Charting by exception Study guides, Class notes & Summaries

Unitek midterm Questions and Answers 2023 What best defines the nursing process? 1. Assessment - identify a client's health care status 2. Diagnosis - actual or potential health problems 3. Outcomes identification 4. Planning - establish plans to meet the identified needs 5. Implementation - to deliver specific nursing interventions to address those needs 6. Evaluation - determine if goals were met What is the most effective process to ensure that the care plan is meeting the needs...

PNR 104 Exam 2 (Answered) Verified Solution Steps of the nursing process in order Assessment, nursing dx, planning, implementation, and evaluation Assessment and nursing DX RN's are responsible for this part of the nursing process Data Collection LPN's main role in nursing process Documentation of the plan Should be constructed right after the admission database is collected. Must be readily available to each nurse who is assigned to the patient. (Reviewed & updated once every 24 hrs.) ...

MN Dental Jurisprudence Exam New Update 2024/2025 Questions and Answers Actual Test with complete solution/100% Verified. MN Dental Jurisprudence Exam New Update 2024/2025 Questions and Answers Actual Test with complete solution/100% Verified. A person at the scene of an emergency who knows that another person is exposed to or has suffer harm shall give reasonable assistance to the exposed person Ans- Good Samaritan Law General supervision Ans- The dentist has prior knowledge and ha...

What are the 5 steps in the nursing process? - Assessment Diagnosis Planning Implementation Evaluation What is the assessment portion of the nursing process used for? - data collection what is the nursing diagnosis portion of the nursing process used for? - analyzing the data what is the planning portion of the nursing process used for? - the steps to resolve the health problem present what is the implementation portion of the nursing process used for? - carrying out the steps of the p...

Exam 1: NSG121/ NSG 121 (NEW 2024/ 2025 Update) Health Assessment | Review with Questions and Verified Answers| 100% Correct| Graded A- Herzing QUESTION When percussing a client and you hear a dull sound , where might you be ? Answer: Over an organ (heart, liver, spleen) QUESTION If you hear a flat sound where might you be? Answer: Over muscles, bone, or tumor QUESTION If you hear a tympany sound where might you be? Answer: Over air pockets (sto...

NUR 104 FINAL EXAM 2023 - QUESTIONS AND ANSWERS Graded 100%. After leaving work the RN realizes an administered medication was not recorded in the medical record and contacts the nurse caring for the patient. The RN is demonstrating what principle? Ethics Accountability submitted Negligence Fraud The RN is reviewing a client’s medical record. Which of the following abbreviations require follow up? Select all that apply. MS mL PO u QOD Which rationale would support the RN’s propo...

MN Dental Jurisprudence Exam 2023/2024 *general supervision - ANSWERS The dentist has prior knowledge and has given consent for the procedures being performed during which the dentist is not required to be present in the dental office or on the premises. *indirect - ANSWERS The dentist is in the office, authorizes the procedures, and remains in the office while the procedures are being performed by the allied dental personnel. direct - ANSWERS The dentist is in the dental office, per...

FOUNDATIONS AND ADULT HEALTH NURSING 9TH EDITION COOPER GOOSNELL TEST BANK CHAPTER 1-41 | COMPLETE GUIDE A+ 2023-2024. Which of the following must the nurse recognize regarding the health care delivery system? a. It includes all states. b. It affects the illness of patients. c. Insurance companies are not involved. d. The major goal is to achieve optimal levels of health care. ANS: D The nurse must recognize that in the health care delivery system, the major goal is to achieve optimal lev...

What is charting by exception? (Ans- Shorthand method of documenting findings by only charting abnormal findings. Proper Documentation Guidelines include: (Ans- Content- complete, accurate, concise. Reflects nursing process. Timing- Document immediately after. Never before you carry out. Accountability- First initial, last name, title to each entry. No dittos, whiteout, or erasers. Format- Standard terminology. Confidentiality- Students, don't use names in reports or care plans...

HESI Medical-Surgical LPN/PN Question 1 The nurse is providing care for a patient who is unhappy with the health care provider’s care. The patient signs the Against Medical Advice (AMA) form and leaves the hospital against medical advice. What should the nurse include in the documentation of this event in the patient’s medical record or on the AMA form? 1. Documentation that the patient was informed that he or she cannot come back to the hospital 2. Documentation that the patient was i...

Why are standardized nursing languages important? Correct Answer-Make nursing visible. Support Nursing Research. Provide standardized terminology for use in EHR systems. Charting by exception Correct Answer-is a system of charting in which only significant findings or exceptions to standards and norms of care are documented. Advantages of Charting By Exception Correct Answer--reduces the amount of time spent documenting -reduces repetitive charting of routine care -provides a record th...