QUESTIONS AND ANSWER WITH RATIONALE

1.The client asks the nurse why an electronic health record (EHR) system is being used. Which response by the nurse indicates an understanding of the rationale for an EHR system?
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1) It includes organizational reports of unusual occurrences that are not part of the client's record.
2) This type of system consists of combined documentation and daily care plans.
3) It improves interdisciplinary collaboration that improves efficiency in procedures.
4) This type of system tracks medication administration and usage over 24 hours

Answer: 3) It improves interdisciplinary collaboration that improves efficiency in procedures.

Rationale:
The EHR has several benefits for use, including improving interdisciplinary collaboration and making procedures more accurate and efficient. An occurrence report is an organizational record of an unusual occurrence or accident that is not a part of the client's record. Integrated plans of care (IPOC) are a combined charting and care plan format. A medication administration record (MAR) is used to document medications administered and their usage.

2.A 73-year-old patient who sustained a right hip fracture in a fall requests pain medication from the nurse. Based on his injury, which type of pain is this patient most likely experiencing?
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1) Phantom
2) Visceral
3) Deep somatic
4) Referred

Answer: 3) Deep somatic

Rationale:
Deep somatic pain originates in ligaments, tendons, nerves, blood vessels, and bones. Therefore, a hip fracture causes deep somatic pain. Phantom pain is pain that is perceived to originate from a part that was removed during surgery. Visceral pain is caused by deep internal pain receptors and commonly occurs in the abdominal cavity, cranium, and thorax. Referred pain occurs in an area that is distant to the original site.
3.Which of the following is/are an example(s) of theoretical knowledge as defined in this chapter? Select all that apply.

1) Antibiotics are ineffective in treating viral infections.
2) When you take a patient's blood pressure, the patient's arm should be at heart level.
3) In Maslow's framework, physical needs are most basic.
4) When drawing medication out of a vial, inject air into the vial first.

Answer: 1) Antibiotics are ineffective in treating viral infections.
3) In Maslow's framework, physical needs are most basic.

Rationale:
Theoretical knowledge consists of research findings, facts (e.g., "Antibiotics are ineffective . . ." is a fact), principles, and theories (e.g., "In Maslow's framework . . ." is a statement from a theory). Instructions for taking a blood pressure and withdrawing medications are examples of practical knowledge—what to do and how to do it.

4.Which of the following incidents requires the nurse to complete an occurrence report?
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1) Medication given 30 minutes after scheduled dose time
2) Patient's dentures lost after transfer
3) Worn electrical cord discovered on an IV infusion pump
4) Prescription without the route of administration

Answer: 2) Patient's dentures lost after transfer

Rationale:
You would need to complete an occurrence report if you suspect your patient's personal items to be lost or stolen. A medication can be administered within a half-hour of the administration time without an error in administration; therefore, an occurrence report is not necessary. The worn electrical cord should be taken out of use and reported to the biomedical department. The nurse should seek clarification if the provider's order is missing information; an occurrence report is not necessary.

5.Which of the following aspects of nursing is essential to defining it as both a profession and a discipline?

1) Established standards of care
2) Professional organizations
3) Practice supported by scientific research
4) Activities determined by a scope of practice
 
Answer: 3) Practice supported by scientific research

Rationale: The American Nurses Association (ANA) has developed standards of care, but they are unrelated to defining nursing as a profession or discipline. Having professional organizations is not included in accepted characteristics of either a profession or a discipline. A profession must have knowledge that is based on technical and scientific knowledge. The theoretical knowledge of a discipline must be based on research, so both are scientifically based. Having a scope of practice is not included in accepted characteristics of either a profession or a discipline.

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