.

Accepted Answer

The most appropriate action of the nurse is to the option of administering another type of pain medication for pain relief with the physician. A nurse is a client advocate. S/he should to the physician implementing alternative methods of pain relief. A and B do not address the main concern of the client. D is not correct as it is not cost-effective to have another physician assess the client. If a nurse feels that a physician is not addressing a client's concern, s/he must talk to the physician and raise this issue.

Question 14

A nurse manager has deliberately changed the method of nursing care delivery system from functional nursing to team nursing. A licensed practical nurse rejects the change and is refusing to take part in the process. Which of the following is the most effective strategy to overcome the resistance of the licensed practical nurse?
A)Make use of coercion with the licensed practical nurse.
B)Provide incentives.
C)Schedule a face-to-face meeting and confront the issue.
D)Focus on the negative effects of functional nursing.

Accepted Answer

The most effective strategy when dealing with a person who is resistant to change is to confront the issue head-on. Confrontation allows verbalization of feelings, identification of problems, and planning of strategies to resolve the issue. Option A may cause further resistance. Option B may solve the issue temporarily; it does not address the main concern of the licensed practical nurse. Option D is not correct; it is more effective to focus on the benefits of team nursing.

Question 15

A registered nurse is planning the client assignments for the shift. The RN leads a nursing team that consists of one licensed practical nurse and two certified nursing assistants. Which of the following is the most appropriate assignment for a certified nursing assistant?
A)A client who requires tracheal suctioning, as necessary.
B)A client who is ordered for a urinary catheterization.
C)A client with diabetes who is for discharge.
D)A client who requires assistance during range-of-motion exercises.

Accepted Answer

A client who requires assistance during range-of-motion exercises is correctly assigned to a certified nursing assistant. The CNA is skilled to perform this procedure. Tracheal suctioning and urinary catheterization are appropriately assigned to a licensed practical nurse. A client for discharge requires the skills of a registered nurse.

Question 16

A case manager reviews the critical paths of the clients admitted to a medical-surgical unit. When conducting a variance analysis, which of the following cases would indicate the need for further action to achieve better outcomes and maximize client care revenues?
A)An obese female client and her family members attending a weight loss teaching session.
B)A client for discharge is demonstrating correct techniques of insulin administration after a teaching session.
C)A client with chronic low back pain cancels a session of physical therapy due to pain intolerance.
D)Absence of signs of wound infection in a post-total knee arthroplasty client.

Accepted Answer

Further action and analysis are required for a client with chronic low back pain who cancels a session of physical therapy. Variances are actual deviations from the critical paths. A positive variance occurs when a client achieves maximum benefit of care and is earlier discharged than expected on the critical path. A negative variance occurs when unexpected events prevent a timely discharge, causing longer hospital stay. A client who cancels a session of physical therapy is a negative variance.

Question 17

A newly hired registered nurse is attending an orientation regarding the nursing care delivery system implemented in the facility. The nurse is informed that the facility follows a team nursing approach. Based on this nursing model of practice, the nurse will plan delivery of care based on which of the following characteristics?
A)A task-approach system in which major tasks are delegated by the charge nurse to individual members of the team.
B)A nurse is actively involved in client care at bedside as s/he plans for goal-oriented and individualized care.
C)Nursing personnel are led by a registered nurse who is responsible for providing care to a group of clients.
D)Each staff member does not work fully within the area of educational and clinical expertise.

Accepted Answer

A team nursing model is characterized by nursing personnel being led by a registered nurse who is responsible for providing care to a group of clients. In this model, each member functions fully within his or her educational and clinical expertise. Each member is accountable for client care and outcomes. Option A refers to functional nursing, which involves a task-approach to nursing care. In this system, major tasks are delegated by the charge nurse to individual team members. Option B refers to primary nursing, a system that keeps a nurse bedside as s/he actively plans for client care.

Question 18

A registered nurse leads a team consisting of two licensed practical nurses and two certified nursing assistant. After reviewing the clients' records, the RN begins to delegate tasks to each member of the team. All of the following tasks may be appropriately assigned to a licensed practical nurse EXCEPT:
A)Assist a post-laminectomy client to assist ambulation in the hall.
B)Administer a medication to a diabetic client through the intramuscular route.
C)Initiate teaching about proper insulin administration to a client for discharge.
D)Irrigate the wound and change the dressing of a post cholecystectomy client.

Accepted Answer

A licensed practical nurse is not assigned to initiate teaching to a client for discharge. This task is appropriately assigned to a registered nurse. An RN is assigned to perform assessment and planning of care, initiate teaching, and administer intravenous medications. A licensed practical nurse can perform the tasks that a certified nursing care assistant can do and certain invasive procedures, such as suctioning, administration of medications intramuscularly, and wound irrigation or dressing.

Question 19

A Registered Nurse is providing care to five clients on a nursing unit. The RN works with a certified nursing assistant. The RN assigns the CNA to administer an enema to a client who is scheduled for a voiding cystourethrography. The CNA carries out the care on the assigned client and reports back to the registered nurse. Which of the following is NOT accurately derived from the given situation?
A)The registered nurse transfers responsibility and authority when the task is delegated to and accepted by the certified nursing assistant.
B)By reporting back to the registered nurse, the certified nursing assistant demonstrates responsibility for his or her actions.
C)The registered nurse continuously own ups to the results of the task although it has been delegated to a certified nursing assistant.
D)The certified nursing assistant is responsible to accomplish the task.

Accepted Answer

By reporting back to the registered nurse, the certified nursing assistant demonstrates accountability for his or her actions. Accountability is accepting or owning up the results of one's actions. An RN can transfer responsibility for which s/he is responsible, but not accountability. In addition to responsibility, the nurse must also transfer authority or the right to act. Without transferring authority, the delegate cannot accomplish the task.

Question 20

A nursing unit manager practices democratic style of leadership when managing a 50-bed pediatric unit. Which of the following most accurately describes this leadership style?
A)The nursing unit manager makes decisions and solves all problems.
B)The nursing unit manager mainly acts as a facilitator and a resource person.
C)The nursing unit manager assumes a passive and inactive approach.
D)The nursing unit manager approaches the needs of the unit and the tasks to be achieved.

Accepted Answer

A nursing unit manager who utilizes democratic leadership mainly acts as a facilitator and a resource person. A nursing unit manager who utilizes this style believes that every member of the group should have an input into the development of goals and strategies to solve problems. An autocratic leader makes decisions and solves all problems. A leader that utilizes the laissez-faire inactively and passively approaches the responsibilities in the unit. A situational leader approaches the needs of the unit and tasks to be achieved based on the situations or events involved.

Quiz 3: Professionalism

Which of the following best describes the "minimum standard of care" required by Registered Nurses in Canada?

The Canadian Nurses Association Code of Ethics explains the nursing values and ethical responsibilities of all Registered Nurses. The primary nursing values include all of the following EXCEPT:

A community nurse is helping a small farming town secure a location for an indoor walking group. The nurse is following the principles of primary health care to assist the community in their endeavors. All of the following are principles of primary health care, except:

There are four major roles identified within the profession of nursing: administrator, educator, practitioner, and researcher. Although the setting of practice and the level of expertise influence the level of focus, which of the following is the most fundamental role to nursing?

A medical facility utilizes case management to organize work, deploy nursing staff, and provide organization of rules and structures that define responsibility and accountability. Which of the following is the advantage of case management over the other nursing care delivery systems?

Every client has the right to expect that he or she will be treated with respect, provided with adequate information, and have his or her confidentiality maintained. A nurse respects a client's right to autonomy in which of the following situations?

Principles are applied when deciding on the facility's organizational structure, which is the basis of the organization's goals and the department's philosophy and objectives. Which of the following accurately describes the principle of continuing responsibility?

A methodical and careful planning process is essential to the success of any health care institution or organization. One of these types is called strategic planning. Which of the following statements best describes strategic planning?

A registered nurse is planning the client assignments for the shift. The RN leads a nursing team that consists of one licensed practical nurse and two certified nursing assistants. Which of the following is the most appropriate assignment for a certified nursing assistant?

A case manager reviews the critical paths of the clients admitted to a medical-surgical unit. When conducting a variance analysis, which of the following cases would indicate the need for further action to achieve better outcomes and maximize client care revenues?

A nursing unit manager practices democratic style of leadership when managing a 50-bed pediatric unit. Which of the following most accurately describes this leadership style?