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Management of Care – Part 3

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Management of Care – Part 3

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Question 1 of 35

1. Question

1. The charge nurse is notified that the unit will be receiving an admission of a client from another bed in the hospital in order to make room for others being admitted through the emergency room. The unit is the Women’s Health Center of the hospital. Which of the following people would be most appropriate to be transferred to this unit?

A. A 26-year old woman who had a bowel resection.
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B. A 40-year old man who underwent a hernia repair.
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C. A 31-year old woman with septicemia and who is on a ventilator.
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D. A 91-year old man with Alzheimer's disease recovering from a fall.
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Hint

Hint: Consider matching the patient’s gender and expected level of post-op stability to the specialty unit—choose the noncritically ill adult who fits the unit’s patient population and care capabilities.
Question 2 of 35

2. Question

2. A 22 year old patient has been declared to have experienced an irreversible cessation of brain activity following a motor vehicle accident. The nurse has the legal obligation to address organ donation with the family. The nurse’s priority action at this time would be to:

A. Determine who is legally responsible to provide consent.
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B. Provide a private area where the family can discuss organ donation.
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C. Notify the physician of patient condition.
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D. Notify Center for Organ Recovery and Education (CORE).
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Hint

Hint: In situations of declared brain death, alert the designated organ procurement organization immediately—trained coordinators handle donor evaluation and family discussions and should be involved before donation consent is sought by staff or family.
Question 3 of 35

3. Question

3. Examples of preservation of self-integrity include all of the following except:

A. Using assistive equipment to move bariatric clients.
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B. Participating in wellness programs.
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C. Accepting the challenge of caring for clients with oppositional beliefs or practices.
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D. Using hand hygiene and personal protective equipment.
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Hint

Hint: Preservation of self-integrity refers to practices that protect your physical safety, health, and professional boundaries—identify which option describes taking on a potentially value-conflicting challenge rather than a protective or self-care action.
Question 4 of 35

4. Question

4. Which of the following is an example of intragroup conflict?

A. A nurse writes a grant for a non-profit organization to raise money for advertising.
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B. Members of a multidisciplinary team cannot agree on the best course of action for a client.
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C. A client does not receive his medication on time because the nurse was on break.
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D. A nurse feels frustrated that her employer does not provide on-site child care.
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Hint

Hint: Intragroup conflict occurs when disagreement arises among members of the same team about decisions or actions—think about conflicts within a single care team rather than between individuals and the organization.
Question 5 of 35

5. Question

5. What does an anti-kickback statute prevent?

A. It prevents healthcare workers from providing food or parties to celebrate special occasions at work.
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B. It promotes thorough and complete documentation when a client becomes injured.
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C. It forbids giving or accepting gifts to promote or provide referrals for certain services.
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D. It prevents physicians from ordering treatments that may require nursing care that is over and above the usual amount.
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Hint

Hint: Think about laws that prohibit financial incentives or inducements designed to influence referrals or the provision of services—especially gifts or payments intended to generate patient referrals.
Question 6 of 35

6. Question

6. The nurse working at an acute care hospital is transferring a patient to a skilled nursing facility. The patient’s vital signs documented at 1400 are: T-37.5 degrees Celcius, P- 88, RR-16, BP-135/70, Sp02 93% on RA. The following vital signs documented at 1800, just prior to discharge, are as follows: T-38.5 degrees Celcius, P-102, RR- 18, BP- 158/82, Sp02-91% on RA. What should be the nurse’s next course of action?

A. Discharge the patient, but notify the skilled nursing facility of the patient's change in status.
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B. Discharge the patient, but notify the physician of patient's change in status.
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C. Delay discharge and notify the physician of the patient's change in status.
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D. Delay discharge and notify the skilled nursing facility of the patient's change in status.
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Hint

Hint: Recognize the trend of clinical deterioration (rising temperature, heart rate, and BP with falling SpO2) — when stability is lost before transfer, the priority is to withhold discharge and escalate to the prescribing clinician for orders.
Question 7 of 35

7. Question

7. Which of the following is an example of intrapersonal conflict?

A. Hospital bills are denied by an insurance company due to policies.
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B. A nurse is called to testify in court about a client she cared for three years ago.
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C. A nurse feels guilty when she administers essential medication that causes a client to have nausea and vomiting.
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D. The spouse of a nurse is upset that she is working overtime.
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Hint

Hint: Intrapersonal conflict occurs within the individual—think internal emotions, values, or guilt about actions rather than external disputes with others or systems.
Question 8 of 35

8. Question

8. A nurse with five years of experience working in a hospital unit is promoted as a mentor and preceptor to a new nursing staff. This is an example of:

A. Collegiality.
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B. Competence.
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C. Advocacy.
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D. Integration.
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Hint

Hint: Think about the professional, supportive relationship where an experienced nurse guides and fosters the development of a colleague—this reflects teamwork and mutual support among peers rather than individual skill or policy action.
Question 9 of 35

9. Question

9. All of the following are essential components of supervision EXCEPT:

A. All tasks to be delegated or supervised are within the nurse's scope of practice.
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B. The necessary tasks require repeated assessments.
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C. The nurse has adequate time to develop staff assignments.
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D. Policies have been developed that govern nursing practice.
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Hint

Hint: Supervision requires appropriate assessment and oversight, clear policies, and time to plan assignments, but it does not universally mandate repeated assessments for every delegated task—frequency depends on the situation.
Question 10 of 35

10. Question

10. Which of the following is an example of a breach to a client’s right to privacy?

A. A nurse who is not caring for the client reads his personal information in his chart.
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B. A client is not allowed to keep a copy of his original medical record.
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C. A nurse filed an incident report about a client that was reviewed with all staff at a meeting.
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D. A client's photograph was used without permission for the hospital newsletter.
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Hint

Hint: Think about use of identifiable images or information without patient consent—publicly sharing a client’s likeness or identifying details without permission is a clear privacy violation.
Question 11 of 35

11. Question

11. Which of the following abides by the Americans with Disabilities Act of 1990?

A. A nurse is allowed to have a leave of absence to recover after a back injury.
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B. A nurse manager cannot cancel an interview with a potential employee because he has left-sided paralysis.
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C. A nurse is mandated to receive 12 weeks' off of work after having a baby.
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D. A nurse manager must hire a nurse who uses a walker for mobility.
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Hint

Hint: Remember that the ADA protects applicants from discrimination during hiring processes and requires equal opportunity to be considered despite a disability, rather than mandating employers to hire or provide specific leave policies.
Question 12 of 35

12. Question

12. A patient that is post-op day three from a total knee replacement informs the nurse that he lives alone and has two sets of stairs in his home. The following action taken by the nurse would be appropriate after gathering the above information:

A. Notify the physician.
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B. Notify the social worker.
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C. Arrange for a family member of the patient to stay with the patient.
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D. All of the above.
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Hint

Hint: Think about which team member specializes in assessing home safety and coordinating community or in-home support services for discharge planning rather than medical orders or family arrangements.
Question 13 of 35

13. Question

13. Because of budget cuts in the hospital, the nursing manager informs the staff that they must either float to other units more often or take their turns staying home from work. Which principle is this nurse manager demonstrating?

A. Justice.
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B. Paternalism.
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C. Veracity.
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D. Fraternity.
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Hint

Hint: Consider the ethical duty that emphasizes honesty and truth-telling in communication with staff when policies or changes are announced.
Question 14 of 35

14. Question

14. A group of nurses who work on the quality assurance council of a unit have gathered to discuss ideas about how to educate their coworkers about Joint Commission requirements. Each of the nurses gives ideas, which are listed together without initially criticizing any of the suggestions. Eventually, all ideas on the list will be discussed as to their validity. This activity is known as:

A. Optimizing.
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B. Satisficing.
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C. Brainstorming.
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D. Centralizing.
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Hint

Hint: Think of the group technique that first emphasizes free generation of many ideas without criticism, followed by later evaluation and selection of the best options.
Question 15 of 35

15. Question

15. An assisted living facility is an example of which type of healthcare provider?

A. Primary care.
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B. Secondary care.
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C. Tertiary care.
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D. None of the above.
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Hint

Hint: Recall that tertiary care refers to highly specialized, consultative services usually provided in referral centers—compare that definition to the typical services and level of medical complexity offered in an assisted living facility.
Question 16 of 35

16. Question

16. Which of the following statements is true regarding non-profit organizations?

A. They are located in poor or rural areas to provide care to the largest number of people.
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B. They are mandated to care for people, even if clients are unable to pay for services.
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C. The money they receive for services is divided among stockholders that have invested in the organization.
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D. They are also called proprietary organizations.
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Hint

Hint: Focus on the mission-driven, charitable nature of non-profit organizations: they reinvest surplus into services and community benefit rather than distributing profits to private owners or being classified as proprietary.
Question 17 of 35

17. Question

17. Which of the following is a function of risk management?

A. To consider the problems that arise if errors happen and their effect on the healthcare environment.
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B. To identify how nursing care responds to specific client problems.
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C. To view clients as customers and decide what actions will provide a satisfying healthcare experience.
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D. To analyze physician-nurse relationships and determine where collaboration efforts can improve.
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Hint

Hint: Think about risk management as a process that anticipates potential errors and evaluates their consequences on patient safety and the healthcare system, emphasizing prevention and system-level responses.
Question 18 of 35

18. Question

18. Which of Erikson’s stages of psychosocial development is associated with a preschool-aged child?

A. Trust vs. Mistrust.
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B. Industry vs. Inferiority.
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C. Initiative vs. Guilt.
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D. Identity vs. Role Confusion.
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Hint

Hint: Think about early childhood (preschool) development where children assert power and purpose through imaginative play and goal-directed activities—contrast that with infancy, school-age, and adolescent stages.
Question 19 of 35

19. Question

19. What is the relationship between HIPPA and technological advances?

A. Technology helps to foster HIPPA confidentiality.
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B. Computers help us to share information with others.
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C. Computer screens are not visible to others in the area.
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D. Technology places us at risk for HIPPA violations.
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Hint

Hint: Consider how electronic storage, transmission, and multiple access points can create new vulnerabilities for patient privacy—focus on security breaches and unauthorized access rather than assuming technology always protects confidentiality.
Question 20 of 35

20. Question

20. Which technological advance is MOST likely to place you at risk for HIPPA violations?

A. Social media.
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B. Word processing programs.
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C. Spreadsheets.
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D. Clouds and SOEs.
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Hint

Hint: Consider technologies that encourage broad public sharing and reduce your control over who accesses protected health information—platforms designed for social interaction pose a high risk for inadvertent PHI disclosure.
Question 21 of 35

21. Question

21. A physician is explaining a procedure to a patient that may cure her recurring Staph infection. The doctor explains how the procedure is done, what to expect, the odds of the procedure curing the infection, and possible side effects and risks. The physician is:

A. Preparing the patient to give informed consent.
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B. Protecting HIPAA by listing all of the steps of the procedure with the risks involved.
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C. Not required to inform the patient of any alternative therapies.
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D. None of the above.
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Hint

Hint: Focus on the ethical and legal process requiring disclosure of the procedure, benefits, risks, and what to expect—this describes the key elements needed before a patient can make a voluntary decision.
Question 22 of 35

22. Question

22. After a lengthy explanation of a medical procedure, the patient asks many questions. The physician answers all of the questions to the best of her ability. The patient then gives consent for treatment. The costly equipment and supplies are put into place and the patient is prepared. Two minutes before the procedure is to start, the patient begins panicking and changes her mind. Which of the following situations would be the best way to avoid litigation?

A. Document that the patient originally gave consent and proceed if the benefits of the procedure outweigh the patient's wishes.
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B. Have the patient sign a form that she is refusing consent. If she refuses to sign, proceed with the procedure.
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C. Repeat the explanation of the procedure until the patient understands that having the procedure done is the best form of treatment. Proceed with the procedure.
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D. Do not proceed. Document the patient's refusal, have the patient sign a refusal to consent to treatment. If the patient refuses to sign the form, have a witness available to sign.
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Hint

Hint: Remember that a patient can withdraw consent at any time; the safest practice is to honor the refusal, document it thoroughly, and obtain a witness if the patient will not sign the refusal form.
Question 23 of 35

23. Question

23. Who of the following wrote a medical code of ethics?

A. Hammurabi.
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B. Tomas Percival.
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C. Hippocrates.
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D. All of the above.
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Hint

Hint: Each of these historical figures is linked to an early formalized set of rules or principles guiding medical practice — from ancient legal codes and classical oaths to early professional conduct manuals.
Question 24 of 35

24. Question

24. In which of the following examples would informed consent be required?

A. A patient is apprehensive about an upcoming surgery and chooses not to learn of the risks involved with the procedure.
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B. A child is rushed to the Emergency Room after falling from a third story window.
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C. An adult in a coma in a mental health institution with no listed next of kin.
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D. None of the above require informed consent.
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Hint

Hint: Consider the emergency/implied-consent exception and the patient’s capacity or available surrogate—life‑saving care can be given without formal informed consent, and competent adults who waive information still must have their decision capacity respected and documented.
Question 25 of 35

25. Question

25. A woman has died as a result of a motor vehicle accident. She is listed as an organ donor and her family is considering whether to comply with her wishes. Which of the following is true?

A. The woman would have had to list herself as an organ donor and notify her family prior to her death that she has considered donating her organs.
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B. The Uniform Anatomical Gift Act requires the physician caring for the patient to inform the family who receives the donor organs.
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C. Physicians can choose to go against the deceased's wishes if the family decides that organ donation is not an acceptable choice.
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D. Physicians have the legal responsibility to inform patients of the risks involved in donating organs.
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Hint

Hint: Remember that a legally documented anatomical gift reflects patient autonomy and generally takes precedence over family objections—clinicians follow the decedent’s expressed wishes regarding organ donation.
Question 26 of 35

26. Question

26. Which of the following reasons would be legal when considering a patient’s medical record?

A. Allowing a patient's brother to view her chart to find out her birthdate and address so that he can mail her a card.
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B. Not allowing a patient to view her own chart because the physician feels this information would be detrimental to her wellbeing.
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C. Not allowing a patient to view her chart because she is behind on her payments.
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D. All of the above are legal.
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Hint

Hint: Remember that patients generally have a legal right to their records, but there are narrow, clinically justified exceptions that allow a clinician to restrict access if disclosure would likely cause significant harm to the patient’s wellbeing.
Question 27 of 35

27. Question

27. Which of the following persons is at highest risk of developing type 2 diabetes?

A. A 40-year old Caucasian man with a BMI of 27.
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B. A 48-year old Hispanic woman with low levels of HDL cholesterol.
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C. A 39-year old Asian woman who recently had a baby weighing 8 lbs, 2 oz.
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D. A 50-year old Caucasian man with low levels of LDL cholesterol.
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Hint

Hint: Consider known risk factors for type 2 diabetes such as ethnicity and dyslipidemia—specifically low HDL is a component of metabolic syndrome that increases diabetes risk.
Question 28 of 35

28. Question

28. The purpose of performing quality control is to:

A. create a paper trail to show that the laboratory is compliant with OSHA standards for quality control.
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B. improve the odds that the results that are reported for any given test are as accurate and reliable as possible.
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C. Are required by law to be part of a quality assurance program.
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D. All of the above.
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Hint

Hint: Think about the primary clinical goal of quality control in the lab—what ensures patient care decisions are based on trustworthy test data rather than paperwork or regulatory checkboxes.
Question 29 of 35

29. Question

29. Richard is a 72-year-old with stage 4 lung cancer who has been admitted to the hospital for pneumonia. He is alert and oriented, and states he would like to sign a do not resuscitate (DNR) order. His wife enters the room after he has signed it and is very upset that he has made this decision without discussing it with her. She wants to know what she can do to get the DNR reversed. What should your first response be?

A. Contact the unit manager to talk with her.
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B. Contact the hospital's attorney to discuss with her.
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C. Try to talk Richard out of his decision.
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D. Offer caring support for both parties.
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Hint

Hint: Remember that an alert, competent patient’s treatment decisions take priority—your immediate role is to honor that autonomy while providing empathetic support and facilitating communication between the patient and family.
Question 30 of 35

30. Question

30. You are on the unit and overhear another nurse talking on the phone to a patient’s friend who wants to see her patient who is comatose and on a ventilator. Since you cared for that patient yesterday, you know that the patient’s significant other, who is also the designated health care surrogate (HCS) and has power of attorney (POA), has expressly stated that he wants this person on the list for restricted visitors. The nurse whispers that she’ll call him to visit as soon as the significant other has gone home. What should your first response be?

A. Inform the significant other.
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B. Report the nurse to the nurse manager.
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C. Speak with the nurse directly in private.
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D. Call the visitor and tell him he can't visit.
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Hint

Hint: Address the potential breach of patient rights and confidentiality by approaching the colleague privately and promptly to clarify the surrogate’s visitation instructions before escalating.
Question 31 of 35

31. Question

31. Teresa is an 84-year-old with stage 4 ovarian cancer who has been admitted for a bowel obstruction. She recently stated that she has decided that she doesn’t want any further aggressive care and is requesting to be placed under hospice care. Her husband and daughter are supportive of her decision. She spoke with her oncologist about it, and he stated that he did not agree, and wrote orders on her chart for chemotherapy. What would be the best first response to this situation?

A. Give the patient a list of other oncologists.
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B. Tell the family to report the doctor to the state quality board.
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C. Notify the doctor that the patient refuses the chemotherapy.
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D. Give the patient hospice information.
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Hint

Hint: Remember patient autonomy—when a competent patient declines further treatment, your role is to advocate for them by promptly informing the prescribing clinician and documenting the refusal.
Question 32 of 35

32. Question

32. Jack is a 2-month-old with a diagnosis of spinal muscular atrophy (SMA) type I. He has been admitted to the hospital for progressive respiratory difficulty. His parents have been informed that if he is not placed on ventilatory support, he will continue to decompensate and die of respiratory failure. Jack’s physician discusses the poor prognosis of Jack’s condition, and tells the parents that he will not be able to be removed from ventilatory support once it is initiated, due to his progressive neurological disease. After much discussion, the parents have decided to decline ventilatory support, agree to a do not resuscitate (DNR) order, and request hospice care for Jack. Another parent heard them discussing Jack’s situation in the waiting room and says she could never do that to her baby. What is the most appropriate response to this parent?

A. You never know what you'll do until you're in that situation."
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B. I can't discuss another patient's situation."
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C. They have been through too much already."
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D. You can contact administration with your concerns."
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Hint

Hint: Prioritize patient confidentiality—acknowledge the parent’s feelings but avoid discussing another family’s specific situation or medical decisions.
Question 33 of 35

33. Question

33. Albert is a patient in the hospital who is scheduled for surgery the following morning. After the pre-operative visit from the anesthesia staff member who has obtained surgical consent, Albert asks for an explanation of what type of surgery he is going to have. He states that he’s not sure what he just signed. What is your best response?

A. Don't worry, they'll explain it in the operating room."
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B. It's standard procedure to get the consent, you don't need to worry."
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C. Let me ask the nurse anesthetist to come back and explain it further."
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D. Someone will review it with you prior to surgery."
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Hint

Hint: A patient has the right to understand the procedure and to have the clinician who obtained consent clarify any uncertainties—ask that specific anesthesia provider to return and explain further rather than offering vague reassurances.
Question 34 of 35

34. Question

34. If a nurse prevents intentional harm from occurring to a patient, which ethical principle is she supporting?

A. Beneficence.
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B. Nonmaleficence.
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C. Justice.
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D. Fidelity.
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Hint

Hint: Consider the ethical duty that emphasizes avoiding or preventing harm to patients—often summarized by the phrase “do no harm”—rather than promoting benefit or fairness.
Question 35 of 35

35. Question

35. What ethical principle has led to the need for informed consent?

A. Autonomy.
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B. Justice.
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C. Fidelity.
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D. Beneficence.
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Hint

Hint: Consider the principle that emphasizes a patient’s right to make informed choices about their own body and treatment — it’s the foundation for requiring disclosure and voluntary agreement.

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