Fy 15 RN Mental Health Annual Education Policy/Procedure/Protocol Quiz
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A. accurate identification of all patients who have attempted suicide while on inpatient status
B.
B. assessment of degree of suicidal potential at the time of discharge
C.
C. reassessment on follow-up outpatient visits
D.
All of the above
E.
A and B only
Correct Answer
D. All of the above
Explanation 12. Suicide Attempts: CPM 116-13-05. T drive --- all CPMs, type the word “suicide” in the search box
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2.
A large precentage of patient suicides occur within three months of discharge from acute inpatient care.
A.
True
B.
False
Correct Answer
A. True
Explanation 12. Suicide Attempts: CPM 116-13-05. T drive --- all CPMs, type the word “suicide” in the search box
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3.
Suicide potential of those patients who have attempted suicide is minimized by addressing discharge planning needs including:
A.
A. arranging continuity of care
B.
B. ensuring/modifying the environment to which the patient will return to render it as safe as possible
C.
C. formulating an adequate safety plan with patient and family involvemen
D.
D. placed on the High Risk List
E.
All of the above
F.
All except D
Correct Answer
E. All of the above
Explanation 12. Suicide Attempts: CPM 116-13-05. T drive --- all CPMs, type the word “suicide” in the search box
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4.
All suicides (including in-patient suicides) or suspected suicides will be reported to the office of Quality Management (OOQM), Director’s office, and the Mental Health Service Line executive within 12 hours of receiving the knowledge of a suicide.
A.
True
B.
False
Correct Answer
B. False
Explanation 12. Suicide Attempts: CPM 116-13-05. T drive --- all CPMs, type the word “suicide” in the search box
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5.
The Suicide Attempt Assessment is to be completed prior to discharge or within _______ business days of admission to the in-patient psychiatric unit, whichever comes first.
A.
2
B.
3
C.
4
D.
5
Correct Answer
D. 5
Explanation 12. Suicide Attempts: CPM 116-13-05. T drive --- all CPMs, type the word “suicide” in the search box
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6.
Recommendations determined after the Suicide Attempt Assessment is completed are to be documented in the Medical Record or most perferably in the Discharge Summary.
A.
True
B.
False
Correct Answer
A. True
Explanation 12. Suicide Attempts: CPM 116-13-05. T drive --- all CPMs, type the word “suicide” in the search box
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7.
The following statements are correct concerning continuity of care for all patients who have attempted suicide prior to admission and whose aftercare plan includes follow-up in the Menatl Health Service except:
A.
An appointment with a Mental Health Clinical Provider within three days
week of discharge date.
B.
Any appropriate additional appointments for follow-up
individual/group therapy, maintenance ECT, etc.
C.
Psychopharmacological agents with relatively safe overdose
profiles are considered, including a reduction in the amount of pills available to the patient, not to exceed 30 days of dosage.
D.
Documentation in all ensuing progress notes of the presence of suicidal ideation, intent and/or plan.
Correct Answer
A. An appointment with a Mental Health Clinical Provider within three days
week of discharge date.
Explanation 12. Suicide Attempts: CPM 116-13-05. T drive --- all CPMs, type the word “suicide” in the search box
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8.
Underlying suicide risk factors that are specific to Veterans include all of the following except:
A.
Frequent deployment
B.
Physical/sexual assault while in the service
C.
Service related injury
D.
Deployments to hostile environments
E.
Financial and/or legal crisis.
Correct Answer
E. Financial and/or legal crisis.
Explanation 12. Suicide Attempts: CPM 116-13-05. T drive --- all CPMs, type the word “suicide” in the search box
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9.
Nursing personnel will take the following action on all patients exhibiting suicidal or homicidal thought except:
A.
A. All unit personnel must be able to recognize him or her and report any suicidal self-harm behaviors or threats to the Nurse Manager and physician.
B.
B. Patient will be placed on one to one observation pending a mental health provider’s determination that suicidal precautions are necessary or until such time as these orders are rescinded
C.
C. Patient is restricted to clinical area
D.
D. Staff will escort patient to restroom, medical procedures or evaluations remaining in one to one observation at all times.
E.
E. All of the above are correct interventions
F.
F. All except D are correct interventions.
Correct Answer
E. E. All of the above are correct interventions
Explanation The correct answer is E. All of the above are correct interventions. This means that all of the actions mentioned in options A, B, C, and D are appropriate for nursing personnel to take when dealing with patients exhibiting suicidal or homicidal thoughts. These actions include recognizing and reporting self-harm behaviors or threats, placing the patient on one-to-one observation, restricting the patient to the clinical area, and escorting the patient to necessary locations while maintaining observation.
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10.
All patients that are placed on 1:1 Observation, nursing care include the following except:
A.
An assigned staff member will provide a direct and visual observation of the patient’s behavior at all times
B.
Educate the patient regarding unit restriction
C.
Remove undergarments including t-shirt and change into hospital pajamas. If patient request undergarments, only mesh underwear will be issued. (Patient can wear own undergarments if they have extra with them).
D.
Complete a thorough search of the patient, his/her belongings and the environment (assigned room
Correct Answer
C. Remove undergarments including t-shirt and change into hospital pajamas. If patient request undergarments, only mesh underwear will be issued. (Patient can wear own undergarments if they have extra with them).
Explanation 9. Restraints—CPM 11 -13-18. T drive---Chief of Staff---use of restraint for seclusion
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11.
A thorough search of the patient, his/her belongings and the environment (assigned room). Particularly, belongings must be inventoried utilizing Attachment B of CPM 118-35, Patient, Clothing, Valuables, Incidentals and Services, this inclues all of the following except:
A.
Personal items must be secured outside the patient’s assigned room.
B.
Remove contraband
C.
Distribute paper bags to eliminate plastic storage bags or trash bags from the environment
D.
Observe patient closely when using writing tools (pen, pencil, marker etc.), staple, razor, curling iron, paperclip, plastic container, nail clipper or products that contain alcohol such as mouthwash, perfume, body wash and/or hair spray. Secure these items after single use.
E.
All of the above are correct
F.
None of the above are correct
Correct Answer
E. All of the above are correct
Explanation 1. Patient Clothing. This policy is located at CPM 118-35, attachment B.
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12.
Document the patient’s behavior every 30 minutes on the standard observation sheet. Notify provider of behavioral, vital sign or respiratory changes.
A.
True
B.
False
Correct Answer
B. False
Explanation The correct answer is False because the statement suggests that the patient's behavior should be documented every 30 minutes on the standard observation sheet and the provider should be notified of any changes in behavior, vital signs, or respiration. However, this may not be necessary for all patients as it depends on the individual's condition and the healthcare facility's protocols. It is important to follow specific guidelines and instructions provided by the healthcare team regarding documentation and notification of changes in patient's condition.
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13.
An assigned nursing employee is responsible for counting eating utensils before and after each meal or snack.
A.
True
B.
False
Correct Answer
A. True
Explanation The statement is true because it states that an assigned nursing employee is responsible for counting eating utensils before and after each meal or snack. This suggests that it is a part of the employee's job to ensure that the correct number of utensils are available and accounted for before and after each meal or snack. This practice is important for maintaining hygiene, preventing loss or theft of utensils, and ensuring that all residents or patients have access to the necessary utensils for their meals.
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14.
Optimize safety, inventory patient’s assigned room for items not permitted at least once per day.
A.
True
B.
False
Correct Answer
B. False
Explanation The statement suggests that it is necessary to optimize safety by checking the patient's assigned room for items that are not permitted at least once per day. However, the correct answer is false, indicating that this statement is not true. This implies that optimizing safety does not necessarily require daily checks of the patient's room for prohibited items.
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15.
What is the proper way to clean using CAVIWIPES 1?
A.
Apply gloves, wipe, and let dry 1 minutes
B.
Apply gloves, wipe, and let dry 2 minutes
C.
Apply gloves, wipe, and let dry 3 minutes
D.
Apply gloves, wipe, and let dry 4 minutes
Correct Answer
A. Apply gloves, wipe, and let dry 1 minutes
Explanation The proper way to clean using CAVIWIPES 1 is to apply gloves, wipe the surface, and let it dry for 1 minute. This ensures that the surface is properly disinfected and any pathogens are effectively killed. Waiting for a longer duration may not be necessary as the product is designed to work within a specific timeframe.
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16.
What is the proper procedure to verify a patient's identification?
A.
Ask the patient to state his/her full name and last four of social security number.
B.
Ask the patient to state his/her lastl name and last four of social security number.
C.
Ask the patient to state his/her full name and full social security number.
D.
Ask the patient to state his/her full name and last full social security number.
Correct Answer
C. Ask the patient to state his/her full name and full social security number.
Explanation 7. Patient Identification: CPM 118-14-23. T-drive,--All CPMS----type the word “patient identification” in the search box
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17.
What is the timeframe for evaluating and documenting PRN medications?
A.
30 minutes
B.
60 minutes
C.
90 minutes
D.
120 minutes
Correct Answer
D. 120 minutes
Explanation 3. CPM 119-27 Medication Management. Located on the T drive--All CPM--Pharmacy. Type in the search box "controlled substances".
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18.
How often do the narcotics in the Omnicelle get inventoried?
A.
Daily
B.
Bi-weekly
C.
Weekly
D.
Monthly
Correct Answer
C. Weekly
Explanation 8. Pyxis (Omnicelle) : CPM 119-27. T-drive,--All CPMS----Pharmacy. type the word “medication management” ” in the search box
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19.
What is considered contraband?
A.
Weapons
B.
Non-prescription drugs
C.
Knives
D.
Rope
E.
All of the above
F.
None of the above
Correct Answer
E. All of the above
Explanation Contraband refers to items that are illegal or prohibited. The given options include weapons, non-prescription drugs, knives, and rope. All of these items are commonly considered contraband because they are either dangerous or have the potential to be used for illegal activities. Therefore, the correct answer is "all of the above".
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20.
Who may count the narcotic inventory in the Omnicelle?
A.
Two RNs only
B.
Two LPNs only
C.
Two licensed nurses
Correct Answer
C. Two licensed nurses
Explanation 8. Pyxis (Omnicelle) : CPM 119-27. T-drive,--All CPMS----Pharmacy. type the word “medication management” ” in the search box
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21.
According to policy, how often is IV tubing changed?
A.
24 hours
B.
48 hours
C.
60 hours
D.
72 hours
Correct Answer
D. 72 hours
Explanation 20. IV tubing. Mosby skills—go to Library on the intranet page, Mosby skills—type intravenous” in the search box
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22.
What is this facility's (RHJ VAMC) emergency number?
A.
5911
B.
6911
C.
7911
D.
8911
Correct Answer
C. 7911
Explanation 10. Hospital Emergency number. ITD 11-14: located on T drive—Master Index under information technology
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23.
According to the CPM 136-02, who does one call to obtain assistance fo a hard of hearing patient or a language interpreter?
A.
AT&T Relay Service
B.
TTY Phone
C.
Bellsouth Relay Service
D.
Both A and B
Correct Answer
D. Both A and B
Explanation 6. Communication with Hearing Impaired/non-English Speaking Individual. located on the T drive--Health Administration Office
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24.
Glasses and dentures locations are documented in CPRS as part of the admission assessment.
A.
True
B.
False
Correct Answer
A. True
Explanation The given statement is true because glasses and dentures are important personal items that need to be documented during the admission assessment in CPRS (Computerized Patient Record System). This documentation ensures that the healthcare team is aware of the patient's needs and can provide appropriate care. Additionally, knowing the location of these items can help prevent loss or damage during the patient's stay in the healthcare facility.
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25.
Where does one find a list that will inform you of which MD has privilleges for RHJ VAMC?
A.
S drive
B.
U drive
C.
T drive
D.
V drive
Correct Answer
C. T drive
Explanation 11. MD privileges: Located on the T drive under Privileges-- Scopes of Practices
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26.
THE FOLLWOING INTERVENTIONS ARE TO BE PERFORMED IN THE EVENT THAT AN IMPATIENT SUFER A FALL, CHECK ALL THAT APPLY:
A.
ROM
B.
Neuro check
C.
Report to Patient Safety Hotline
D.
Peripheral pulses in all extermities
Correct Answer(s)
A. ROM B. Neuro check C. Report to Patient Safety Hotline
Explanation 24. Falls ----CPM 118-13-18. T drive—all CPMS— Type “falls.” in the search box
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27.
A patient with a score of 48 is considered to be at __________ for Falls according to the Morse Fall Scale.
A.
Low risk
B.
Moderate risk
C.
High risk
Correct Answer
C. High risk
Explanation 24. Falls ----CPM 118-13-18. T drive—all CPMS— Type “falls.” in the search box
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28.
Which of the following medications are associated with risk for Falls (select all that apply:
A.
Diuretics
B.
Opioids
C.
Antidiabetic
D.
Antihistamines
Correct Answer(s)
A. Diuretics B. Opioids C. Antidiabetic D. Antihistamines
Explanation 24. Falls ----CPM 118-13-18. T drive—all CPMS— Type “falls.” in the search box
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29.
What is the minimum CIWA-AR score that should be treated?
A.
5
B.
7
C.
9
D.
11
Correct Answer
C. 9
Explanation 19. Alcohol Detoxification: this policy is located on the T drive--Clinical Guidelines and Protocols. Type in the search box "alcohol" and this will bring up the policy.
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30.
Because CIWA-AR is a nurse driven policy, no order is needed to initiate the protocol.
A.
True
B.
False
Correct Answer
B. False
Explanation 19. Alcohol Detoxification: this policy is located on the T drive--Clinical Guidelines and Protocols. Type in the search box "alcohol" and this will bring up the policy.
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31.
How much Lorazepam should the patient receive for a CIWA-AR score of 14 on the initial assessment?
A.
L mg
B.
2 mg
C.
3mg
Correct Answer
B. 2 mg
Explanation 19. Alcohol Detoxification: this policy is located on the T drive--Clinical Guidelines and Protocols. Type in the search box "alcohol" and this will bring up the policy.
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32.
When assessing and obtaining a CIWA-AR score, what else should the nurse be obtaining?
A.
B/P only
B.
B/P and HR only
C.
B/P, HR, and Respirations
D.
Temperature only
Correct Answer
C. B/P, HR, and Respirations
Explanation 19. Alcohol Detoxification: this policy is located on the T drive--Clinical Guidelines and Protocols. Type in the search box "alcohol" and this will bring up the policy.
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33.
When can the CIWA-AR protocol be discontiuned?
A.
CIWA-AR score of less than 4 for three consecutive times
B.
CIWA-AR score of less than 6 for three consecutive times
C.
CIWA-AR score of less than 8 for three consecutive times
D.
CIWA-AR score of less than 10 for three consecutive times
Correct Answer
C. CIWA-AR score of less than 8 for three consecutive times
Explanation 19. Alcohol Detoxification: this policy is located on the T drive--Clinical Guidelines and Protocols. Type in the search box "alcohol" and this will bring up the policy.
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34.
Where is the location for administering electroconvulsive treatments?
Posey Twice-as-Tough Cuffs-Key Lock can be used with patients having the following indications except:
A.
Patient at risk of disrupting life-saving treatments
B.
Patient at risk of line pulling which may prevent monitoring of vital signs
C.
Patient assessed to be inextreme danger of injury to themselves
D.
Patient who is or becomes suicidal or highly aggressive or combative
Correct Answer
B. Patient at risk of line pulling which may prevent monitoring of vital signs
Explanation 16. Posey Twice-as-Tough Cuffs-Key Lock Application and instruction
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37.
Which department is responsibility for collecting the Posey Twice-as-Tough Cuffs-Key Lock restraints and sending them out for processing (cleaning)?
A.
Infection Control Staff
B.
Engineering Staff
C.
Environmental Management Staff
D.
Linen Room Staff
Correct Answer
C. Environmental Management Staff
Explanation 16. Posey Twice-as-Tough Cuffs-Key Lock Application and instruction
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38.
Prior to sending the Posey Twice-as-Tough Cuffs-Key Lock restraints out for cleaning, the nurse should fasten the hook and loop closures of all buckles.
A.
True
B.
False
Correct Answer
A. True
Explanation 16. Posey Twice-as-Tough Cuffs-Key Lock Application and instruction
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39.
How many Posey Twice-as-Tough Cuffs-Key Lock restraints are available on your unit?
A.
3
B.
4
C.
5
D.
6
Correct Answer
D. 6
Explanation 16. Posey Twice-as-Tough Cuffs-Key Lock Application and instruction
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40.
The "why" question may evoke a defensive answer from the patient.
A.
True
B.
False
Correct Answer
A. True
Explanation 14. Article: Core Communication skills in Mental Health nursing: Useful open questions
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41.
The following interaction was noted between nurse and patient: " I don't think you are very happy with your husband?". What type of question is this:
A.
Closed question
B.
Leading question
C.
Why question
D.
Multiple question
Correct Answer
B. Leading question
Explanation 14. Article: Core Communication skills in Mental Health nursing: Useful open questions
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42.
The following are considered "boundary violations (excursions across professional lines of behavior). Select all that apply::
A.
Excessive personal disclosure by the nurse
B.
Demeaning harassing of the patient
C.
The nurse fails to reconginize feelings of sexual attraction to the patient
D.
Inappropriate amounts of time with the patient
Correct Answer(s)
A. Excessive personal disclosure by the nurse B. Demeaning harassing of the patient C. The nurse fails to reconginize feelings of sexual attraction to the patient D. Inappropriate amounts of time with the patient
Explanation 12. Suicide Attempts: CPM 116-13-05. T drive --- all CPMs, type the word “suicide” in the search box
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43.
Major life stressors for Veterans include all of the following (select all that apply):
A.
Serious medical illness
B.
Chronic intractable pain
C.
Major failure at an important personal endeavor
D.
Anniversary dates of experienced tramatic events
Correct Answer(s)
A. Serious medical illness B. Chronic intractable pain C. Major failure at an important personal endeavor D. Anniversary dates of experienced tramatic events
Explanation 12. Suicide Attempts: CPM 116-13-05. T drive --- all CPMs, type the word “suicide” in the search box
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44.
When ulities fail and the back-up system does not function within a reasonable amount of time, the policy of Mental Health Services will be as follows (select all that apply):
A.
Ensure the safety of patients
B.
Unplug all unneccessary equipment
C.
Notify Facility Management
D.
Notify Chief Nursing Officer
Correct Answer(s)
A. Ensure the safety of patients B. Unplug all unneccessary equipment C. Notify Facility Management
Explanation 13. CPM 116-12-22 Mental Health Service Supplemental Emergency Plan
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45.
In the event that Mental Health Service is required to evacuate all parts of their areas, the staff will do the following (select all that apply):
A.
Ensure safety of patients
B.
List names and condition of patients needing evacuation
C.
Arrangement of security of all vital documents
D.
Reassign staff to the Manpower Pool to help with evacuation using sleds
Correct Answer(s)
A. Ensure safety of patients B. List names and condition of patients needing evacuation C. Arrangement of security of all vital documents D. Reassign staff to the Manpower Pool to help with evacuation using sleds
Explanation 13. CPM 116-12-22 Mental Health Service Supplemental Emergency Plan
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46.
An RN may initiate a behavioral seclusion order, but It requires a telephone/written order within 2 hours after initiation:
A.
True
B.
False
Correct Answer
B. False
Explanation 9. Restraints—CPM 11 -13-18. T drive---Chief of Staff---use of restraint for seclusion
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47.
A face-to-face doctor assessment is required within 8 hours of placing a patient in behavioral restraints.
A.
True
B.
False
Correct Answer
B. False
Explanation 9. Restraints—CPM 11 -13-18. T drive---Chief of Staff---use of restraint for seclusion
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48.
Renewal orders for behavioral restraints should be done within 4 hours.
A.
True
B.
False
Correct Answer
A. True
Explanation 9. Restraints—CPM 11 -13-18. T drive---Chief of Staff---use of restraint for seclusion
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49.
Notification of clinical leadership by the charge nurse is done when the patient:
A.
Has been in seclusion restraints > 12 hours
B.
Has been in seclusion restraints for 3 or more episodes within 12 hours
C.
Has been in seclusion restraints > 8 hours
D.
Has been in seclusion restraints for 4 or more episodes within 12 hours
Correct Answer
A. Has been in seclusion restraints > 12 hours
Explanation 9. Restraints—CPM 11 -13-18. T drive---Chief of Staff---use of restraint for seclusion
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50.
I pledge to demonstrate the core values of the American Nurses Association Code of Ethics of honesty and integrity. By answering yes, you certify that you are the person taking the test.
A.
YES
B.
NO
Correct Answer
A. YES
Explanation The correct answer is "YES" because by selecting this option, the individual is affirming their commitment to upholding the core values of honesty and integrity as outlined in the American Nurses Association Code of Ethics. Additionally, by answering "YES," the person confirms that they are the one taking the test, ensuring the accuracy and authenticity of their responses.
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