Title: Exam - Computer, Legal Ethical, Verbal Written Communication
Course: PRN 0930 Practical Nursing I > Section: Verbal and Written Communications

Q: Assuming responsibility for a patient’s care forms a legally binding situation described as:
- nurse-patient relationship.
- accountability.
- advocacy.
- standard of care.
A: nurse-patient relationship.
If right: When the nurse assumes responsibility for a patient’s care, the nurse-patient relationship is formed. This is a legally binding “contract” for which the nurse must take responsibility.
If wrong: When the nurse assumes responsibility for a patient’s care, the nurse-patient relationship is formed. This is a legally binding “contract” for which the nurse must take responsibility.

Q: Universal guidelines that define appropriate measures for all nursing interventions that should be observed during the performance of those interventions are known as:
- scope of practice.
- advocacy.
- standard of care.
- prudent practice.
A: standard of care.
If right: Standards of care define actions that are permitted or prohibited in most nursing interventions. These standards are accepted as legal guidelines for appropriateness of performance.
If wrong: Standards of care define actions that are permitted or prohibited in most nursing interventions. These standards are accepted as legal guidelines for appropriateness of performance.

Q: A nurse who failed to irrigate a feeding tube as ordered resulting in harm to the patient could be found guilty of:
- malpractice.
- harm to the patient.
- negligence.
- failure to follow the Nurse Practice Act.
A: malpractice.
If right: The nurse can be held liable for malpractice for acts of omission. Failure to meet a legal duty, thus causing harm to another, is malpractice. The Nurse Practice Act has general guidelines that can support the charge of malpractice.
If wrong: The nurse can be held liable for malpractice for acts of omission. Failure to meet a legal duty, thus causing harm to another, is malpractice. The Nurse Practice Act has general guidelines that can support the charge of malpractice.

Q: Patients have expectations regarding the health care services they receive. To protect these expectations, which has become law?
- American Hospital Association’s Patient’s Bill of Rights
- Self-Determination Act
- American Hospital Association’s Standards of Care
- JCAHO rights and responsibilities of patients
A: American Hospital Association’s Patient’s Bill of Rights
If right: The American Hospital Association developed the Patient’s Bill of Rights.
If wrong: The American Hospital Association developed the Patient’s Bill of Rights.

Q: The nurse is preparing the patient for a thoracentesis. What must be completed before the procedure may be performed?
- Physical assessment
- Interview
- Informed consent
- Surgical checklist
A: Informed consent
If right: The patient must consent to allow certain procedures to be performed after being fully informed of the benefits and risks.
If wrong: The patient must consent to allow certain procedures to be performed after being fully informed of the benefits and risks.

Q: An older adult is admitted to the hospital with numerous bodily bruises, and the nurse suspects elder abuse. The best nursing action is to:
- cover the bruises with bandages.
- take photographs of the bruises.
- ask the patient if anyone has hit her.
- report the bruises to the charge nurse.
A: report the bruises to the charge nurse.
If right: The nurse must be alert to signs of elder abuse and know procedures for reporting.
If wrong: The nurse must be alert to signs of elder abuse and know procedures for reporting.

Q: Although the nurse may disagree with a do-not-resuscitate (DNR) order, legally he or she:
- may question the doctor.
- may seek advice from the family.
- may discuss it with the patient.
- must follow the order.
A: must follow the order.
If right: When a DNR order is written in the chart, the nurse has a duty to follow the order.
If wrong: When a DNR order is written in the chart, the nurse has a duty to follow the order.

Q: The nurse has strong moral convictions that abortions are wrong. When assigned to assist with an abortion, the nurse has the right to:
- ask for another assignment.
- leave work.
- transfer to another floor.
- protest to the supervisor.
A: ask for another assignment.
If right: The nurse should not abandon the patient, but ask for another assignment.
If wrong: The nurse should not abandon the patient, but ask for another assignment.

Q: Since a nurse’s first duty is to the patient’s health, safety, and well-being, it is necessary to report:
- unethical behavior of other staff members.
- a worker who arrives late.
- favoritism shown by nursing administration.
- arguments among the staff.
A: unethical behavior of other staff members.
If right: A member of the nursing profession must report behavior that does not meet established standards.
If wrong: A member of the nursing profession must report behavior that does not meet established standards.

Q: Which is a nursing care error that violates the Health Insurance Portability and Accountability Act (HIPAA)?
- Administering a stronger dose of drug than was ordered
- Refusing to give a patient’s daughter information over the phone
- Informing the patient’s medical power of attorney of a medication change
- Leaving a copy of the patient’s history and physical in the photocopier
A: Leaving a copy of the patient’s history and physical in the photocopier
If right: Leaving the document in the photocopier could expose it to the public. Inappropriate drug administration is possible malpractice. Sharing information with the power of attorney is legal.
If wrong: Leaving the document in the photocopier could expose it to the public. Inappropriate drug administration is possible malpractice. Sharing information with the power of attorney is legal.

Q: A nurse could be cited for malpractice in the event of:
- refusing to give 60 mg of morphine as ordered.
- giving prochlorperazine (Compazine) to a patient allergic to phenothiazines.
- dragging an injured motorist off the highway and causing further injury.
- informing a visitor about a patient’s condition.
A: giving prochlorperazine (Compazine) to a patient allergic to phenothiazines.
If right: Standards of care dictate that a nurse must be aware of all the properties of drugs administered. Prochlorperazine (Compazine) is a phenothiazine. Providing confidential information or refusing to give an excessively large narcotic dose is not considered malpractice. Good Samaritan laws generally protect a person giving aid to an injured motorist.
If wrong: Standards of care dictate that a nurse must be aware of all the properties of drugs administered. Prochlorperazine (Compazine) is a phenothiazine. Providing confidential information or refusing to give an excessively large narcotic dose is not considered malpractice. Good Samaritan laws generally protect a person giving aid to an injured motorist.

Q: A lumbar puncture was performed on a patient without a signed informed consent form. This may be a situation in which a patient could sue for:
- punitive damages.
- civil battery.
- assault.
- nothing; no violation has occurred.
A: civil battery.
If right: Civil assault charges can be brought against someone performing an invasive procedure without the patient’s informed consent legally documented.
If wrong: Civil assault charges can be brought against someone performing an invasive procedure without the patient’s informed consent legally documented.

Q: The nurse considers the feelings and needs of a patient by stating, “I know you are concerned about your surgery tomorrow. How can I help you?” This type of communication is:
- intrusive.
- aggressive.
- closed.
- assertive.
A: assertive.
If right: Assertive communication takes a patient’s feelings and needs into account, yet honors the patient’s rights as an individual.
If wrong: Assertive communication takes a patient’s feelings and needs into account, yet honors the patient’s rights as an individual.

Q: If a nurse sits in a chair near the patient’s bed, leans forward to hear what the patient is saying, and does not interrupt, the nurse is demonstrating:
- support.
- caring.
- active listening.
- interest.
A: active listening.
If right: When demonstrating active listening, the nurse must give his or her full attention and make an effort to understand both the verbal and nonverbal message.
If wrong: When demonstrating active listening, the nurse must give his or her full attention and make an effort to understand both the verbal and nonverbal message.

Q: A nurse tells a patient, “This PM you are going for an abdominal A&P, an H&H, as well as an IV pyelogram. Please sign these consent forms.” The use of medical jargon can cause:
- understanding.
- speed in communication.
- misinterpretation.
- clarity in the message.
A: misinterpretation.
If right: Jargon is terminology unique to people in a special type of work and is not understood by everyone. Although jargon does speed communication and is clear to those who know it, it may be misinterpreted and not understood by all people.
If wrong: Jargon is terminology unique to people in a special type of work and is not understood by everyone. Although jargon does speed communication and is clear to those who know it, it may be misinterpreted and not understood by all people.

Q: A nurse examines whether patient interventions have been appropriate and expected outcomes have been met. The nurse is demonstrating which step of the nursing process?
- Assessment
- Planning
- Implementation
- Evaluation
A: Evaluation
If right: A nurse evaluates the effectiveness of interventions based on the patient’s ability to meet established goals and outcomes.
If wrong: A nurse evaluates the effectiveness of interventions based on the patient’s ability to meet established goals and outcomes.

Q: Nursing process is best defined as a:
- method to ensure that the physician’s orders are implemented correctly.
- series of assessments that isolate a patient’s health problem.
- framework for the organization of individualized nursing care.
- preset formula for the design of nursing care.
A: framework for the organization of individualized nursing care.
If right: The nursing process is a framework by which to organize individualized nursing care.
If wrong: The nursing process is a framework by which to organize individualized nursing care.

Q: The subjective data the nurse records following a head-to-toe examination includes:
- rash on back.
- prolonged nausea.
- blood pressure of 190/100.
- white blood cell count of 19,000.
A: prolonged nausea.
If right: Another term for subjective data is symptoms, which cannot be observed or measured. This data must come from the patient.
If wrong: Another term for subjective data is symptoms, which cannot be observed or measured. This data must come from the patient.

Q: Objective data the nurse would include after a patient assessment includes:
- headache of 3 days duration.
- severe stomach cramps.
- flatulence.
- anxiety.
A: flatulence.
If right: Objective data are observable and measurable by people other than the patient.
If wrong: Objective data are observable and measurable by people other than the patient.

Q: The two primary methods used to collect data are:
- written report by patient and family.
- review of the chart and the nurse's notes.
- interview and physical examination.
- review of the physician’s orders and the Kardex.
A: interview and physical examination.
If right: The two primary methods of collecting data are interview and physical examination.
If wrong: The two primary methods of collecting data are interview and physical examination.

Q: The establishment of priorities of care during the planning phase of the nursing process often uses the framework of:
- Erikson’s developmental tasks.
- Piaget’s cognitive table.
- Maslow’s hierarchy of needs.
- Freud’s classifications.
A: Maslow’s hierarchy of needs.
If right: A useful framework to guide prioritization is Maslow's hierarchy of needs.
If wrong: A useful framework to guide prioritization is Maslow's hierarchy of needs.

Q: What type of assessment is performed continuously throughout nurse-patient contact?
- Complete
- Body systems
- Focused
- Subjective
A: Focused
If right: Focused assessments are performed continuously throughout nurse-patient contact based on the nursing care plan.
If wrong: Focused assessments are performed continuously throughout nurse-patient contact based on the nursing care plan.

Q: The basis for designing and selecting nursing interventions to meet patient needs is the:
- nursing diagnosis.
- care plan.
- doctor’s orders.
- nurse’s notes.
A: nursing diagnosis.
If right: The nursing diagnosis is the basis for developing nursing interventions.
If wrong: The nursing diagnosis is the basis for developing nursing interventions.

Q: When a nurse selects interventions to assist the patient to meet the needs demonstrated, the nurse is in which phase of the nursing process?
- Assessment
- Planning
- Implementation
- Evaluation
A: Planning
If right: During the planning phase, the nurse connects nursing interventions to nursing orders.
If wrong: During the planning phase, the nurse connects nursing interventions to nursing orders.

Q: During an admission assessment the nurse collects objective and subjective data. An example of subjective data is that the patient:
- is asleep.
- is tearful.
- has facial grimacing.
- states, “I hurt all over.”
A: states, “I hurt all over.”
If right: Subjective data are the verbal statements provided by the patient. Statements about nausea and descriptions of pain, fatigue, and anxiety are examples of subjective data. Stating “I hurt all over.” is an example of subjective data. All other options are examples of objective data.
If wrong: Subjective data are the verbal statements provided by the patient. Statements about nausea and descriptions of pain, fatigue, and anxiety are examples of subjective data. Stating “I hurt all over.” is an example of subjective data. All other options are examples of objective data.

Q: During an admission assessment the nurse collects objective and subjective data. An example of subjective data is the patient:
- is coughing.
- has cyanosis of the lips.
- experiences tachypnea.
- complains of generalized discomfort.
A: complains of generalized discomfort.
If right: Subjective data are the verbal statements provided by the patient. Statements about nausea and descriptions of pain, fatigue, and anxiety are examples of subjective data. Complaining of generalized discomfort is an example of subjective data. All other options are examples of objective data.
If wrong: Subjective data are the verbal statements provided by the patient. Statements about nausea and descriptions of pain, fatigue, and anxiety are examples of subjective data. Complaining of generalized discomfort is an example of subjective data. All other options are examples of objective data.

Q: During an admission assessment the nurse collects objective and subjective data. An example of objective data is that the patient:
- complains of chest pain.
- states, “I feel nauseous.”
- complains of feeling faint.
- is short of breath on exertion.
A: is short of breath on exertion.
If right: Objective data are observable and measurable signs. Objective data can be recorded. A camera can record a rash, a skin lesion, or puffy eyes. A tape recorder can give evidence of crying or slurred speech. A thermometer can record a temperature elevation. Other terms for objective data are signs and objective cues. Shortness of breath on exertion is an example of objective data. All other options are examples of subjective data.
If wrong: Objective data are observable and measurable signs. Objective data can be recorded. A camera can record a rash, a skin lesion, or puffy eyes. A tape recorder can give evidence of crying or slurred speech. A thermometer can record a temperature elevation. Other terms for objective data are signs and objective cues. Shortness of breath on exertion is an example of objective data. All other options are examples of subjective data.

Q: During an admission assessment the nurse collects objective and subjective data. An example of objective data is that the patient:
- complains of feeling depressed.
- states, “I hear voices in my head.”
- complains of auditory hallucinations.
- is pacing back and forth while chanting.
A: is pacing back and forth while chanting.
If right: Objective data are observable and measurable signs. Objective data can be recorded. A camera can record a rash, a skin lesion, or puffy eyes. A tape recorder can give evidence of crying or slurred speech. A thermometer can record a temperature elevation. Other terms for objective data are signs and objective cues. Pacing back and forth while chanting is an example of objective data. All other options are examples of subjective data.
If wrong: Objective data are observable and measurable signs. Objective data can be recorded. A camera can record a rash, a skin lesion, or puffy eyes. A tape recorder can give evidence of crying or slurred speech. A thermometer can record a temperature elevation. Other terms for objective data are signs and objective cues. Pacing back and forth while chanting is an example of objective data. All other options are examples of subjective data.

Q: An example of an appropriate nursing diagnosis is:
- impaired skin integrity.
- skin breakdown noted.
- turn patient every 2 hours.
- the patient has scabies on his back.
A: impaired skin integrity.
If right: “Impaired skin integrity” is an example of a nursing diagnosis. “Skin breakdown noted” is an example of a charting entry, “turn patient every 2 hours” is a nursing intervention, and “scabies” is a medical diagnosis.
If wrong: “Impaired skin integrity” is an example of a nursing diagnosis. “Skin breakdown noted” is an example of a charting entry, “turn patient every 2 hours” is a nursing intervention, and “scabies” is a medical diagnosis.

Q: Which is an example of a nursing diagnosis?
- Pneumonia
- Diabetes mellitus
- Impaired skin integrity
- Congestive heart failure
A: Impaired skin integrity
If right: Impaired skin integrity is the only example of a nursing diagnosis; all other options are examples of medical diagnoses.
If wrong: Impaired skin integrity is the only example of a nursing diagnosis; all other options are examples of medical diagnoses.

Q: Which is an example of a medical diagnosis?
- Constipation
- Diabetes mellitus
- Impaired skin integrity
- Altered nutrition: less than body requirements
A: Diabetes mellitus
If right: Diabetes mellitus is the only example of a medical diagnosis; all other options are examples of nursing diagnoses.
If wrong: Diabetes mellitus is the only example of a medical diagnosis; all other options are examples of nursing diagnoses.

Q: When events are not consistent with facility or national standards of expected care, the form that explains the lapse is the:
- subjective data.
- focus chart.
- incident report.
- nursing assessment.
A: incident report.
If right: An incident report is completed when patient care was not consistent with facility or national standards. The form explains the event, time, extent of injury, and who was notified.
If wrong: An incident report is completed when patient care was not consistent with facility or national standards. The form explains the event, time, extent of injury, and who was notified.

Q: Adherence to the concept of confidentiality for the patient’s medical record requires that the nurse:
- provide information only to another nurse.
- provide information only to an attorney.
- share information only with the family.
- have a clinical reason for reading the record.
A: have a clinical reason for reading the record.
If right: The nurse should not read the patient’s medical record unless there is a clinical reason for doing so.
If wrong: The nurse should not read the patient’s medical record unless there is a clinical reason for doing so.

Q: The purpose of QA (quality assurance) is to:
- screen employment applications.
- evaluate care results against accepted standards.
- conduct in-services for “quality documentation.”
- report deviation from standards to the state health department.
A: evaluate care results against accepted standards.
If right: QA is an in-house department that evaluates care services and results against accepted standards.
If wrong: QA is an in-house department that evaluates care services and results against accepted standards.

Q: The nurse knows that for a hospitalized patient, the legal owner of the patient’s medical record is the:
- patient.
- physician.
- institution.
- state.
A: institution.
If right: Ownership of a medical record belongs to the institution in the case of a hospitalized patient, or the doctor in the case of private office visits.
If wrong: Ownership of a medical record belongs to the institution in the case of a hospitalized patient, or the doctor in the case of private office visits.

Q: When using electronic (or computerized) documentation, which process should the nurse use to ensure that no one alters the information the nurse has entered?
- Charting in code
- Logging off
- Charting in privacy
- Signing on with a password
A: Logging off
If right: Logging off closes the computer file that was opened with the nurse’s password. Any other data entry will require that person to sign on with their password.
If wrong: Logging off closes the computer file that was opened with the nurse’s password. Any other data entry will require that person to sign on with their password.

Q: When documenting in a patient’s chart, the nurse should:
- include speculation.
- chart consecutively.
- leave blank spaces.
- include retaliatory comments.
A: chart consecutively.
If right: A nurse should not write retaliatory or critical comments about a patient or care by other health care professionals. The nurse should not leave blank spaces in the nurse’s notes. The nurse should be certain the entry is factual and not speculate or guess. The nurse should chart consecutively, line by line.
If wrong: A nurse should not write retaliatory or critical comments about a patient or care by other health care professionals. The nurse should not leave blank spaces in the nurse’s notes. The nurse should be certain the entry is factual and not speculate or guess. The nurse should chart consecutively, line by line.

Q: The machine components of the computer, including the keyboard, disk drive, and monitor, are called ____.
- software
- hardware
- central processing unit
- computer chips
A: hardware

Q: The programs, or instructions, that run the computer and allow the computer to perform specific tasks are called ____.
- hardware
- software
- input devices
- output devices
A: software

Q: The first noninvasive computer-based body and brain scanner was ____.
- computerized tomography
- magnetic resonance imaging
- positron emission tomography
- ultrasonography
A: computerized tomography

Q: The noninvasive scanning procedure that is used to determine the size, position, sex, and even abnormalities of a fetus is ____.
- computerized tomography
- magnetic resonance imaging
- positron emission tomography
- ultrasonography
A: ultrasonography

Q: A major use of the Internet in health care is for ____.
- statistical research
- organ transplants
- obtaining information
- simulation learning
A: organ transplants

Q: A contingency backup plan is necessary when using computers to ____.
- maintain confidentiality of patient information
- communicate with other computers in a health care facility
- prevent loss of information in case of a power failure
- document care on a patient’s record
A: prevent loss of information in case of a power failure

Q: Which statement is true regarding the way a computer saves the data you input?
- The hard drive automatically saves everything you enter.
- You must give the computer a command to save your data or set it to save at regular intervals.
- If you place a diskette in the drive, your data will be periodically stored on it.
- Data is stored when you turn the computer off.
A: You must give the computer a command to save your data or set it to save at regular intervals.

Q: A surgeon watching a computerized video and using a robotic arm to perform surgery on a patient in another city is an example of ____.
- e-medicine
- telepharmacy
- networking
- telemedicine
A: telemedicine