PNR 300
Seneca College; PNR/ PNR 300 Final Exam Solutions
2.Jeffrey is a 60 year old who had knee surgery 1 day ago. Ashley the night nurse informs
Jalpa the day nurse that Jeffrey received one dose of morphine 2 hours ago and has been
sleeping since then with no pain. Jalpa assesses Jeffrey an...
Seneca College; PNR/ PNR 300 Final Exam Solutions
2.Jeffrey is a 60 year old who had knee surgery 1 day ago. Ashley the night nurse informs
Jalpa the day nurse that Jeffrey received one dose of morphine 2 hours ago and has been
sleeping since then with no pain. Jalpa assesses Jeffrey and finds he has no vital signs, a
Code Blue is called and Jeffrey is declared deceased. On chart review Ashley did not
assess Jeffrey at any time after giving morphine, hospital policy dictated vital signs should
be assessed every 15 mins for one hour after giving morphine. Ashley's failure to properly
monitor Jeffrey is an example of what:
Assault
Intentional Tort
Negligence
Incapacity
3.Documentation is used to communicate to all members of the health care team and to
monitor client status and progress. All of the following are examples how nurses
demonstrate this standard except?
Ensuring timely, complete and accurate record of care provided
Documenting both objective and subjective data accurately
Using abbreviations appropriately
Ensuring documentation is made in a temporary format or record
4. Riley, a 12-year-old boy with leukemia, has been undergoing treatment for the last two
years. When asked about his disease, Riley is able to articulate the details of his illness and
treatment. For the last six months, Riley's condition has deteriorated, and he has been
admitted to the hospital several times. Riley has expressed desire to discontinue his
treatment and says "I know if I don't have my treatment, I won't live anymore". According to
the Health Care Consent Act:
Riley is a minor and cannot consent to withdrawing treatment
Riley is only 12-years-old and is not capable of making an informed and
voluntary decision
Riley appreciates his illness and its consequences and is considered
capable of making the decision to withdraw treatment.
Riley can withdraw treatment if his parents agree with the decision
5.Monique an RPN has worked in a labour and delivery unit for 20 years. When resolving
ethical situations, Monique does not think she needs to consult with her colleagues because
they do not have as much experience as she does. Monique insists and is adamant on
demonstrating bathing of an infant to the baby's father, because she feels it is beneficial for
fathers to be actively involved. This has been raised as an ethical issue on the unit by
newer staff. What should the team do in this situation?
Regardless of experience or expertise, consulting about ethical situations
helps support decision-making
Monique's experience is enough, and she is able to resolve ethical
conflicts independently
Monique is correct. Parents often experience anxiety over a new baby
Monique should be removed from being a client's primary nurse
whenever their values do not match
,6.A Nurse witnesses a nursing colleague hitting a client. The nurse intervenes and stops the
abuse. The nurse identified that she was tired and frustrated, and that it will never happen
again. She asked the witness not to tell the manager. What is the witness's responsibility in
this situation?
You are responsible for supporting your colleague who is suffering from
nurse fatigue. You are responsible for protecting the client and must report the incident to
the manager
You are responsible for helping your colleague manage challenging
patients who cause all nurses to be frustrated
You can be silent because this is the first incident and the nurse said she
will deal with her fatigue
You are responsible for supporting your client only
7. The nurse is aware that an ethics committee in a health care facility serves to:
Interview all persons involved in an ethical dilemma
Illustrate circumstances that demonstrate malpractice
Serve as a resource for specific situations as they occur
Examine previous similar cases for comparison of outcome decisions
8.Your client who has dementia refuses his 0800 medications. His daughter is his substitute
decision-maker. What should the nurse do?
Crush the medications, put them in apple sauce and then feed it to him
Contact his daughter to discuss the change in behavior
Get someone to help you open his mouth and make sure he swallows the
medications
Contact his daughter and insist she come to the home and make sure her
father takes his medications
9.Alyssa is a client on a mental health unit. On admission, she is a voluntary client and is
competent to make treatment decisions. She is diagnosed with an eating disorder. At meal
times, she is anxious and only eats fruit with ice cream. Her nurses want to give her a prn
(take as needed) medication to reduce her anxiety in order that she will eat more food.
Alyssa is undernourished and has lost weight. Identify the correct statement about Alyssa's
situation
A voluntary patient lacks capacity to make treatment decisions
A patient with incapacity is not able to understand the information
relevant to making a decision about the proposed treatment
A patient with capacity is able to understand the information relevant to
making a decision about the proposed treatment
A person capable of making treatment decisions never needs to be an
involuntary patient
10.Joanne is a RPN on a surgical unit. She has noticed that when she works with RPN Kerri
that the narcotic count is not accurate and Kerri often has slurred speech and an unsteady
gait. Joanne suspects that Kerri is abusing substances. According to the CNA Fact Sheet
on problematic substance abuse by nurses, the most important reason that Joanne needs
to address her colleague's behaviour is:
To ensure there are no potential negative effects on patient care
, To ensure Kerri receives appropriate counselling
To report the behaviour to the nurse manager and the police
To report the behaviour to the CNO
11.Barbara an RPN has been found guilty of a criminal offense. She physically assaulted
Rafael an RPN in the hospital parking lot. She was sentenced to prison for six months. In
accordance with the regulation under the provincial nursing act what must she do?
She can work as a nurse while she is in prison, and then reapply for her
job once she gets out
Provide the College of Nurses with details and findings of the court case.
They will determine a back to work plan when she is released
She does not need to report any information to the College of Nurses as
this did not involve a patient or her role as a nurse
Recommend that her lawyer began an appeal so that it does not affect
her license
12.Sandra is an RPN in a busy downtown emergency department which has been
chronically short staffed. Sandra has been asked to stay past her shift for another 8 hours
because of 2 last minute sick calls. She is feeling very tired as this is her 4th shift in a row
and her second overtime shift this week. Despite feeling pressure to take the shift, Sandra
refuses the extra hours, explaining to her manager that she is too tired and is aware that
fatigue can have a very negative impact on patient care. She also advocates that the
manager start to implement some work life strategies in the ED to help make the ED a safe
work environment for staff. This is an example of which of the following:
Macro level of influence
Micro level of influence
Meso level of influence
Patient abandonment
13.Mr. Patel is a 40 year old male who requires a below the knee amputation of the left leg
as a result of severe ulcers and gangrene. He refuses to have the operation. After the
physician explains to him the purpose for the surgery, the risks, benefits and outcomes of
the surgery and answers questions that he has, Mr. Patel continues to refuse to have
surgery. His family says he is irrational and incompetent and his wishes must be overruled.
They want him to have the surgery. If the health care team tells Mr. Patel that he must
agree to the surgery or else they will have him labeled as incompetent, their action is an
example of:
Coercion of Mr. Patel
Following hospital protocol
Looking out for his own best interests
Making sure Mr. Patel knows the consequences of his decision
14.What is nursing fatigue primarily caused by?
Environmental factors
Nurses' inability to sleep during the day
Nursing shortage
Heavy workloads
All of the above
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