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Ambulatory Care Nursing Certification(30 Sets) Questions with Verified Answers,100% CORRECT
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Certified Medical-Surgical Registered Nurse Sample 138 Questions with Verified Answers,100% CORRECT
Certified Medical-Surgical Registered Nurse Sample 138 Questions with Verified Answers - CORRECT ANSWER Christine Warren, 45 years old, has a long h... [Show More] istory of ulcerative colitis, and non-surgical treatment no longer relieved her symptoms. She underwent a total proctocolectomy and a permanent ileostomy 12 hours ago. The nurse should contact the physician immediately if Mrs. Warren has which of these findings? 1) The stoma appears pale and dry. 2) The stoma appears red and shiny. 3) There is 200 mL of dark green output from the stoma. 4) There is 50 mL of serosanguinous drainage from the stoma. - CORRECT ANSWER 1) The stoma appears pale and dry. Rationale: If there is an adequate blood supply to the stoma, the color is pink or red, and the stoma is moist as a result of mucous production. A pale dry color suggests ischemia of the stoma or bowel and must be reported immediately to the physician. With an ileostomy initially after surgery, the output is a loose, dark green liquid that may contain some blood. The ileostomy usually begins to drain within 24 of surgery at more than one liter per day. When changing Mrs. Warren's ileostomy bag, the nurse notices that the peristomal skin is irritated. Which of these actions by the nurse would be appropriate before reapplying the appliance? 1) Wash the area with antiseptic soap and water. 2) Clean the site with Dakin's solution. 3) Use a solid skin barrier. 4) Obtain an order for a topical antibiotic. - CORRECT ANSWER 3) Use a solid skin barrier. Rationale: The drainage from the stoma can quickly irritate the surrounding tissue. Therefore, a solid skin barrier, with a pectin base or karaya wafer that has a measurable thickness and hydrocolloid adhesive properties, should be applied. Which of these comments, if made by Mrs. Warren before her surgery, would indicate that she had concerns about her body image? 1) "I will have to stop my aerobics classes." 2) "I'm so afraid I may not survive the surgery." 3) "I need to go shopping for some loose, baggy clothes." 4) "I'm concerned that this may be only the first of many surgeries." - CORRECT ANSWER 3) "I need to go shopping for some loose, baggy clothes." Rationale:Body image refers to a person's perception of self and determines how the person interacts with others. One does not need to purchase special clothing after ileostomy surgery, although some minor adjustments may be needed for comfort, e.g., stretch underwear or pantyhose for support. Lewis Palmer, 45 years old, has a history of multiple myocardial infarctions and is a heavy smoker. He takes warfarin sodium (Coumadin) daily. Two weeks ago, he had a right femoral-popliteal bypass, which became occluded 24 hours ago. He is admitted following an angioplasty of the femoral-popliteal bypass graft. Mr. Palmer is receiving continuous IV heparin. Because Mr. Palmer is receiving heparin, it is essential for the nurse to 1) monitor his prothrombin time. 2) observe him for signs of pulmonary embolism. 3) limit his intake of foods high in vitamin K. 4) check the femoral puncture site at frequent intervals. - CORRECT ANSWER 4) check the femoral puncture site at frequent intervals. Rationale: Since bleeding is a common side effect of heparin, it is vital to check the operative site, the femoral puncture area, for signs of bleeding. Attempts to revascularize Mr. Palmer's leg are unsuccessful, and Mr. Palmer has a below-knee amputation (BKA) of his right extremity and is returned to the medical-surgical unit with an intravenous infusion in place. His orders include: heparin drip, morphine sulfate 10 mg IV push q4h prn for pain, and ampicillin sodium g 1 IV q6h. Twelve hours postoperatively, Mr. Palmer is found to be short of breath and diaphoretic. He says, "My chest hurts." His pulse is 140/min, compared to a baseline of 80/min. His blood pressure is105/60 mm Hg, compared to a baseline of 138/70 mm Hg. His respirations are 32/min, compared to a baseline of 16/min. His O2 saturation is 85%. The nurse immediately calls for help. Which of the following questions is most important for the nurse to ask? 1) "Have you ever had this type of chest pain before?" 2) "How long have you had this pain?" 3) "What pain medication do you usually take?" 4) "What were you doing before the pain began?" - CORRECT ANSWER 1) "Have you ever had this type of chest pain before?" Rationale: Because of the patient's symptoms and his history of myocardial infarctions, the nurse should find out if the patient has had this time of pain previously. The nurse receives all of the following stat orders for Mr. Palmer. Which one should the nurse question? 1) Oxygen per nasal cannula at 4 L per minute. 2) Enoxaparin (Lovenox) 40 mg subcutaneously. 3) Troponin level. 4) Computed tomography (CT) angiogram. - CORRECT ANSWER Rationale: The nurse should questions the order for Lovenox because the patient is receiving a heparin drip. Maggie Clark, a 42-year-old female, was admitted with newly diagnosed type 2 diabetes mellitus. Her blood glucose has been stabilized, and the nurse is preparing her for discharge. Her discharge orders will include metformin (Glucophage). Mrs. Clark is also being treated for hypertension. Because Mrs. Clark is to take Glucophage on a regular basis it is important to 1) monitor her glomerular filtration rate. 2) check her serum amylase routinely. 3) obtain her red blood cell count periodically. 4) examine her urine for casts. - CORRECT ANSWER 1) monitor her glomerular filtration rate. Rationale: The estimated glomerular filtration rate (eGFR) is one way to measure the adequacy of kidney function. Glucophage is excreted by the kidney and the risk of lactic acidosis increases in patients with impaired kidney function. The drug may be used if the eGFR is between 45 and 60 mL/min/1.73 m2, i.e., in mild chronic kidney disease. Glucophage is absolutely contraindicated if the eGFR is below 30 mL/min/1.73 m2. Mrs. Clark is prescribed metoprolol tartrate (Lopressor) for hypertension. Which symptom of hypoglycemia would be masked by Lopressor? 1) Diaphoresis. 2) Tingling. 3) Diplopia. 4) Tachycardia. - CORRECT ANSWER 4) Tachycardia. Rationale: A side effect of Lopressor, a beta blocker, is bradycardia. The Lopressor-induced bradycardia can mask tachycardia, a symptom of hypoglycemia. Charles Haverford is diagnosed with prostate cancer and is to have a radical prostatectomy. Mr. Haverford has been researching his diagnosis and now asks the nurse to recommend a reliable web source for accurate prostate cancer information. The nurse should identify which of these websites as most reliable? 1) www.wikipedia.org. 2) www.cancer.gov. 3) www.caringbridge.org. 4) www.google.com. - CORRECT ANSWER 2) www.cancer.gov. Rationale: When a patient asks about researching information on the internet, the patient should be instructed to look at reliable sites. Sites that are most reliable are those sponsored by the government (.gov). Mr. Haverford has the planned surgery and immediately postoperatively he has a urinary catheter inserted. After the urinary catheter is removed Mr. Haverford is urinating normally, however he is experiencing occasional incontinence with dribbling. Mr. Haverford is to be discharged. Mr. Haverford says to the nurse, "I'm so embarrassed. What will my wife think about this dribbling?" In addition to acknowledging his feelings, the nurse should encourage the patient to 1) limit oral intake of fluids before bedtime. 2) palpate his bladder to check for distention three times a day. 3) perform pelvic floor exercises several times daily. 4) avoid interrupting the urinary stream during voiding. - CORRECT ANSWER 3) perform pelvic floor exercises several times daily. Rationale: It is not unusual for a patient who has had a prostatectomy, to complain of not having complete bladder control after catheter removal. To help the patient regain urinary control, pelvic floor strengthening exercises are recommended. A patient's wife is visibly upset and says to the nurse, "I thought my husband only broke his hip, but the doctor thinks he might have had a stroke." Which of the following would be an appropriate response by the nurse? 1) "It's really too early to be concerned about that. Let's wait until the test results come back." 2) "If it is a stroke, your husband is in the right hospital for treatment." 3) "Yes, he does have symptoms of a stroke. That's what the tests will help us find out." 4) "I'm going to get you some information to read about strokes and their treatment." - CORRECT ANSWER 3) "Yes, he does have symptoms of a stroke. That's what the tests will help us find out." Rationale: Symptoms of stroke vary greatly and the initial diagnosis is made after a non-contrast CT scan is done to determine if the event was ischemic or hemorrhagic. Then, further tests are done to confirm the diagnosis and decide on treatment. In the event of a fire in a hospital's dialysis unit, which of these actions should the nurse take first? 1) Extinguish the fire if possible. 2) Activate the fire response system. 3) Confine the fire by closing all fire doors. 4) Remove patients or staff in danger. - CORRECT ANSWER 4) Remove patients or staff in danger. Rationale: When a fire occurs in a patient area within the hospital, the nurses' first actions are to protect patients and staff. This usually involves removing the patients and staff from exposure to the fire. An 80-year-old male who has mild dementia is readmitted for the third time with multiple pressure ulcers. During the nursing assessment, multiple bruises are also observed on his body. He lives with his son and daughter-in-law. The nurse suspects elder abuse/neglect. Which of these actions should the nurse take? 1) Have a staff member present during family visits. 2) Report the findings. 3) Discuss the situation with the family. 4) Ask the patient who is providing his care. - CORRECT ANSWER 2) Report the findings. Rationale: Most states require that health care workers report suspected elder abuse to an official agency, such as Adult Protective Services. A patient who has active pulmonary tuberculosis (TB) states, "I'm not going to take these TB pills!" Which of these responses by the nurse would be appropriate? 1) "You have a legal right to refuse to take this medication." 2) "You need to sign a Refusal of Treatment Form." 3) "You need to ask your doctor about the possibility of discontinuing the medication." 4) "You should know that the health department can require you to take the medication." - CORRECT ANSWER 4) "You should know that the health department can require you to take the medication." Rationale: Tuberculosis (TB) is a public health problem that requires reporting of the disease to the health department. It is essential that the patient understand the need to take prescribed TB medications as directed. Patients who are unwilling or unable to adhere to treatment may be required to do so by law or may be quarantined or isolated until noninfectious. State governments have legal responsibility for TB control activities, including treatment protocols for nonadherent patients. Health care workers should be familiar with the law in their particular states for these procedures. When a patient is having a chest tube removed, which of these instructions would be appropriate? 1) "Take short quick breaths with your mouth open." 2) "Take a deep breath and hold it." 3) "Breathe only through your mouth." 4) "Breathe as you normally do." - CORRECT ANSWER 2) "Take a deep breath and hold it." Rationale: Taking a deep breath and holding it (or performing the Valsalva maneuver) will prevent air from being pulled back into the pleural space as the tube is removed. Using the average cost of a problem and the cost of intervention to demonstrate savings is: A. A cost-benefit analysis B. An efficacy study C. A product evaluation D. A cost-effective analysis - CORRECT ANSWER A. A cost-benefit analysis uses average cost of a problem (such as wound infections) and the average cost of intervention to demonstrate savings. For example, if a surgical unit averaged 10 surgical site infections annually at an additional average cost of $27,000 each, the total annual cost would be $270,000. If the total cost for interventions, (new staff person, benefits, education, and software) totals $92,000, and the goal is to reduce infections by 50% (0.5 X $270,000 for a total projected savings of $135,000), cost benefit is demonstrated by subtracting the proposed savings from the intervention costs ($135,000 - $92,000) for a savings of $43,000 annually. In Erikson's psychosocial model of development, which stage is typical of those entering young adulthood? A.Identify vs role confusion B.Initiative vs guilt C.Ego integrity vs despair D.Intimacy vs isolation - CORRECT ANSWER D. Erickson's psychosocial development model focuses on conflicts at each stage of the lifespan and the virtue that results from finding balance in the conflict. The first 5 stages refer to infancy and childhood and the last 3 stages to adulthood: Intimacy vs isolation (Young adulthood): Love/intimacy or lack of close relationships. Generativity vs stagnation (Middle age): Caring and achievements or stagnation. Ego integrity vs despair (Older adulthood): Acceptance and wisdom or failure to accept changes of aging/despair. A 30-year old patient has been diagnosed with advanced ovarian cancer. The patient says, "This is all my fault." Which of Kubler-Ross's five stages of grief is the patient probably experiencing? A.Denial B.Anger C.Depression D.Acceptance - CORRECT ANSWER B. The patient is experiencing the stage of anger. People grieve individually and may not go through all stages, but most go through at least 2 stages. Kubler-Ross's 5 stages of grief include: Denial: Refusal to believe, confused, stunned, detached. Anger: Directed inward (self-blame) or outward. Bargaining: If - then thinking. ("If I go to church, then I will heal.") Depression: Sad, withdrawn. Acceptance: Resolution. A 68-year old man with mild COPD refuses to exercise because he tires easily. He spends most of every day sitting in a chair watching television. What is the most appropriate nursing diagnosis? A.Ineffective health maintenance B.Impaired physical mobility C.Risk for disuse syndrome D.Activity intolerance - CORRECT ANSWER C. The most appropriate nursing diagnosis for a person who is able to exercise but remains sedentary is risk of disuse syndrome because the patient is putting himself at risk for the development of circulatory impairment and muscle atrophy. Failure to exercise may also exacerbate his condition. While his health maintenance may be ineffective, it is directly due to of his lack of activity. He does not have impaired physical mobility or activity intolerance that precludes exercise. Measuring the effectiveness of an intervention rather than the monetary savings is: A.A cost-benefit analysis. B.An efficacy study. C.A product evaluation. D.A cost-effective analysis. - CORRECT ANSWER D. A cost-effective analysis measures the effectiveness of an intervention rather than the monetary savings. For example, annually 2 million nosocomial infections result in 90,000 deaths and an estimated $6.7 billion in additional health costs. From that perspective, decreasing infections should reduce costs, but there are human savings in suffering as well, and it can be difficult to place a dollar value on that. If each infection adds about 12 days to hospitalization, then a reduction of 5 infections (5 X 12 = 60) would result in a cost-effective savings of 60 fewer patient infection days. The main goal of treatment for acute glomerulonephritis is to: 1. Encourage activity. 2. Encourage high protein intake. 3. Maintain fluid balance. 4. Teach intermittent urinary catheterization. - CORRECT ANSWER 3. Maintain fluid balance. Nursing diagnoses mostly differ from medical diagnoses in that they are: 1. Dependent upon medical diagnoses for the direction of appropriate interventions. 2. Primarily concerned with caring, while medical diagnoses are primarily concerned with curing. 3. Primarily concerned with human response, while medical diagnoses are primarily concerned with pathology. 4. Primarily concerned with psychosocial parameters, while medical diagnoses are primarily concerned with physiologic parameters. - CORRECT ANSWER 3. Primarily concerned with human response, while medical diagnoses are primarily concerned with pathology. A patient who received spinal anesthesia four hours ago during surgery is transferred to the surgical unit and, after one and a half hours, now reports severe incisional pain. The patient's blood pressure is 170/90 mm Hg, pulse is 108 beats/min, temperature is 99oF (37.2oC), and respirations are 30 breaths/min. The patient's skin is pale, and the surgical dressing is dry and intact. The most appropriate nursing intervention is to: 1. Medicate the patient for pain. 2. Place the patient in a high Fowler position and administer oxygen. 3. Place the patient in a reverse Trendelenburg position and open the IV line. 4. Report the findings to the provider. - CORRECT ANSWER 1. Medicate the patient for pain. To prevent a common, adverse effect of prolonged use of phenytoin sodium (Dilantin), patients taking the drug are instructed to: 1. Avoid crowds and obtain an annual influenza vaccination. 2. Drink at least 2 L of fluids daily, including 8 to 10 glasses of water. 3. Eat a potassium-rich, low sodium diet. 4. Practice good dental hygiene and report gum swelling or bleeding. - CORRECT ANSWER 4. Practice good dental hygiene and report gum swelling or bleeding. The most common, preventable complication of abdominal surgery is: 1. Atelectasis. 2. Fluid and electrolyte imbalance. 3. Thrombophlebitis. 4. Urinary retention. - CORRECT ANSWER 1. Atelectasis. A 78-year-old patient is scheduled for transition to home after treatment for heart disease. The patient's spouse, who has chronic obstructive pulmonary disease, plans to care for the patient at home. The spouse says that their grown children, who live nearby, will help. The best approach to discharge planning is to: 1. Arrange nursing home placement for the couple. 2. Consult the spouse's healthcare provider about the spouse's ability to care for the patient. 3. Contact the children to ascertain their commitment to help. 4. Discuss community resources with the spouse and offer to make referrals. - CORRECT ANSWER 4. Discuss community resources with the spouse and offer to make referrals. During an assessment of a patient who sustained a head injury 24 hours ago, the medical-surgical nurse notes the development of slurred speech and disorientation to time and place. The nurse's initial action is to: 1. Continue the hourly neurologic assessments. 2. Inform the neurosurgeon of the patient's status. 3. Prepare the patient for emergency surgery. 4. Recheck the patient's neurologic status in 15 minutes. - CORRECT ANSWER 2. Inform the neurosurgeon of the patient's status. For the evaluation feedback process to be effective, a manager: 1. Conducts weekly meetings with staff members. 2. Considers staff members' interests and abilities when delegating tasks. 3. Informs staff members regularly of how well they are performing their jobs. 4. Provides goals for staff members to meet. - CORRECT ANSWER 3. Informs staff members regularly of how well they are performing their jobs. An 80-year-old patient is placed in isolation when infected with methicillin-resistant Staphylococcus aureus. The patient was alert and oriented on admission, but is now having visual hallucinations and can follow only simple directions. The medical-surgical nurse recognizes that the changes in the patient's mental status are related to: 1. A fluid and electrolyte imbalance. 2. A stimulating environment. 3. Sensory deprivation. 4. Sundowning. - CORRECT ANSWER 3. Sensory deprivation. To prepare a patient on the unit for a bronchoscopic procedure, a medical-surgical nurse administers the IV sedative. The medical-surgical nurse then instructs the licensed practical nurse to: 1. Educate the patient about the pending procedure. 2. Give the patient small sips of water only. 3. Measure the patient's blood pressure and pulse readings. 4. Take the patient to the bathroom one more time. - CORRECT ANSWER 3. Measure the patient's blood pressure and pulse readings. Which physiological response is often associated with surgery-related stress? 1. Bronchial constriction 2. Decreased cortisol levels 3. Peripheral vasodilation 4. Sodium and water retention - CORRECT ANSWER 4. Sodium and water retention A patient's family does not know the patient's end-of-life care preferences, but assumes that they know what is best for the patient under the circumstances. This assumption reflects: 1. Justice. 2. Paternalism. 3. Pragmatism. 4. Veracity. - CORRECT ANSWER 2. Paternalism. Which statement by a patient with diabetes mellitus indicates an understanding of the medication insulin glargine (Lantus)? 1. "Lantus causes weight loss." 2. "Lantus is used only at night." 3. "The duration of Lantus is six hours." 4. "There is no peak time for Lantus." - CORRECT ANSWER 4. "There is no peak time for Lantus." Which action occurs primarily during the evaluation phase of the nursing process? 1. Data collection 2. Decision-making and judgment 3. Priority-setting and expected outcomes 4. Reassessment and audit - CORRECT ANSWER 4. Reassessment and audit Which action best describes a sentinel event alert? 1. Documenting the breakdown in communication during a shift report 2. Indicating that a community or institution is unsafe 3. Recording the harm done when a medication error occurs 4. Signaling the need for immediate investigation and response - CORRECT ANSWER 4. Signaling the need for immediate investigation and response Which is primarily a developmental task of middle age? 1. Learning and acquiring new skills and information 2. Rediscovering or developing satisfaction in one's relationship with a significant other 3. Relying strongly upon spiritual beliefs 4. Risk taking and its perceived consequences - CORRECT ANSWER 2. Rediscovering or developing satisfaction in one's relationship with a significant other A medical-surgical nurse, who is caring for a patient with a new diagnosis of cancer, observes the patient becoming angry with the physicians and nursing staff. The best approach to diffuse the emotionally charged discussion is to: 1. Allow the patient and family members time to be alone. 2. Arrange time for the patient to speak with another patient with cancer. 3. Direct the discussion and validation of emotion, without false reassurance. 4. Request a consultation from a social worker on the oncology unit. - CORRECT ANSWER 3. Direct the discussion and validation of emotion, without false reassurance. It is hospital policy to assess and record a patient's pulse before administering digoxin (Lanoxin). By auditing the nursing records to determine the frequency of compliance with this policy, the quality assessment and improvement committee is conducting: 1. A process analysis. 2. A quality analysis. 3. A system analysis. 4. An outcome analysis. - CORRECT ANSWER 1. A process analysis. The nursing diagnosis for a patient with a myocardial infarction is activity intolerance. The plan of care includes the patient outcome criterion of: 1. Agreeing to discontinue smoking. 2. Ambulating 50 feet without experiencing dyspnea. 3. Experiencing no dyspnea on exertion. 4. Tolerating activity well. - CORRECT ANSWER 2. Ambulating 50 feet without experiencing dyspnea. A nursing department in an acute care setting decides to redesign its nursing practice based on a theoretical framework. The feedback from patients, families, and staff reflects that caring is a key element. Which theorist best supports this concept? 1. Erikson 2. Maslow 3. Rogers 4. Watson - CORRECT ANSWER 4. Watson Which statement by a patient demonstrates an accurate understanding about herbal supplements? 1. "Herbs may interact with prescribed medications but not other herbs." 2. "Most herbs have been tested and found to be safe and therapeutic." 3. "The Food and Drug Administration regulates herbs and allows advertising." 4. "There is no standardization among the manufacturers of herbs in this country." - CORRECT ANSWER 4. "There is no standardization among the manufacturers of herbs in this country." For a patient with Crohn's disease, the medical-surgical nurse recommends a diet that is: 1. High in fiber, and low in protein and calories. 2. High in potassium. 3. Low in fiber, and high in protein and calories. 4. Low in potassium. - CORRECT ANSWER 3. Low in fiber, and high in protein and calories. When examining a patient who is paralyzed below the T4 level, the medical-surgical nurse expects to find: 1. Flaccidity of the upper extremities. 2. Hyperreflexia and spasticity of the upper extremities. 3. Impaired diaphragmatic function requiring ventilator support. 4. Independent use of upper extremities and efficient cough. - CORRECT ANSWER 4. Independent use of upper extremities and efficient cough. After completing a thorough neurological and physical assessment of a patient who is admitted for a suspected stroke, a medical-surgical nurse anticipates the next step in the immediate care of this patient to include: 1. Administering tissue plasminogen activator. 2. Obtaining a computed tomography scan of the head without contrast. 3. Obtaining a neurosurgical consultation. 4. Preparing for carotid Doppler ultrasonography. - CORRECT ANSWER 2. Obtaining a computed tomography scan of the head without contrast. The first step in applying the quality improvement process to an activity in a clinical setting is to: 1. Assemble a team to review and revise the activity. 2. Collect data to measure the status of the activity. 3. Select an activity for improvement. 4. Set a measurable standard for the activity. - CORRECT ANSWER 3. Select an activity for improvement. The registered nurse has an unlicensed assistant working with her for the shift. When delegating tasks, the nurse understands that the unlicensed assistant: A. interprets clinical data. B. collects clinical data. C. is trained in the nursing process. D. can function independently - CORRECT ANSWER B. collects clinical data. Rationale: Unlicensed personnel make observations, collect clinical data, and report findings to the nurse. Option A is incorrect because the registered nurse, who has learned critical thinking skills, interprets the data. Option C is incorrect because although unlicensed assistants are trained to perform skills, they don't learn the nursing process. Option D is incorrect because unlicensed assistants don't function independently; they're assigned tasks by a registered nurse who retains overall responsibility for the patient. When performing an assessment, the nurse identifi es the following signs and symptoms: impaired coordination, decreased muscle strength, limited range of motion, and reluctance to move. These signs and symptoms indicate which nursing diagnosis? A. Health-seeking behaviors B. Impaired physical mobility C. Disturbed sensory perception D. Deficient knowledge - CORRECT ANSWER B. Impaired physical mobility Rationale:Impaired physical mobility is a limitation of physical movement and is defined by the patient's signs and symptoms. Options A, C, and D are nursing diagnoses with different defining signs and symptoms. When prioritizing a patient's care plan based on Maslow's hierarchy of needs, the nurse's fi rst priority would be: A. allowing the family to see a newly admitted patient. B. ambulating the patient in the hallway. C. administering pain medication. D. using two nurses to transfer the patient. - CORRECT ANSWER C. administering pain medication. Rationale: In Maslow's hierarchy of needs, pain relief is on the first layer. Activity (Option B) is on the second layer. Safety (Option D) is on the third layer. Love and belonging (Option A) are on the fourth layer When a nurse asks another nurse for advice on handling a particular patient problem, she's seeking what type of consultation? A. Patient-centered case consultation B. Consultee-centered case consultation C. Program-centered administrative consultation D. Consultee-centered administrative consultation - CORRECT ANSWER A. Patient-centered case consultation Rationale: Patient-centered case consultation (Option A) provides expert advice on handling a particular patient or group of patients. Consultee-centered case consultation (Option B) focuses on work difficulties with patients, which are used as a learning opportunity. Program-centered administrative consultation (Option C) provides expert advice on developing new programs or improving existing ones. Consultee-centered administrative consultation (Option D) considers work problems in the areas of program development and organization. When implementing an evidence-based nursing program to decrease the incidence of pressure ulcers on a medical-surgical unit, which of the following is the most important to ensure its success? A. Obtaining support from management, administration, and physicians B. Determining and documenting patient outcomes C. Identifying a significant problem that needs to be addressed D. Evaluating research based on its validity and reliability - CORRECT ANSWER A. Obtaining support from management, administration, and physicians Rationale: To successfully implement an evidence-based nursing program, it's important to obtain the support of management, administration, and physicians. Option B is part of evaluating evidence-based nursing program implementation. Option C is part of the first step of the evidence-based nursing program process. Option D is part of the critical evaluation of resources. When planning the implementation of evidence-based practices to prevent falls, which of the following steps should the nurse take fi rst? A. Identify the common causes of falls. B. Gather and review currently existing literature and guidelines for the prevention of falls. C. Identify fall prevention practices that are applicable to the patient care setting. D. Gather data to identify the effectiveness of the new practice guidelines. - CORRECT ANSWER B. Gather and review currently existing literature and guidelines for the prevention of falls. Rationale: Options A, B, and C are correct steps in planning for the implementation of evidence-based practices; however, Option B would be the initial step, followed by Options A and C. Option D is part of the evaluation phase of evidence-based practice implementation Which measure most effectively reduces the risk of health care-associated infections? A. Keeping employee health records up-to-date B. Performing hand hygiene C. Providing annual influenza vaccinations D. Always wearing a mask when caring for patients - CORRECT ANSWER B. Performing hand hygiene Rationale: Performing hand hygiene in compliance with the World Health Organization or Centers for Disease Control and Prevention guidelines is the most effective in reducing the risk of health care-associated infections. Keeping employee health records up-to-date (Option A), providing annual influenza vaccinations (Option C), and always wearing a mask when caring for patients (Option D) aren't the most effective ways to reduce the risk of health care-associated infections. Which action should the nurse take when receiving a telephone order from a physician? A. Inform the physician that telephone orders are not permitted. B. Write the order in the patient's medical record immediately. C. Write down the order and then read back the complete order to the physician. D. Immediately carry out the order. - CORRECT ANSWER C. Write down the order and then read back the complete order to the physician. Rationale: When receiving a telephone or other verbal order, the nurse should write down the order and then read back the complete order to the physician to verify its accuracy. Options A, B, and D aren't appropriate actions for the nurse to take when receiving a telephone order from a physician. A secondary latency phase that occurs in some diseases that is commonly followed by another acute phase is referred to as: A. remission. B. convalescence. C. the acute phase. D. the subclinical acute phase. - CORRECT ANSWER A. remission. Rationale: A secondary latency phase that occurs in some diseases that is commonly followed by another acute phase is referred to as remission. Convalescence (Option B) is progression toward recovery. The acute phase (Option C) refers to the disease at its full intensity, possibly with complications. The subclinical acute phase (Option D) occurs when the patient is in the acute phase but still functions as if the disease weren't present. Qualitative research emphasizes developing new insights, theories, and knowledge. Which term in qualitative research describes the researcher laying aside what is known about the experience being studied? A. Bracketing B. Saturation C. Intuiting D. Theoretical sampling - CORRECT ANSWER A. Bracketing Rationale: Bracketing requires the researcher to lay aside what's known about the experience being studied and be open to new insights. Saturation (Option B) describes the point at which data collection is ended because continuing would result in acquiring more of the same information or data. Intuiting (Option C) refers to the focused awareness on the phenomena being studied. Theoretical sampling (Option D) is the selecting of subjects on the basis of concepts that have theoretical relevance to an evolving theory. The nurse leaves a patient who is elderly and confused to fi nd someone to assist with transferring the patient to bed. While the nurse is gone, the patient falls and hurts herself. The nurse is at fault because she hasn't: A. properly educated the patient about safety measures. B. restrained the patient. C. documented that she left the patient. D. arranged for continual care of the patient. - CORRECT ANSWER D. arranged for continual care of the patient. Rationale: By leaving the patient, the nurse is at fault for abandonment. The better courses of action are to turn on the call bell or elicit help on the way to the patient's room. Options A and C are incorrect because neither excuses the nurse from her responsibility for ensuring the patient's safety. Option B is incorrect because restraints are only to be used as a last resort, when all other alternatives for ensuring patient safety have been tried and have failed; moreover, restraints won't ensure the patient's safety. [Show Less]
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Nursing Practice Exam 35 Questions with Verified Answers,100% CORRECT
Nursing Practice Exam 35 Questions with Verified Answers Nursing - CORRECT ANSWER is defined as a protection promotion and optimization of health and ... [Show More] abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations (American Nurses Association (ANA), 2010b) Nursing Historical Events - CORRECT ANSWER 1860 Florence Nightingale notes on nursing • Established first nursing philosophy based on health maintenance and restoration • Developed the first program for training nurses • Use EBP in her practice Modern influences in Nursing - CORRECT ANSWER Early 20th century nurses expanded and advanced practice roles were established - In the early 1950s specialty nursing organizations formed - Social influence • Health care reform • Women health care • Human rights • Threat of bioterrorism • Nursing Shortage Consumer influence - CORRECT ANSWER Culture diversity • Healthy people.gov - Safety • National patient safety goals - Health promotion and wellness • Exercise • Nutrition Nursing as a Profession - CORRECT ANSWER A profession requires an extended education of its members • A profession has a theoretical body of knowledge leading to define skills abilities and norms • A profession provides a specific service • Members of a profession have autonomy in decision-making and practice • The profession as a whole has a code of ethics and practice Scope and Standards of Practice - CORRECT ANSWER Standard of Practice • Standards of professional performance • Code of Ethics ANA Standard of Nursing Practic - CORRECT ANSWER 1. Assessment 2. Diagnosis 3. Outcomes identifications 4. Planning 5. Implementation 6. Evaluation ANA Standard of Professional Performance - CORRECT ANSWER 1. Quality of practice 2. Education 3. Professional practice evaluation 4. Collegiality 5. Collaboration 6. Ethics 7. Research 8. Resource utilization 9. Leadership Responsibilities and Roles of a Nurse - CORRECT ANSWER Autonomy and Accountability • Caregiver • Advocate • Educator • Communicator • Manager • Career development Nursing Education - CORRECT ANSWER RN program - AD -2 year program - BSN- 4 year program - MSN • Educator • Administrator • Advance practice Nurse (NP, CNS, Mid-wife) - DSN/DNP Licensure: NCLEX-RN - CORRECT ANSWER National Council Licensure Exam for Registered Nurses - Given by each State Board of Nursing - The same in every state - Provides a standardized minimum knowledge base for nurses Certification - CORRECT ANSWER In a specific area of practice - Minimum requirements are set based on the certification - Maintain by ongoing CEU Continuing education - CORRECT ANSWER Formal educational programs - Update knowledge on latest research and practices - Teaches new skills In-Service education - CORRECT ANSWER Instructional or training program Clinical Nurse Specialist - CORRECT ANSWER Expert clinician in specialized area - Educators, consultants and researchers Nurse Practitioner - CORRECT ANSWER Care for clients in an ambulatory setting - Acute care, family, pediatric, women, and geriatric Certified Nurse-Midwife - CORRECT ANSWER Care of women during pregnancy, labor and delivery - Care of new born, GYN services, family planning Certified Registered Nurse Anesthetist - CORRECT ANSWER Provide surgical anesthesia under the guidance and supervision of an anesthesiologist Educator - CORRECT ANSWER Works in schools, staff development, and education departments - Doctorate or advanced degrees in nursing, education, or administration Administrator - CORRECT ANSWER Assistant nurse manager, manager, director, Chief nurse executive. - Holds a masters degree in business, hospital administration or public health Researcher - CORRECT ANSWER Investigate problems to improve nursing care - Academic setting, hospitals - Masters or doctoral degree Nursing Organizations - CORRECT ANSWER American Association of College Nurses (AACN) • National League of Nurses • Accreditation Commission for Education in Nursing, Inc. ( formally NLNAC) • American Nurses Association(ANA) • National Student Nurses Association Quality and Safety Education for Nurses (QSEN) - CORRECT ANSWER Patient -Centered Care • Teamwork and Collaboration • Evidence-Based Practice • Quality Improvement • Safety • Informatics Quality and Performance Improvement - CORRECT ANSWER Every health care organization gathers data on health outcome measures as a way to gauge their quality of care. • Quality Improvement - Medication delivery - Fall management • Performance Management - Ulcers - VAP - Hospital acquired infections Evidence - Based Practice (EBP - CORRECT ANSWER A problem solving approach to clinical practice • Integrates the best evidence, clinical expertise, and values in decision making Step of Evidence-Based Practice - CORRECT ANSWER 1. Ask a clinical question 2. Collect the most relevant and best evidence 3. Critically evaluate the evidence you collected 4. Integrate all evidence with ones clinical expertise and client preference and values in making a practice decision or change. 5. Evaluate the practice decision or change Ask a clinical question - CORRECT ANSWER Problem on interest - Time consuming - Costly PICO Question - CORRECT ANSWER - P= patient population of interest - I= intervention of interest - C= comparison of interest - O= outcome Collect the Best Evidence - CORRECT ANSWER - Research journals • AHRQ • CINAL MEDLINE • National Guideline Clearinghouse - Nursing journals • AJN • AACN - Peer-reviewed journal Evaluation of the Evidence - CORRECT ANSWER - Analyzing the data - Determine the value and feasibility in making practice change - Evaluate scientific merit and clinical applicabilty - Careful review of the article Integrate the Evidence - CORRECT ANSWER - Evidence is strong and appropriate for practice change - Incorporate the research in the plan of care for the client - Meet with policy and procedure makers - Pilot study Evaluation - CORRECT ANSWER Does the intervention work? - Is it effective - Track effectiveness in intervals 3-6-12 months Nursing Research - CORRECT ANSWER Nursing research provides a way for nursing questions and problems to be studied in broader context. • Identify new knowledge • Improve professional education and practice • Use resources effectively Outcomes Management Research - CORRECT ANSWER Designed to assess and document the effectiveness of health care services and interventions • A response of the health care industry to demands from policy makers, insurers, and public - Examples: Central line infections, fall's, HAI's Research Process - CORRECT ANSWER Study with human subjects - Institutional review board (IRB) • Informed consent - Full disclosure of purpose - Full understanding - Free choice • Confidentiality - Guarantees information provided will no identify the subject or give information to people outside the research team • Anonymity - Cannot link subject to data [Show Less]
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Med-Surg Certification Practice 271 Questions with Verified Answers,100% CORRECT
Med-Surg Certification Practice 271 Questions with Verified Answers A newly diabetic patient will receive instructions from his nurse. Which of the fo... [Show More] llowing actions should the nurse take first? A. Provide the patient with brochures for making smart choices for cooking/baking. B. Ask the patient what they know about diabetes. C. Instruct the patient on exercise or activities that will increase their metabolism. D. Teach them how to use the glucometer. - CORRECT ANSWERB. First ask the patient what they know about diabetes. *ACTION questions ask for intervention, NOT assessment The post hysterectomy patient with calls the clinic stating that she has been having difficulty with incontinence. Which of the following statements if made by the patient, indicates that further teaching is needed? A. I drink 8 oz. of fluid on the even hours while awake. B. I will attempt to void 30 minutes after drinking 200 cc. of fluid C. I will only drink fluid when I eat my meals D. I will set the timer to remind me when to void - CORRECT ANSWERC. A patient saying that he or she will only drink fluids when eating meals indicates that they don't know what to do in case of incontinence. FURTHER TEACHING indicates that the patient needs more information An RN assesses a patient in the Cancer Center with a diagnosis of terminal cancer. The patient states to the RN that he is short of breath, has no appetite and hurts everywhere. Which of the following statements by the nurse is best? A. Tell me how your family is coping B. Show me where it does not hurt C. I'll teach you relaxation techniques D. Your physician should increase your pain medication - CORRECT ANSWERC A clinical nurse returns to the desk to find 4 phone messages. Which of the following messages should the nurse respond to first? A. A post cervical laminectomy patient complaining of sudden difficulty talking. B. A patient with multiple sclerosis complaining of change in peripheral vision. C. A patient with a herniated disc complaining of consistent back pain. D. A patient with a cast due to a fracture of the right tibial bone complaining of tingling toes. - CORRECT ANSWERA B and C are expected symptoms of the patient's condition. A and D are unexpected. D is less critical than A. Best answer is A. A 75 year old patient complains to the clinical nurse that he is having difficulty sleeping. Which of the following actions by the nurse is most appropriate? A. Determine the patient's usual sleeping and waking patterns. B. Suggest that the client abstain from alcohol and caffeine before bed time. C. Recommend that client establish a bedtime routine. D. Ask how much sleep the client required before retirement. - CORRECT ANSWERA B and C are recommendations that the RN can share after he/she determines the patient's sleeping and waking patterns. So remove B and C. D is an inquiry, but is concerned about the past (when the person retired). Remove D. A is the best answer. The nurse cares for a patient several hours after a thyroidectomy. The RN observes that the patient is diaphoretic and confused. The vital signs are: Temp = 102° (38.9 ° C); BP is 160/90; pulse is 110, respiration is 22. The nurse expects the physician to order which of the following? A. NPO, Dextran 10 ml/kg. IV, 02 4 L/min. B. Propranolol (Inderal) 1 mg. IV, D5W 125 cc/hr IV, propylthiaouracil (PTU) 200 mg po qld. C. Levothyroxine Sodium (Synthroid) 100 mcg IV, Lactated Ringer's 125 cc/hr IV, and ciprofloxacin (cipro) 500 mg. po bid. D. Morphine sulfate 2.5 mg. IV q. 4 hrs. prn, 0.9% NACl. - CORRECT ANSWERB A 63 year old female patient contacts the clinic to report that she is has been extremely fatigued, is sleeping 12 hours a night, is always cold and her hair is falling out. Which of the following responses by the nurse is most appropriate? A. You will have more energy if you walk 30 min every day. B. You don't need to worry. Sleeping a lot is good for you. C. Come in and see your health care provider today. D. You should eat more green leafy vegetables. - CORRECT ANSWERC Need more info The RN performs blood pressure screening at the local community center. Which of the following individuals is most likely to suffer from a cerebrovascular accident? A. A 30 year old man who is an account executive B. A 40 year old man who jogs four times a week. C. A 60 year old man whose father had a stroke. D. A 75 year old man who takes multi-vitamins. - CORRECT ANSWERC For the patient with a new tracheostomy, the nurse must be alert to which early complication? a) Decannulation b) Infection c) Bleeding d) Tracheomalacia - CORRECT ANSWERC Common acute risks of tracheostomy include bleeding, airway loss, damage to adjacent structures, and failure of the chosen technique to achieve successful airway EVERYTHING 24 HR POST SURGERY, FIRST COMPLICATION IS BLEEDING. Infection comes 2-3 days later. When a pulse oximetry monitor indicates that a patient has a drop in SpO2 from 96% to 85% over 4 hours, the nurse will first: 1. Request an order for stat ABGs 2. Start the patient on oxygen by NC at 2L/minute 3. Notify the physician of the change 4. Check the position of the probe on patient's finger or earlobe - CORRECT ANSWER4 Pulse oximetry is inaccurate if the probe is loose, or in the presence of poor circulation, nail polish, or dark skin pigmentation. To decrease a patient's shortness of breath and a sense of impending doom during an asthma attack, the nurse will: A. Place the patient on a cardiac monitor and observe from the nurses' station. B. Let the patient rest alone in a quiet, calm environment. C. Reassure the patient that the doctor will arrive soon D. Stay with the patient and encourage pursed-lip breathing. - CORRECT ANSWERD The patient experiencing an acute asthma exacerbation will be fearful and anxious. It is important for the nurse to stay with the patient for ongoing assessment and to provide a calm environment. Helping the patient breathe with pursed lips will facilitate the expiration of trapped air and help the patient regain control of his or her breathing. A 68 year old woman is admitted to the surgical unit after a gastric resection for gastric cancer. She states that she doesn't want anyone to see her in this condition, even her husband. This nurse's best response is: A."Patients' rights protect your privacy. I won't allow anyone in." B."I've seen gastric cancer patients who look much worse. Don't worry." C."Would you like to talk to a social worker?" D."What about your condition worries you?" - CORRECT ANSWERD The nurse should allow the patient to share her concerns and express her feelings in a nonjudgmental environment. If there is psych/behavioral component- AFFIRM AND VALIDATE, NO PROBING A patient with a tricuspid valve disorder will have impaired blood flow between the: A. Vena cava and right atrium B. Left atrium and left ventricle C. Right atrium and right ventricle D. Right ventricle and pulmonary artery - CORRECT ANSWERC Tricuspid valve is located between right atrium and right ventricle MITRAL VALVE- left atrium and left ventricle If the Purkinje system is damaged, conduction of the electrical impulse is impaired through the: A. Atria B. AV node C. Ventricles D. Bundle of His - CORRECT ANSWERC Purkinje fibers provide a high-speed distribution of excitation throughout the ventricular myocardium; if the pattern of contraction is disrupted, the ventricles will not efficiently eject blood Order of impulse is SA node to AV node to Bundle of His to bundle branch to purkinje fibers The P-wave on an EKG is representative of: A. Ventricular depolarization B. Atrial depolarization C. Atrial repolarization D. Ventricular repolarization - CORRECT ANSWERB. Atrial depolarization Ventricular repolarization is represented by the QRS There is no distinctly visible wave representing atrial repolarization in the ECG because it occurs during ventricular depolarization, ventricular repolarization is shown as the interval between the start of the QRS complex and the end of the T wave A patient admitted with an abscess in her left thigh undergoes incision and drainage. 3 days later, she develops fever (temperature of 103°F), chills, lethargy, and shortness of breath. Infectious endocarditis is suspected. In addition to blood cultures, the nurse would expect which of these tests? A. Transesophageal echocardiogram B. Computed tomography of the chest C. Cardiac stress test D. Cardiac enzymes - CORRECT ANSWERA. Echocardiogram to visualize cardiac structures. Which of the following is a sign of poor perfusion? A. Mean arterial pressure <80 mmHg B. Urine output <0.5 ml/kg/hr for 2 consecutive hours C. Lactate levels > 1mmol/L D. Systolic BP of 150 mmHg - CORRECT ANSWERB UO should be greater or equal to .5ml per kg per hour. MAPs should be between 65-85 Lactate levels should be less than 2.3 SBP of 150 is high but does not indicate poor perfusion When performing discharge teaching with a patient who is taking warfarin sodium (Coumadin), the nurse learns that patient used complementary therapies at home. Which of the following substances is most concerning? A. Echinacea B. Vitamin B12 C. Vitamin D D. Garlic - CORRECT ANSWERD. Garlic When taking warfarin, caution with - garlic, ginseng, ginkgo, ibuprofen, pain drugs, vitamin E Garlic may increase bleeding, so supplemental garlic may cause a synergic effect when combined with coumadin For the same patient - who is being discharged and is taking warfarin (Coumadin), the nurse should also emphasize that: A. Regular follow-up with healthcare provider is essential B. Aspirin would be recommended for headache therapy C. The medication can be taken any time of the day D. Diet should be high in iron content - CORRECT ANSWERA Discuss INR. High INR is a risk for bleeding (GI, hemorrhagic stroke, etc) Aspirin also being a blood thinner can be too much blood thinning action Timing of dose needs to be consistent Iron, mag, and zinc bind with coumadin and decrease absorption, it is not an absolute contraindication, but it recommended that these supplements be taken two hours apart from coumadin Which of the following patient teaching points should the nurse include when providing discharge instructions to a patient with a new permanent pacemaker and the caregiver (select all that apply)? A. Avoid or limit air travel B. Take and record a daily pulse rate C. Obtain and wear a Medic Alert ID or bracelet at all times D. Avoid lifting arm on the side of the pacemaker above shoulder E. Avoid microwave ovens because they interfere with pacemaker function - CORRECT ANSWERB, C, D Back in the day, persons with pacers needed to carry a medical device ID card as proof a pacer when they would go through security, as security heightened and body scans became normal this isn't really needed anymore Daily record keeping of HR is recommended as is wearing a med alert id bracelet, patients should NOT lift above the shoulder for a period of time so that the leads can stabilize in the body without being disrupted (about 2-4 weeks) Microwaves and most other household appliances pose no risk but extreme magnetic forces do Causes of secondary hypertension would include: A. Alcohol abuse B. Diabetes C. Obesity D. Renal artery stenosis - CORRECT ANSWERD Renal stenosis → narrowing of arteries that carry blood to the kidneys → less blood to the kidneys → raises blood pressure A 60-year-old African American male who works as a soccer coach, is admitted with hypertension. On admission his blood pressure was 210/108 mmHg. His last total cholesterol level was 156 mg/dl, and a random blood glucose was 110 mg/dl. Which is unalterable risk factor for hypertension? A. His blood glucose level B. His cholesterol level C. His occupation D. His ethnicity - CORRECT ANSWERD Other risk factors: elevated serum lipids, DM, sedentary lifestyle A patient who has type 2 diabetes is prescribed carvedilol (Coreg) for hypertension. The nurse monitors for A. Hypoglycemia B. Hyperglycemia C. Hypocalcemia D. Hypercalcemia - CORRECT ANSWERA. Hypoglycemia In patients with DM, Coreg may increase the effects of hypoglycemic drugs (prevent adrenalin from stimulating the liver to make glucose) and mask symptoms of hypoglycemia. Which of the following is an AHA recommendation for patients with coronary artery disease for stroke prevention? A. Fibrate therapy B. Heparin therapy C. Beta-blocker therapy D. Aspirin therapy - CORRECT ANSWERD. Aspirin therapy This is a core measure for patients with CAD Heparin is not indicated nor is it really sustainable for home use, betablockers don't decrease your risk of stroke directly although it does reduce bp which reduces risk of stroke A client complains of crushing chest pain that radiates to his left arm. Which of the following treatments should you anticipate: A. Aspirin, oxygen, nitroglycerin, and morphine B. Aspirin, oxygen, nitroglycerin, and codeine C. Oxygen, nitroglycerin, meperidine, and thrombolytics D. Aspirin, oxygen, nitroprusside, and morphine - CORRECT ANSWERA. Aspirin, oxygen, nitroglycerin, and morphine MONA A patient is recovering from an uncomplicated MI. Which of the following rehabilitation guidelines is a priority to include in the teaching plan? A. Refrain from sexual activity for a minimum of 3 weeks. B. Plan a diet program that aims for a 1- to 2-pound weight loss per week. C. Begin an exercise program that aims for at least five 30-minute sessions per week. D. Consider the use of erectile agents and prophylactic NTG before engaging in sexual activity. - CORRECT ANSWERC Avoid intercourse for 4-6 weeks The need for a weight loss plan would be patient specific You do not want to mix nitrates and ED meds because this can cause and unsafe drop in BP The most common finding in individuals at risk for sudden cardiac death is: A. aortic valve disease B. mitral valve disease C. left ventricular dysfunction D. atherosclerotic heart disease - CORRECT ANSWERC. left ventricular dysfunction Those with LV dysfunction are at high risk for ventricular arrythmias. Typically, the LV dysfunction is secondary to MI, cardiomyopathy or advanced heart failure. A patient with a history of myocardial infarction (MI) complains of chest pain while walking to the restroom. Which action should the nurse perform first? A. Assess patient's vital signs B. Instruct patient to sit down C. Obtain a STAT EKG D. Call the physician - CORRECT ANSWERB. Instruct patient to sit down Having the patient sit down reduces myocardial oxygen demand to help relieve pain and take stress off the heart. The other actions are important, but would come after having the patient sit down to ensure safety. The key diagnostic test for heart failure is: A. Serum potassium B. B-type natriuretic peptide C. Troponin I D. Cardiac enzymes - CORRECT ANSWERB. B-type natriuretic peptide Hyperkalemia can be common in heart failure secondary to treatments like ACE inhibitors and betablockers can cause the kidneys to retain potassium, similarly diuretic can be used to treat fluid overload associated with heart failure, the desired effect achieving of high urine output to decrease preload can also lead to low potassium levels Troponin is the hallmark diagnostic test for acute coronary syndrome, has no value with HF, same goes for cardiac enzymes A nurse is instructing a patient taking diuretics for heart failure about foods that are high in potassium to include in her daily diet. The nurse concludes that additional education is needed when the client states that the food highest in potassium is: A. Spinach B. Apples C. Avocado D. Sweet potatoes - CORRECT ANSWERB. Apples From this list avocadoes have the most, followed by sweet potatoes, then spinach. Apples have the least Mr. Jones is 72 years old and admitted with an exacerbation of left-sided heart failure. The nurse would expect to see which of these signs or symptoms? A.Hepatomegaly B. Enlarged spleen C. Oliguria D. Ascites - CORRECT ANSWERC. Oliguria Left-sided HF - sodium and water retention and peripheral edema. Decreased blood flow to the kidneys can lead to oliguria. Ascites, hepatomegaly, enlarged spleen are signs of right-sided heart failure. LEFT- Lungs and Kidneys Mr. Jones develops acute pulmonary edema. In anticipation of the arrival of the Rapid Response Team, the nurse should take which of these measures? (select all that apply) A. Place Mr. Jones in high Fowler's position. B. Apply high-flow oxygen. C. Administer nitroglycerin sublingually. D. Insert an indwelling urinary catheter. - CORRECT ANSWERA, B This patient is going to feel like they're drowning in their lungs, and they are. Set the patient upright immediately and supplement O2. Nitroglycerine is a vasodilator and could be used to decrease afterload and strict urine output measuring will be ideal when diuretic treatment is initiated but these are not your initial steps at this time. In preparing for discharge, Mr. Jones should receive education about which of these types of medication? A .Beta-adrenergic agonists B. Angiotensin-converting enzyme (ACE) inhibitors C. Nonsteroidal anti-inflammatories D. Prokinetic agents - CORRECT ANSWERB. ACE inhibitors Ace inhibitors are commonly used to treat HF as are ARBs, beta blockers, calcium channel blockers, and diuretics Beta-adrenergic agonists are used to help with dilating airways but breathing difficulty in HF is a secondary issue to fluid build up in the heart and lungs NOT inflammation or obstruction of the airway NSAIDS and prokinetic agents like Reglan offer no value here A patient with heart failure has been started on metoprolol 12.5mg daily. The nurse should report serious adverse reactions to the medication including: A. Crackles in lungs B. Edema C. Dry, hacking cough D. Dry mouth - CORRECT ANSWERA. Crackles in lungs Indication of exacerbation of HF symptoms → possible complication of starting beta blockers due to the decrease in inotropic response caused by the medication. Edema is also a sign of worsening HF, but is not as specific as lung crackles. Betablockers do cause cough and dry mouth but these are not serious adverse reactions; They're just annoying and anticipated. A patient with HF and atrial fibrillation is treated with a digitalis glycoside and a loop diuretic. To prevent possible complications of this combination of drugs, the nurse needs to: A. monitor serum potassium levels. B. keep an accurate measure of intake and output. C. teach the patient about dietary restriction of potassium. D. withhold digitalis and notify health care provider if heart rate is irregular. - CORRECT ANSWERA. monitor serum potassium levels. Loop diuretics and most diuretics will deplete potassium as they effectively reduce preload by increase urine output. Yes, you do want to measure I&Os, but the question asks about complications not verifying the effectiveness of the regimen. Some HF drugs can lead the kidneys to hold on to K, as we discussed on an earlier slide but there is no mention of those drugs in this regimen so we don't need to educate on reducing K, rather, since they are on diuretics we need to watch for low K. Dig is antiarrhythmic drug, its being used here for the AFIB, it makes no sense to hold it for an irregular HR. This is a distraction option since we learned early in pharmacology class to auscultate the apical pulse for one minute and hold if less than 60 when giving dig. Patients with a heart transplantation are at risk for which of the following complications in the first year after transplantation (select all that apply)? A. Cancer B. Infection C. Rejection D. Vasculopathy E. Sudden cardiac death - CORRECT ANSWERB, C, E Cancer is not a complication of transplant. Infection risk is significant because these patients are on medications to help keep their body from rejecting the organ, this reduces their defenses to infection and can also mask early signs of infection. Rejection comes in different types and can happen early or late post transplant Vasculopathy is a complication of transplant but is not seen in the first year, this is seen later. Sudden cardiac death can occur in the event of graft failure, which tends to happen earlier post transplant Which assessment finding would the nurse expect to auscultate in a patient with mitral valve insufficiency? A. Harsh systolic murmur heard best at the right upper sternal border B. Rumbling diastolic murmur heard best at the left lower sternal border C. Holosystolic murmur heard best at the cardiac apex D. Mid-systolic click and soft diastolic murmur at the right lower sternal border - CORRECT ANSWERC Mitral insufficiency or regurgitation is characterized by a holosystolic murmur at the apex. Think back to your pneumatic devices from the previous slide Which of the following is a risk factor for a deep vein thrombosis (DVT)? A. Decreased thyroid stimulating hormone level B. Elevated liver function tests C. Hypocoagulability D. Dehydration - CORRECT ANSWERD. Dehydration A has minimal relevance, some studies have shown a potential link to two elevated liver enzyme values increasing a risk for VTE but it is not directly linked, hypocoagulapthy is a distractor to trick you into selecting it thinking it is hypercoagulability In a dehydrated state blood vessels narrow and blood becomes more concentrated, therefore creating an ideal situation for blood to pool and clot Virchow's Triad - stasis of blood flow, endothelial injury, hypercoagulability Dehydration can promote hypercoagulability Which are probably clinical findings in a patient with an acute VTE? SATA. A. Pallor and coolness of foot and calf B. Mild to moderate calf pain and tenderness C. Crossly diminished or absent pedal pulses D. Unilateral edema and induration of the thigh E. Palpable cord along a superficial varicose vein - CORRECT ANSWERB, D VTE will generally present as a warm, reddened, unilaterally swollen extremity with mild to moderate pain. A 50-year-old woman weighs 85kg and has a history of cigarette smoking, high blood pressure, high sodium intake, and sedentary lifestyle. When developing an individualized care plan for her, the nurse determines that the most important risk factors for peripheral artery disease that need to be modified are: A. Weight and diet B. Activity level and diet C. Cigarette smoking and high blood pressure D. Sedentary lifestyle and high blood pressure - CORRECT ANSWERC. Cigarette smoking and high blood pressure These really all need to be addressed but smoking most of all, especially combined with high BP A patient is admitted with peripheral artery disease. The nurse would expect to observe which of these findings in the affected lower extremity? A. Hypersensitivity to touch B. Brown pigmentation C. Pallor when elevated D. Bounding pulse - CORRECT ANSWERC. Pallor when elevated Pallor when the leg is elevated is a symptom of peripheral artery disease, compared to the brown pigmentation seen peripheral vein disease. Neither PAD or PVD will present with a bounding pulse, though pulses may be difficult to find in PAD due to poor perfusion or in PVD due to edema. Generalized pain to the touch will not be specific to either of them. In planning care and patient teaching for the patient with venous leg ulcers, the nurse recognizes that the most important intervention in healing and control of this condition is: A. Sclerotherapy B. Taking horse chestnut extract daily C. Using moist environment dressings D. Applying graduated compression stockings - CORRECT ANSWERD. Applying graduated compression stockings Compression hose will be utilized for patients with PVD but not PAD. Sclerotherapy is a treatment for varicose veins, moist dressings might be recommended but not as important as compression socks, horse extract is not widely studied or proven. "Third-spacing" can cause which form of shock? A. Anaphylactic B. Hypovolemic C. Septic D. Cardiovascular - CORRECT ANSWERB. Hypovolemic Third-spacing = movement of fluid out of the vascular system into the interstitial areas, resulting in loss of fluid leading to hypovolemic shock A patient is prescribed simvastatin (Zocor). Which of the following is an adverse effect of Zocor that should be reported immediately? A. Muscle pain B. Blurred vision C. Urinary retention D. Gastrointestinal reflux - CORRECT ANSWERA. Muscle pain Muscle pain is an adverse effect of Zocor that should be reported immediately, since muscle pain can be an indication of rhabdomyolysis and ultimately kidney failure. In a patient with thrombocytopenia, which of the following assessment findings should be immediately reported to the physician? A. Blood pressure of 210/110 B. Heart rate of 90 C. Oxygen saturation of 95% D. Specks of blood in nasal discharge after vigorous blowing - CORRECT ANSWERA. Blood pressure of 210/110 I think this question could be applicable to really any disease. A is a medical emergency regardless of the background where as the other choices are normal ranges and findings. These patients are at risk for hemorrhagic complications so elevated BP will only increase that risk. A 18-year-old male is admitted after a motor-vehicle accident with air-bag release. He complains of chest tightness and is restless and anxious. Heart sounds are barely audible on auscultation. The patient is most likely experiencing what condition? A. Cardiac tamponade B. Acute myocardial infarction C. Pulmonary edema D. Aortic aneurysm - CORRECT ANSWERA. Cardiac tamponade We know that this patient sustained trauma to the chest. Cardiac tamponade occurs when there is fluid build up around the heart that applies pressure to the heart and impairs its ability to pump adequately. This can happen with trauma or uncontrolled bleeding from an open heart procedure. Signs and symptoms include chest pain and pressure, muffled heart tones, shortness of breath, and jugular vein distention Immediately following soft tissue injury, the doctor prescribes treatment that follows the acronym "RICE," which stands for: A. Rest, immobilization, compression, exercise B. Relax, ice, conserve energy, elevation C. Rest, ice, compression, elevation D. Rigid fixator, immobilization, compression, exercise - CORRECT ANSWERC. Rest, ice, compression, elevation [Show Less]
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Ambulatory Care Nursing Certification review 54 Questions with Verified Answers,100% CORRECT
Ambulatory Care Nursing Certification review 54 Questions with Verified Answers What documents primarily defines the scope of telehealth nursing pract... [Show More] ice - CORRECT ANSWER Nurse State Practice Acts In School Age Children with acute vomiting, rehydration therapy might include which of the following - CORRECT ANSWER half-strength sports drinks and popscicles Which of the following are signs of volume overleoad in a chronic heart failure patient - CORRECT ANSWER Edema, Dyspenea, Neck vein distension, sudden weight gain Joshua is a 5 year old with siclke cell disease. his mother called to report that Joshua has a fever over 101.5 orally. The nurse should: - CORRECT ANSWER tell the mother to bring Joshua in right away to be evaluated. The following are elements of Dieteary Approches to Stop hypertension (DASH) - CORRECT ANSWER Low Cholesterol and toal fat, reducted sweets, high fiber Untreated Hypertension may lead to - CORRECT ANSWER organ damage in the eyes? Promoting advocacy and positive patient/family relations includes - CORRECT ANSWER Providing service recovery processes that resolve patient/family complaints or concerns Which of the following scenarios potentially violates the confidentiality of a patient's protected health information - CORRECT ANSWER Talking to an elderly patient's daughter about the need to bring the patient back for another appointment because tests came back with some abnormalities Activities taht require ambulatory nurses to apply critical thinking include - CORRECT ANSWER Analyzing information in development of a diagnosis and plan of care Which organization has established criteria for accepted nursing languages and approves languages meeting the criteria - CORRECT ANSWER American Nurses Association Federal and state laws require public health reporting in which of the following situations - CORRECT ANSWER Diagnosis of a serious communicable disease Decision support tools, such as prototcols, guidelines or algorithms, generally have the following characteristics - CORRECT ANSWER They provide standardization and decrease omissions The Ambulatory Care Nursing Conceptual Framework is a diagram that specifies - CORRECT ANSWER Concepts that form the focus of nursing practice and the relationship among those concepts The purposes of nursing practice standards include - CORRECT ANSWER Serve as a guide for the structure and processes in the delivery of nursing care Which of the following is true about delegation by a registered nurse - CORRECT ANSWER The delegating nurse remains ultimately responsible for the service Which of the following would be a semi-critical item and require high level disinfection - CORRECT ANSWER and endoscope used for upper gastroenterological procedures Primary prevention of Human Immunodeficiency Virus and other sexually transmitted diseases would include the following - CORRECT ANSWER A) Use of Condoms and avoidance of anonymous partners. B) Vaccination against herpes, hepatitis, and menigococcal infections, C) Prophylactic antibiotics or any oral sex D) Annual Health Screenings Mr. McIntire is a 37 year old patient who has a 25 a pack-year history of smoking. Today he has told his physician that he is ready to quit, and Ryan, the ambulatory care nurse, has been asked to assist Mr. McIntire. Which of the following describes a potential method to assist this patient to quit smoking? - CORRECT ANSWER A) Explain that relapsing is part of the process B) Advise Mr. McIntire about the harms of smoking, which impact nearly every organ in the body C) Set specific goals and a quit date D) Use motivational interviewing to help him understand his ambivalence about quitting The nurse is educating an adult patient regarding medications for asthma. Which order would be most appropriate for administration? - CORRECT ANSWER Telephone triage may be a responsibility of the ambulatory care nurse. What are the appropriate components of telephone triage? - CORRECT ANSWER What are the best question types to ask when gaining information from a patient? - CORRECT ANSWER In what order would the nurse prioritize the care of the following patients presenting to the clinic at the same time: a parent carrying a smiling infant with a fever, a pale and sweaty male with flank pain for tow days, a carpenter with a nail in his thumb, and a three year old with vomiting? - CORRECT ANSWER Mom has described her child's symptoms as a fever for three days and vomiting for the last 24 hours. She states the child has been very sleepy for the last two to three hours. What subtle symptom alerts the nurse that this child needs to be seen as soon as possible. - CORRECT ANSWER The ambulatory care nurse takes a phone call from the daughter of a 60 year old male stating that he isn't himself today. When questioned further, the nurse discovers that the man has had periods of slurred speech for a few minutes on two occasions in the last 24 hours. What is your recommendation for this caller regarding what should be done for her father? - CORRECT ANSWER A 70 year old female prsents to the ambulatory care clinic complaining of fatigue. You begin your triage assessment and she has a heart rate of 50, a repsiratory rate of 24, and a blood pressure of 70/40. She denies chest pain, but you notice she rubs her elbows and states her arthritis is acting up. What would be your first priority when caring for this patient? - CORRECT ANSWER A mother presents to the ambulatory clinic with a very wheezy three year old in her arms. You notice the child is pale and listless. What is your immediate response? - CORRECT ANSWER What nonverbal clues would indicate that a patient of any age is having difficulty breathing? - CORRECT ANSWER What would be the most appropriate order of importance for information an adult client shares when coming to a clinic visit? - CORRECT ANSWER A 50 year old male comes to the clinic stating he cannot shake this "flu". You observe that he is clammy, plae, and has an irregular heart rate. He is a large man with a rugged appearance. He is friendly and apolgetic for bothering you with his silly complaints. What is your plan of care for this patient? - CORRECT ANSWER The ambulatory care setting must include which of the following for the nurse to be able to properly triage a patient? - CORRECT ANSWER The nurse working in the ambulatory care setting must have which of the following skills to perform the role of triage nurse? - CORRECT ANSWER The triage nurse is responsible for screening, assesment, and the initial patient contact in the ambulatory care setting. It is important to look for verbal and nonverbal clues when doing a triage assessment. What important information should the triage nurse screen for with every patient on every health visit, regardless of complaint? - CORRECT ANSWER What is the most appropriate way to ask a patient about possible physical abuse during the triage process? - CORRECT ANSWER Which invasive procedures would a nurse in the ambulatory care setting be expected to perform as part of his or her scope of practice? - CORRECT ANSWER An adult male presents to the ambulatory care setting with a 24 hour history of wheezing, coughing, and shortness of breath. What would be the most appropriate invasive procedure that he may require from the nurse in this setting? - CORRECT ANSWER Which noninvasive procedure is part of a routine school physical for students in kindergarten that can be performed in the ambulatory care setting? - CORRECT ANSWER Which ambulatory care team member may be responsible for sterilization or disinfection of the equipment in a clinic setting? - CORRECT ANSWER Describe the process of protecting the privacy of the patient during a non invasive procedure, such as and EKG - CORRECT ANSWER An 18 year old female presents to the ambulatory care clinic complaining of pelvic pain and foul discharge. What would be the most appropriate nursing interventions for this patient? - CORRECT ANSWER What best describes the advantages of doing on site testing for patients, such as glucose monitoring, urine tests, rapid strep cultures, or blood tests to diagnose flulike symptoms? - CORRECT ANSWER What would be the result of improper sterilization or disinfection of equiptment in the ambulatory care setting? - CORRECT ANSWER What should the nurse understand about the physical assessment of a patient in the ambulatory care setting? - CORRECT ANSWER A parent brings her teenage son into the ambulatory care facility stating that he has been wheezing for a day or two with no history of asthma. The boy does not appear to be in distress but does have an audible wheeze. What non invasive procedure might a nurse consider as part of the physical assessment? - CORRECT ANSWER The nurse in the ambulatory care setting is caring for a young mother and her toddler. Which statment demonstrates that primary prevention is part of the role of the ambulatory care nurse? - CORRECT ANSWER A nurse working in the ambulatory care setting is offering patient education to a 50 year old male client. Which statement demonstrates an understanding of the meaning of secondary prevention? - CORRECT ANSWER The nurse in the ambulatory care setting is triaging a teen with a fever, sore throat, and rash. Which statement correctly demonstrates a clear understanding of treatment planning and implementation? - CORRECT ANSWER What disease entitiy/client would respond best with a consistent continuity of care over a longer length of time? - CORRECT ANSWER That types of ancillary testing or consultations may the ambulatory care nurse need to coordinate for a client who first appears for treatment in the ambulatory care setting? - CORRECT ANSWER Which client/incident presenting to an ambulatory care facility may need to be referred to another facility as part of the appropriate treatment and implementation? - CORRECT ANSWER Which statement correctly demonstrates the responsibility of the nurse to a chronically ill patient? - CORRECT ANSWER Which statement best describes understanding the role of ambulatory care nursing in the cost of care for clients? - CORRECT ANSWER Which statement demonstrates the nurse using outside resources when providing client care? - CORRECT ANSWER A nurse refers a client to the community hospital education program for new diabetics. Which category of care management does this fall under? - CORRECT ANSWER The nurse practicing in an amublatory care setting understanding that performance improvement becomes part of the responsibility of the health-care team. Which item would be a performance improvement indicator for an ambulatory care facility and the health-care team? - CORRECT ANSWER [Show Less]
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Ambulatory Care Nurse Certification Exam (ANCC) 170 Questions with Verified Answers,100% CORRECT
Ambulatory Care Nurse Certification Exam (ANCC) 170 Questions with Verified Answers The Ambulatory care Nurse is triaging a client whose chief complaint... [Show More] is chest pain. What is a priority action for the nurse to take? A. Complete full head to toe B. Administer ASA C. Perform Electrocardiogram (ECG) D. Call 911 - CORRECT ANSWER C. Perform an Electrocardiogram Which of the following is essential for the ambulatory care nurse to remind the client of when performing an Electrocardiogram? A. Take a deep breath during the test B. Hold you breath during the test C. Try not to move during the test D. You may keep your bra on during the test - CORRECT ANSWER C. Try not to move during the test The Ambulatory Care nurse is assessing a client. Which of the following questions will yield more information from the client? A. Are you feeling pain? B. What brought you in today? C. How many Children do you have? D. When was your last menstrual period? - CORRECT ANSWER B. What Brought you in today? The ambulatory care nurse is conducting an annual assessment of a client. The client denies frequent urination, blurry vision, excessive thirst or hunger. The clients Blood sugar is 500mg/dl by finger stick. What should the nurse do next? A. Transport client to the ER B. Notify the healthcare provider immediately C. Retest the Blood glucose D. Order a Hemoglobin A1c - CORRECT ANSWER C. Retest the blood glucose Which of the following laboratory test is most effective in monitoring a client with DM blood glucose level? A. Urine Glucose Level B. Glucometer blood glucose testing C. Hemoglobin A1C D. Creatinine Levels - CORRECT ANSWER C. Hemoglobin A1C The client complains of sporadic Abnormal heart rate. An ECG performed showed Normal Sinus rhythm. Labs were WNL and assessment revealed no cardiovascular abnormalities. Which of the following should the nurse anticipate the healthcare provider will order? A. Halter Monitoring B. Admission to the hospital C. Continuous EEG D. Chest X-ray - CORRECT ANSWER A. Halter Monitoring The Ambulatory care nurse is preparing the client for the application of a Holter monitor. Which information is vital for the nurse to give the client? A. Check blood glucose during halter monitoring B. Maintain normal diet and exercising C. Avoid Microwaves and the use of cell phones D. Reduce exercise routine - CORRECT ANSWER B. Maintain normal Diet and exercise The Ambulatory care nurse is assessing a new graduate nurses' understanding of the importance of getting clients height and weight before chemotherapy. Which statement indicates they understand ? A. Height and weight are seldom required B. height and weight are only needed when the chemotherapy regimen is changed C. Height and weight are needed to calculate the correct dosage of chemotherapy D. The chemotherapy dose will remain the same, even if there is an increase in the amount of eight lost. - CORRECT ANSWER C. Height and weight are needed to calculate the correct dosage of chemotherapy. The Ambulatory care nurse is performing a guaiac fecal occult blood test (gFOBT), Which of the following would indicate a positive result? A. Green reaction B. Red reaction C. Blue reaction D. Yellow reaction - CORRECT ANSWER C. Blue reaction The nurse in the Medical oncology clinic is assessing a client who is undergoing chemotherapy. The nurse obtained an oral temp of 102 degrees. which statement by the nurse indicates an understanding of the clients' condition? A. Since the client is feeling "ok" there is no further intervention B. A temp of 102 is an expected finding after chemotherapy C. Cal the MD to obtain an order of Tylenol as soon as possible D. The client is post chemo and at risk for neutropenia fever. This is an emergency and requires stat ABX or hospitalization - CORRECT ANSWER D. The client is post chemo and at risk for neutropenia fever. This is an emergency and requires stat ABX or hospitalization The Ambulatory care nurse is performing a physical assessment on a child who underwent chemotherapy. Which statement by the client indicates that further evaluation is needed? A. I ate my entire meal B. My ears are ringing C. I play with my rother everyday D. Sometimes I am tired - CORRECT ANSWER B. My ears are ringing The ambulatory care nurse is scheduling the client for gFOBT. Which statement made by the client indicates that teaching was effective? A. This is an invasive test B. I will not eat Mushrooms for 48-72 hours C. I can take ASA if I am having a headache D. I will reduce my fiber intake - CORRECT ANSWER B. I will not eat Mushrooms for 48-72 hours Prioritization is an important aspect of the ambulatory care nurse's time management plan. Which of the following clients would the nurse see first? A. A client with a BS of 150mg/dl and is asymptomatic B. A client who complains of blood in urine 24hours POP TURP C. A client with a blood pressure of 140/89 and is asymptomatic D. A client in her 3rd trimester and has signs of preterm labor. - CORRECT ANSWER D. A client in her 3rd trimester and has signs of preterm labor. A client informed the ambulatory care nurse that the internet is very helpful to her when reviewing health information. Which actin is appropriate for the nurse to take? A. Encourage the client to continue her independence by taking her health in her own hands. B. Educate the client on credible websites and the importance of protecting private information C. Do nothing. The client is knowledgeable about using the internet. D. Document the clients response in the chart. - CORRECT ANSWER B. Educate the client on credible websites and the importance of protecting private information Which of the following strategies is appropriate when facilitating conflict resolution? A. Choose a side as soon as possible B. Refrain from judging C. Use minimal choices and options to reach a speedy solution D. Blame the guilty party - CORRECT ANSWER B. Refrain from judging The ambulatory care nurse is working with a healthcare organization that is seeking Magnet recognition. Which of the following activities by the nurse is the best supporting evidence in the Magnet application process A. Being the charge nurse in the clinic B. Participating in the nurses week celebration C. Advancing to RN2 on the clinical ladder D. Being the chairperson of the evidenced based council committee - CORRECT ANSWER D. Being the chairperson of the evidenced based council committee There are three ethical principles for human research. Which of the following means the client has the right to elf determination? A. Respect B. Justice C. Beneficence D. Non maleficence - CORRECT ANSWER Which of the following organizations is responsible for evaluating proposed research studies prior to their commencement? A. Centers for disease control and prevention B. Department of Health and Human services C. Institution Review Board D. Office of Disease prevention and Health Promotion - CORRECT ANSWER C. Institution Review Board According to the Joint Commission standard, when should the initial assessment of the nurse competencies be conducted in a health care setting? A. During the orientation process B. Prior to the orientation process C. During Nursing school D. After the orientation process - CORRECT ANSWER A. During the orientation process The purpose of using Scope and Standards of Practice for Ambulatory Care Nursing includes which if the following? A. Use a guide to provide quality of care B. Use to prevent law suits C. Use to increase the income of the facility D. Use to train nurses - CORRECT ANSWER A. Use a guide to provide quality of care The ambulatory care nurse is teaching a client ho to change their wound dressing. Which of the following indicates emotional readiness to learn? A. The client accepts the need to learn the new skill B. The client has the psychomotor function to change the dressing C. The client is a wound care medical MD D. The client has dressed his/her own wound in the past - CORRECT ANSWER A. The client accepts the need to learn the new skill To educate the client the ambulatory care nurse needs a systematic and planned process that consists of teaching and learning. Which of the following factors could influence the education process? A. Culture B. Learner's readiness C. Gender D. Socio-Economic Status - CORRECT ANSWER B. Learner's readiness The Ambulatory care nurse is discharging a 10-year-old child from the pediatric clinic. To whom should the nurse given the discharge teaching? A. The Child B. The mother C. Both the child and the caregiver D. the grandparents - CORRECT ANSWER C. Both the child and the caregiver The ambulatory care nurse is caring for a Native Hawaiian whose choice of food intake, health and wellbeing perception can pose barriers to life style modification. To be effective in getting the client to participate in dietary modification, which of the following steps should the nurse take? A. Give the client a brochure B. Teach the client about nutrition from a family framework perspective C. Give the client the web address for the dietary information D. Recommend a specific diet regimen - CORRECT ANSWER B. Teach the client about nutrition from a family framework perspective The Ambulatory care nurse is working in the client with a variety of clients from different racial and ethnic groups. When providing care, the nurse should know which group has the highest asthma prevalence of any racial/ethnic group in the USA? A. Hispanics B. Caucasian C. African Americans D. Asian - CORRECT ANSWER C. African Americans The Joint commission requires accredited healthcare organizations to develop and use a list of abbreviations that should not be used. Which of the following if documented by the ambulatory care nurse indicate understanding of the "Do not Use" list? A. QD B. U C. Unit D. IU - CORRECT ANSWER B. U A client fell in the clinic during the intake process. The ambulatory care nurse is documenting the occurrence. Which of the following indicates proper documentation of the incident? A. Document the incident in the patients chart B. Make no mention of the fall in the clients charts C. Report it the the risk management and they will document the incident D. Document the occurrence of the fall in the organization's incident reporting system - CORRECT ANSWER D. Document the occurrence of the fall in the organization's incident reporting system Which of the following actions should the ambulatory care nurse implement for a client who presents tot he clinic with chest pain? A. Refer the client immediately to the ER B. Take vital signs and obtain ECG C. Take detailed history D. Call the EMS for transport - CORRECT ANSWER B. Take vital signs and obtain ECG Which of the following is used to determine the type and the numbers of staff needed in an ambulatory clinic? A. Only the volume of client B. Nurses; years of experience C. Nurses college degree D. The complexity and the number of clients - CORRECT ANSWER D. The complexity and the number of clients Which action by the ambulatory care nurse indicates that he/she is compliant with the client self-determination Act? A. Asking the client if they have a Advanced Directives B. Completing a head to toe assessment C. Reviewing the clients care plan D. Complying with the client's right to refuse medication - CORRECT ANSWER A. Asking the client if they have a Advanced Directives Which of the following medications does the ambulatory care nurse anticipate the MD will prescribe for a client with chronic Asthma for long-term treatment A. Fluticasone (Flovent) B. Albuterol ( Ventolin) C. Ipratropium (Atrovent) D. Levalbuterol (Xopenex) - CORRECT ANSWER A. Fluticasone (Flovent) The Ambulatory care nurse asses a client with Shortness of breath, lack of energy, and dry mouth. Which of the following disease should the ambulatory care nurse suspect? A. COPD B. Congestive Heart Failure C. Asthma D. Respiratory Failure - CORRECT ANSWER A COPD The parent of an eight year old child reports that the child cannot efficiently use the metered dose inhaler. Which of the following actions should the nurse take? A. Give the child a nebulizer B. Give the child a spacer C. Recommend discontinuation of the medication D. Inform the parent that the medication is not important - CORRECT ANSWER B. Give the child a spacer The ambulatory care nurse is formulating a research question using the PICO format. the "C" in PICO stands for which of the following? A. Comparison B. Characteristics C. Culture D. Cure - CORRECT ANSWER B. Characteristics PICO (T) Format - CORRECT ANSWER Formula for creating answerable research questions. P: Population/patient - age, gender, ethnicity, individuals with a certain disorder I: Intervention/indicator (Variable of Interest) - exposure to a disease, risk behavior, prognostic factor C: Comparison/control - could be a placebo or "business as usual" as in no disease, absence of risk factor, Prognostic factor B O: Outcome - risk of disease, accuracy of a diagnosis, rate of occurrence of adverse outcome T: Time - the time it takes for the intervention to achieve an outcome or how long participants are observed The ambulatory care nurse is teaching a client how to use the peak flow meter. Which statement indicates that teaching was effective? A. I Should move the indicator to the bottom of the number scale before suing the meter B. I Should blow out as slowly as possible C. I should blow multiple time in a meter during a single test D. I should lie down when using the meter - CORRECT ANSWER A. I Should move the indicator to the bottom of the number scale before suing the meter Which of the following if noted in the clients urine analysis would require further actions? A. Protein B. Bacteria C. Bilirubin D. White Blood Cells. - CORRECT ANSWER C. Bilirubin The client is being scheduled for a lower gastrointestinal study using double-contrast barium enema. Which of the following should be included in the clients teaching? A. The procedure will take 6 hours B. Have a low residual diet 1-2 days before the procedure C. Decrease fluid intake after the procedure D. East a light meal the night before the procedure. - CORRECT ANSWER B. Have a low residual diet 1-2 days before the procedure The ambulatory care nurse reviews the clients lab results and notices that the creatinine is mg/dl. What action should the nurse take? A. Notify the healthcare provider immediately B. Collect urine ample C. Do nothing, The result is WNL D. Administer diuretics - CORRECT ANSWER C. Do nothing, The result is WNL A client wit a DX of bipolar disorder is being seen in the clinic. The healthcare provider prescribed Lithium. Which of the following is important for the ambulatory care nurse to teach a client? A. You can breast feed while taking the medication B. Low Sodium level can lead to toxicity C. Minimize fluid intake D. There is no need to use contraceptives while on this medication - CORRECT ANSWER B. Low Sodium level can lead to toxicity Which of the following statements if reported to the ambulatory care nurse indicates that the treatment for a client with CHF needs to be modified? A. The client gains 1 pound in hours B. The client now sleeps sitting up C. The clients BP is / D. Increased Activity tolerance. - CORRECT ANSWER B. The client now sleeps sitting up With the implementation of telemedicine, the method of triaging has changed. What components would an ambulatory care nurse utilize when triaging using the telephone? A. Take a quick and accurate history in order to make an accurate decision B. HIPPA law does not allow client to call ambulatory care facility with health issues C. Call 911 as soon as the client states there is a problem D. Give information that is general that can be applied to most clients. - CORRECT ANSWER A. Take a quick and accurate history in order to make an accurate decision The ambulatory care nurse is assessing a client. Which questions should the nurse ask to assess the clients health goals? A. It seems to me that you want to be healthy, Is that true? B. What are your health goals? C. Do you want to be healthy? D. Do you exercise? - CORRECT ANSWER B. What are your health goals? The ambulatory care nurse is caring for an elderly client. The nurse caring for the client should know what about elder abuse? A. All victims of elder abuse are victims of poly-victimization B More than 3 in 5 victims are men and 75 years or older C. Elder abuse can be the result of intentional or unintentional neglect D. elder abuse is not an issue, the nurse should not be concerned about. - CORRECT ANSWER C. Elder abuse can be the result of intentional or unintentional neglect The ambulatory care nurse is caring for a 30 year old married woman in the clinic who was accompanied by her husband. Upon assessment, the nurse noted bruises on the clients arm. What action should the nurse take? A. Conduct further assessment without the clients husband in the room. B. Ask both the husband and the client what happened C. Call 911 D. Inform the client to leave her husband for safety - CORRECT ANSWER A. Conduct further assessment without the clients husband in the room. When coding for visits of new patients, the key component that must be included to document the correct level of evaluation and management (E/M) are: A. History, physical and medical decision making B. Physical exam and medical decision making C. History and physical exam D. Age, DX, and medical decision making - CORRECT ANSWER A. History, physical and medical decision making If a patient is trying to make an informed decision about whether to have surgery or more conservative treatment for prostate cancer and asks the ambulatory care nurse for advise on making the decision, the nurse should: A. Advise the patient on the best course of treatment B. Suggest the patient carry our research before deciding C. provide the patient with print and online resources D. Advise the patient to ask the physician for more information - CORRECT ANSWER C. provide the patient with print and online resources An Ambulatory care center has analyzed the type of patient complaints and finds there are four complaints that are most common ( delays, rescheduling, difficulty scheduling and parking) but not easily solvable and that staff members handle these complaints in different manners. The service recovery program should begin by: A. Posting signs apologizing for these problems B. Warning patients in advanced that these problems may occur C. Providing patents with complaint forms D. Establishing protocols for dealing with complaints - CORRECT ANSWER D. Establishing protocols for dealing with complaints If a patient is to have an arthrodesis and injection of corticosteroid into the right knee and the ambulatory care nurse is setting up equipment, the correct needle gauge syringe sizes are: A. 18G needle and 10-20ml syringe B. 20G needle and 20ml syringe C. 16G needle and 10-20ml syringe D. 19g needle and 50ml syringe - CORRECT ANSWER A. 18G needle and 10-20ml syringe The coding system that is used for outpatient procedure claims is: A. ICD-10-PCS B. HCPCS/CPT C. ICD-10-CM D. ICD-9 - CORRECT ANSWER B. HCPCS/CPT The issue of licensure portability is especially a concern with: A. Outreach programs B. Collaboration among medical facilities and programs C. Telemedicine D. Recruitment of healthcare personnel - CORRECT ANSWER C. Telemedicine If a leader wants to influence others in an organization to change attitudes, the first step is to: A. Provide incentives to change B. Outline disciplinary actions for failure to change C. Outline the desired change D. Model the desired change - CORRECT ANSWER D. Model the desired change When conducting a urine permanency test, the specimen should be: A. First voided in AM B. Second voiding the AM C. Obtained after the patient drinks 8 oz of liquid D. Obtained any time - CORRECT ANSWER A. First voided in AM In a crisis situation which decisions must be made quickly and effectively, the most effective leadership style is probably: A. Democratic B. Laissez-faire C. Authoritarian D. Bureaucratic - CORRECT ANSWER C. Authoritarian The ambulatory care nurse is preparing electronic educational material to be viewed over the internet and plans to include both deep links to articles and inline links to images from commercial sites. The nurse should: A. Include the links as desired B. Ask permission to utilize links C. Provide a works cited list D. Provide the course link in the text - CORRECT ANSWER B. Ask permission to utilize links With problem based learning, the role of the instructor is that of: A. Leader B. Lecturer C. Observer D. Facilitator - CORRECT ANSWER A. Leader If delegating a task to staff person, the first issue to consider is whether the: A. Task is suitable for the individual B.. Individual has time to carry out the task C. Individual can be adequately supervised D. Individual wants to carry out the task - CORRECT ANSWER A. Task is suitable for the individual A family practice physician's office schedule is usually fully booked with patients scheduled every 15 minutes, but the MD routinely adds patients who have acute needs to the schedule resulting in delays in seeing patients, unpaid staff OT and staff complaints. The best solution for the nurse manager may be to: A. Schedule staff later in the day B. Suggest referring patient to ED C. As for payment for any OT D. Leave open slots in the schedule - CORRECT ANSWER D. Leave open slots in the schedule When conducting a test for the erythrocyte sedimentation (ESR) rate using the Sediplast kit rack, after the blood in the Sediplast tube is inserted into the vial, the results should be checked in: A. 10 min B. 30 min C. 60 Min D. 90 min - CORRECT ANSWER C. 60 min If a patient comes to the ambulatory care center with a 1inch gash on he left foot from a dog bite, the initial response should be to: A. Wash the wound area with soap and water B. Irrigate the wound with -ml of NS C. Irrigate the wound with - ml of hydrogen peroxide D. Soak the foot in povidone-iodine/NS (50/50) solution - CORRECT ANSWER D. Soak the foot in povidone-iodine/NS (50/50) solution If one of the patients nursing diagnosis on the care plan is "Self care deficit" which of the following is an appropriate desired outcome? A. The patient will achieve maximal physical activity B. The patient will perform self care within physical limitations and activity restrictions C. The patient exhibit increased ability to engage in activities D. The patient will need no assistance with persona care - CORRECT ANSWER B. The patient will perform self care within physical limitations and activity restrictions If the ambulatory care nurse is interviewing an adolescent patient with autism spectrum disorder and the patient states at the wall and repeatedly states, "You don't want to be here," this likely means that the patient: A. Senses the nurse doesn't want to be there B. Wants the nurse to leave C. Doesn't want to be there D. Is just repeating a random phrase - CORRECT ANSWER C. Doesn't want to be there An ambulatory surgery center that has received accreditation and deemed status from the Joint Commission: A. Does not need to undergo the CMS certification process B. Must still undergo the CMS certification process C. Must undergo an abbreviated CMS certification process D. Can opt to pay a fee rather than undergo CMS certification - CORRECT ANSWER A. Does not need to undergo the CMS certification process If the Ambulatory nurse is carrying out a point of care rapid HIV test on a patient, the nurse should: A. Advise the patient that the test is simply routine B. Remind the patient of the right to refuse test C. Tell the patient not to worry because most test are negative D. Discuss the implications of the test with the patient first. - CORRECT ANSWER D. Discuss the implications of the test with the patient first. According to the CDCs infection prevention and control assessment tool for outpatient settings, the organization's written infection prevention policies and procedures should be reassessed at least every: A. month B. 6 months C. 12 months D. 24 Months - CORRECT ANSWER C. 12 months If a physician is registered as a Vaccines for Children's (VFC) provider and plans to administer vaccines to four patients, which of the following patient would be eligible for the program? A. 6 year old whose health insurance is provided by Medicaid B. a 19 year old AA patient C. A 13 year old with insurance coverage for vaccines D. A 3 year old Polynesian patient with insurance but unpaid deductible - CORRECT ANSWER A. 6 year old whose health insurance is provided by Medicaid If an office practice has 3 FTE physicians, approximately how many FTE support staff persons are likely to be necessary? A. 5 B. 10 C. 15 D.20 - CORRECT ANSWER C. 15 ( 1 FTE physician requires 4.5-5.5 support staff) [Show Less]
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ANCC nursing certification Exam 262 Questions with Verified Answers,100% CORRECT
ANCC nursing certification Exam 262 Questions with Verified Answers ANA definition of NI (2008) - CORRECT ANSWER Nursing informatics is a specialty that... [Show More] : A. integrates nursing science B. Computer science C. Information science to manage and communicate: 1. Data 2. Information 3. Knowledge and 4. Wisdom in nursing practice NI Supports: a. consumers b. patients c. nurses d. other providers in their decision-making in all roles and settings. This support is accomplished through: i. use of information structures ii. information processes iii. information technology What year did the ANA identify NI as a nursing specialty? - CORRECT ANSWER 1992 When was the first scope of practice statement for NI published? - CORRECT ANSWER 1994 ANA definition of NI - CORRECT ANSWER Specialty that integrates nursing science with multiple informative and analytical sciences to identify, define , manage and communicate data information, knowledge, and wisdoms in nursing practice What are the foundations of practice - CORRECT ANSWER A. Professional practice B. Methodologies & Theories C. Rules, regulations, & requirements D. Interprofessional collaboration ANA definition of NI (2015) - CORRECT ANSWER NI is a specialty that integrates nursing science with multiple information and analytical sciences to: A. Identify B. Define C. Manage and D. Communicate data, information, knowledge, and wisdom in nursing practice NI supports: 1. Nurses 2. Consumers 3. Patients 4. Users 5. Interprofessional healthcare team 6. Other stakeholders in their decision-making roles and settings to achieve desired outcomes This support is accomplished through the use of: a. information structures, b. information processes, and c. information technology Tenents (beliefs) of Nursing Informatics - CORRECT ANSWER 1. A unique body of knowledge, preparation, and experience that aligns with the nursing profession. 2. Involves the synthesis of data & information into knowledge & wisdom 3. Supports decision-making of healthcare consumers, nurses, and other professionals achieve healthcare consumer safety and advocacy 4. Supports data analytics, including quality of care measures, to improve population health outcomes and global health 5. Promotes data integrity and the access and exchange of health data for all consumers of health information 6. Supports national and international agendas of interoperability and the efficient and effective transfer and delivery of data, information, and knowledge 7. Ensures that collaboration is an integral characteristic of practice 8. Interleaves user experience and computer-human interaction concepts throughout practice 9. Incorporates key ethical concerns of NI such as advocacy, privacy, and assurance of the confidentiality and security of data and information 10. Considers the impact of technological changes on patient safety, healthcare delivery, quality, reporting, and the nursing process 11. Leads in the design and promotion of useful, innovative information technologies that advance practice and achieve desired outcomes(Scope & Standards ) When was the ANA Standards of Practice for NI released? - CORRECT ANSWER 1995 When was the scope and standards of NI practice released combining both scope and standards of practice? - CORRECT ANSWER 2001 then updated in 2008 What are analytical sciences? - CORRECT ANSWER A listing of sciences that integrate with NI includes: 1. computer science 2. cognitive science 3. science of terminologies and taxonomies (including naming and coding conventions) 4. information management 5. library science 6. heuristics 7. archival science 8. mathematics What are the NI competencies for all RNs? - CORRECT ANSWER TIGER-Technology informatics guiding education reform identified that all nurses in every role must be prepared to make HIT. TIGER formed an informatics competency collaborative which defines the competencies recommended for the NI discipline: 1. Basic computer skills 2. Information literacy 3. information management According to Staggers, Gassert, Curran 2002, what are the levels of informatics competencies? - CORRECT ANSWER 1. Beginning nurse 2. Experienced nurse 3. Informatics nurse specialist 4. Innovator Name some additional competencies - CORRECT ANSWER 1. Pierce, Tanner, & Pravikoff (2005) information literacy 2. Telehealth competencies (ATA, ICN) 3. Genetics & genomics competencies 4. National league for nursing 5. Amer Assoc of College of Nurses 6. Forecasting informatics competencies for nurses in the future of connected health IOS Press 2017 Name the types of roles - CORRECT ANSWER 1. Project manager 2. Decision support/outcomes 3. Educator 4. Product developer 5. Systems analyst 6. Consultant 7. Programmer 8. Advocate/policy developer 9. Web developer 10. CIO/CNIO 11. Entrepreneur 12. Researcher 13. Sales and Marketing 14. Consumer advocate What are the functional areas: Informatics nurses - CORRECT ANSWER 1. Administration, leadership, & management 2. Systems analysis & design 3. Compliance & integrity management 4. Consultation 5. Coordination, facilitation, & integration 6. Development 7. Educational & professional development 8. Genetics & genomics 9. Information management/operational architecture 10. Policy development & advocacy 11. Quality & performance improvement 12. Research & evaluation 13. Safety, security & environmental health What are the standards of nursing informatics Practice? - CORRECT ANSWER 1. Evaluates quality & effectiveness of NI practice 2. Performance appraisal 3. Maintains knowledge and NI competency-life-long learning 4. Contributes to the professional development of others 5. Bases decisions and actions on ethical principles 6. Collaborates with others 7. Contributes to the body of informatics research 8. 16 Standards are highlighted with measurement criteria What are the NI Standards of practice? - CORRECT ANSWER Standard 1: Assessment Standard 2: Diagnosis, Problems & Issues Identification Standard 3: Outcomes Identification Standard 4: PlanningStandard 5: Implementation Standard 6: Evaluation Standard 7: Ethics Standard 8: Education Standard 9: Evidence-Based Practice and Research Standard 10: Quality of Practice Standard 11: Communication Standard 12: Leadership Standard 13: Collaboration Standard 14: Professional Practice Evaluation Standard 15: Resource Utilization Standard 16: Environmental HealthADOPIEEEEQCLCPRE What makes up EBP? - CORRECT ANSWER 1. Literature searches 2. Clinical practice guidelines 3. Clinical protocols Boolean search Definition of EBP - CORRECT ANSWER *A problem-solving approach to clinical decision-making within a healthcare organization *Integrates best available scientific evidence with best available experience *Uses research & non-research evidence (ethical or personal) Evidence-Based nursing practice is the process: - CORRECT ANSWER By which nurses make a clinical decision using: 1. The best available research evidence 2. Their clinical expertise 3. Patient preferences Formulating answerable clinical questions is the foundation of EBP. - CORRECT ANSWER 1. Start with the patient: clinical problems & questions arise out of patient care 2. Translate the clinical questions into a searchable question using PICOT 3. Decide on the best type of study to address the question 4. Perform a literature search in the appropriate sources What is the PICOT model to support EBP - CORRECT ANSWER P-Population/condition I-Intervention C-Comparison O-Outcome T-Time of study What is the ACE Star Model of EBP (2004)? - CORRECT ANSWER 5 points of knowledge transformation: 1. Discovery 2. Summary 3. Translation 4. Integration 5. Evaluation NI support nurses, consumers, patients, interprofessional healthcare team, and stakeholders through the use of which three things? - CORRECT ANSWER 1. Information structures 2. Information processes 3. Information technology Name a Metastructure - CORRECT ANSWER DIK (Blum-1986) 1. Data 2, Information 3. Knowledge 4. WisdomDIKW (Graves & Corcoran-1989) What is Data? - CORRECT ANSWER Discrete entities that are described objectively with interpretation What is Information? - CORRECT ANSWER Data that have been: 1. Interpreted 2. Organized or 3. Structured What is Knowledge? - CORRECT ANSWER Information that is synthesized so that relationships are identified and formalized Focuses on what is known The appropriate use of knowledge involves? - CORRECT ANSWER Integration of empirical, ethical, personal, and aesthetic knowledge into actions What is Wisdom? - CORRECT ANSWER The appropriate use of knowledge to manage and solve human problems. It consists of knowing when and how to apply knowledge to deal with complex problems or specific human needs Focuses on the appropriate application of that knowledge and an appreciation of the consequences of selected actions Relationship of Data, Information, Knowledge, and Wisdom Nelson 2002 - CORRECT ANSWER Data - naming, collecting, and organizing Information - Organizing and interpreting Knowledge - Interpreting, integrating, and understanding Wisdom - Understanding, applying and applying with compassion NI is concerned with - CORRECT ANSWER Creation Structure Storage Delivery Exchange Interoperability Reuse of nursing and clinical information along the continuum of care. What is the informatics nurse specialist often responsible for? - CORRECT ANSWER Implementing or coordinating projects involving multiple professions and specialties Support other RNs to best use data, information, knowledge, and technology NIs support through the use of: - CORRECT ANSWER Information structures Information processes Information technology NIs Foci - CORRECT ANSWER Information user, information recipients, exchange data, information, knowledge, and wisdom Design, structure, interpretation, and representation of data, information, knowledge, and wisdom Design, develop, implement, and evaluate applications and technologies, ensuring their safety, quality, effectiveness, efficiency, and usability Standardized terminologies - CORRECT ANSWER Have become a significant vehicle for facilitating interoperability between different concepts, nomenclatures, and information systems What is the systems development life cycle (SDLC)? - CORRECT ANSWER *Standardized approach*Process for developing information systems in a: -deliberate -structured -methodical manner What are the four phases of the SDLC? - CORRECT ANSWER 1. Planning2. Analysis3. Design, Develop, Customize4. Implementation, Evaluate, Maintain, Support What is a project life cycle? - CORRECT ANSWER 1. Initiating2. Planning3. Execution4. ClosingMay be used in conjunction with the SDLC What is the Planning phase of the SDLC? - CORRECT ANSWER It is a foundational, fundamental and often longest phase (sets the stage for the project)*system requirements*feasibility study*project charter*project plan In the Planning phase of the SDLC, what are the system request components? - CORRECT ANSWER 1. Project sponsor2. Business need3. Business requirements4. Business value5. Special issues/considerations In the Planning phase of the SDLC, what are the feasibility analysis types? - CORRECT ANSWER 1. Technical, "can we build it?"2. Economic, "should we build it?"3. Operational, "if we build it, will they use it?" In the Planning phase of the SDLC, what are the elements of the project charter? - CORRECT ANSWER 1. Project champion2. Dates (start, milestones, end)3. Problems or opportunity statements (purpose/justification)4. Objectives (what we want to achieve)5. Key stakeholders6. Scope of the project7. Target benefit8. Budget In the Planning phase of the SDLC, what is a project charter? - CORRECT ANSWER 1. Draws from system requests2. Created by project sponsor or initiator (often delegated to the project manager or informatics nurse)3. Formally authorizes the existence of a project4. Authorizes project manager to apply organizational resources In the Planning phase of the SDLC, what are the goals assessment? - CORRECT ANSWER 1. Return on investment (ROI)-ratio of expected financial gains divided by the total costs2. Cost-benefit analysis (CBA). Attempt to quantify tangible and intangible items3. Tangible-improve revenue, decrease staff needed4. Intangible-increase in patient satisfaction In the Planning phase of the SDLC, what are the tools used? - CORRECT ANSWER System Selection & Implementation: -customer site visit -surveys -RFI/RFP -Gap analysisSystem/Product Development -Stakeholders analysis -Market survey -Feasibility analysis -Assessment of competitors In the Planning phase of the SDLC, what is a GAP analysis template? - CORRECT ANSWER A visual tool that involves a comparison of actual performance & potential or desired performance. In the Planning phase of the SDLC, what is the informatics roles and skills? - CORRECT ANSWER System Selection & Implementation: -Project manager -SME -System analyst -Autor of artifacts: project charter system selection plan RFI/RFPSystem/Product Development -Market/user researcher -SME -Systems analyst -Author of artifacts product concepts scope document feasibility assessments other artifacts of planning -Respond to RFI/RFP In the Planning phase of the SDLC, what is an RFI? - CORRECT ANSWER *Is it a request for information*A document that the organization sends to vendors*Indicates interest in gaining knowledge about the vendor's product*Lists (high level) the key features desired for the new system*Vendor responds to RFI w/their products ability to meet these high-level requirements In the Planning phase of the SDLC, what is an RFP? - CORRECT ANSWER *Request for proposal*Created by the project team*Sent to selected vendors requesting greater and more detailed information about the features/functions desired for the new system*Response from vendor from an RFP are equally detailed*Supports comparison of vendors In the Planning phase of the SDLC, what are outputs? - CORRECT ANSWER System Selection & Implementation -system request -feasibility assessment -charter -team formation proj governance structure/implement committee proj team(s) (actually implements the system) -gap analysis -timeline -workplan & resource requirementsSystems/Product Development -feasibility assessment -product scope document what it will and will no contain functionally -product concept document summary of customer needs proposed solution potential market use -In product development, the decision to "go" or "no go" is made in the planning phase In the Planning phase of the SDLC, what are typical teams and committees? - CORRECT ANSWER Systems Selection & Implementation: -Executive steering committee -Data governance committee -Information technology steering committee -Physician advisory committeeSystems/Product Development: -Project core group or build team(s) -Testing team -Change management/communication team -Training team -Support team In the Planning phase of the SDLC, what is the purpose of a project charter? - CORRECT ANSWER To formally authorize a project or a phase and document initial requirements which satisfy the stakeholder's needs & expectations. Categories of competencies with nursing informatics include? - CORRECT ANSWER 1. Basic computer skills2. Information management skills3. Information literacy skills The foundation of an organizations' strategic system planning begins with a review of the? - CORRECT ANSWER The organization's business mission In what phase of the SDLC are feasibility studies performed? - CORRECT ANSWER Planning phase The informatics nurse may recommend gap analysis in order to determine the? - CORRECT ANSWER Resources needed to move from the current state to a proposed state When looking at potential products and gathering information, one of the first tools is often a: - CORRECT ANSWER Request for Information (FRI) What is the 2nd phase in the SDLC? - CORRECT ANSWER System Analysis During the Analysis phase of the SDLC, what are the main focus? - CORRECT ANSWER -Fact-finding phase-In-depth assessment and leads to the definition of the new system's requirements-Understanding the existing situation (the as-is system)-Identifying improvements-Define requirements for the new system (to-be system) During the Analysis phase of the SDLC, what are the major activities performed? - CORRECT ANSWER 1. Answers the question of: Who uses the system? What the system does Where and when the system will be used2. All deliverables are combined into the System Proposal -Requirements determination -Use case analysis -Process modeling -Data modelingPrimary Deliverable: SYSTEM PROPOSAL During the Analysis phase of the SDLC, what are the key deliverables? - CORRECT ANSWER 1. Gap analysis 2. Technical requirements for hardware, software, ^ networks3. Functional design document4. System proposal document During the Analysis phase of the SDLC, what are the goals for a system selection & implementation? - CORRECT ANSWER -Conduct a detailed assessment of gaps-gap analysis-and user needs (requirements) understanding the "must-have" functionality of the desired system-Conduct market survey to assess options/compare for selection-Develop FRI and RFP-Establish a system selection process including an objective decision-scoring methodology typically developed from the RFP scores based on functional requirements necessary elements scored higher than "nice-to-have"-Assess readiness for change During the Analysis phase of the SDLC, what are the goals for a systems/product development? - CORRECT ANSWER -Fully understand and prioritize gaps and needs in existing systems and products How will your development address those?-Understand the diagram-related workflows, data flows, and processes in order to effectively analyze-Document functional and technical requirements Functional end-user requirements Technical: define programmer instructions-Outline future-state workflows, data flows, & processesOutline the impact on existing processes During the Analysis phase of the SDLC, what are the tools used in systems selection & implementation and systems/product development? - CORRECT ANSWER *Qualitative analytical methods: -Interviews and focus groups with stakeholders -Observations, questionnaires -Artifact analysis (document examination)*Quantitative analytical methods: -RFP and RFI scoring tools to quantify the best product to meet the need -Context diagrams (high-level data flow diagram/summary of the system) -Data flow diagrams (additional detail about each part of the business process) -Clinical workflow diagrams -Gap analysis*Current state assessment to determine "where we are now" During the Analysis phase of the SDLC, what are the roles and skills of the informatics nurse in the systems selection & implementation? - CORRECT ANSWER #NAME? During the Analysis phase of the SDLC, what are the roles and skills of the informatics nurse in the systems/product development? - CORRECT ANSWER #NAME? During the Analysis phase of the SDLC, what are the system analysis outputs of the systems selection & implementation? - CORRECT ANSWER -prioritizing end-user requirements-workflows (steps/process)-dataflows (information)-RFI/RFP-product demonstrations-reference call and site visits-product select scoring process-final recommendations-readiness assessment During the Analysis phase of the SDLC, what are the system analysis outputs of the systems/product development? - CORRECT ANSWER -report to stakeholders including interview results & end-user requirements-regulatory requirements related to the product you are developing-product scope documents-functional requirements-technical requirements (from which the product can be developed) and also for hardware, software, & networks During the Analysis phase of the SDLC, what are the system analysis outputs? - CORRECT ANSWER 1. The requirements analysis (or determination) is a major output of this phase2. A detailed list of requirements that are supported by the other activities of the analysis phase 3. The system proposal combines much of the analysis output into a report. Key components of this report can include: a. requirements definition: simply lists the functional & non-functional requirements in an outline format b. use cases: define what the users or roles will be doing in the solution. Created considering the actor (someone who interacts with the system), the system (system function process) and goals or tasks to be fulfilled. c. process models d. data models During the Analysis phase of the SDLC, what are the system analysis Outputs Use Case examples? - CORRECT ANSWER 1. Information exchange to be solved electronicallyActors: PCP Ambulatory practice, MD specialty practiceSystem: EHR interfaceGoal: To improve care coordination and meet MU2 transition of care During the Analysis phase of the SDLC, what is a data flow diagram - CORRECT ANSWER A DFD shows the flow of the data through a system and the work or processing performed on the data as it moves through the system During the Analysis phase of the SDLC, what is an entity-relationship diagram? - CORRECT ANSWER -Shows relationships between entities. -Data modeling-data object and relationship between objects-graphically illustrates an information system's entities and the relationship between those entities In what stage of the SDLC are requirements lists developed? - CORRECT ANSWER System Analysis phase In the SDLC analysis phase, name non-functional requirements - CORRECT ANSWER 1. maintainability2. portability3. robustness The informatician is developing a diagram that shows the sequential steps of a process. What is the best choice for chart diagrams? - CORRECT ANSWER Flow Chart A data flow diagram shows graphically what? - CORRECT ANSWER How data flows into a system and from one process to another What phase comes after the planning and analysis phases of the SDLC? - CORRECT ANSWER System design, develop, customize In the SDLC design phase, what is determined? - CORRECT ANSWER 1. architecture and operation of the system with regard to processes, hardware, software, networking, data retrieval, archiving, and use, user interface, and so on.2. development user requirements are translated into new software solutions3. Implementation-vendor tools are customized to meet user needs. In the SDLC System Design phase, what is the primary deliverable? - CORRECT ANSWER 1. System specification document (architecture document, technical system blueprint) In the SDLC System Design phase, what are the key deliverables? - CORRECT ANSWER 1. Functional specifications2. Technical specifications3. Implementation Workplan regarding interfaces, testing, training, cut over and go-live. In the SDLC System Design phase, what are the major activities in system design? - CORRECT ANSWER 1. Transform business requirements identified during previous phases into detailed specifications covering all aspects of the system2. All deliverables from the Design phase are combined into the System Specification document In the SDLC System Design phase, Design versus Build? - CORRECT ANSWER In this phase, all the information form planning and analysis are used to create a document for the design.Design does not mean build-build is done in the implementation phase. In the SDLC System Design phase, what are the goals in System Selection & Implementation? - CORRECT ANSWER *Customization of software, including data elements, documentation templates, & screen design*With commercial-off-the-shelf (COTS) products, customization/localization is the primary goals*End-user input & engagement for customization to meet (clinician) needs-extremely important in the design phase In the SDLC System Design phase, what are the goals in Systems/Product Development? - CORRECT ANSWER *Develop teams to write code that will convert functional and technical specifications into software applications*USABILITY testing of prototypes and early product versions lead to system enhancements*Stakeholder reviews to ensure that what is built matches the original vision & scopeUsability-easy to use, navigate, better adoption In the SDLC System Design phase, what are the tools used in the Systems Selection and Implementation? - CORRECT ANSWER *Vendor system configuration, including databases, data dictionaries, documentation forms, flowsheets, security profiles, process redesign maps*Change management & end-user educational artifacts like stop-start-continue*Project management tracking artifacts*Clinical & administrative committee review minutes & approval documents*Project management overarching during the design phase In the SDLC System Design phase, what are the tools used in Systems/Product Development? - CORRECT ANSWER *Software programming code*Product prototypes*Software applications*Software development progress-tracking artifacts In the SDLC System Design phase, what are some of the design strategies (methods)? - CORRECT ANSWER Waterfall *RAD-Rapid Application Development: Iterative*RAD-Rapid Application Development: System PrototypingAgile In the SDLC System Design phase, what are the steps in the Waterfall development tool? - CORRECT ANSWER Planning Analysis Design Implementation SystemEach phase has to be completed before moving onto the next phase In the SDLC System Design phase, what are the steps of the Rapid Application Development (RAD) Iterative tool? - CORRECT ANSWER Planning Analysis Design Implement System Version I Analysis Design Implement System Version II and so onWorking system but keeps improving and adding enhancements. In the SDLC System Design phase, what are the steps of the Rapid Application Development (RAD): System Prototyping tool? - CORRECT ANSWER Planning Analysis Design Implementation System Prototype Implementation SystemAll are done at the same time In the SDLC System Design phase, what are the steps of the Agile tool? - CORRECT ANSWER Planning Analysis Design System Implementation-Analysis, design, and implementation are all happening concurrently-Short period of time to a functioning product-Defined time frames (i.e. 4/5 weeks called sprints/scrum-Time boxing-working on chunks of the product In the SDLC System DESIGN phase, what are informatics roles and skills of the system selection and implementation? - CORRECT ANSWER 1. Participant on system configuration teams; like clinical documentation, CPOE, clinical decision support/CDS, and other2. Process redesign analyst3. Change manager4. The developer of training materials In the SDLC System DESIGN phase, what are informatics roles and skills of the system product development? - CORRECT ANSWER 1. SME resource for developers2. Developer3. Usability Tester4. Development manager In the SDLC System DESIGN phase, what are informatics roles and skills of other functions and proficiencies in line with clinical informatics contributions? - CORRECT ANSWER 1. Ensuring systems have an appropriate display of patient-level data for clinical decision making. 2. Designing reports identifying trends to align with quality measures initiatives.3. Translating user requirements into informatics solutions a. bridge communication divides between technical experts and clinical end-users.4. Customizing vendor data elements and forms to meet needs.5. Workflow considerations and interfaces with respect to retrofitting legacy systems with newer technology. In the SDLC System DESIGN phase, during the design, develop, customize phase, what are the OUTPUTS of systems selection and implementation? - CORRECT ANSWER 1. Vendor system configuration documents; like database dictionary, documentation forms, flowsheets, security profiles, process redesign maps, and other artifacts2. Change management and end-user artifacts3. Clinical committee reviews and approvals4. Project management tracking artifacts In the SDLC System DESIGN phase, during the design, develop, customize phase, what are the OUTPUTS of systems/product development? - CORRECT ANSWER 1. Software/programming code2. Product prototypes3. Software applications4. Software development documentation-including tracking of progress and artifacts In the SDLC System DESIGN phase, during the design, develop, customize phase, what are the aspects of PROJECT MANAGEMENT? - CORRECT ANSWER 1. Project management is an essential tool of the design phase of the SDLC because it is required to keep implementation and development projects: a. on time, b. within the scope and c. on budget. 2. PMBOK = Project Management Body of Knowledge a. The entire collection of processes, terminologies, and guidelines that are accepted as standards within the project management industry. In the SDLC System DESIGN phase, what are some project management artifacts? - CORRECT ANSWER 1. Gantt chart2. PERT - Program Evaluation and Review Technique3. CDS - Clinical Decision Support In the SDLC System DESIGN phase, what is the Gantt chart in the project management artifacts? - CORRECT ANSWER At a glance...the Gantt chart lest you see:1. What are the various activities2. When each activity begins and ends3. How long each activity is scheduled to last4. Where and by how much activities overlap5. Start and end date of the entire projectalso considered a bar chart In the SDLC System DESIGN phase, what is PERT chart in the project management artifacts? - CORRECT ANSWER Program Evaluation and Review Technique1. PERT diagrams show precedence, activities that must be completed before the next activities may be started2. It illustrates the dependencies and flow of project events and milestones3. Once a diagram is drawn, it is possible to identify the CRITICAL PATH, the longest path/duration through the activities4. Monitoring critical path will identify shortest time to complete the project. PERT Diagram - CORRECT ANSWER 1. Circles mark the beginning and ends of tasks to be done in the project (aka NODES)2. Arrows are the tasks themsevles. They are identified by letters. The actual names of tasks could be used instead of letters. The lengths of the arrows do not relate to their length in time3. Numbers after the task names are the durations of the task. The time interval may be anything from picoseconds to years. Critical path-longest # of days the shortest amount of time without missing any tasks [Show Less]
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Essentials of nursing final 111 Questions with Verified Answers,100% CORRECT
Essentials of nursing final 111 Questions with Verified Answers To become a Neonatal Intensive Care Nurse Specialist, you must pass the Neonatal Inten... [Show More] sive Care Nursing Certification exam through the National Certification Corporation. - CORRECT ANSWER true APRNs treat and diagnose illnesses, advise the public on health issues, manage chronic disease and engage in continuous education to remain at the very forefront of any technological, methodological, or other developments in the field. - CORRECT ANSWER true The Nurse Practice Act requires annual license renewal for practicing nurses. - CORRECT ANSWER false, biennial How many RN programs are there in Arkansas? - CORRECT ANSWER 28 What are the five major concepts included in the UAM School of Nursing philosophy? - CORRECT ANSWER - person - environment - health - professional nursing - professional nursing education CPR certification is required from what organization? - CORRECT ANSWER American Heart Association The overall mission of the School of Nursing is to strive for excellence in the: - CORRECT ANSWER preparation of professional nurse generalists What is the highest paid nursing speciality? - CORRECT ANSWER Nurse Anesthetist The Nurse Licensure Compact (mutual recognition) allows a nurse to have one license (in his or her state of residency) and to practice (both physically and electronically) in other states that have enacted the nurse licensure compact, subject to each state's practice laws and regulations. - CORRECT ANSWER true All nurses complete a rigorous program of extensive education and study, and work directly with patients, families and communities using the core values of the nursing process. - CORRECT ANSWER true Health is viewed as a continuum throughout the lifespan that is influenced by the person's risk reduction behaviors and adaptive responses that promote goal adaptation and need integrity. - CORRECT ANSWER true Which organizing framework provides the basis for identification of strands that support the nursing curriculum? - CORRECT ANSWER Roy Adaptation Model LPNs cannot administer medications. That is the RNs job. - CORRECT ANSWER false How many nurse licenses have been issued by the ASBN? - CORRECT ANSWER over 52,000 All UAM School of Nursing programs are approved by the: - CORRECT ANSWER Arkansas State Board of Nursing The overall mission of the School of Nursing is to strive for excellence in the preparation of professional nurse generalists. This mission is accomplished through the following goals: (select all that apply) - CORRECT ANSWER - the preparation of graduates to provide nursing care for individuals, families, and communities within a variety of health care settings - the encouragement of critical thinking to guide therapeutic nursing interventions that promote, maintain, and restore health - the development of accountability through a commitment to professional nursing practice and lifelong learning The mission of the ASBN is to protect the nurse. - CORRECT ANSWER false, the patient Which of the following nurse specialties will (1) start your own business venture within the healthcare field, (2) hire employees to help you grow the business, and (3) raising funds and taking care of the financial side of the business, including payroll and taxes. - CORRECT ANSWER Nurse Entrepreneur Select all of the modes included in the organizing framework. - CORRECT ANSWER - physiological - self-concept - role function - interdependence A Nursing Writer or Author can work from home. - CORRECT ANSWER true What is the registered nursing licensing examination called? - CORRECT ANSWER NCLEX-RN What is the "nursing building" where your advisor and course professor are located? - CORRECT ANSWER Sorrells Hall The nursing profession was founded to protect, promote and improve health for all ages. - CORRECT ANSWER true Emergency nurses are in demand because their specialized skills, efficiency, and steady nerves are a few of the many qualities that make them a valuable asset to any emergency department. - CORRECT ANSWER true In testing situations, use of cell phones/smart watches or similar communication devices may lead also to a charge of academic dishonesty and additional sanctions under the Academic Dishonesty Policy. - CORRECT ANSWER true What is the ratio of clinical simulation hours to clinical hours? - CORRECT ANSWER 1:3 This nurse specialty cares for patients who have been the victims of sexual abuse, violence and assault. - CORRECT ANSWER Forensic Nurse Select all of the student learning outcomes for this course. - CORRECT ANSWER - discuss nursing in today's evolving health care environment - identify nursing standards, values, ethics, and scope of practice - discuss the current state of nursing, health care delivery systems, and future challenges for the nursing profession Select all of the following "high demand" nurse specialties. - CORRECT ANSWER - cardiac care nursing - home health nursing - psychiatric nursing - telemetry nursing - obstetrics nursing What page is the Student Appeal Process found on? - CORRECT ANSWER 40 Environment includes all __________ and __________ stimuli that affect development and responses - CORRECT ANSWER internal and external What is the website for the Arkansas State Board of Nursing? - CORRECT ANSWER www.arbsn.org The faculty of the School of Nursing holds the following beliefs about the major concepts of - CORRECT ANSWER - person - environment - health - professional nursing - professional nursing education _____________________ is a process of being and becoming an integrated holistic person by continuously adapting to change. - CORRECT ANSWER health ANF stands for the American Nurses Fellowship. - CORRECT ANSWER false What type of nurse will with surgeons on a variety of invasive and non-invasive procedures, from the small and elective, like dermabrasion, to the more complex, like facial reconstruction after an accident. - CORRECT ANSWER plastic surgery nurse This nurse will help people who have limited access to basic healthcare and resources, such as modern medicine, vaccines and clean drinking water. - CORRECT ANSWER missionary nurse How many LPN programs are in Arkansas? - CORRECT ANSWER 29 Beyond the time-honored reputation for compassion and dedication lies a highly specialised profession, which stays consistent to address the needs of society - CORRECT ANSWER false Select all of the following strands covered in the BSN degree. - CORRECT ANSWER - Leadership - Nursing Process - Research - Communication - Critical thinking - Teaching/Learning LPNs provide health promotion, counseling, and education instead of the RN. - CORRECT ANSWER false How much do final exams count for course grades? - CORRECT ANSWER 20% Select all of the following places a Nurse Educator could work. - CORRECT ANSWER - Hospital - University - Continuing education programs - Long-term care centers In assessing a patient, nurses just consider test results. - CORRECT ANSWER false Match the need integrity to the mode covered in the School of Nursing curricular strands. - CORRECT ANSWER physiological - physical self-concept - psychic role function - social interdependence - affectional adequacy __________ and __________ are integral to professional nursing. - CORRECT ANSWER caring and value based beliefs Where is the final exam taken? - CORRECT ANSWER UAM Testing Center Nurses are in every community - large and small - providing expert care from birth to the end of life. - CORRECT ANSWER true What is the phone number to call regarding setting up your final exam? - CORRECT ANSWER 460-1454 The Nurse Practice Act requires that any person practicing as a registered nurse, advanced practice nurse, registered nurse practitioner, practical nurse, or psychiatric technician nurse in this state shall be licensed by the Arkansas State Board of Nursing. - CORRECT ANSWER true Licensed Practical Nurses (LPN), also known as Licensed Vocational Nurses (LVNs), support the core health care team and work under the supervision of an RN, APRN or MD. - CORRECT ANSWER true Which type of nurse would work in a county health department, a city health department, a federal health organization, or a mobile health care service unit? - CORRECT ANSWER public health nurse Temporary nursing permits may be issued to Arkansas licensed nurses who are graduates of a nursing program. - CORRECT ANSWER true Through long-term monitoring of patients' behavior and knowledge-based expertise, nurses are best placed to take an all-encompassing view of a patient's wellbeing. - CORRECT ANSWER true You have the option to complete the personal toolbox assignment for bonus points. - CORRECT ANSWER false The process of professional nursing education guides the student in the acquisition of: (select all that apply) - CORRECT ANSWER - nursing knowledge - skills - attitudes - values What is the phone number to contact the course professor? - CORRECT ANSWER 460-1168 This type of RN helps prepare living donors, and patients who are receiving an organ, for their procedures, and assist doctors during transplant surgeries. - CORRECT ANSWER transplant nurse Advanced Practice Registered Nurses (APRNs) are registered nurses who have been educated beyond the requirements for a registered nurse in: (select all that apply) - CORRECT ANSWER - Certified Nurse Practitioner (CNP) - Certified Registered Nurse Anesthetist (CRNA) - Clinical Nurse Specialist (CNS) - Certified Nurse Midwife (CNM) A Master (MSN) or Doctoral (PhD) degree in nurse is required to become a Clinical Nurse Specialist. - CORRECT ANSWER true Any student enrolled in a nursing course who is in danger of academic failure, NCLEX-RN failure, withdrawing from the nursing program, and/or any student with an average grade of less than 75% after two exams or at midterm in any nursing course is called a: - CORRECT ANSWER high-risk student LPNs form the backbone of health care provision in the United States. - CORRECT ANSWER false; registered nurses How many points is each discussion question worth? - CORRECT ANSWER 25 When did the Arkansas Legislature passed the original Nurse Licensure Compact (NLC)? - CORRECT ANSWER 1999 There are five steps to the nursing process. - CORRECT ANSWER true How much is the NLCEX-RN application fee? - CORRECT ANSWER $200 One must be an Advanced Practice Registered Nurse (APRN) to become a certified nurse midwife. - CORRECT ANSWER true The professional nurse uses leadership skills in communicating, collaborating, and negotiating with consumers and other members of the health care team in the delivery and promotion of health services. - CORRECT ANSWER true According to the January 2012 "United States Registered Nurse Workforce Report Card and Shortage Forecast" in the American Journal of Medical Quality, a shortage of registered nurses is projected to spread across the country between 2009 and 2030. In this state-by-state analysis, the authors forecast the RN shortage to be most intense in the South and the West - CORRECT ANSWER true The focus of nursing should be on the person and not the disease. - CORRECT ANSWER true The annual average salary for a Nurse Advocate is $46,000 to $93,000 depending on experience. - CORRECT ANSWER true Each RN on the board must be an Arkansas resident with at least five years of successful experience as a RN in nursing practice, administration, or teaching. - CORRECT ANSWER true The Arkansas Nurse Practice Act is the most important piece of legislation related to nursing practice. - CORRECT ANSWER true A Nurse Anesthetist has a faster paced job than an Occupational Health Nurse. - CORRECT ANSWER true How many teaching/learning principles are there? - CORRECT ANSWER 11 A Critical Care Nurse usually has a lower salary than a Flight Nurse. - CORRECT ANSWER false The ASBN acts as the publics advocate by effectively regulating the practice of nursing. - CORRECT ANSWER true There are over 6 million registered nurses in the United States today - CORRECT ANSWER false Who is the course professor? - CORRECT ANSWER Christine Felts How many quizzes are included in this course? - CORRECT ANSWER 6 What is the passing percentage in the School of Nursing? - CORRECT ANSWER 75 Are students allowed readmission to the School of Nursing if the student fails a course? - CORRECT ANSWER Yes, but only if the student petitions for readmission A cardiac care nurse takes care of patients who have catheters inserted into the bladder for urinary problems or heart defects. - CORRECT ANSWER true What type of nurses are there? Select all that apply. - CORRECT ANSWER - LPNs - APRN - RNs All ASBN board members that are nurses must hold an Arkansas or Texas nurses licenses and must be actively practicing in their license category. - CORRECT ANSWER false Select all of the following School of Nursing Committees that students are elected to serve on. - CORRECT ANSWER - Curriculum - Admissions Committee - Teaching Resources When does the board meet? - CORRECT ANSWER every month except March, August, and December In the United States today, nursing roles can be divided into four categories by the specific responsibilities they undertake. - CORRECT ANSWER false; three How many Registered Nurses (RNs) do you have to interview for the course assignment "Notes from interviews"? - CORRECT ANSWER 3 The Arkansas State Board of Nursing acts as the publics advocate by effectively regulating the practice of nursing. - CORRECT ANSWER true A ____________ nurse is a scientist who works with patients during clinical trials, recording and managing data with the intent of discovering newer, better ways to provide care. - CORRECT ANSWER research Medicine is the heart of healthcare. - CORRECT ANSWER false; nursing*** Select all of the following degrees that allow a RN to become specialized as a Dermatology Nurse. - CORRECT ANSWER ADN or BSN Assessment - CORRECT ANSWER Nurses assess patients on an in-depth physiological, economic, social and lifestyle basis. Diagnosis - CORRECT ANSWER Through careful consideration of both physical symptoms and patient behavior, the nurse forms a diagnosis. Outcomes / Planning - CORRECT ANSWER The nurse uses their expertise to set realistic goals for the patient's recovery. These objectives are then closely monitored. Implementation - CORRECT ANSWER By accurately implementing the care plan, nurses guarantee consistency of care for the patient whilst meticulously documenting their progress. Evaluation - CORRECT ANSWER By closely analyzing the effectiveness of the care plan and studying patient response, the nurse hones the plan to achieve the very best patient outcomes. ________________ is viewed as an individual, a family, and/or a community and as a holistic adaptive system in constant interaction with an increasingly interconnected global environment. - CORRECT ANSWER person The Arkansas Nurse Practice Act and ASBN Rules can be downloaded free of charge. - CORRECT ANSWER true Professional nursing is only considered a science. - CORRECT ANSWER false; a science and an art Board meetings are open to the public. - CORRECT ANSWER true When was the AR State Board of Nursing established? - CORRECT ANSWER 1913 Select all of the following nurse specialties that are research-oriented. - CORRECT ANSWER - Nurse Educator - Informatics Nurse - Genetics Nurse - Case Management Nurse - Pediatric Endocrinology Nurse What are the steps taken to become a Perianesthesia Nurse? Put the below steps in order. - CORRECT ANSWER 1. Earn a Bachelors degree in Nursing (BSN). 2. Pass the NCLEX-RN after graduation. 3. Gain 1800 hours of experience working as a RN in a perianesthesia unit. 4. Pass the Certified Post Anesthesia Nurse exam or Certified Ambulatory Perianesthesia Nurse exam through the American Board of Perianesthesia Nursing Certification Inc. This nurse specialty takes care of patients who've swallowed poison, come into contact with a toxin, been bitten by a snake, or stung by a bee or wasp. - CORRECT ANSWER Toxicology Nurse What age range does a Pediatric Nurse take care of? - CORRECT ANSWER birth until the late teen years What is the course number? - CORRECT ANSWER NURS 1001 This type of nurse provides pain management and general health education to patients, in non-emergency situations, outside of a hospital environment. - CORRECT ANSWER Ambulatory Care Nurse The ASBN is comprised of ________ Arkansas residents appointed by the Governor for terms of four years, subject to confirmation by the Senate. - CORRECT ANSWER 13 How much does the criminal background check cost the student? - CORRECT ANSWER $49.50 [Show Less]
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CNA certification practice exam 158 Questions with Verified Answers,100% CORRECT
CNA certification practice exam 158 Questions with Verified Answers Giving medication - CORRECT ANSWER A nursing assistant knows that the responsibiliti... [Show More] es of her position do not include.... bathe a resident without his permission - CORRECT ANSWER An example of "battery" is to... Involuntary seclusion - CORRECT ANSWER Keep in a resident isolated from others as a form of punishment is an example of... Report the suspected situation to the nurse assistance immediate supervisor. - CORRECT ANSWER An NA suspects that a resident is being abused due to multiple unexplained bruises, refusal to answer most questions, and refusal of ADL's. What do you do? MRSA - CORRECT ANSWER A resistant strain of bacteria that is difficult to treat with antibiotics Frequent hand washing - CORRECT ANSWER The best way for an NA to prevent infection... Supportive measures to hand washing - CORRECT ANSWER Wearing gloves, using antiseptic rub before and after care, and using standard precautions for care are... Allow participation to promote a sense of independence - CORRECT ANSWER A key part of care when giving a bath to a resident is... When shaving a resident - CORRECT ANSWER Look for shaving instructions related to problems or issues clotting. An electric razor maybe necessary. Small, watery leakage of stool - CORRECT ANSWER Fecal impaction (bowel obstruction) may present with the following symptom. Alert the nurse - CORRECT ANSWER If any red pressure spots are identified during skin care... Neuropathy - CORRECT ANSWER Common side effect of diabetes. numbness in the feet Breathing - CORRECT ANSWER Dyspnea means difficulty with... Alzheimer's residents - CORRECT ANSWER It is important to maintain a routine to avoid confusion and overstimulation with.. Notable for Alzheimer's residents - CORRECT ANSWER Hallucinations and a decrease in appetite are common. It is important to frequently reorientate the patient. Rules for making an occupied to bed - CORRECT ANSWER Lower it to the lowest level when the procedure is complete. Mitering the corners of sheets, raise side rails, and never placed soiled linens on the floor. 60 to 100 - CORRECT ANSWER What is an acceptable pulse rate? Signs of hypoglycemia - CORRECT ANSWER Sweating, confusion, and tremors Guidelines for residents who are hard of hearing - CORRECT ANSWER Speak clearly and slowly as you face the resident High Fowler - CORRECT ANSWER Position where a patient, typically in a hospital, is placed when the head of the bed needs to be elevated as high as possible. The upper half of the patient's body is between 60 degrees and 90 degrees in relation to the lower half of their body. The legs of the patient may be straight or bent.This position is also required postoperatively for pneumonectomy patients. Gloves and gown - CORRECT ANSWER Protective equipment worn when changing an incontinent patient Sudden onset confusion - CORRECT ANSWER Symptom most likely due to an infection NPO - CORRECT ANSWER Nothing by mouth Alert the nurse - CORRECT ANSWER If a patient with diabetes does not touch their meal... Every 2 hours - CORRECT ANSWER Bed rest residents must be turned how often Radial artery - CORRECT ANSWER Most commonly used location for pulses in vital signs Throat obstructions - CORRECT ANSWER step 1. Ask the resident if they are choking, -If they are able to talk or cough, air is still moving through the trachea. If they nod yes, but are unable to speak, it's time to begin the Heimlich maneuver. HIPPA - CORRECT ANSWER The fact that you must keep clients health information confidential is due to what? Take the client to the bathroom - CORRECT ANSWER A client with alzheimer's wakes up more confused than usual in the morning. After breakfast it is most important to support normal gastrointestinal functions so you should... Taking the client to the bathroom will most likely prompt a poop. The confuse patient may not remember with this urge means. Check the chart for physician orders. - CORRECT ANSWER A diabetic client asks the NA to help her cut her toenails. What needs to happen first? Diabetic clients often have special instructions regarding nail trimming. Physical activity: walking - CORRECT ANSWER What is the best method to promote rest and well being at night (prevent insomnia)? Wait 15 minutes and retake the temperature - CORRECT ANSWER If a client has a slightly elevated temperature (100.6) after eating or drinking warm items, what do you do? Positioning boots - CORRECT ANSWER In chronic foot drop, the NA can expect to find what in the clients room? Orthotics that ensure that the feet are dorsiflexed to prevent contractures and discomfort. Foot drop - CORRECT ANSWER A weakening of the muscles that makes it possible to flex the ankle and toes. Causes the patient to drag the front of the foot while walking. To compensate for this scuffle, they bend the knee to lift the foot higher than usual. Alert the nurse - CORRECT ANSWER If a client has low blood pressure (82/43) and reports feeling dizzy... Abduction - CORRECT ANSWER Moving the extremity away from the body. Ab is to move away. Ad is to move closer (add) Bending at the knees. - CORRECT ANSWER Proper body mechanics when lifting clients involve... Keeping a straight spine, Get help, and... Jaundice - CORRECT ANSWER Primary indication of hepatitis. Important for confused clients - CORRECT ANSWER Reorient the client frequently with clocks, calendars, and family Momentos. Hospice - CORRECT ANSWER Type of care for terminally ill clients. Cheyne-Stokes - CORRECT ANSWER A breathing pattern marked by increased respirations, labored breathing, and periods of no breathing. Respiration occurring in clients close to death. 20 seconds - CORRECT ANSWER Appropriate time for correct hand washing. Time it takes to sing happy birthday. Orthopneic - CORRECT ANSWER Position meant to assist in breathing: leaning forward makes it easier to get air into the lungs. Foods high in potassium - CORRECT ANSWER Bananas Cantaloupe Dark leafy greens On the right side: so that it can help support the strong side - CORRECT ANSWER When helping a client with left sided weakness, the nurse should position the clients cane... Perform CPR - CORRECT ANSWER If a client has no pulse and is not breathing Remove the patient - CORRECT ANSWER In the event of a fire is found in a patient's room (trash can), first.. RACE - CORRECT ANSWER Used in fire situations - rescue, alarm, contain, extinguish. First rescue the client to prevent injury. Log - rolling - CORRECT ANSWER Technique used in the safe diagnosis of spinal cord injury. Further damage can occur to the spinal cord if the legs cross over the midline (twisting motion). Incontinence - CORRECT ANSWER Can occur if a patient ignores the need to go to the bathroom. Anticipatory - CORRECT ANSWER Normal and healthy part of grieving that occurs before the loss actually happens. Complicated, unresolved and inhibited grieving indicate there is a problem with recovering from the loss. Clear liquid diet - CORRECT ANSWER Includes water, coffee and tea Foley catheter bag - CORRECT ANSWER should be kept below the bladder level. Keeping it below ensures bacteria cannot travel down to the bladder via gravity. Rules for Foleys - CORRECT ANSWER Hang below the bladder level, Keeping it below the level of the cavity ensures bacteria cannot migrate to the bladder by gravity, The bag hangs from the bedframe, chair, or wheelchair but does not touch the floor, Drain every 6 to 8 hours: prevents growth of microbes, Tubing should not have dependent loops: prevents stasis in the tubes that promotes backflow into the bladder. Physicians orders - CORRECT ANSWER For restraints to be legally applied one needs what? 480 ml - CORRECT ANSWER A large glass of juice should be recorded how? collect sputum specimens - CORRECT ANSWER First thing in the morning collect this. It will be most concentrated and you the most accurate results Leave quickly and quietly - CORRECT ANSWER What do you do if you enter a patient's room and they are rubbing one out? Speak calmly in a neutral manner to soothe the client. - CORRECT ANSWER You have an extremely agitated client who screams and bites. What do you do? Allow the patient to perform as much as they can while you assist as needed. - CORRECT ANSWER The best way to support a patient's independence during bathing. Burn severity levels - CORRECT ANSWER Superficial burn - blotchiness of the skin was no blistering, Partial thickness - blistered and red, Total thickness - Appears waxy and white Stages of grief - CORRECT ANSWER Denial: The first reaction is denial. In this stage individuals believe the diagnosis is somehow mistaken, and cling to a false, preferable reality. Anger: When the individual recognizes that denial cannot continue, it becomes frustrated, especially at proximate individuals. Certain psychological responses of a person undergoing this phase would be: "Why me? It's not fair!"; "How can this happen to me?"; '"Who is to blame?" Bargaining: The third stage involves the hope that the individual can avoid a cause of grief. Usually, the negotiation for an extended life is made in exchange for a reformed lifestyle. People facing less serious trauma can bargain or seek compromise. Depression: "I'm so sad, why bother with anything?"; "I'm going to die soon so what's the point?"; During the fourth stage, the individual becomes saddened by the mathematical probability of death. In this state, the individual may become silent, refuse visitors and spend much of the time mournful and sullen. Acceptance: "It's going to be okay."; "I can't fight it, I may as well prepare for it."; "Nothing is impossible." In this last stage, individuals embrace mortality or inevitable future, or that of a loved one, or other tragic event. People dying may precede the survivors in this state, which typically comes with a calm, retrospective view for the individual, and a stable condition of emotions. Transfer belt - CORRECT ANSWER Best assistive equipment for moving in a mobile client from the bed to a chair. The lateral aspect of the patients - CORRECT ANSWER To safely give a bath to a patient with a Foley catheter or, move the catheter where to ensure it's not pulled out? Tell them you understand that they are in pain and stay to comfort them. - CORRECT ANSWER When a patient is notified about a death and responds in disbelief and pain, do what? Enema - CORRECT ANSWER Helps expel a few days of poop before it can become impacted prolonged bed-rest clients - CORRECT ANSWER Should be turned every two hours. Turning can prevent pressure ulcers Turning, Coughing and deep breathing - CORRECT ANSWER prescribed for bedridden clients to prevent complications of pneumonia. massage can minimize pain. Active and passive range of motion exercises with hydration are also appropriate to prevent contractures and promote skin integrity. Elevate - CORRECT ANSWER Above the heart prevent swelling. You may also need to extend the limb from the body Proper application of a jacket restraint - CORRECT ANSWER straps should be secured to the bed frame and never to the side rails. secured so that two fingers can slide easily between the restraint and the clients skin, A safety knot in the restraint straps prevents tightening, should not tighten when force is applied against them: allows quick and easy removal in case of emergency Cauliflower - CORRECT ANSWER Avoid this to help prevent stomach aches and bloating since it is a food that forms gas. Also: beans, cabbage, radishes, cucumbers Hot sitz baths - CORRECT ANSWER The ideal temperature is between 95 and 110°F. This temperature will help relieve muscle spasm, soften exudates, speed the suppuration process, quicken healing in perianal surgeries, provide comfort in the perineal area and reduce congestion. Rules for urinary specimens for sugar and ketones - CORRECT ANSWER Collect 4: 30 minutes before meals and at bedtime Some sugar and acetone appear in urine. Tests are done four times a day (as noted). Double-voided specimens are best for these tests. Double-void: a urinalysis procedure in which the first specimen is discarded and a second, obtained 30 to 45 minutes later, is tested. Changing non-sterile dressings - CORRECT ANSWER Always know the color, odor, amount and consistency of the drainage on the old dressing. Cleanse the wound and scab using circular motions and start from the wound itself and extend out to the skin (clean to dirty). Apply clean dressings: holding the dressings by the corners as you apply them so as not to contaminate the center of the bandage. Tape the dressing in place leaving the edges free: do not tape completely around the edges. Ostomy care - CORRECT ANSWER It is done aseptically. It does not require a doctors order for changing. The collection bag must be changed when it's full or when the seal is broken. A client with osteomy will have a change in the normal bowel movement. Poop will be collected through a bag that is held over the stoma (hole) by a special adhesive or paste. Rules for Elastic stockings - CORRECT ANSWER Used to help prevent blood clots by exerting pressure on the veins, promoting blood flow to the heart. Embolic stockings are applied before the client gets out of bed. Swelling can occur from sitting or standing. If the stockings are off, the client should be in bed. Oxygen therapy - CORRECT ANSWER An NA can keep the connection secure and free of kinks. Turning oxygen on and off and picking an oxygen delivery device are duties of a doctor. Elastic bandages - CORRECT ANSWER Check: the exposed fingers or toes to allow circulation, color and temperature of the limb every hour. Complaints of pain, itching, tingling, or numbness should prompt you to remove the bandage and tell the nurse immediately. Binder application - CORRECT ANSWER T binders secure dressings in place after rectal and Perianal surgeries. Double T binders are for men, while Single T binders are for women. A breast binder is specifically used to support the breast after breast surgery. Straight abdominal binders are applied with the person supine. It is secured in front of the body by safety pin, Velcro, zippers, hooks, or other closures. The top part is at the person's waist; the lower part is over the hips. Protective Devices - CORRECT ANSWER Used to prevent and treat skin pressure ulcers and skin breakdown, Possibly- Bed cradle, Trochanter rolls, Flotation pads Bed cradle - CORRECT ANSWER Placed on the bed and over the person; may be used as a protective device to prevent pressure ulcers and skin breakdown. Trochanter roll - CORRECT ANSWER Apply to prevent the hips and legs from turning outward and aid in proper positioning of the client; may be used as a protective device to prevent pressure ulcers and skin breakdown. Top linens - CORRECT ANSWER brought over the bed cradle to prevent pressure on the legs and feet; may be used as a protective device to prevent pressure ulcers and skin breakdown. Hypoxia - CORRECT ANSWER Risk for clients on oxygen therapy, Cells do not have enough oxygen: life threatening. May also have increased respiratory rate, increased pulse rate or cyanosis which is blue discoloration of the skin. Restlessness, dizziness, disorientation. The call bell - CORRECT ANSWER Should always be in the clients reach Air mattress - CORRECT ANSWER Used in the prevention of bed and pressure sores dying - CORRECT ANSWER allow the client to express feelings when they are.. ADL - CORRECT ANSWER Activities of Daily Living After a back rub - CORRECT ANSWER Note any changes in skin Client with a hearing loss - CORRECT ANSWER Face them and speak clearly to communicate Prosthesis - CORRECT ANSWER Term for device used to take the place of a missing body part? the weak left side - CORRECT ANSWER When a client has left-sided weakness dress starting with... staff on the next shift. - CORRECT ANSWER It is appropriate for a nurse aide to share the information regarding the client status with the... weak side. - CORRECT ANSWER When helping a client who is recovering from a stroke to walk, support them on the... Talk in a slow, calm, reassuring manner. - CORRECT ANSWER You are caring for a client who is agitated. protect the client from injury. - CORRECT ANSWER The purpose for padding side rails on the clients bed is to... range of motion - CORRECT ANSWER Exercises that move each muscle and joint are called... Encourage the client to talk. - CORRECT ANSWER How can you best help a client who is not excepting a loss? blocked airway. - CORRECT ANSWER The Heimlich maneuver (abdominal thrust) is used for a client who has a... write out communication. - CORRECT ANSWER If your client is totally deaf... point to the date on a calendar and say the date. - CORRECT ANSWER A confused client asks what day it is. The NA should... upper thigh. - CORRECT ANSWER To avoid puling the catheter when turning a male client, the catheter tube must be taped to the clients... allowing the client to talk about their beliefs. - CORRECT ANSWER A NA can assist clients with their spiritual needs by... doing peri-care. - CORRECT ANSWER An NA must wear gloves when... let the client choose what to wear. - CORRECT ANSWER When getting ready to dress a client, the nurse aide should... remove the client. - CORRECT ANSWER If the NA discovers fire in a room, the first thing to do is... look directly at the client when speaking. - CORRECT ANSWER To communicate clearly with a client with a hearing loss, the NA should... Acceptance. - CORRECT ANSWER The final stage of dying: Listen quietly. - CORRECT ANSWER If a client says, "God is punishing me" or "why me", how should the NA respond? help protect clients rights. - CORRECT ANSWER The ombudsman's role is to.. respect the clients beliefs and avoid starting religious discussions. - CORRECT ANSWER An NA who is active in her church has a client who is not a member of any religious group the NA should... give the client the unopened mail and offer help if needed. - CORRECT ANSWER The NA notices that a client's mail has been delivered. The NA should... 300 cc. - CORRECT ANSWER A correct measurement of urinary output..., It's only measured in cc or milliliters abuse - CORRECT ANSWER -Leaving a client alone in the bathtub, -threatening not to give meals, -leaving a client in a wet or dirty bed Not abuse - CORRECT ANSWER Restraining a client per Dr.'s orders leave, give the client privacy. - CORRECT ANSWER If a client is masturbating in his room... 4×30=120 mL - CORRECT ANSWER To convert 4 ounces of juice to milliliters (cubic centimeters), multiply..., 1 ounce equals 30 mL Privacy - CORRECT ANSWER The Bill of Rights says that you must provide this during personal care. politely refuse. - CORRECT ANSWER The client offers you a $20 bill as a thank you for all you have done. The NA should... hearing. - CORRECT ANSWER The last sense a dying client will lose is... Check the clients diet before offering food. - CORRECT ANSWER The client wakes up during the night and asks for something to eat. What do you do? decline. - CORRECT ANSWER The normal aging process is best defined as a time when normal body functions and senses... recognize familiar things and people. - CORRECT ANSWER If a client is confused, you should help the client to Rehabilitation - CORRECT ANSWER The process of restoring a disabled client to the highest level of functioning possible: after the full procedure - CORRECT ANSWER When changing and unsterile dressing, you should wash hands before you remove the dressing, after removing the dressing, and.. now officially dirty linen. - CORRECT ANSWER Clean bed linen placed in the clients room but not used is... call for assistance from the nurse in charge. - CORRECT ANSWER You find a conscious client lying on the bathroom floor. The first thing you should do is.. ask whats wrong. - CORRECT ANSWER If you find a client who is sad and crying, you should... use a telephone. - CORRECT ANSWER Clients have the right to... watch for skin irritation. - CORRECT ANSWER Proper use of a waist restraint requires the NA to... Put them in the dirty linen container. - CORRECT ANSWER To prevent the spread of infection, do what with the soiled linens removed from the bed. Ask an NA for help. - CORRECT ANSWER A client needs to be repositioned but is heavy and you are not sure you can move the client alone. frequently when the client is awake. - CORRECT ANSWER To prevent dehydration you should offer fluids... legs. - CORRECT ANSWER When transferring a client, most of the clients weight should be supported by the NAs... same time of day. - CORRECT ANSWER For more accurate weight measurements, weigh at the... 4 - CORRECT ANSWER How many feet does a quad-cane base have? 10 to 20 minutes. - CORRECT ANSWER Before taking the oral temperature of a client who just finished a cold drink, wait... roll it dirty-side-in, away from the body. - CORRECT ANSWER The correct way to remove a dirty isolation gown is to... do as much as possible and assist as needed. - CORRECT ANSWER The best way to promote independence while bathing with a client who has had a stroke is to encourage the client to... transfers/gate belt. - CORRECT ANSWER A safety device used to help a dependent client from a bed to a chair is called a... take the gown off before leaving the clients room. - CORRECT ANSWER If you wear a gown to care for a client in isolation, you must.. raise the side rail on the unattended side. - CORRECT ANSWER When making an occupied bed... suggest that this is not the place to discuss the client. - CORRECT ANSWER A group of NAs are eating lunch together in the employees dining room and begin talking about how rude a client behaved. You ... Tell the nurse in charge. - CORRECT ANSWER A client says he is in pain. Sit with the client and allow her to talk about her feelings. - CORRECT ANSWER A client is upset and crying over the recent death of her husband. Rectum - CORRECT ANSWER This is the most accurate temperature location. Discoloration - CORRECT ANSWER This is the beginning signs of a pressure sore. Report the damage to the charge nurse. - CORRECT ANSWER While doing denture care the NA see an upper plate crack. Respect the clients wishes. - CORRECT ANSWER If a client refuses to wear a clothing protector at lunch. respond when appropriate - CORRECT ANSWER The best way to show that you are listening to the client is to... before it happens. - CORRECT ANSWER This is the best time to prepare for disaster: 30 cc - CORRECT ANSWER 1 ounce = ? cubic centimeters 30 mL - CORRECT ANSWER 1 ounce = ? milliliters 100-119 - CORRECT ANSWER Normal systolic blood pressure range 62-79 - CORRECT ANSWER Normal diastolic blood pressure range 60-100 - CORRECT ANSWER Normal pulse - bpm 12-20 - CORRECT ANSWER Normal respiration - rpm Always - CORRECT ANSWER Test the temperature of the water before putting on gloves, Wash your hands before and after each skill, Provide privacy, Provide a call light, Lower the bed to the lowest position [Show Less]
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Nurse Practice Act Exam 50 Questions with Verified Answers,100% CORRECT
Nurse Practice Act Exam 50 Questions with Verified Answers The definition of practical nursing includes: - CORRECT ANSWER Maintaining safe nursing care ... [Show More] that is rendered indirectly It is outside the scope of practice for an LPN to: - CORRECT ANSWER Assess a client to formulate a plan of care An example of an additional act that may be performed by an LPN that requires additional education and training as prescribed by the Board and that is recognized as proper to be performed by a practical nurse would be (hint:see advisory opinions) - CORRECT ANSWER Administering IV medications It would be a violation of the nurse practice act for an LPN to: - CORRECT ANSWER Provide nursing services independent of a registered nurse (RN) or physician Which of the following is included in the definition of registered nursing (RN): - CORRECT ANSWER Establishing a nursing diagnosis Which of the following activities would be outside the scope of practice for an RN: - CORRECT ANSWER Writing orders for laboratory tests An example an additional act that may be performed by an RN that requires additional education and training as prescribed by the Board and that is recognized as proper to be performed by an RN (excluding advanced practice nurses) would be: - CORRECT ANSWER Insertion of an intra-arterial catheter It would be a violation of the nurse practice act for an RN to: - CORRECT ANSWER Delegate assessment to an LPN It is within the scope of practice for a clinical nurse specialist (CNS) in Arizona to: - CORRECT ANSWER Prescribe durable medical equipment Under the definition of delegation, a nurse may delegate: - CORRECT ANSWER A selected task to a competent person It would be a violation of the nurse practice act for an RN to delegate: - CORRECT ANSWER Planning of care to an LPN If applying for initial registered nurse practitioner (RNP) certification on or after July 1, 2004 the applicant must possess: - CORRECT ANSWER National certification as a nurse practitioner It would be a violation of the nurse practice act for a registered nurse practitioner (RNP) to: - CORRECT ANSWER Prescribe in a different specialty than the RNPs certification The definition of unprofessional conduct: - CORRECT ANSWER Includes any conduct that may be harmful to the public It would be unprofessional conduct for a nurse to: - CORRECT ANSWER Fail to report another nurse with evidence of impairment while on duty The nurse who is convicted of a felony is subject to: - CORRECT ANSWER Revocation of the license An RN license applicant was convicted of a Class 2 felony in 2007 and applies for licensure in 2009. The applicant would be: - CORRECT ANSWER Denied a license The Arizona State Board of Nursing has authority over: - CORRECT ANSWER Nursing education programs leading to initial licensure or certification The Nurse Practice Act authorizes the board to adopt rules for practitioners to practice: - CORRECT ANSWER In collaboration with one or more licensed physicians A nurse who changes his/her address shall notify the Board of the new address withing: - CORRECT ANSWER 30 days A person can practice nursing in Arizona without an Arizona or multistate compact license when the person is a: - CORRECT ANSWER Nurse licensed in another state and employed by the federal government A physician tells you that she would like to challenge the RN licensure exam (NCLEX) so she can work as an RN on the weekends. You would tell the physician that in order to do this she would need to: - CORRECT ANSWER Complete an approved nursing program To qualify for licensure in Arizona, graduates of international nursing programs must show evidence of: - CORRECT ANSWER Passing NCLEX, graduating from a comparable nursing program, and English language proficiency The Board ensure that nurses who renew their licenses are competent and qualified by requiring: - CORRECT ANSWER Nurses to meet a practice requirement or take a refresher course In Arizona a nursing license must be renewed every: - CORRECT ANSWER 4 years In 2009, the date for renewing a license was changed from July 1 of the year of expiration to: - CORRECT ANSWER April 1 of the year of expiration A nursing assistant certification must be renewed every: - CORRECT ANSWER 2 years One way the Board ensures that nursing assistants who renew their certifications are competent and qualified is to require: - CORRECT ANSWER CNAs practice 160 hours in the past 2 years Requirements to become a CNA in Arizona include: - CORRECT ANSWER Passing a manual skills and written examination If the Board believes that there is insufficient evidence to support a disciplinary action but sufficient evidence to notify a licensee or certificate holder of its concern, the board may issue: - CORRECT ANSWER A letter of concern If an applicant has an outstanding felony conviction during the 5 years before the application is received the Board shall: - CORRECT ANSWER Deny the application based on the felony conviction The Arizona State Board of Nursing is composed of: - CORRECT ANSWER Eleven members: 5 RNs, 2 LPNs, 2 public members, 1 CNA or CNA instructor and 1 NP or CNS Graduates of approved nursing programs, who are not yet licensed, may use the title: - CORRECT ANSWER Nurse Extern The abbreviation CNA may be used by: - CORRECT ANSWER Persons currently certified by the Board as nursing assistants To administer anesthetics, a nurse must: - CORRECT ANSWER Complete an accredited nurse anesthesia program A nurse who administers anesthesia must do so: - CORRECT ANSWER At the direction and in the presence of a physician or surgeon If the Board finds that a nurse has committed an act of unprofessional conduct related to patient care, it may: - CORRECT ANSWER Issue a decree of censure An example of an nondisciplinary action the Board may take is: - CORRECT ANSWER A letter of concern The Board may issue an administrative penalty to a nurse who: - CORRECT ANSWER Practices nursing with an expired nursing license The Board will open a complaint on a licensee only if the person making the complaint: - CORRECT ANSWER Provides information that the nurse violated the nurse practice act It is a class 6 felony to: - CORRECT ANSWER Practice registered or practical nursing without a license The nurse licensure compact allows: - CORRECT ANSWER A nurse licensed and residing in a compact state to practice in Arizona If a nurse from a compact state changes their primary state of residence to Arizona they should: - CORRECT ANSWER Inactivate their home state license and obtain an AZ comact license within 30 days A nurse practicing nursing on a compact license from another state must abide by the nurse practice act: - CORRECT ANSWER In the state where the patient is located The board may dismiss a complaint if it finds that the nurse: - CORRECT ANSWER Did not commit a violation of the nurse practice act It is an act of unprofessional conduct for a nurse to: - CORRECT ANSWER Fail to document the care the patient received An activity that would meet the practice requirement of the Arizona State Board of Nursing would be: - CORRECT ANSWER Consulting on staffing plans with a health care facility A nurse tells a patient that they are very attractive and the nurse would be interested in dating the patient. The nurse is: - CORRECT ANSWER Attempting to engage in a dual relationship If another nurse arrives for duty with alcohol on her breath, the nurse's first action should be to: - CORRECT ANSWER Take measures to remove the nurse from patient care activities Unprofessional conduct would include: - CORRECT ANSWER Falsely claiming CPR certification on an employment application [Show Less]
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Nursing Informatics Certification Exam 252 Questions with Verified Answers,100% CORRECT
Nursing Informatics Certification Exam 252 Questions with Verified Answers Metastructure of NI - CORRECT ANSWER The ability of the nurse to utilize da... [Show More] ta, information, and knowledge to make wise clinical decisions. Definition of Nursing Informatics - CORRECT ANSWER A speciality that integrates nursing science with multiple information and analytical sciences to identify, define, manage and communicate data, information, knowledge and wisdom in nursing practice. Meaningful Use - CORRECT ANSWER Using certified electronic health record technology to: - improve quality, safety, efficiency, and reduce health disparities - engage patients and families - improve care coordination, population and public health Total Quality Management (TQM) - CORRECT ANSWER Used to depect Quality Management measures. Examples include: - cause and effect diagrams - flowcharts - histograms - Pareto charts - Run charts - Control charts - scatter diagrams Quality and Safey Education for Nurses (QSEN) - CORRECT ANSWER Goal is to tackle the task of preparing nurses to enhance "the quality and safety of the healthcare systems in which they work" Used in Nursing Education and focuses on six competencies: • Patient-centered care • Teamwork and collaboration • Evidence-based practice • Quality improvement • Safety • Informatics Failure mode and Effects Analysis (FMEA) - CORRECT ANSWER A systematic, proactive approach for evaluating a process to identify where and how it might fail and to assess the relative impact of different failures. Ishikawa Diagram (Fishbone) - CORRECT ANSWER Used for brainstorming and to help identify root causes for performance improvement by visualizing causes and effects. The effect is the "head" and the causes are the "bones" Root Cause Analysis - CORRECT ANSWER Structured method to analyze serious adverse events. Identifies underlying problems that increase the likelyhood of errors (retrospective approach) FOCUS Model and PDCA - CORRECT ANSWER An preformance improvement model F- find a process to improve 0- organize an effort C- clarify current knowledge U- understand process variation/capability S- select a strategy for continious improvement PDCA: repetitive process during FOCUS stages Plan - Do - Check - Act Turley's Model of Nursing Informatics - CORRECT ANSWER Nursing Informatics is is the center of computer, cognitive, and informations sciences under the umbrella of Nursing Science Lewin's Theory of Change - CORRECT ANSWER Used infacilitating change, the concepts of this theory include: Unfreezing - Movement - Refreezing Driving and restraining forces Deals with disconfirmation Cogintive redefinition Creation of psychological safety or overcoming learning anxiety Lean Six Sigma - CORRECT ANSWER Focus on removing wasteful practices and making processes smoother and more efficient Six Sigma - CORRECT ANSWER Used for process improvement. Project increase quality and yield while reducing defects and variations. Define, Measure, Analyze, Improve, Control Leapfrog Group - CORRECT ANSWER Triggers giant leaps in the safety, quality, and affordability of healthcare by: - supporting informed healthcare decisiona - promoting high-value healthcare through incentives and rewards Good Leapfrog scores - more patients Regulatory and Accreditation Requirements - CORRECT ANSWER -Joint Commission -Centers for Medicare and Medicaid Services (CMS) -Meaningful Use -HITECH (health information technology for economic and clinical health) -Affordable Care Act -ADA regulations (Americans with Disabilities Act) Models Supporting Practice - CORRECT ANSWER Data: 1st step of database design; conceptual design Workflow: Swimlane models, Lean Six Sigma, value stream mapping Predictive: (Analytics) used to predict future outcomes Ludwig Von Bertalanffy Systems theory - CORRECT ANSWER The Nursing Informatics specialist must understand the fundamentals of systems and how systems affect the decision-making process; closed versus open systems Shannon-Weaver Model of Communication Theory - CORRECT ANSWER Sender - Message - Receiver Obstacles to effective communication: - Interference (noise) - Facilitation - Block (body language, assumptions) Communication is a continuous loop Maslow's Hierarchy of Needs - CORRECT ANSWER Depicted as a pyramid, needs listed from the base of the pyramid to the top. Based on importance to survival. Physiological needs Safety Social Self-Esteem Self-actualization Cognitive Theory - CORRECT ANSWER -Learning process may be unique to the student -Learning involves mental associations that cannot be observed -Knowledge is organized -Learning relates information to experience Benner's Stage's of Clinical Competence Novice to Expert Nurse - CORRECT ANSWER Novice: little experience, rule-governed Advanced Beginner: some experience with new situations Competent: ability to master new situations, needs extra planning time, lacks flexibility Proficient: thinks holistically, relies on experience, adaptable Expert: wealth of experience, acts intuitively Computer Science - CORRECT ANSWER Foundation of NI; the study of the principles and the use of computers. Information Science - CORRECT ANSWER Foundation of NI; the study of processes for storing and retrieving information, especially scientific or technical information. Cognitive Science - CORRECT ANSWER Foundation of NI; much of learning cannot be observed or predicted, in that, the individual is processing information based on experience, associations, and subjective interpretation Nursing Science - CORRECT ANSWER Foundation of NI; the ethical application of knowledge aquired through education, research and practice to provide services and interventions to patients in order to maintain, enhance, or restore their health; to advocate for health, and to aquire, process, generate, and disseminate nursing knowledge to advance the nursing profession Data Standards - CORRECT ANSWER standards that provide a common language and set of expectations that enable interoperability between systems and/or devices Interoperability - CORRECT ANSWER The ability to exchange data in a meaningful and comparable way Metadata - CORRECT ANSWER Data about Data - a set of data that describes and gives information about other data - describes content, quality, condition and other characteristics of the data Semantic Representation - CORRECT ANSWER Relating to meaning in language or logic - the study of meaning in language -pertains to the meaning or interpretation of a word, sign or other representation Taxonomies - CORRECT ANSWER The study of classification Classification - CORRECT ANSWER Ordering of entities into groups or classes Terminologies - CORRECT ANSWER A concept-based representation of a collection of domain-specific terms Nomenclature - CORRECT ANSWER Terms or labels for describing concepts in nursing; synonymous with "vocabulary" Clinical Care Classification - CORRECT ANSWER The standardized nursing terminology system that includes nursing diagnoses, outcomes, interventions, and actions Perioperative Nursing Data Set - CORRECT ANSWER PNDS- Used for perioperative diagnosis, interventions, and outcomes Nuring Intervention Classification - CORRECT ANSWER NIC- Classification used for nursing interventions for all healthcare settings Nursing Outcomes Classification - CORRECT ANSWER NOC- Classification used for patient outcomes North American Nursing Diagnosis Association-International - CORRECT ANSWER NANDA-I- Used for standardized classification of nursing diagnoses according to a multiaxial taxonomy of domains and classes OMAHA System - CORRECT ANSWER Comprehensive documentation of patient care that includes: -assessment -problem classification scheme -intervention scheme -problem rating scale for outcomes SNOMED-CT - CORRECT ANSWER (Systematized Nomenclature of Medicine - Clinical Terms) is a standardized, multilingual vocabulary of clinical terminology that is used by physicians and other health care providers for the electronic exchange of clinical health information Current Procedural Terminology (CPT) - CORRECT ANSWER Used to code traditional medical treatments provided by physicians or nurse practitioners ICD-9/10 International Classification of Disease - CORRECT ANSWER Used to code for diseases which are classified numerically by etiology and anatomic system. Healthcare Common Procedure Coding System Level II (HCPCS II) - CORRECT ANSWER Used to code for services and equipment for outpatient services ABC Codes - CORRECT ANSWER Used to bill for Intergrative or alternative healthcare practices (yoga, renki) LOINC - CORRECT ANSWER A common language (set of identifiers, names, and codes) for identifying health measurements, observations, and documents. If you think of an observation as a "question" and the observation result value as an "answer." Hierarchical Database - CORRECT ANSWER Tree-like structure where data is stored as linked records Relational Database - CORRECT ANSWER Data is stored in tables and each table has a key field that connects it to other tables, so all tables are related Data Integration - CORRECT ANSWER The combination of techincal and business processes used to combine data from disparate sources into meaningful and valuable information Data Warehouse - CORRECT ANSWER A large collection of data imported from several systems into one database. Data is inputted and the output is information. Shows the "big picture" and trends over time. Data Marts - CORRECT ANSWER Smaller collections of data Data Mining - CORRECT ANSWER Applying computational techinques to find patterns and trends in data stored in data warehouses. Data Representation - CORRECT ANSWER Alpha: alphabetic characters (A-Z) Numeric: numbers (0-9) Alphanumeric: combination of numbers and letters Data Aggregation - CORRECT ANSWER Information (data) is gathered in a summarized form for analytical purposes Database Features - CORRECT ANSWER Each field in a table is an ATTRIBUTE with fields being columns and records being rows Data Organization - CORRECT ANSWER Must be processed and organized so patterns and relationships are apparent Data - CORRECT ANSWER Discrete entities, described objectively with no content or pattern. Data System Model - CORRECT ANSWER Input - System - Output Data Input - CORRECT ANSWER Any data that is entered into an information system for storage or processing via forms, screens, voice or interactive web fill-in forms Data Output - CORRECT ANSWER Information delivered to users through the information system by way of intranet, extrants or the web on printed reports, displays, or via audio Information - CORRECT ANSWER A group of data that is interpreted, organized, structured System Design Lifecycle - CORRECT ANSWER 1. Planning 2. Analysis 3. Design/Build 4. Testing/Education/Implementation 5. Evaluation/Maintenance/Support Feasibility Study - CORRECT ANSWER Determines whether a project is possible. 3 types: Techincal Economic Operational Gap Analysis - CORRECT ANSWER Techinque for determining the steps to be taken to move from current state to future state. 1. List's what is 2. List's what should be 3. List's what is needed GANTT Chart - CORRECT ANSWER Bar chart used to illustrate a project schedule. Indicates start/finish dates of terminal elements PERT Diagram - CORRECT ANSWER Program Evaluation Review Technique: used to schedule, organize and coordinate tasks within a project System Planning - CORRECT ANSWER Key Components: Multidisciplinary approach System planning concepts Strategic goals and priorities (outcomes) Feasibility analysis and needs assessments Vendor, product, and market analtsis Resource and benefit analysis (ROI) Conceptual Framework - CORRECT ANSWER Determines the architecture of the plan Determines the type of plan to be used Determines the philosophical and intellectual approach of the plan System Analysis - CORRECT ANSWER A way of determinig how seperate parts or functions work together to form a result. Similar to the nursing process. Nursing Process - CORRECT ANSWER Observe, assess, diagnose, plan, implement, evaluate Requirements Definition - CORRECT ANSWER Agree on objectives Identify needs of business and end users Involve users from all levels in the organization Involve leadership, strategic planners Requirements become apart pf RFI, RFP document Process Analysis - CORRECT ANSWER The activities, skills, and specific actions required to gain the desired output/result. Indentifies: -Users -What they are doing -How they carry out actions -When they execute the actions -Why are the actions necessary Decision Trees - CORRECT ANSWER Predictive models that help reach conclusions about probable outcomes Flow Charts - CORRECT ANSWER Schematic representation of an algorithm or process Workflow Diagram - CORRECT ANSWER Demostrate the flow of work on a unit or department or process Swimlane Diagram - CORRECT ANSWER Depicts the steps in a process based on each unit System Design - CORRECT ANSWER Defines the architecture, componets, modules, interfaces, and data for a system to satisfy specific requirements Hardware and Software Design - CORRECT ANSWER Used to streamline the design process, optimize hardware partitioning to reduce product costs and ease integration by automatically generating interfaces. Critical Success Factors - CORRECT ANSWER -The design must align with and be compatible with the mission of the organization -Fiscal factors must be considered -Question shared resources -What are the interfaces/interactions between technology and manual subsystems -Question performance dictated by protocols (internal/external) -Question adequate support Algorithm - CORRECT ANSWER A definite set of specific steps or actions for completing a given task from beginning to end to reach a specific outcome. Fundamental Programming Concepts - CORRECT ANSWER Support theoretical basis and practical applications Design Software - CORRECT ANSWER New research area focused on the design of small embedded systems Analytical Science - CORRECT ANSWER Allows for decision-making based on available information Compliance - CORRECT ANSWER A facility undertakes activities or establishes practices or policies in accord with the requirements or expectations of an external authority. Benchmarking - CORRECT ANSWER A comparison of one organization to another to identify their comparative strengths and weaknesses and learn how to improve. Business Decision Support Systems - CORRECT ANSWER Focused on financial metrics and models Decision Support Systems - CORRECT ANSWER Computer applications designed to facilitate human decision making by analyzing data and providing recommendations. Clinical Decision Support Systems - CORRECT ANSWER Focus on healthcare and outcomes. Help answer questions and make recommendations for assessments and/or actions. Helps support best practice and use of evidence-based methods. (allergy checking, interactions, abnormal labs, contraindications). Expert Systems - CORRECT ANSWER A complex computer-based system that captures and uses the knowledge of an expert for solving a particular problem. Clinical Practice Guidelines - CORRECT ANSWER Statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options. Wisdom - CORRECT ANSWER Appropriate use of knowledge to manage and solve human problems. Knowing when and how to apply knowledge to deal with complex problems or specific human needs. Human Computer Interaction (HCI) - CORRECT ANSWER The aspect of a computer that enables communications between humans and the computer. The layer of the computer between humans and the computer. Needs continuous user input and is centerd around the user. Human Systems Integration - CORRECT ANSWER A disciplined, unified, and interactive approach to design. The integration of human considerations (cognitive and physical) into system design. Ergonomics (Human Factors) - CORRECT ANSWER An applied science concerned with designing and arranging things people use so that the people and things interact most efficiently and safely. Case Management Information Systems - CORRECT ANSWER Provide standardized plans of care that support best practice. Utilizes decision support software to guide preventative measures and development of the care plan. Acuity System - CORRECT ANSWER Facilitates staffing ratios according to patient acuity. Uses the 5 rights of staffing: 1. Right number of staff 2. Right skills 3. Right location 4. Right time 5. Right patient assignments FMEA Method - CORRECT ANSWER A 12 step process that begins with describing the process in detail then brainstorming each step looking for potential faliures and adverse outcomes. Then a risk priority number is assigned. Then methods are determined to reduce failures and identify performance measures. Knowledge Acquisition - CORRECT ANSWER Obtaining knowledge Knowledge Generation - CORRECT ANSWER Creating new knowledge by changing and evolving Knowledge Processing - CORRECT ANSWER Collecting, analyzing, sythesizing, saving and storing knowledge Knowledge Dissemination - CORRECT ANSWER Distributing and sharing knowledge Scope Creep - CORRECT ANSWER The tendency of a project to enlarge in scope due to additions and changes as well as problems encountered in completing the tasks and miscalculations. Peplau's Theory of Nursing - CORRECT ANSWER Stresses the importance of collaboration between the nurse and the patient. Validation - CORRECT ANSWER Process to ensure that information being stored in a data warehouse is correct, reliable, and consistant. Prevents submitting the wrong data, submitting data by an unauthorized person, asking the system to perform an unacceptable function Information Processing - CORRECT ANSWER The aquisition, recording, organization, retrival, display and dissemination of information. Locates and captures information using software to manipulate it into a desired form and outputting the data. Information Management - CORRECT ANSWER An elemental process by which one files, stores, manipulates and reports data for various uses. Personal Health Record - CORRECT ANSWER A health record "owned" by the patient where the patient maintains and updates their information. Evidence Hierarchy - CORRECT ANSWER Level I - systematic reviews of RCT and non-RCT Level II - single RCT or non-RCT Level III - systematic review of observational studies Level IV - single observational study Level V - systematic review of descriptive/qualitative studies Level VI - single descriptive/qualitative study Level VII - opinions of authorities/experts Organizational Change Management - CORRECT ANSWER A structure approach to helping those in an organization accept and work through the process of moving from current state to future state Column Graph - CORRECT ANSWER Useful for showing data changes over a period of time, or comparisons for 3 or more groups Line Graph - CORRECT ANSWER Used to compare changes over the same period of time for more than one group. Bar Graph - CORRECT ANSWER Used to compare things between different groups or to track changes over time, especially large changes Pie Chart - CORRECT ANSWER Used for comparing parts of a whole. They do not show changes over time. SWOT Analysis - CORRECT ANSWER A framework for identifying and analyzing the internal and external factors that can have an impact on the viability of a project, product, place or person. (strengths, weaknesses, opportunities and threats) Force Field Analysis - CORRECT ANSWER A method for listing, discussing, and assessing the various forces for and against a proposed change by analyzing all of the forces impacting on the change and weighing the pros and cons. Used to develop strategies to reduce the impact of the opposing forces and strengthen the supporting forces. (Kurt Lewin) Adaptation Curve - CORRECT ANSWER Innovators - pull the change Early Adaptors - will try new ideas but careful Early Majority - careful but accept change quicker Late Majority - will accept change after majority Laggards - accept change only after new way becomes tradition Shannon's Information Theory - CORRECT ANSWER Evaluates the effectiveness of comminucations systems. Elements include: -Signal to noise (S/N) ratio -Channel capacity (max information transmitted with minimal error) -Entropy (amount of energy, code, or bits needed for storage or communication of one signal) Weiner's Attribution Theory - CORRECT ANSWER Explains people's behaviors and the cause for the behavior by observing behaviors, judging that the behavior was intentional, and attributing the cause for the behavior on internal or external causes. Data Archiving - CORRECT ANSWER Moving data from current storage to a seperate device for long-term storage of data that is no longer necessary for active use. Low Level Data Input Error - CORRECT ANSWER Wrong sequence of steps triggers an alarm/hardstop until correct; fairly easily corrected Moderate Level Data Input Error - CORRECT ANSWER Inputting data incompatible with the system High Level Data Input Error - CORRECT ANSWER The system is unable to make a decision about the corrective action or unable to correctly interpret outcomes data. Cache Memory - CORRECT ANSWER Stores in-process data for quick retrevial Random Access Memory (RAM) - CORRECT ANSWER Temporary memory used when working on a task (lost when turned off) Read Only Memory (ROM) - CORRECT ANSWER Permanent or semi-permanent memory that stores saved data. Essential to the OS Virtual Memory - CORRECT ANSWER Temporary use of the hard drive for memory when many programs are running at the same time. Small Computer System Interface (SCSI) - CORRECT ANSWER An interface that provides the means for an attachment of additional hardware devices. Ex. Scanner Integrated Drive Electronics Controller (IDE) - CORRECT ANSWER Primary interface for the hard drive, CD-ROM, and DVD drive Peripheral Component Interconnection Bus (PCI) - CORRECT ANSWER Connects plug-in components to the computer with a series of slots on the motherboard. Ex. mouse, keyboard Basic Input/Output System - CORRECT ANSWER Boot firmware. Type of ROM that the computer uses when it boots up. Qualified EHR - CORRECT ANSWER Contains demographics, clinical health information, medical history and problem lists. Capable of providing support for clinical decisions and entry of physician orders. Has the capacity to capture and query information relevant to healthcare quality and exchange electronic health information with and integrate information from other sources. Certified EHR Technology - CORRECT ANSWER An EHR that meets specific governmental standards for the type of record involved. Health Information Technology for Economic and Clinical Health Act (HITECH) - CORRECT ANSWER Addresses the development, adaptation, and implementation of HIT policies and standards and provides enhanced privacy and securities protections for patient information. Reference Database - CORRECT ANSWER Focuses on one type of information. A good place to begin a search for specific types of information SQL Database - CORRECT ANSWER A standardized programming language used for managing relational databases and performing various operations on the data in them. Relational Model - CORRECT ANSWER A collection of data items organized as a set of formally-described tables from which data is accessed or reassembled in different ways without reorganizing the table Small Form Factor - CORRECT ANSWER Computers that have less volume, therefor taking up less desk space, than standard computers Enterprise Integration - CORRECT ANSWER The electronic linkage of healthcare providers, health plans, the government, and other interestes parties. Enables the electronic exchange and use of health information amoung all the components in the health care infrastructure. Nationwide Health Information Network (NwHIN) - CORRECT ANSWER Ensures the secure internet exchange of information through standards, policies, and services. The primary goal is to assist HCP to mover from paper to EHR that is easily accessible and able to evaluate the quality of care. Social Organizational Analysis - CORRECT ANSWER Identifies the different responsibilities of various users so HCI can support collaboration. Strategies Analysis - CORRECT ANSWER Evaluates the manner in which work is actually carried out by users. Worker Competencies Analysis - CORRECT ANSWER Considers design restraints associated with the users. Control Task Analysis - CORRECT ANSWER Considers the control structure with which the user must interact. Work Domain Analysis - CORRECT ANSWER Evaluates system functions and the information needed by users. Malware - CORRECT ANSWER Specifically designed to gain access or damage a computer without knowledge of the owner. Bugs - CORRECT ANSWER Anomaly and failure in the system; a coding error Black Box Testing - CORRECT ANSWER Used in software testing to determine the functional workings of the system. Benchmark Testing - CORRECT ANSWER Compares hardware and software performance Operational System Testing - CORRECT ANSWER Assesses how well a system functions after the introduction of a new component User Acceptance Testing - CORRECT ANSWER Completed during alpha or beta testing; confirms all user requirements are met. Subsystem Integration Testing - CORRECT ANSWER Ensures that the program components integrate into the subsystems. Ensures that the subsystems integrate properly into the application. Load Testing - CORRECT ANSWER Performance testing that checks applications ability to perform under anticipated user loads Stress Testing - CORRECT ANSWER Preformance testing under extreme workloads to see how it handles high traffic Endurance Testing - CORRECT ANSWER Performace testing performed to make sure the software can handle expected loads over time Spike Testing - CORRECT ANSWER Performence testing that checks reaction to sudden larger loads Volume Testing - CORRECT ANSWER Performance testing that checks the software's performance under varying volumes Scalability Testing - CORRECT ANSWER Performance testing that checks the effectiveness in scaling up to support increase in user load. Standards of Professional Performance - CORRECT ANSWER - Evaluates qualitu and effectiveness of NI practice -Performance appraisal -Maintains knowledge and NI competency (life-long learning) -Contributes to professional development of others -Bases decisions and actions on ethical principles -Collaborates with others -Contribute to body of informatics research Competencies of the NI - CORRECT ANSWER -Advanced computer skills -Information literacy -Nursing competency -Process inprovement skills -Project management skills -Communication -Team building -Conflict management -Staff development NI Standards of Practice - CORRECT ANSWER -Assessment -Diagnosis -Outcomes identification -Planning -Implementation -Evaluation -Ethics -Education -Evidence-based practice and research -Quality of practice -Communication -Leadership -Collaboration -Professional practice evaluation -Resource utilization -Enviromental health Adult Teaching/Learning Principals - CORRECT ANSWER -Adults tend to be self-directed -Adults have a reservoir of experience, can be a resorce for learning -Adults tend to have life, task, problem-centered orientation to learning -Adults tend to have an internal/intrinsic motivation to learn Asynchronous Learning - CORRECT ANSWER A student-centered teaching method that uses online learning resources to facilitate information sharing outside the constraints of time and place among a network of people Synchronous Learning - CORRECT ANSWER A learning event in which a group of students are engaging in learning at the same time. Didactic Learning - CORRECT ANSWER The pedagogy of instruction and immutable facts, of authority and telling, and of right and wrong answers - it is teacher-centred and values learners who sit still and listen quietly and attentively, passively accepting the teacher as the knower and expert, both the source of knowledge and judge-jury of knowing. Traditional Learning - CORRECT ANSWER A back-to-basics, conventional education or customary education Hybrid Learning - CORRECT ANSWER Combines online digital media with traditional classroom methods. It requires the physical presence of both teacher and student, with some element of student control over time, place, path, or pace. End-to-End Testing - CORRECT ANSWER Verifies proper function of the system from client to network to server to database Alpha Testing - CORRECT ANSWER An initial phase of testing often used in software testing Beta Testing - CORRECT ANSWER Final stage of testing before release Re-engineering - CORRECT ANSWER Identifies, analyzes, and redesigns the core business process to achieve dramatic improvement in critical performance measures; cost, quality, service and speed Logical Database Design - CORRECT ANSWER Steps followed to produce a detailed data model of a database 1. Scope 2. Logical Design 3. Technical Optimization 4. Implementation Primary Keys - CORRECT ANSWER Unique identifiers used in relational databases columns Secondary Keys - CORRECT ANSWER Secondary unique identifiers used in relational databases that are not assigned as primary Physical Database Design - CORRECT ANSWER Translates the Logical Database Design through 3 phases: 1. Concept- produces a data model that develops relevant entities and relationships fpr the application domain 2. Logic- procedures and measures that maximize the potential for the database 3. Physical- specifies how database records are stored, accessed, and related for the best performance Hashing - CORRECT ANSWER Performing a calculation on a record key to determine a physical address Indexing - CORRECT ANSWER A look-up procedure on a field value that determines a physical location from a primary key Quality Assurance - CORRECT ANSWER The planned and systematic activities implemented in a quality system so that quality requirements for a product or service will be fulfilled Auditing - CORRECT ANSWER An evaluation to indicate needed corrective responses through the observation of techniques and activities Parallel Implementation - CORRECT ANSWER Running two systems simultaneously. Expensive and time-consuming. Domains - CORRECT ANSWER Copies of the software system at various states. Also known as "enviroments". Fountain Method - CORRECT ANSWER Strategy where implementation occurs in stages with considerable overlap. Waterfall Method - CORRECT ANSWER Strategy when implementation occurs in stages when one phase leads to another. Pilot Implementation - CORRECT ANSWER Strategy where implementation occurs on a stand alone unit with minimal interactions with other units. Build and Fix Method - CORRECT ANSWER Strategy of implementation where codes are written and modified until the outcome is achieved. Most risky implementation method. Spiral Method - CORRECT ANSWER Strategy of implementation that allows for reiteration of earlier stages and a progressive implementation. Big Bang Approach - CORRECT ANSWER Strategy of implementation where are users are switched from the original system to a new system at once. Backup and Recovery - CORRECT ANSWER -Backup should be stored on multiple devices -Backups should be performed during times of minimal access -Systems should be backed up at least weekly and tested at least monthly -"Warm Site" off site back up system containing patient data. Able to activate within hours and located 50 miles from home site. User Authentication - CORRECT ANSWER User access that requires valid username and password combinations. Should be changed every 30-60 days. NI Functional Areas - CORRECT ANSWER -Quality and Performance Improvement -Operational Architecture -Genetics and Genomics -Analyst -Compliance and Integrity -Consultants -Coordination, Facilitation, and Integration -Development of systems, products, resources -Education and Professional development -Research and Evaluation -Informatics Administrator/Officer Performance Improvement - CORRECT ANSWER Setting goals, implementing systematic changes, measuring outcomes, and making subsequent appropriate improvements to meet the needs of patients. Quality Improvement - CORRECT ANSWER Systematic and continuous actions that lead to measurable improvement Knowledge Management - CORRECT ANSWER The creation of systems that enable organizations to tap into the knowledge, experiences, and creativity of their staff to improve their performance Technology Informatics Guiding Education Reform (TIGER) Initiative - CORRECT ANSWER focused on education reform and interprofessional community development. Maximizes the integration of technology and informatics into seamless practice, education and research resource development. NI Entry-Level Core Competencies - CORRECT ANSWER Focuses primarily on developing and using skills that rely upon the ability to retrieve and enter data in an electronic format that is relevant to patient care, the analysis and interpretation of information as part of planning care, the use of informatics applications designed for nursing practice, and the implementation of policies relevant to information. • Basic computer literacy, including the ability to use basic desktop applications and electronic communication • The ability to use IT to support clinical and administrative processes, which presumes information literacy to support evidence-based practice • The ability to access data and perform documentation via computerized patient records • The ability to support patient safety initiatives via the use of IT • Recognition of the role of informatics in nursing NI The Experienced Nurse - CORRECT ANSWER This practitioner has the expertise to serve as a content expert in system design, to see relationships among data elements, to execute judgments based on observed data patterns, to safeguard access to quality of information, and to participate in efforts to improve information management and communication •Proficiency in his or her area of specialization and the use of IT and computers to support that area of practice including quality improvement and other related activities (ANA 2008) • Knowledge representation methodologies for evidence-based practice • The ability to use information systems and work with informatics specialists to enact system improvements • Proficiency in using evidence-based databases • The promotion of innovative applications of technology in healthcare NI The Informatics Nurse - CORRECT ANSWER This individual has advanced preparation in information management and possesses the following skillS: • Proficiency with informatics applications to support all areas of nursing practice including quality improvement activities, research, project management, system design, development, analysis, implementation, support, maintenance, and evaluation • Fiscal management • Integration of multidisciplinary language/standards of practice • Skills in critical thinking, data management and processing, decision making, and system development, and computer skills • Identification and provision of data for decision making NI The Informatics Nurse Specialist - CORRECT ANSWER Possesses a sophisticated level of understanding and skills in information management and computer technology, demonstrating most of the competencies seen at the previous three levels. Tthe innovator who sees the broad vision of what is possible and how it may be attained. The Scope and Standards of Nursing Informatics Practice (ANA 2008) calls for educational preparation to conduct informatics research and generate informatics theory. Well suited to work in a variety of areas and functional roles including project management and administration. Department of Health and Human Services (HHS) - CORRECT ANSWER (2009) Government body that establishes programs to improve healthcare quality, safety, and efficiency through the use of HIT. Forming - CORRECT ANSWER In this first stage, team members are getting to know each other; there is little friction and the team is polite and will offer few opinions. At this stage they do not fully understand what work is required or how each will work together. At this point the PM must be directive and make sure the team has clear objectives. It is also a good time to evaluate individual skills and personalities. Storming - CORRECT ANSWER In the second stage, there may be conflict among team members; there may be challenges to the PM decisions; members may jockey for positions. At this stage, the PM may need to clarify roles if they have not been clear in the past; at this stage authority may be challenged. The APN PMs must remember that they are ultimately responsible for the project. Norming - CORRECT ANSWER In the third stage, the team starts to work better together and resolve their differences; they better understand and respect their different roles as well as those of the PM. As the team moves along and as new tasks come up, there may be periods when they move back to storming as they again clarify their roles. It will be important to facilitate further collaboration among the team members. Performing - CORRECT ANSWER In the fourth stage, the team, without friction, moves toward accomplishing the project goals and objectives. At this point, the APN may more easily delegate much of the work, but must always remember the ultimate responsibility for the entire project lies with the PM Status Meetings - CORRECT ANSWER Provide the timely status of the project at least on a weekly basis. The reports provide updates to the planning and implementation process and establish a pattern of a way to keep everyone informed. Access code - CORRECT ANSWER Unique identifier generally provided by a name and password for the specific purpose of restricting computer or information system use to persons who have legitimate authority to view or use information found in the computer or information system. Accountable care organizations (ACOs) - CORRECT ANSWER Payment and healthcare delivery reform model that ties provider reimbursement to quality metrics and reductions in the total cost of care for a given patient population. Administrative information systems - CORRECT ANSWER Systems that support patient care by managing financial and demographic information and providing reporting capabilities. Aggregate data - CORRECT ANSWER Data that are derived from large population groups. American Recovery and Reinvestment Act of 2009 (ARRA) - CORRECT ANSWER Legislation that included provisions for health information technology and funding for the Office of the National Coordinator of Health Information Technology (ONCHIT). Archetypes - CORRECT ANSWER Re-usable clinical models of content and processes significant for an initiative to develop a lifelong electronic record. Architecture - CORRECT ANSWER Structure of the central processing unit and its interrelated elements within an information system. Arden Syntax - CORRECT ANSWER Standard language used in the healthcare industry for writing rules. Asynchronous Transfer Mode (ATM) - CORRECT ANSWER High-speed data transmission method suitable for voice, data, image, text, and video information that use fiber or twisted pair cable. It is faster than ISDN, but less frequently used for reasons of cost, availability, and a lack of standards. Authoring tools - CORRECT ANSWER Software programs that allow persons with little or no programming expertise to create instructional computer programs. Backloaded - CORRECT ANSWER Information that is preloaded into the system before the go-live date. Batch processing - CORRECT ANSWER Manipulation of large amounts of data into meaningful applications at times when computer demands are lowest as a means to maintain system performance during peak utilization hours. Batch-processed information is not available before processing and is little used today except to run reports. Bennett Bill - CORRECT ANSWER Although not passed into law, the Medical Records Confidentiality Act of 1995 was a significant piece of legislation because it attempted to establish the role of healthcare providers in the protection of client information; to fix conditions for the inspection, copying, and disclosure of protected information; and to institute legal protection for health-related information. Bibliography database manager (BDM) - CORRECT ANSWER Software that allows the importation of references directly from databases. Selected examples include EndNote, Reference Manager, ProCite, Biblioscape, and the Web-based Zotero. Business continuity management - CORRECT ANSWER Process to ensure that organizations can withstand any disruption to normal functioning. Business continuity planning (BCP) - CORRECT ANSWER Combines information technology and disaster recovery planning with business functions recovery planning. Business impact assessment or analysis (BIA) - CORRECT ANSWER Process of determining the critical functions of the organization and the information vital to maintain operations as well as the applications and databases; hardware; and communications facilities that use, house, or support this information. File Transfer Protocol (FTP) - CORRECT ANSWER Set of instructions that controls both the physical transfer of data across a network and its appearance on the receiving end. Healthcare Information Exchange (HIE) - CORRECT ANSWER Electronic sharing of patient information such as demographic data, allergies, presenting complaint, diagnostic test values, and other relevant data between providers such as primary physicians, specialists, hospitals, and ambulatory care settings according to nationally recognized standards. International Classification of Nursing Practice (ICNP) - CORRECT ANSWER A system that serves to unify various approved nursing languages and classification systems to ensure the acceptance of common meanings across different settings. Mapping - CORRECT ANSWER Process by which the definition of terms used in one information system are associated with comparable terms in another system, thereby facilitating the exchange of information from one system to another. Master patient index (MPI) - CORRECT ANSWER Database that lists all identifiers used in connection with one particular client in a healthcare alliance. Identifiers may include items such as Social Security number, birth date, and name. Nursing Minimum Data Set (NMDS) - CORRECT ANSWER Collection of data comprised of nursing diagnoses; interventions; and outcomes that allows comparison of data across different healthcare settings in order to project trends and stimulate research. Ontology - CORRECT ANSWER System that organizes concepts by meaning describing the definitional structure/relationship and organizes concepts for storage and retrieval of semantically accurate data. Public key infrastructure (PKI) - CORRECT ANSWER Provides a unique code for each user that is embedded into a storage device. Agency for Healthcare Research and Quality (AHRQ) - CORRECT ANSWER An agency within the U.S. Department of Health and Human Services that supports health services research initiatives. Bagging - CORRECT ANSWER The use of voting and averaging in predictive data mining to synthesize the predictions from many models or methods or for using the same type of a model on different data; it deals with the unpredictability of results when complex models are used to data mine small data sets. Casuist approach - CORRECT ANSWER An approach to ethical decision making that grew out of the concern for more concrete methods of examining ethical dilemmas. Casuistry is a casebased ethical reasoning method that analyzes the facts of a case in a sound, logical, and ordered or structured manner. The facts are compared to the decisions arising out of consensus in previous paradigmatic or model cases. Classification and regression trees (CART) - CORRECT ANSWER A decision tree method that is used for sorting or classifying a data set. A set of rules that can be applied to a new data set that has not been classified; the set of rules is designed to predict which records will have a specified outcome. Entity-relationship diagram (ERD) - CORRECT ANSWER Diagram that specifies the relationships among the entities in the database. Sometimes the implied relationships are apparent based on the entities' definitions; however, all relationships should be specified as to how items relate to one another. There are typically three relationships: one to one, one to many, and many to many. Metrics - CORRECT ANSWER Measurements or a set of measurements to quantify performance; they provide understanding about the performance of a process or function. National Health Information Infrastructure (NHII) - CORRECT ANSWER An initiative intended to improve the effectiveness, efficiency, and overall quality of health and health care in the United States. A comprehensive knowledge-based network of interoperable systems of clinical, public health, and personal health information that would improve decision making by making health information available when and where it is needed. The set of technologies, standards, applications, systems, values, and laws that support all facets of individual health, health care, and public health. The NHII is voluntary and not a centralized database of medical records or a government regulation. Nationwide Health Information Network (NHIN) - CORRECT ANSWER An agency of the U.S. Department of Health and Human Services charged with the development of a safe, secure, interoperable health information infrastructure. Office of the National Coordinator for Health Information Technology (ONC) - CORRECT ANSWER An office within the U.S. Department of Health and Human Services that was established through the HITECH Act. The ONC is headed by the national coordinator, who is responsible for overseeing the development of a nationwide health information technology infrastructure that supports the use and exchange of information. Online analytical processing (OLAP) - CORRECT ANSWER A fast analysis of shared data stored in a multidimensional database that allows the user to easily and selectively extract and view data from different points of view. Ontological approach - CORRECT ANSWER Theory that considers ontology development (domain analysis) and its mapping to object models (specification of infrastructure). Based on enumerating all concepts used in a domain and in providing their formal definitions according to suitable formalisms (usually logic based). Ontology - CORRECT ANSWER Study of that which is compositional in nature and a partial representation of the entities within a domain and the relationships that hold between them. An explicit specification of a conceptualization. Qualitative study - CORRECT ANSWER A type of research design that focuses on the human experience of a phenomenon using words, concepts, language, and meanings rather than numbers to capture the essence of the subject under study. Subjective study. Quantitative study - CORRECT ANSWER Research that looks at the what, where, and when to provide understanding of phenomena based on quantifying data and using statistical measures; depending on the research, a study may ascertain cause-and-effect relationships. Objective study. Radio frequency identification (RFID) chip - CORRECT ANSWER An identification chip that stores information for retrieval. Sarbanes-Oxley Act (SOX) - CORRECT ANSWER Legislation that was put in place to protect shareholders as well as the public from deceptive accounting practices in organizations. Standard Generalized Markup Language (SGML) - CORRECT ANSWER Metalanguage; markup language for documents. Extensible Markup Language (XML) began as a simplified subset of SGML. Structured English Query Language (SQL) - CORRECT ANSWER A database querying language, rather than a programming language. SQL is a standard language for accessing and manipulating databases. It simplifies the process of retrieving information from a database in a functional or usable form while facilitating the reorganization of data within the database. Synchronous dynamic random-access memory (SDRAM) - CORRECT ANSWER The most common type of dynamic random-access memory found in personal computers. TELOS strategy - CORRECT ANSWER An approach that provides a clear picture of the feasibility of a project; TELOS stands for "technologic and systems, economic, legal, operational, and schedule feasibility." Terabyte (TB) - CORRECT ANSWER A measurement term for data storage capacity. One terabyte equals 1,024 gigabytes. Thick (fat) client - CORRECT ANSWER A computer connected to a network designed primarily for data processing and not communications or storage. Thin client - CORRECT ANSWER A computer that conveys input and output from the user to the server and back, but does no processing. Tuple - CORRECT ANSWER A record in a database; also known as a row. Ubiquity - CORRECT ANSWER State of being everywhere at once (or seeming to be everywhere at once). Presence in many places especially simultaneously. With changing models of healthcare delivery, information and knowledge should be available anywhere. [Show Less]
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School nurse certification exam 85 Questions with Verified Answers,100% CORRECT
School nurse certification exam 85 Questions with Verified Answers What is the period of rapid growth as compared to preschool and school age? - CORRECT... [Show More] ANSWER adolescence what is the maturation of a body or system? this term involves the process of acquiring new abilities and skills? - CORRECT ANSWER development what are some examples of development? - CORRECT ANSWER logical and abstract thought manual dexterity language skills interpersonal communication skills in what direction does development occur? - CORRECT ANSWER cephalocaudally ( from head to toe) proximodistally ( from the trunk to the extremities) both growth and development are affected by what? - CORRECT ANSWER genetics environment health nutrition Children should be observed in what kind of activities in order to make an assessment? - CORRECT ANSWER in structured AND unstructured activities low to the ground balance beam activity promotes... - CORRECT ANSWER balance hopscotch develops.... - CORRECT ANSWER motor coordination climbing equipment develops..... - CORRECT ANSWER body awareness upper body strength preschool (ages 3-5) are able to jump off steps that are approximately how many inches? - CORRECT ANSWER 12 inches high A preschool child (age 3-5 y/o) can copy what figure? - CORRECT ANSWER circle and a cross At what age/ stage do children begin to develop a conscience? - CORRECT ANSWER during the preschool years (3-5 y/o) what type of play can a preschooler (age 3-5 y/o) do? - CORRECT ANSWER parallel play associative play group play independent play At what age do children develop causality? - CORRECT ANSWER Preschool age (3-5 y/o) note: the child may still exhibit magical thinking What is the total amount of steps/directions a preschooler age 3-5 y/o can successfully follow? - CORRECT ANSWER can follow 2 step directions a child in preschool (3-5 y/o) can draw what figure? - CORRECT ANSWER man with 3 parts At what age do children become aware of racial and sexual differences? - CORRECT ANSWER preschool age (3-5 y/o) when should developmentally appropriate teaching regarding sexuality begin? - CORRECT ANSWER preschool ( 3-5 y/o) what are the diet and nutritional requirements for a preschool child 3-5 y/o? - CORRECT ANSWER 3 meals plus 2 healthy snacks each day ONE TABLEspoon per year of age for EACH serving/food group what is the appropriate discipline for preschool age (3-5 y/o)? - CORRECT ANSWER ONE minute for each year of age; tell child when their time out is over because they have a poor sense of time yes or no? should you compare one child to another in terms of ability or psychosocial traits? - CORRECT ANSWER NO! how often should a preschooler see a dentist? - CORRECT ANSWER annually how often should a child brush their teeth? - CORRECT ANSWER twice daily at what age should you introduce dental flossing? - CORRECT ANSWER preschool age 3-5 y/o A child should be in the forward facing positing in the back seat until what age and weight? - CORRECT ANSWER 4 y/o and 40 lbs Until what heigh should a child use a booster seat? - CORRECT ANSWER until they are 4'9" children should remain in backseat up to what age? - CORRECT ANSWER up to the age of 13 this terms refers ONLY to an increase in size of an organ or structure (ex. height/weight) and it DOES NOT indicate function - CORRECT ANSWER growth - CORRECT ANSWER at what stage do children like to accomplish tasks? - CORRECT ANSWER school age (6-12 y/o) school age (6-12 y/o) still have difficulty with what? - CORRECT ANSWER directionality and spatial location T/F school age children (6-12 years old) rarely contract serious ilnesses? - CORRECT ANSWER TRUE (p. 19) note: minor childhood diseases continue to occur which group is at the highest risk of injuries, acute illnessess, learning difficulties, and emotional and adjustment problems ? - CORRECT ANSWER school age (6-12 y/o) T/F school age children (6-12 y/o) may begin to develop secondary sex characteristics and begin pre-puberty growth? - CORRECT ANSWER TRUE Precocious puberty is less than what age for Caucasian girls? - CORRECT ANSWER less than 7 years of age Precocious puberty is less than what age for African american females? - CORRECT ANSWER less than age 6 precocious puberty is less than what age for males? - CORRECT ANSWER less than age 9 on the exam ages that are covered are.. - CORRECT ANSWER ages 3-21 what is fhe shortest time period you can have the HBV series? - CORRECT ANSWER 6 months does every state have the same immunization requirements? - CORRECT ANSWER no. there are immunizarion laws in all states but they differ in evert state. the stare derermi s which ones are required and when they are done. cephalocaudal - CORRECT ANSWER head to toe proximodistal - CORRECT ANSWER from core to extemities gross motor to fine motor paiget deals with what development - CORRECT ANSWER cognitive development erickson deals with - CORRECT ANSWER psychosocial development kohlberg deals with - CORRECT ANSWER moral development piaget stages - CORRECT ANSWER preoperational ages 2-7 concrete operational 7-11 formal - 11 years and older Erickson psychosocial stages - CORRECT ANSWER autonomy vs shame/doubt ages 1-3 initiative vs guilt ages 3-6 industry vs inferiority ages 6-12 identitt vs role confusion ages 12-19 years old moral development occurs at what age - CORRECT ANSWER 9 years old preschool diet should be - CORRECT ANSWER 3 meals 2 snacks do not mix food together what age do you lose first teeth - CORRECT ANSWER age 6 all permanent teeth should be in by what age - CORRECT ANSWER age 12 what is the earliest puberty is seen and is considered normal - CORRECT ANSWER age 8 booster seat until when - CORRECT ANSWER 8 yeara old and 80 pounds age of first sign of puberty in boys - CORRECT ANSWER age 11 sperm development in boys - CORRECT ANSWER around 13 BEFORE pubic hair and growth spurt first sign of female puberty - CORRECT ANSWER breast buds menses occurs when - CORRECT ANSWER 2-3 years after bud stage (also considered end if growth) males will grow until what age - CORRECT ANSWER 20 menarch and body fat - CORRECT ANSWER 17% body fat to start 22% body fat to maintain leadinf cause of death in school age - CORRECT ANSWER accidents leading cause of death in adolescents - CORRECT ANSWER suicide homicide tympanic temperature - CORRECT ANSWER pull ear UP and BACK temporal artery - CORRECT ANSWER from middle of forehead to hairline when should temp be taken - CORRECT ANSWER 30-60 minutes AFTER intervention 20-30 minutes after drinking hot or cold apical pulse location - CORRECT ANSWER at PMI (point of maximum impulse) left of clavicular line at 4th intercostal space if child is less than 7 years old. at 5th intercosral space if child is greater than 7 years old for murmurs documente - CORRECT ANSWER rate rythm and quality of sound normal HR for up to age 8 - CORRECT ANSWER 75-115/min. normal heart rate for ages 8-11 - CORRECT ANSWER 70-110 /min normal heart rate in teens - CORRECT ANSWER 60-100 how to know if a child is in true respiratory distress - CORRECT ANSWER can they speak in a full sentence respiratory rate for ages 3-7 - CORRECT ANSWER 20-25 respiratory rate for ages 8-11 years old - CORRECT ANSWER 14-22 respiratory rate for ages 12 and older - CORRECT ANSWER 12-20 which arm should you use for BP - CORRECT ANSWER right. for consistency p. 24 BP for age 3 - CORRECT ANSWER 90/40 BP for age 7 - CORRECT ANSWER 97/57 BP for age 11 - CORRECT ANSWER 104/61 BP for teens - CORRECT ANSWER 113/64 when should you retake BP - CORRECT ANSWER in 5 minutes of abnormal with: headache flushing weak pulse bounding pulse pallor dizziness tympany - CORRECT ANSWER loud GI resonance - CORRECT ANSWER hollow lungs dullneaa - CORRECT ANSWER thud liver flatness - CORRECT ANSWER bone bell is to listen to - CORRECT ANSWER LOW sounds (cardiac) - CORRECT ANSWER [Show Less]
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Ambulatory Care Nursing Certification Review 35 Questions with Verified Answers,100% CORRECT
Ambulatory Care Nursing Certification Review 35 Questions with Verified Answers Definition of Ambulatory care nursing - CORRECT ANSWER complex, multifac... [Show More] eted specialty that encompasses independent and collaborative practice. Ambulatory Care Nursing includes - CORRECT ANSWER clinical, management, education, research Ambulatory nurses work with patients who seek care for - CORRECT ANSWER health promotion, health maintenance, health related problems Services focus on cost-effective ways to: - CORRECT ANSWER maximize wellness, prevent illness, disability, disease and minimize symptoms of acute minor ailments Supports patients in managing chronic disease- - CORRECT ANSWER to effect a more positive health status throughout the lifespan up to & including a peaceful death Conceptual framework is a guide/map that specifies: - CORRECT ANSWER essential concepts & skills in an area of practice and relationships between major content and skill area Major Roles of the Ambulatory Care Nurse - CORRECT ANSWER Clinical Practice, Professional development, & Organizational operation systems Care management defined - CORRECT ANSWER collaborated process of assessment, planning, facilitation, and advocacy for options and services to meet individuals needs Continuum of Health care - CORRECT ANSWER refers to the categories of care and care services that address healthcare needs across the consumers' life span Primary Care: - CORRECT ANSWER principle point of contact within a health care system-integrates primary services with other levels of care. Involves widest scope of health care. Continuity is key characteristic Secondary care: - CORRECT ANSWER synonymous with hospital services Tertiary Care: - CORRECT ANSWER highly specialized, highly technological hospital services Mass Casualty Triaging - CORRECT ANSWER First responders using START to evaluate victims and assign them to one of 4 categories Mass casualty (RED) - CORRECT ANSWER Immediate Mass casualty (YELLOW) - CORRECT ANSWER Delayed Mass casualty (Green) - CORRECT ANSWER Walking wounded/minor Mass casualty (black) - CORRECT ANSWER Deceased/expectant Coordination of care includes - CORRECT ANSWER resource utilization, transition management, case management, disease management Autonomy - CORRECT ANSWER the right to choose one's own course of action without coercion Beneficence - CORRECT ANSWER doing what is good. requires determining "good" in the situation, understanding what is in the best interest of the patient Non-maleficence - CORRECT ANSWER avoiding harm, either intentionally or as an unintended outcome Justice - CORRECT ANSWER fair and equitable distribution of resources Veracity - CORRECT ANSWER truth telling confidentially - CORRECT ANSWER Respecting the privacy of both parties and keeping details secret fidelity - CORRECT ANSWER faithfulness, keeping of promises advocacy - CORRECT ANSWER act or process of supporting a cause or proposal nursing advocacy - CORRECT ANSWER combines knowledge with actions Assessment/Nursing process - CORRECT ANSWER assessment, diagnosis, planning & organizing, implementation, evaluating responses, reassessment & revision of the plan Order of performing a physical assessment (non abd) - CORRECT ANSWER Inspection, palpitation, percussion, auscultation Order of abdominal assessment - CORRECT ANSWER inspection, auscultation, percussion, palpation The 7 dimensions of a symptoms (Scholar) - CORRECT ANSWER S=Symptoms associated C=Characteristics (quantitate/qualitative) H=History w/this problem O=Onset (when, sudden, gradual) L=Location (where/radiates) A=Aggravating factors R=Relieving factor Nursing Diagnosis - CORRECT ANSWER Analyze and interpret the data Planning - CORRECT ANSWER involves the patient & family, determine goals/outcomes, apply critical thinking Implementation - CORRECT ANSWER Pt education & teaching, perform the nursing actions Evaluation - CORRECT ANSWER determine effectiveness of interventions, revise as indicated [Show Less]
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ANCC Nursing Informatics Certification Review 276 Questions with Verified Answers,100% CORRECT
ANCC Nursing Informatics Certification Review 276 Questions with Verified Answers HIPPA only applies to organizations that have electronic health record... [Show More] s. True False - CORRECT ANSWER False The Informatics nurse is involved with measure to protect the security and confidentiality of patient data because: a. it is a joint commission mandate b. it is regulated by HIPPA legislation c. the major cause of security breaches is human error d. both B and C are correct - CORRECT ANSWER d. It is regulated by HIPPA Legislation and The Major cause of security breeches is human error. Controls to protect data privacy and integrity are both logical and: a. physical b. analytical c. theoretical d. psychological - CORRECT ANSWER b. analytical Which of the following is not a mechanism for protecting the security of health data: a. Automatic sign-offs b. A Strong Password c. Having one password per nursing unit d. Firewalls - CORRECT ANSWER C. Having one password per nursing unit. An audit trail is : a. a log of which project meetings and events have been completed b. an electronic tool that can track system access by individual user who viewed a specific client record. c. a proactive tool to monitor who will be using a system and modifying data. d. used primarily as a data integrity tool - CORRECT ANSWER b. an electronic tool that can track system access by individual user who viewed a specific client record. Data can be represented by all EXCEPT: a. text b. audio c. transmission waves d. video - CORRECT ANSWER a. text Things to consider related to disaster planning include: a. should have only 1 database to make it easier to recover b. all data should be stored onsite so it is accessible c. must have a solid communication plan during disaster and recovery. d. an association or group that shows uniformity - CORRECT ANSWER C. Must have a solid communication plan during disaster and recover. Some examples of physical security for healthcare data are fences, walls, locks, safes, vaults, armed guards, sensors, alarms. True False - CORRECT ANSWER TRUE One way to track the activity that is occurring in a system is: a. a GANTT chart b. an audit trail c. a data backup d. biometrics - CORRECT ANSWER b. an audit trail PHI stands for : a. physician hospital interchange b. password hint indicator c. potential hardware incursion d. protected health information - CORRECT ANSWER d. Protected Health Information If the informatics nurse is concerned that a computer system may not function well during peak times of access the type of testing needed is: a. Functional Testing b. System Integrated testing c. Black box testing d. Load volume testing - CORRECT ANSWER Load Volume Testing What is Load Volume Testing? - CORRECT ANSWER Load/volume testing is a non-functional testing for reliability that assesses the ability of the system to function under various loads, such as at peak times when multiple users in multiple departments are accessing the system. The purpose of load/volume testing is to determine the maximum load capacity and to identify the load at which problems begin to occur. Testing is done at both the safe working load (SWL) and above the SWL. In preparation for the workflow redesign necessitated for implementation of an EHR, the first step should be to a. Assess the EHR requirments b. Conduct surveys about the workflow c. Assess compatibility with the EHR d. Map the current workflow - CORRECT ANSWER map the current workflow Which resource for evidence-based research is provided by the National Library of Medicine? a. BMJ Publishing b. CINAHL c. PubMed d. World View on Evidence based- nursing - CORRECT ANSWER PubMed is a resource for evidence-based research that is provided by the National Library of Medicine, which was developed by the National Center for Biotechnology Information (NCBI). PubMed provides access to numerous databases with 24 million citations from MEDLINE (the National Library of Medicine's bibliographic database with references to life sciences and biomedical sciences), life science journals, and electronic books with links to full text when it is available. When considering transitioning to cloud storage and assessing vendors, the most critical assessment relates to: a. regulatory compliance b. monitoring mechanisms c. cost analysis d. interoperability - CORRECT ANSWER The most critical assessment relates to compliance with regulatory requirements because if the vendor cannot verify that the company meets HIPAA requirements and satisfies the Code of Federal Regulations Title 21, Part 11 (which provides regulations regarding electronic records and electronic signatures), then security of patient data may be inadequate. Other important considerations include cost analysis (including cost of implementation and ongoing costs), monitoring mechanisms, and interoperability. When utilizing a prioritization matrix to prioritize activities as a project manager, the informatics nurse must first establish: a. rating scale and categories b. criteria and timeframe c. criteria and rating scale d. rating scale and timeframe - CORRECT ANSWER the informatics nurse must first establish criteria and a rating scale. The criteria includes those factors that are utilized to determine how important each project is; for example, a project mandated by regulations is more important than a project that may improve customer satisfaction. A rating scale for each project should be established with numeric values (such as 1 to 10) used to demonstrate how effective the project is in meeting the criteria. A typical prioritization matrix may have up to a dozen criteria. An advantage of an identity and access management (IAM) system is that the IAM system: a. provides HIPAA-required encryption for PHI b. satisfies the Code of Federal Regulations Title 21, Part 11 c. meets HIPAA's Security Rule requirements regarding access to PHI d. meets HIPAA's Privacy Rule requirements regarding identification - CORRECT ANSWER An advantage of an identity and access management (IAM) system is that the IAM system meets HIPAA's Security Rule requirements regarding access to PHI through identity management. An IAM system provides, captures, updates, and records user IDs and provides appropriate access privileges, preventing "privilege creep," which increases risks to security. The IAM system should provide authentication (single sign-in and session management), authorization (based on roles, rules, and attributes), user management (provisioning and password management), and a central directory. When utilizing a prioritization matrix to prioritize activities as a project manager, the informatics nurse must first establish: a. rating scale and categories b. criteria and timeframe c. criteria and rating scale d. rating scale and timeframe - CORRECT ANSWER first establish criteria and a rating scale. The criteria includes those factors that are utilized to determine how important each project is; for example, a project mandated by regulations is more important than a project that may improve customer satisfaction. A rating scale for each project should be established with numeric values (such as 1 to 10) used to demonstrate how effective the project is in meeting the criteria. A typical prioritization matrix may have up to a dozen criteria. An advantage of an identity and access management (IAM) system is that the IAM system: a. provides HIPAA-required encryption for PHI b. satisfies the Code of Federal Regulations Title 21, Part 11 c. meets HIPAA's Security Rule requirements regarding access to PHI c. meets HIPAA's Privacy Rule requirements regarding identification - CORRECT ANSWER provides HIPAA-required encryption for PHI Which of the following standardized nursing terminologies is comprised of (1) a problem classification scheme, (2) an intervention scheme, and (3) a problem rating scale for outcomes? a. NANDA-I b. PNDS c. OMAHA c. ICNP - CORRECT ANSWER OMAHA is standardized nursing terminology that is comprised of (1) a problem classification scheme, (2) an intervention scheme, and (3) a problem rating scale for outcome. OMAHA was developed by the Visiting Nurse Association in Omaha, Nebraska, in the 1970s and was later developed further through research projects funded by the US Department of Health and Human Services. OMAHA is in the public domain but must be used as published (as opposed to modified). The smallest possible piece of data utilized in computer processing is the: a. byte b. zettabyte c. nibble d. bit - CORRECT ANSWER Bit The smallest piece of data utilized in computer processing is the bit (binary digit), which comprises zeros (off) and ones (on). Four bits equal one nibble, eight bits equal one byte, 1024 bytes equal one kilobyte, 1024 kilobytes equal one megabyte, and 1024 megabytes equal one gigabyte. Communication software is most commonly used for: a. video files b. e-mail and IM c. audio files d. documents - CORRECT ANSWER e-mail and IM. The network that connects the departments in an organization is likely a(n): a. WAN b. VSN c. MAN d. LAN - CORRECT ANSWER LAN When an institution is transitioning to a CPOE, a primary role of the informatics nurse is that of: a. system designer b. purchasing agent c. liaison d. software modifier - CORRECT ANSWER Liason - When an institution is transitioning to a CPOE, a primary role of the informatics nurse is that of liaison to promote multidisciplinary collaboration and cooperation among the various members of the healthcare team, including nurses, physicians, and IT specialists, to ensure that the end-product has the functionality that is needed for workflow and that it meets the requirements for safety and security. Needs regarding both hardware and software must be clearly communicated to IT personnel. The field of science that attempts to create intelligent technologies and then apply these technologies to the field of informatics is: a. cognitive science b. information science c. artificial intelligence d. cognitive informatics - CORRECT ANSWER AI - Artificial Intelligence. Researchers in artificial intelligence must engineer general intelligence and reasoning skills into the artificial intelligence programs as well as the ability to develop and learn from experiences and errors and to process natural language. One example of an artificial intelligence program is Siri®, which responds to verbal queries and is found on Apple devices, such as the iPhone and iPad. In an EHR with CPOE and CDS, allergy alerts should be triggered: a. after orders are written b. on physician request by accessing a link c. before orders are written d. in response to contraindicated drug orders - CORRECT ANSWER in response to contraindicated drug order. The human-technology interface (HTI): a. connects a user device to the Internet b. allows user interaction with technology c. standardizes applications utilized in all devices d. allows access to the technology only to authorized people - CORRECT ANSWER Allows user interaction with technology. The nurse informaticist (NI) is working on the implementation of a replacement laboratory system. One major consideration in order to have a fully operational system is: A. End-user support B. Stress testing C. Executive level support D. Data conversion - CORRECT ANSWER D. Data Conversion - All responses are important, but in order to move from one system to another the data needs to be moved. The organization has agreed to be the first major test site in which software will be installed. This site is known as a/an: A. Primary site B. Secondary site C. Alpha site D. Beta site - CORRECT ANSWER D. Beta site. Beta site testing is the final stage of testing (usually before commercial release). Primary and secondary sites are not the appropriate terms and alpha site is an initial phase of testing often used in development of software. The Informatics Nurse Specialist is developing a test scenario to determine if the admissions, discharge, and transfer application will work with the clinical documentation and laboratory results reporting modules of a larger electronic health record. This is known as: A. Unit testing B. Acceptance testing C. Integration testing D. System Testing - CORRECT ANSWER C. Integration testing - Integration testing is testing between systems. Unit testing only tests one discrete function and acceptance testing occurs when users test entire system to determine if the system meets the specified requirements of the design. The implementation team has determined that the conversion to the new system will occur department by department, with two weeks in between each installation. This is known as: A. Parallel installation B. Phased installation C. Big bang installation D. Risky installation - CORRECT ANSWER b. phase installation - Phased installation is when the implementation is done in stages, where one phase leads to another. Parallel installation defined: - CORRECT ANSWER Parallel installation occurs when old and new system are implemented simultaneously, and the 2 systems run simultaneously (i.e. paper and electronic, "old" system and "new" system). Which of the following is NOT a major phase in implementation and testing? A. Education and Training B. Conversion and "Go Live C. Operations and Language Barriers D. Implementation Strategies - CORRECT ANSWER C. Operations and language barriers Rationale: Operations and Language Barriers are not a major phase in implementation and testing. In a formal plan for implementation and testing it is not necessary to include: A. Team members B. Vendor representatives C. Executive Staff D. Crisis Coaches - CORRECT ANSWER Crisis coaches. Formal Plan must include: - Staff - Team members - Vendors - Executive staff - External resources A domain is: A. A copy of the software system, or environment, in a particular state B. An implementation strategy involving reiteration C. A go-live conversion factor involving conversion discrepancies D. A data storage device - CORRECT ANSWER A. A copy of the software system, or environment, in a particular state. Rationale: A domain is a copy of the software system, or environment, in a particular state. For example, test system (or domain); development system (or domain), training system and production system. "Bugs" in computer language are not really insects, but A. A testing methodology B. Commentary within the code indicated with an asterisk (*) C. Aberrancies and failures in the system D. The nickname of the coder who designed the first EHR - CORRECT ANSWER c. Abberancies Rationale: "Bugs" in computer language are defined as aberrancies and failures in the system or a coding error. System and Functional Testing: A. Does not include security testing of databases B. Is done in an ad hoc fashion as staff are available C. Addresses cultural impacts of new processes D. Includes multiple subsystems and phases of testing - CORRECT ANSWER D. includes multiple subsystems and phases of testing. Rationale: Systems are usually made up of subsystems and all must be tested. System and Functional Testing must include security testing and must be structured and controlled. Cultural impacts of new processes is not an aspect of testing. When the SDLC is done correctly: A. All steps are done in order for all areas. B. End users have final say on all aspects of the project. C. There is a formal change management process throughout to address new information as it comes to light. D. There is only one phase of implementation. - CORRECT ANSWER There is a formal change management process throughout to address new information as it comes to light. Change management is vital to the installation of a system. There may be several phases, particularly during a phased approach and end-users do not have final say on all aspects of the project and not all steps are done in order for all areas. What are the pieces that require ongoing evaluation? A. Hardware and software B. Interfaces and integrations C. Support D. All of the above - CORRECT ANSWER d. all of the above. Ongoing evaluation is needed on all aspects of the system - hardware, software, interfaces and integrations (which are software), and support. Support can include training as well as help desk operations. Financial evaluation should: A. Have the maximum budget finalized prior to assessment and purchases of priority items conformed to that ceiling, which will not be adjusted B. Involve primarily clinicians working to design the system C. Include both tangible and intangible costs D. Focus on costs for stages one and two primarily - CORRECT ANSWER C. Include both tangible and intangible costs Which is NOT true about backup and recovery: A. Use multiple backup devices B. Perform backups on Wednesdays during peak use C. Use full backups to minimize the time to restore databases D. Test the backups periodically to make sure data can be restored - CORRECT ANSWER B. Perform backups on Wednesdays during peak use Rationale: Backups do not need to happen on a particular day of the week. In practice it is best to backup during periods of least use. The Informatics Nurse is concerned with user support. Procedure manuals will be developed that will: A. Include policies that are changed by the system B. Describe how to perform business tasks while using the system C. Provide step-by-step instructions on how to program the applications D. Outline security controls in the system - CORRECT ANSWER B. Describe how to perform business tasks while using the system Rationale: Users will need to know how to perform their job using the automated system. Most users will not be involved in programming the applications, only using them. During the evaluation phase which of the following tools are used for construction and consistency? A. Setting defaults B. Amending the database C. Formatting and transferring data D. All of the above - CORRECT ANSWER D. all of the above Rationale: All of the above are tools used for construction and consistency. Which of the following is NOT part of documentation testing? A. Proofreading B. Subscriber color preferences C. Readability and accuracy D. Punctuation and grammar - CORRECT ANSWER B. subscriber color preferences. Rationale: Subscriber color preferences is an aspect of usability, not documentation testing. Quality Monitoring: A. Focuses on audit trails to see who is accessing which patient data B. Is one single methodology C. Does not include integration and interfaces D. Is part of system performance maintenance strategies - CORRECT ANSWER D. Is part of system performance maintenance strategies. Rationale: Quality monitoring may include audit trails, but it is more than one methodology. It is a component of a system performance maintenance strategy. Evaluation and support: A. Should be outlined in the original project plan as an ongoing process. B. Are unnecessary once the implementation is complete. C. Does not require dedicated resources. D. Can be done by assigned super users - CORRECT ANSWER a. Should be outlined in the original project plan as an ongoing process. Rationale: Evaluation is a major component of the system design life cycle and planning for evaluation should be included in the original project plan. Work flow: A. Almost never changes with the implementation of a system B. Is reflected solely in policies and procedures C. Changes in many ways including culture, productivity, and clinical practice during an implementation D. Can be determined by individual departments and specialties - CORRECT ANSWER C. Changes in many ways including culture, productivity, and clinical practice during an implementation Rationale: Workflow WILL change with the implementation of the system and is more than simply documenting policies and procedures. The workflow must be determined organization-wide and not be left to individual departments as systems and processes must be integrated. Which is NOT a type of maintenance? A. Corrective B. Preventative C. Flexible D. Emergent - CORRECT ANSWER C. Flexible Rationale: According to the chart in the Module, three types of maintenance are corrective, preventative, and emergent. What are the techniques that apply algorithms for extracting patterns from data stored in data warehouses that are typically not apparent to human decision makers are known as: A. Data mining or knowledge discovery in databases. B. Statistical generation from warehoused data c. Evidence generation from warehoused data d. Data retrieval and cleansing - CORRECT ANSWER A. Data mining or knowledge discovery in databases There is no examples of wisdom in nursing practice, as it is merely a theoretical concept. True False - CORRECT ANSWER FALSE. Rationale: wisdom is defined as understanding, applying and applying with compassion. An example is selecting a protocol to caring for a patient based on patient preferences. What kind of information might be included in a clinical practice guideline? a. typically written as narrative b. background material an evidence c. ranking of strength of evidence d. All of the above. - CORRECT ANSWER D. All of the above: Rationale: a CPG is typically written as a narrative text providing background material and evidence. The strength of that evidence is ranked. Which of the following use a knowledge base and set of rules to analyze data and provide recommendations? a. knowledge generator b. decision support systems c. wisdom wizards d. benchmarkers - CORRECT ANSWER Decision Support Systems (DSS) Rationale a DSS uses a knowledge base and a set of rules to analyze data and provide recommendations. Benchmarking is: a. drawing a line in a doorway at the organization to monitor organizational growth b. a way of finding best practices c. comparing one organization to another d. both B & C - CORRECT ANSWER D. Both B & C. Benchmarking is defined as a way of finding best practices and then comparing ones organization against another. CDSS stands for: a. corporate decision support silos b. clinical decision support systems c. client decision support systems c. customer service support systems - CORRECT ANSWER b. clinical decision support systems Wisdom is : a. information that is used to identify relationships b. the recognition of patterns in data c. the use of knowledge to solve problems c. the use of decision support systems - CORRECT ANSWER b. the recognition of patterns in data The next step in complexity above information is: a. knowledge b. wisdom c. data d. compliance - CORRECT ANSWER a. knowledge These come together in decision support systems: a. data and information b. information and knowledge c. knowledge and wisdom d. data and knowledge - CORRECT ANSWER B. information and knowledge The major difference between Decision support systems (DSS) and Expert systems (ES) is: a. a DSS uses rules and ES uses queries b. that they are synonymous c. DSS is a step up or more complex than ES d. That a DSS leaves the ultimate decision to the decision maker and the ES selects the best solution. - CORRECT ANSWER d. That a DSS leaves the ultimate decision to the decision maker and the ES selects the best solution. What are three clinical decision systems areas in which decision assistance can be found? A. Test solutions, monitoring actions, change in condition B. Optimizing process flow and workflow, monitoring actions, intake and output C. Intake and output, change in condition, choice of treatmen___Incorrect D. Choice of treatment, test solutions, monitoring actions - CORRECT ANSWER A. maybe???? Benchmarking is: A. Taking information and comparing it to another's data to identify strengths and weaknesses Correct B. Using information from other facilities to identify if they have better reimbursement than your facility C. Comparing one nurse to another in different hospitals D. A method used to develop decision support systems - CORRECT ANSWER A. Taking information and comparing it to another's data to identify strengths and weaknesses How is wisdom defined by Nursing Informatics: Scope and Standards of Practice? A. Being an expert in the field of informatics B. Using data to interpret outcomes for the leaders of the organization C. Understanding data and knowledge and applying the knowledge with compassion D. Understanding data and knowledge to improve outcomes - CORRECT ANSWER C. Understanding data and knowledge and applying the knowledge with compassion While caring for a 40-year old patient with terminal cancer, the key area of the clinical practice guideline is to: A. Reduce waste of resources, assist in telling your patient what is going to happen and eliminate errors B. Show the nurse what to do for the patient with a terminal illness C. Assist the patient with questions to ask the nurse about the cause of cancer D. Encourage best practice, eliminate errors and reduce unjustified practice variations - CORRECT ANSWER D. Encourage best practice, eliminate errors and reduce unjustified practice variations One of the steps in creating a clinical practice guideline is to: A. Identify what has always been done in the facility B. Review evidence-based studies C. Discuss what is the easiest process to meet the goal D. Send out a survey about what is currently being practiced - CORRECT ANSWER B. Review evidence-based studies What type of information should be included in the clinical practice guideline? A. Background material and evidence ranking of strength of evidence B. Ranking of strength of evidence and age of the information C. The orders the doctor should write D. How long the patient will be in the hospital - CORRECT ANSWER A. Background material and evidence ranking of strength of evidence What is one metastructure to help organize information management and knowledge generation specific to nursing informatics? A. Knowledge, wisdom and data B. Wisdom C. Data D. Wisdom conceptual framework, knowledge, information and data - CORRECT ANSWER D. Wisdom conceptual framework, knowledge, information and data The key to interpreting data is: A. It must be meaningful B. It must be organized so that patterns and relationships are apparent C. It must be current D. It must be specific to the outcomes being reviewed - CORRECT ANSWER B. It must be organized so that patterns and relationships are apparent ICD-10, The Omaha System, and Clinical Care Classification (CCC) are all examples of which of the following? A. Raw data B. Nomenclatures C. Standardized terminologies D. Clinical practice guidelines - CORRECT ANSWER C. Standardized terminologies What is the difference between a data warehouse and a data mart? A. Data warehouses are large collections of data from several different sources and data marts are where the data is purchased. B. Data warehouses are large collections of data from several different sources and data marts are smaller collections that could be from a single department. C. Data warehouses are where hospitals find how well they are doing and data marts are where the information is inputted. D. Data warehouses are large collections of data from one source which are then sent out to data marts. - CORRECT ANSWER B. Data warehouses are large collections of data from several different sources and data marts are smaller collections that could be from a single department. Information in a data warehouse can be used to: A. Support decision support systems and executive information systems B. Support hospital billing and revenue cycles C. Dispel myths about the cost of care D. Dispel the need for decision support systems and executive information systems - CORRECT ANSWER A. Support decision support systems and executive information systems Data mining in knowledge data discovery (KDD) allows providers to: A. Follow up on the providers' attendance record to meetings B. Find out who has the most patients in their practice C. Apply algorithms for extracting patterns that are not typically apparent to human decision makers Correct D. Find the best time to take a patient out of the intensive care unit - CORRECT ANSWER C. Apply algorithms for extracting patterns that are not typically apparent to human decision makers The transformation and analysis of information must go through validation before being used. What is information validation? A. Process to ensure information in data warehouse is correct, reliable and consistent B. Process to ensure information in data warehouse is from the correct facility C. Process to ensure information in data warehouse is from the correct time submission D. Process to ensure information in data warehouse is correct and from the correct charts - CORRECT ANSWER A. Process to ensure information in data warehouse is correct, reliable and consistent Adult learners who repeatedly cancel attending classes on the new computer system could be classified as which type of adopter? A. Early Adopters B. Early Majority C. Innovators D. Late Adopters - CORRECT ANSWER D. Late Adopters What is the foundational process that a nurse uses in care of patients? A. Information Science B. Nursing Science C. Organizational Theory D. Computer Science - CORRECT ANSWER B. Nursing Science What is the foundation of knowledge? A. Information B. Wisdom C. Data D. Bits - CORRECT ANSWER a. information What is the foundation of wisdom? A. Information B. Knowledge C. Data D. Bytes - CORRECT ANSWER B. Knowledge What is data? a. alphanumeric characters b. discrete entities that are described objectively without interpretation c. groups of numbers without context d. information that has not yet been categorized - CORRECT ANSWER a. alphanumeric characters ??? What is information? A. The building blocks of wisdom B. Organized alphanumeric characters C. Data that are interpreted, organized or structured D. Data that is used to support decision-making - CORRECT ANSWER C. data that are interpreted, organized and structured. What is knowledge? A. The sum of information B. The categorization of data C. Information that has been explained and understood D. Information that is synthesized so that relationships are identified and formalized - CORRECT ANSWER D. Information that is synthesized so that relationships are identified and formalized Metastructures are: A. Large buildings used in health care B. Illnesses that impact an entire population C. Overarching concepts used in theory and science D. Theorems used to solve nursing problems - CORRECT ANSWER C. Overarching concepts used in theory and science One set of vital signs is an example of: A. Knowledge B. Information C. Opinion D. Wisdom - CORRECT ANSWER B. Information Nursing terminology is: A. A body of the terms used in nursing B. The words used that are common to nursing C. Terminology not used by other disciplines D. The foundation of nursing care plans - CORRECT ANSWER A. A body of the terms used in nursing Which is NOT considered a factor that makes nursing informatics a professional discipline in nursing? A. Concern with the phenomena of the discipline of nursing B. Varied definitions about scope of practice C. Defined competencies for the area of specialty nursing practice D. A body of research in the specialty - CORRECT ANSWER B. Varied definitions about scope of practice Nursing informatics is a specialty that integrates which of the following into nursing practice? A. Nursing science with multiple information management and analytical sciences B. Nursing science, patient outcomes, data containment C. Computer science, patient outcomes, data containment D. Information management, data regulation, nursing science - CORRECT ANSWER A. Nursing science with multiple information management and analytical sciences Decision making involves: A. Understanding the data that is presented B. Using decision support tools C. Cognitive processing that results in selecting a choice D. Using wisdom gained from data to make the correct choice - CORRECT ANSWER C. Cognitive processing that results in selecting a choice The HITECH act and HIPAA Privacy and Security rules are intended to: A. Prevent access to patient records B. Provide patients with greater access and control over their PHI C. Allow patients to access their PHI at any time D. Prevent anyone other than the direct caregiver from accessing PHI - CORRECT ANSWER B. Provide patients with greater access and control over their PHI ??? Workflow is: a. a group of steps or tasks b. related tasks that produce an outcome c. a progression of actions that fulfill a distinct work process d. a process from start to end - CORRECT ANSWER d. a process from start to end Which of the following may be a legal issue involved in telehealth? A. Ethical issues regarding the effectiveness of treatment in remote locations B. Practitioner licenses may not allow for care when the patient is in another state C. Differing cultural values regarding healthcare D. Inability to effectively diagnose and treat patients located in another geographic area - CORRECT ANSWER B. Practitioner licenses may not allow for care when the patient is in another state Usability refers to: A. The efficiency and effectiveness of an application B. The location and accessibility of the hardware C. The use of ergonomic concepts D. Enhancing the computer skills of end users - CORRECT ANSWER A. The efficiency and effectiveness of an application Which of the following is NOT one of the approaches to the system development life cycle? A. Waterfall B. Rapid prototyping C. Dynamic development D. Object-oriented system development - CORRECT ANSWER A. Waterfall _____________ is a teaching strategy for educating staff that involves face-to-face and online learning. A. Virtual learning B. Web-based learning C. Group learning D. Hybrid learning - CORRECT ANSWER D. Hybrid learning During the analysis phase of the systems development lifecycle, which of the following occurs? A. The system is designed. B. The implementation education is planned. C. Organizational needs are assessed. D. Work flows and business practices are examined. - CORRECT ANSWER D. workflows and business practices are examined During the feasibility stage of the SDLC, which of the following occurs? A. Workflows are examined for match to the organization. B. The project plan and estimated budgets are determined. C. Interface mapping occurs to identify compatibility. D. Beta testing is completed to provide user acceptance. - CORRECT ANSWER B. The project plan and estimated budgets are determined Integration testing involves: A. Testing by combining software modules to test as a group B. Testing the flow of data across all interfaces C. Testing to determine the effectiveness of the workflow design D. Testing that is done by all disciplines charting on the same practice patient - CORRECT ANSWER B. Testing the flow of data across all interfaces The waterfall SDLC model is: A. Sequential B. Iterative C. Input driven D. Output driven - CORRECT ANSWER A. sequential All of the following are ways to determine the best type of system implementation for your organization EXCEPT: A. Analyze the project B. Consider combining strategies C. Assess your resources D. Avoid combining strategies - CORRECT ANSWER D. Avoid combining strategies Which of the following is a feature of system enhancement? A. Planned by vendor B. Packaged with other enhancements C. Requested by staff or informatics D. Automatically included with system purchase - CORRECT ANSWER C. Requested by staff or informatics Which of the following lists the steps of the planning structure in the correct order, starting with the first step? A. Identify a planning need, determine preliminary resource list, establish goals and timeline B. Establish goals and timeline, identify a planning need, determine preliminary resource list C. Establish goals and timeline, identify a planning need, identify stakeholders D. Identify a planning need, identify stakeholders, establish goals and timeline - CORRECT ANSWER A. Identify a planning need, determine preliminary resource list, establish goals and timeline. ??? A clinical information system contains the following process: A. Input, processing, outputs B. Input, processing, outputs, analysis C. Outputs, inputs, processing, analysis D. Processing, inputs, outputs - CORRECT ANSWER A. Input, processing, outputs In an organization, the CTO is responsible for: A. Information technology infrastructure B. Information processing and data security C. Application of informatics within the system D. Technologic research and development within the organization - CORRECT ANSWER D. Technologic research and development within the organization. Information science is concerned with: A. The stability and security of the technical infrastructure in an organization in order to facilitate the effective retrieval of information B. Obtaining, gathering, organizing, manipulating, managing, storing, retrieving, recapturing, disposing of, distributing or broadcasting information C. The management and application of information in a methodical and systematic manner to facilitate the practice of professionals in a healthcare setting D. The design and use of specific data-capturing capabilities that facilitate and enhance the input and output of healthcare data - CORRECT ANSWER B. Obtaining, gathering, organizing, manipulating, managing, storing, retrieving, recapturing, disposing of, distributing or broadcasting information In order for information to be meaningful, it must be: A. Organized, categorized, quantified, identified, evidence-based, and verified B. Accessible, accurate, timely, complete, cost effective, flexible, reliable, relevant, simple, verifiable and secure C. Available, informational, descriptive, reliable, divisible, secure, controlled, reportable, meaningful and visible D. Approved, practice-based, multidisciplinary, reportable, secured, graphical, input, alphabetical or numeric, standardized and statistical - CORRECT ANSWER A. Organized, categorized, quantified, identified, evidence-based, and verified Information science is the: A. Study of the application and use of knowledge in organizations B. Infrastructure that supports the management of data C. Exploration of the transition of data to wisdom D. Combination of information and science - CORRECT ANSWER A. Study of the application and use of knowledge in organizations Integrated clinical decision support tools can include: A. Alerts, reminders, guidelines, information retrieval, order sets protocols B. Nursing-specific documentation forms and drop down lists C. Advanced order sets with nursing specific content D. Access to online journal articles relevant to patient care - CORRECT ANSWER A. Alerts, reminders, guidelines, information retrieval, order sets protocols The human-technology interface includes the: A. Keyboard and mouse B. Processor C. Network D. Power system - CORRECT ANSWER a. keyboard and mouse Which of the following is a computer in a network with the ability to access shared resources and files through a server? A. Client B. Peripheral device C. Bus D. Modem - CORRECT ANSWER a. client During project discussions about workflow, it is realized that there is insufficient information immediately available to complete the discussion regarding the future state of the system. Which of these would be used to track this item? 1. Gap analysis 2. Parking lot 3. Needs Assessment 4. Process flow - CORRECT ANSWER The correct answer is the parking lot. When you have insufficient information or resources to make a decision, it goes onto the parking lot for follow up. Once you know where you are (current state) and where you are going (future state) you can develop a gap analysis. Current and future states are often mapped out in process flows (sometimes called workflows). Once you have a gap analysis, you can do a needs assessment to determine what you need to do to get to future state. 1. If the informatics nurse is concerned that a computer system may not function well during peak times of access, the type of testing needed is: a. functional testing b. black box testing c. system integration testing d. load/volume testing - CORRECT ANSWER d. load/volume testing Rationale: This is a non-functional testing for reliability that assesses the ability of the system to function under various loads, such as at peak times when multiple users in multiple departments are accessing the system. The purpose of load/volume testing is to determine the maximum load capacity and to identify the load at which problems begin to occur. Testing is done at both the safe working load (SWL) and above the SWL. [Show Less]
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Nurse Practice Act Exam 65 Questions with Verified Answers,100% CORRECT
Nurse Practice Act Exam 65 Questions with Verified Answers T/F: the nurse practice act is different in every state - CORRECT ANSWER True Nurse practi... [Show More] ce act: it gives us rules and laws so that we can stay _____ - CORRECT ANSWER safe What is the Triple Aim? - CORRECT ANSWER -improve QUALITY of care -improve the patient EXPERIENCE -control cost Law or rule? Scope of practice - CORRECT ANSWER law Law or rule? Competent practice - CORRECT ANSWER rule Law or rule? Protect patient safety - CORRECT ANSWER rule Law or rule? maintain privacy & confidentiality - CORRECT ANSWER rule means the expected actions of any nurse who holds the identified level of licensure - CORRECT ANSWER Standards r/t scope of practice means the direction and periodic consultation provided to an individual to whom a nursing task or patient care activity is delegated." - CORRECT ANSWER Supervision any conduct or practice that is or might be harmful or dangerous to the health of a patient or the public includes one or more of the following: (read syllabus pg 22 for more info) - CORRECT ANSWER Unprofessional conduct what is the non disciplinary action consequence? *KNOW THIS! - CORRECT ANSWER Letter of concern (low risk that potentially caused harm to the public) What are the 4 types of disciplinary consequences? - CORRECT ANSWER -Decree of censure -Probation -Civil Penalty -Revocation it is like a slap on hand, public repremand that you violated nurse' practice act. Community says "Yes you violated, but not severe enough to cause continued risk to public. They want this on your record, but not as severe as next level. - CORRECT ANSWER Decree of censure (disciplinary consequence) cannot work for ___ months, or must do XYZ before you can come back. Specific restrictions - CORRECT ANSWER probation (disciplinary consequence) we see this when we have HIPPA breaches. Not only does the person at fault get FINED, but the organization as well gets penalized. Usual minimum amount of money had to be paid is $1000 - CORRECT ANSWER Civil penalty (disciplinary consequence) licence is revoked. Has to be pretty severe such as doing something assaulting, or sexual to patient - CORRECT ANSWER revocation (disciplinary consequence) Once I delegate a task to an unlicensed health care worker, I am no longer accountable for what happens. - CORRECT ANSWER False Arizona's Nurse Practice Act specifically allows me to delegate nursing care activities - CORRECT ANSWER True but it depends Arizona's Nurse Practice Act specifies that I must know the competencies and abilities of the person to whom I delegate T/F - CORRECT ANSWER True Arizona's Nurse Practice Act states that I may be in violation of the standards of conduct if I delegate tasks to those I have reason to know lack the ability to perform the function or responsibility T/F - CORRECT ANSWER True If I fail to supervise those to whom nursing tasks have been delegated, I may be disciplined by the state board T/F - CORRECT ANSWER True Employer policies or directives can relieve me of my responsibility for making judgments about the delegation of nursing activities T/F - CORRECT ANSWER False *Nurse Practice Act is top, while employers have own policy/procedure. Employers policy CANNOT override law For which reason would a nurses' license be revoked or the nurse be put on probation? A. The nurse lost a malpractice suit. -we don't know severity B. The nurse was found guilty of practicing while under the influence of drugs or alcohol? C. The nurse was accused of negligence? D. The nurse gave a wrong medication? - CORRECT ANSWER B. The Nurse was found guilty of practicing while under the influence of drugs or alcohol Susan RN noticed that Karen RN was intoxicated while giving care. However, Susan didn't report it to the supervisor. That same day, Karen made a medication error and a patient was injured. Who may be held responsible? A. Karen RN B. Susan RN, Karen RN, and the hospital C. Susan RN D. Karen RN, and the hospital - CORRECT ANSWER B. Susan RN, Karen RN, and the hospital The definition of practical nursing includes: - CORRECT ANSWER maintaining safe nursing care that is rendered indirectly It is OUTSIDE the scope of practice for an LPN to: - CORRECT ANSWER assess a client to formulate plan of care An example an additional act that may be performed by an LPN that requires additional education and training as prescribed by the Board and that is recognized as proper to be performed by a practical nurse would be (hint: see advisory opinions): - CORRECT ANSWER Administering IV medications it would be a violation of the nurse practice act for an LPN to - CORRECT ANSWER provide nursing services independent of a registered nurse (RN) or physician which of the following is included in the definition of registered nursing (RN)? - CORRECT ANSWER establishing a nursing diagnosis which of the following activities would be outside the scope of practice for an RN: - CORRECT ANSWER writing orders for lab tests An example an additional act that may be performed by an RN that requires ADDITIONAL EDUCATION and training as prescribed by the Board and that is recognized as proper to be performed by an RN (excluding advanced practice nurses) would be (hint: see advisory opinions): - CORRECT ANSWER insertion of an intra-arterial catheter It would be a violation of the nurse practice act for an RN to: (choose 1) -delegate assessment to an LPN -supervise the care of other RNs -delegate a sterile dressing change to an LPN -provide lab results to a client - CORRECT ANSWER -delegate assessment to an LPN It is within the scope of practice for a clinical nurse specialist (CNS) in AZ to: - CORRECT ANSWER prescribe durable medical equipment Under the definition of delegation, a nurse may delegate: - CORRECT ANSWER A selected task to a competent person it would be a violation of the nurse practice act for an RN to delegate: (choose 1) -VS to a CNA -Planning care to an LPN -Changing a central line dressing to an LPN -application of commercial diaper cream to a CNA - CORRECT ANSWER Planning care to an LPN if applying for initial registered nurse practitioner (RNP) certification after july 1 20014, the applicant must posses: - CORRECT ANSWER national certification as a NP It would be a violation of the nurse practice act for a registered nurse practitioner (RNP) to: - CORRECT ANSWER prescribe in a different specialty than the RNP's certification the definition of unprofessional conduct: - CORRECT ANSWER includes any conduct that may be harmful to the public it would be unprofessional conduct for a nurse to: - CORRECT ANSWER -fail to report another nurse w/ evidence of impairment while on duty the nurse who is convicted of a felony is subject to: - CORRECT ANSWER -REVOCATION of license the AZ State Board of Nursing has authority over: - CORRECT ANSWER Nursing education programs leading to initial licensure or certification The Nurse Practice act authorizes the board to adopt rules for nurse practitioners to practice: - CORRECT ANSWER In collaboration w/ one or more licensed physicians a nurse who changes her address shall notify the Board of the new address within ____ days - CORRECT ANSWER 30 days a person can practice nursing in Arizona without an Arizona or multi-state compact license when the person is a : - CORRECT ANSWER nurse licensed in another state and employed by the federal government a physician tells you that she would like to challenge the RN licensure exam (NCLEX) she can work as an RN on the weekends. You would tell physician that in order to do this she would need to: - CORRECT ANSWER complete an approved nursing program To qualify for licensure in Arizona, graduates of international nursing programs must show evidence of: - CORRECT ANSWER -passing NCLEX -graduating from a comparable nursing program -and English language proficiency The Board ensures that nurses who renew their licenses are competent and qualified by requiring - CORRECT ANSWER Nurses to meet a practice requirement or take a refresher course In Arizona a nursing license must be renewed every: - CORRECT ANSWER 4 years In 2009, the date for renewing a license was changed from July 1 of the year of expiration to: - CORRECT ANSWER April 1 of the year of expiration A Nursing Assistant certificate must be renewed every ___years - CORRECT ANSWER 2 years One way the Board ensures that nursing assistants who renew their certificates are competent and qualified is to require: - CORRECT ANSWER CNAs practice 160 hours in the past 2 years requirements to become a CNA in AZ include - CORRECT ANSWER passing a manual skills and written examination if an applicant has an outstanding felony conviction during the 3 years before the application is received the Board shall: - CORRECT ANSWER -deny the application based on felony conviction the Arizona State Board of Nursing is composed of: - CORRECT ANSWER 11 members -5 RNs -2 LPNs -2 public members -1 CNA (or CNA instructor) -1 NP (or CNS) graduates of approved nursing programs, who are not yet licensed, may use the title of - CORRECT ANSWER Nurse Extern the abbreviation CNA may be used by: - CORRECT ANSWER -persons currently certified by the Board as nursing assistants a nurse who administers anesthesia must do so: - CORRECT ANSWER at the direction and in the presence of a physician or surgeon if the Board finds that a nurse has committed an act of unprofessional conduct r/t patient care, it may: - CORRECT ANSWER issue a decree of censure the Board may issue an administrative penalty to a nurse who: - CORRECT ANSWER practices nursing w/ expired license class 6 felony to... - CORRECT ANSWER practice registered nursing without a license nurse licensure compact allows - CORRECT ANSWER a nurse licensed and residing in a compact state to practice in AZ a nurse practicing on a compact license from another state must abide by the NPA in - CORRECT ANSWER the state where the patient is located It is an act of unprofessional conduct for a nurse to - CORRECT ANSWER fail to document the care the patient received an activity that would meet the practice requirement of the AZBN would be - CORRECT ANSWER consulting on staffing plans w/ a health care facility unprofessional conduct would include - CORRECT ANSWER falsely claiming CPR certification on an employment application [Show Less]
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School Nurse Certification Exam (NBCSN unofficial) 447 Question with Verified Answers,100% CORRECT
School Nurse Certification Exam (NBCSN - unofficial) 447 Questions with Verified Answers What is the first sign of puberty in females? - CORRECT ANSWE... [Show More] RS Breast development approx age 10 (7-13), about 3 years to develop When does Menses begin? - CORRECT ANSWERS ages 8-16 first is irregular and w/o ovulation What is FSH? What does it do in females? - CORRECT ANSWERS FSH - follicle stimulating hormone Females - stimulates ovarian development and estrogen production. What is FSH? What does it do in males? - CORRECT ANSWERS FSH - follicle stimulating hormone males - develops tubes in testes --> spermatogenesis & fertility What age does penis reach adult size? - CORRECT ANSWERS 17 What age does sperm emission start? - CORRECT ANSWERS age 13 What is the first sign of puberty in males, and around what age? - CORRECT ANSWERS Testicular enlargement - around age 11-15 What is LH? - CORRECT ANSWERS Luteninizing hormone (LH) What does LH do? - CORRECT ANSWERS stimulates testosterone release from leydig cells (testicular enlargement) Does sperm emission happen before or after pubic hair development and growth spurt - CORRECT ANSWERS Before Role of Pituitary gland in puberty - CORRECT ANSWERS Releases Luteninizing hormone (LH) and follicle stimulating hormone (FSH) Role of Hypothalamus in puberty - CORRECT ANSWERS produces gonadotropin-releasing hormone. starts the process. this tells the Pituitary gland to start Define Puberty - CORRECT ANSWERS the physical changes to the body due to hormone activity as per the Tanner Scale What is the Tanner Scale - CORRECT ANSWERS The hormone activity which produces secondary sex characteristics. 13-19 Developmental Tasks - Physical (2 major answers) - CORRECT ANSWERS - Rapid period of growth, completes physical growth - May appear clumsy while adjusting Young males and breast growth - CORRECT ANSWERS Some kids may have growth and tenderness. Will resolve as testosterone level increase. ASSURE child this is normal When does growth spurt start and stop for males? - CORRECT ANSWERS 2 years after girls increases until age 20 When does growth spurt start and stop for females? - CORRECT ANSWERS during puberty finished 2 years after menarche What are secondary sex characteristics for males? - CORRECT ANSWERS chest growth, facial hair, deep voice Define secondary sex characteristics - CORRECT ANSWERS Physical traits that are not directly involved in reproduction but that indicate sexual maturity. Difference of body fat changes in boys vs girls - CORRECT ANSWERS Boys - decrease body fat from 14.3% at Tanner Stage 1 to 11.2% Girls - INCREASE body fat from 15.7% (Tanner 1) to 26.7% (Tanner 4) What are secondary sex characteristics for females? - CORRECT ANSWERS fatty tissue on thighs, hips, breasts, hips broaden, What body fat is needed for Menarche? - CORRECT ANSWERS 17% to start, but need 22% to maintain menstruation. What are secondary sex characteristics for both? - CORRECT ANSWERS pubic hair, increase of sweat glands --> body odor, increase activity of sebaceous glands --> acne Psychosocial growth ages 10-13 (early adolescence) - CORRECT ANSWERS copes with changes in physical self - fantasy role play in different situations - test their independence - peers are important Psychosocial growth ages 14-17 (middle adolescence) - CORRECT ANSWERS explores and identifies personal values and defines self - influenced by peers and their values, fads - need to conform - interest in sex increases, attraction - may initiate sexual relationships - family tensions may increase Psychosocial growth ages 18-19 (late adolescence) - CORRECT ANSWERS independence from parents developing a plan for the future participating in society gender identity - CORRECT ANSWERS the gender with which you identify and feel most comfortable regardless of biologic gender sexual orientation - CORRECT ANSWERS the gender(s) that a person is attracted to emotionally, physically, sexually, and romantically Cis-gender - CORRECT ANSWERS Individuals whose gender identity corresponds to their biological sex Transgender - CORRECT ANSWERS umbrella term for all gender-variant people who by nature do not conform to gender-based expectations Bisexual - CORRECT ANSWERS a person who is sexually attracted to both sexes Cognitive development for adolescence - CORRECT ANSWERS abstract thinking ability to analyze and synthesize use logic Begins awareness of the long-term consequences of their actions. Nutritional intake influences adult health status how? - CORRECT ANSWERS Calcium - needed for bone health High cholesterol can compromise cardiovascular health Diet habits of teens - CORRECT ANSWERS skipping meals (esp bkst) increased snacking fast food - a social event, influenced by peers May become weight-conscious and develop unhealthy dieting habits Dental concerns for teens - CORRECT ANSWERS good oral hygiene bi-annual dentist appts final molars (wisdom teeth) may finally erupt Most common childhood chronic disease - CORRECT ANSWERS Dental Caries Health promotion for teens - CORRECT ANSWERS internet safety (sexting, cyberbullying) attention to body hygiene, self-care pregnancy STI focus on personal responsibility for health Methods to talk to teens - CORRECT ANSWERS motivational interviewing active listening open-ended questions remain nonjudgmental obtain health-related information maintain privacy, modesty Be alert for (when talking to teens) - CORRECT ANSWERS bullying/cyberbullying sexual harrassment/abuse dating violence human trafficking self-harm social determinants of health - CORRECT ANSWERS The conditions in which people are born, grow, live, work, and age, shaped by the distribution of money, power, and resources at global, national, and local levels Adverse Childhood Experiences (ACEs) - CORRECT ANSWERS Traumatic events that occur in childhood that have a dose-response relationship to social and emotional problems High ACE Score risks increase... - CORRECT ANSWERS alcohol abuse depression heart disease suicide attempts smoking early sexual activity teen pregnancy poor academic outcome Pair of ACEs - CORRECT ANSWERS Adverse Childhood Experiences + Adverse Community Environments Biologic family - CORRECT ANSWERS born into Source Family - CORRECT ANSWERS legally and pragmatically functions as the biologic family Non-compliant parent - CORRECT ANSWERS - seek and understanding of the issues and rationales for their decision - assist family to overcome barriers Angry parent - CORRECT ANSWERS - let them vent, then refocus convo into an action - do not reciprocate with anger - assure your own safety - respect their feelings - give a copy of the policy or the name of person responsible for the policy Definition of family - CORRECT ANSWERS two or more people who consider themselves related by blood, marriage, or adoption and residing together. May also include those who "act" as parents or guardians Family Systems Theory - CORRECT ANSWERS view the family as a whole system that continually acts with its members and the environment How does the family system theory affect each member? - CORRECT ANSWERS a change for one results in a change for another Family dysfunction - CORRECT ANSWERS a result of interaction among members and is not caused by any one person % of children raised by grandparents - CORRECT ANSWERS 4% % of children raised by 2 parents - CORRECT ANSWERS 66% (2/3) % children living in one parent homes - CORRECT ANSWERS 23% What type of rules govern foster care? - CORRECT ANSWERS Guardianship/kinship care What type of rules govern rights of children and families? - CORRECT ANSWERS State Laws What type of rules supersede state laws? - CORRECT ANSWERS Tribal or federal laws Define homelessness - CORRECT ANSWERS living temporarily without a permanent address (includes living with friends or family) Homeless children are higher risk of: - CORRECT ANSWERS behavioral/emotional problems child abuse & neglect communicable diseases chronic absenteeism lower academics lower graduation rates McKinney-Vento Homeless Assistance Act - CORRECT ANSWERS The primary piece of federal legislation dealing with the education of homeless children in public schools. What does M/V Act assure? - CORRECT ANSWERS FAPE (Free and appropriate education) How does a child indirectly see domestic violence in their home? - CORRECT ANSWERS Observe bruises, broken furniture, etc. How does a child indirectly HEAR domestic violence in their home? - CORRECT ANSWERS listening to a parent discuss it with someone else Issues seen at school in Children experiencing domestic violence - CORRECT ANSWERS fear depression developmental delays anxiety acting out problems learning and interacting with others Responsibility of school regarding immigrant children - CORRECT ANSWERS address language barriers Children in immigrant families are higher risk for: - CORRECT ANSWERS tuberculosis inadequate immunization levels undiagnosed pre-existing conditions Define culture - CORRECT ANSWERS the pattern of information composed of thoughts, values, beliefs, actions, attitudes, communications and customs shared by a group of people and passed from one generation to the next How culture affects health - CORRECT ANSWERS Affects how families interpret wellness & cause, presence and prognosis of illness - may determine use of recommendations Cultural Sensitivity - CORRECT ANSWERS not doing or sayings things that would be offensive to members of another group cultural competence - CORRECT ANSWERS having an awareness and acceptance of cultures and the ability to interact effectively with people of diverse cultures cultural congruence - CORRECT ANSWERS applying nursing practice that is in agreement with the client's preferred cultural values cultural humility - CORRECT ANSWERS communal reflection to analyze the root cause of suffering and create a more inclusive world view. goal of cultural humility - CORRECT ANSWERS to address health disparities and inequities in medicine What assumption cannot be made about a family and their culture? - CORRECT ANSWERS That they follow all of the prescribed practices of that culture. ASK define school nursing - CORRECT ANSWERS a specialized practice of nursing, protects and promotes student health, facilitates optimal development, and advances academic success. Role of school nurse - CORRECT ANSWERS Bridges health care and education delivers care provides health education help keep children healthy, safe, and ready to learn What does a wellness program include? - CORRECT ANSWERS health promotion and disease prevention Difference between School Nursing and public health - CORRECT ANSWERS School nursing - student focused PH = focuses on the group and not the individual Principles of Public Health - CORRECT ANSWERS 1. focus on the aggregate 2. promote prevention (mass screening & herd immunity) 3. encourage community organization 4. ethical theory of the greater good 5. leadership in health 6. use of epidemiologic knowledge and methods (surveillance) Primary disease prevention - CORRECT ANSWERS Prevent disease occurrence (e.g., HPV vaccination) - Promoting health - bike safety, seat belts, sun safety Secondary disease prevention - CORRECT ANSWERS Screening early for disease - (ex: COVID screening, hearing, vision, dental) - resolve health problems and prevent consequences Acanthosis nigricans - CORRECT ANSWERS thickening and darkening of skin near axillary region, A/w Diabetes Type II and gastric carcinoma What type of disease prevention is Disability Limitation? - CORRECT ANSWERS Secondary - aim to interrupt the progression to decrease the amount of morbidity or complications - ex: Asthma - identifying triggers Tertiary disease prevention - CORRECT ANSWERS Treatment to reduce disability from disease - adaptions in the school to promote inclusion - supportive care 5 key principles of NASN Framework for 21st century school nursing practice - CORRECT ANSWERS 1. Standards of Practice 2. Care Coordination 3. Leadership 4. Quality Improvement 5. Community/Public Health Where do we get standards of practice? - CORRECT ANSWERS Nasn's Scope & Standards of Practice Nurse Practice Acts NASN Position statements clinical competence with evidence-based practice Components of Quality Improvement - CORRECT ANSWERS documentation data collection performance appraisal research What is the WSCC model? - CORRECT ANSWERS Whole School, Whole Community, Whole Child - School Health Services is a component How is academic achievement defined by WSCC? - CORRECT ANSWERS academic performance education behaviors cognitive skills and attitudes 10 Components of WSCC Model - CORRECT ANSWERS Health Education PE and Activity Nutrition services Health services Counseling Social & Emotional Climate Physical Environment Employee Wellness Family engagement Community Involvement Nursing Process - CORRECT ANSWERS Assessment Diagnosis Planning Implementation Evaluation 3 Focuses of school health programs - CORRECT ANSWERS - wellness - health promotion - disease prevention What do school nurses do? - CORRECT ANSWERS - identify health needs - deliver services - refer students to other professionals in community Define health promotion - CORRECT ANSWERS activities directed toward increasing level of well-being and actualizing the health potential Goal of early detection - CORRECT ANSWERS - earlier intervention - improved outcomes Role of school nurse re: immunizations - CORRECT ANSWERS - audit new students - assist in getting immunizations - recommend exclusion of unprotected students Is immunization compliance increasing or decreasing? - CORRECT ANSWERS DECREASING Role of the School Nurse with parent to resists immunizations - CORRECT ANSWERS - dispel fears and address myths - provide health education materials - promote the principle of herd immunity to protect the most vulnerable by having the majority protected when can the deltoid be used for injections? - CORRECT ANSWERS when enough muscle mass What muscle should never be used for vaccines? - CORRECT ANSWERS dorsogluteal buttock site 7 rights of vaccines - CORRECT ANSWERS - right patient - right vaccine - right time (correct age) - right dose - right interval - right route (including correct needle & technique) - right site - right documentation How are live vaccines created? - CORRECT ANSWERS by attenuating (altering by heat or chemicals) the pathogen that causes the disease (ex: MMR) Risk of live vaccines - CORRECT ANSWERS cause a modified, typically weaker, form of the disease How are inactivated vaccines made? - CORRECT ANSWERS Grown in a lab then killed or inactivated - cannot cause disease - therefore need boosters ex: Dtap, Polio Example of vaccines from recombinant DNA technology - CORRECT ANSWERS - Hep B - HiB - pneumococcal - meningococcal What do additives in vaccines do? - CORRECT ANSWERS prevent bacterial growth holds antigen in tissue longer to prolong immune response What food allergy can cause issues with vaccines? - CORRECT ANSWERS Chicken eggs - some additives are grown in chicken eggs What preservative was removed from vaccines and why? - CORRECT ANSWERS Thimerosal - a mercury preservative - possible links to neurodevelopmental deficits What life-threatening allergies are contraindicated for some vaccines? - CORRECT ANSWERS MMR - gelatin Polio - neomycin, streptomycin, polymyxin B Why do you not want to be sick(ill) when get a vaccine? - CORRECT ANSWERS side effects would be hard to differentiate from illness Signs of adverse reaction to vaccine - CORRECT ANSWERS difficulty breathing, wheezing hives pallor tachycardia high fever behavior changes Which vaccine should never be frozen? - CORRECT ANSWERS Influenza Which vaccine should be protected from light (in storage)? - CORRECT ANSWERS MMR Where in the fridge should vaccines be stored? - CORRECT ANSWERS on the middle shelf, not the door Which vaccine has a 3 wk min, not a 4 wk min? - CORRECT ANSWERS Varicella Who makes the requirements for vaccine? - CORRECT ANSWERS State rules - CDC updates recommendations every January. Define incubation period - CORRECT ANSWERS the interval between the receipt of the infectious agent and the onset of clinical disease Define Prodromal Stage - CORRECT ANSWERS Stage where early symptoms occur before the full blown symptoms of disease hit Define period of communicability - CORRECT ANSWERS when the disease is contagious (transmissible) may be before symptoms appear Define convalescent period - CORRECT ANSWERS time between decrease of disease symptoms and complete return to wellness What OTC med should NOT be given for pain relief after vaccine? - CORRECT ANSWERS Aspirin Three focuses of Student Athlete Sports Nutrition - CORRECT ANSWERS hydration, fueling, recovery Low economic status would be associated with which types of hazards - CORRECT ANSWERS psychological There are two primary sources for obtaining the data necessary for building a successful employee wellness program - CORRECT ANSWERS an employee health risk appraisal and an individual interest survey Blood levels of 10 mcg/dL of lead have been shown to produce a drop in IQ of - CORRECT ANSWERS 7.4 points Screening tools must be specific and sensitive for the targeted health issue. They must measure what it says it does and correctly classify participants. This quality is which of the following? - CORRECT ANSWERS validity The Individualized Education Program for students eligible for the services of IDEA has two general purposes. These are: - CORRECT ANSWERS to set reasonable learning goals and to state the services that the school district will provide In terms of semantics related to the computerization of medical and health records, the first-level product that brings together information for other sources is known as which of the following? - CORRECT ANSWERS automated medical record When an award for malpractice is based on the percentage of fault of the respective parties it is known as which of the following? - CORRECT ANSWERS comparative negligence School nurses must consider the ethical principles that guide everyday practice. When beneficent care-giving begins to conflict with the family's decision-making autonomy, this creates a(n) - CORRECT ANSWERS ethical dilemma What system is affected by Diphtheria? Complications? - CORRECT ANSWERS Bacteria that grows in Respiratory tract respiratory Tract Complications: renal, cardiac, CNS Damage where does tetanus travel to? Symptoms? - CORRECT ANSWERS exotoxin goes To nerves Voluntary muscle contraction, rigidity, painful paroxysmal seizures. Starts as Trismus (lockjaw) and difficulty swallowing Complications of tetanus - CORRECT ANSWERS Laryngospasm, respiratory distress, intramuscular hemorrhage, death How is tetanus transmitted? - CORRECT ANSWERS Through organism entering through open skin, often through soil or exposure to rust Guidelines for tetanus vaccine after penetrating wound - CORRECT ANSWERS - If wound is clean, 1st series completed and booster w/in 5 years - just clean wound - If wound is contaminated, 1st series completed and booster > 5 years ago, Toxoid (Td) is given - If wound is dirty, 1st series incomplete - give toxoid AND Tetanus immune serum globulin Define passive immunity - CORRECT ANSWERS the short-term immunity that results from the introduction of antibodies from another person or animal. How is pertussis transmitted? - CORRECT ANSWERS respiratory droplets Complications of pertussis - CORRECT ANSWERS infants and children: pneumonia, convulsions, apnea, encephalopathy, death teens/adults: weight loss, loss of bladder control, passing out, rib fractures Schedule for DTaP - CORRECT ANSWERS 2, 4, 6, 15-18 months and between 4-6 years Contraindication for pertussis vaccine - CORRECT ANSWERS an active neurologic condition ie: seizures When will you see side effects of Dtap? - CORRECT ANSWERS w/in 72 hours. fever, irritability, site pain somnolence, loss of appetite Another name for M, M, & R - CORRECT ANSWERS Measles (Rubeola) Mumps (Parotitis) Rubella (German Measles) How are MMR spread? - CORRECT ANSWERS by respiratory drops Symptoms of congenital rubella - CORRECT ANSWERS -miscarriage -defects -cardiac abnormalities -ocular lesions -deafness - intellectual disability - growth retardation Schedule for MMR vaccine - CORRECT ANSWERS 2 doses; between 12-15 months, between 4-6 years Must be distanced by 4 weeks Why isn't oral polio vaccine given anymore? - CORRECT ANSWERS disease was contracted by immunocompromised people who handled the feces of vaccinated infants Is IPV a live vaccine? - CORRECT ANSWERS No. It is a trivalent enhanced inactivated (killed) vaccine What is the difference between the nasal Flu vaccine and the Injected Flu vaccine? - CORRECT ANSWERS - Nasal is a live attenuated vaccine. Has been approved for > 24mos but usually > age 5. Can have a small case of the flu - Injected flu is inactivated. Recommended for all children & adults. When are hand sanitizers most effective? - CORRECT ANSWERS when alcohol solution is 60-95% alcohol What is recommended agent for cleaning up body fluids? - CORRECT ANSWERS Bleach - 1 park bleach to 10 parts water What do risk reduction programs do? - CORRECT ANSWERS - identify and correct deficient patterns of health care - thereby preventing an increase of the spread of disease and a decrease in risk-taking behaviors - Infection control is one part - Safety education is one part Goal for risk reduction programs - CORRECT ANSWERS - improved students' academic performance - contribute to their health and productivity outside the school environments Leading cause of death for ages 5-9 - CORRECT ANSWERS unintentional injury/accidents congenital anomalies homicide flu/pneumonia - NOT cancer Leading cause of death for ages 1-4 - CORRECT ANSWERS unintentional injury/accidents congenital anomalies homicide cancer flu/pneumonia Leading cause of death for ages 10-14 - CORRECT ANSWERS unintentional injury/accidents congenital anomalies homicide cancer SUICIDE Leading cause of death for ages 15-24 - CORRECT ANSWERS unintentional injury/accidents (MVA) homicide cancer SUICIDE HEART DISEASE What is resiliency Model? - CORRECT ANSWERS a process where one competently adapts to stressors. - balance between risk and protective factors - includes adjustment and adaption Define risk factor (in resiliency Model) - CORRECT ANSWERS environmental stressors or conditions that increase the likelihood that a child will experience poor overall adjustment or negative outcomes What is a strengths-based approach? - CORRECT ANSWERS use protective factors and strengths to build resiliency and help youth succeed in the face of adversity External Factors that promote or deter risky behavior - CORRECT ANSWERS - family cohesion (feeling loved, cared for, supported) - family supervision - safety of the environment / neighborhood - peer pressure - positive or negative role models - parental resilience - parental drug/alcohol use or sexual promiscuity - parents knowledge of parenting - prevention education provided at home - media advertising - access to preventative services - access to illicit substances/activities - feeling connected - to parents, peers, school - ensuring that the student's emotional needs are met Internal factors that promote/deter risky behavior - CORRECT ANSWERS - emotional competence - self-control over actions & impulses - student's intelligence - academic success - social skills - ability to be empathetic - sense of humor - genetic predisposition - temperament - comorbid psychiatric conditions What is needed when a student engages or indicates they will harm self or others? - CORRECT ANSWERS IMMEDIATE psychological evaluation and intervention Principles of good teaching - CORRECT ANSWERS - assess needs - determine goals & objectives - materials - developmentally appropriate - organize the space - respect & rapport - engagement - provide feedback - evaluate outcomes Define Anticipatory guidelines - CORRECT ANSWERS providing information to students and parents of what might happen next and what to expect - ie: before puberty, or next developmental task [Show Less]
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NBCSN - School Nurse Certification Exam 212 Questions with Verified Answers,100% CORRECT
NBCSN - School Nurse Certification Exam 212 Questions with Verified Answers Who administers the National School Lunch Program? - CORRECT ANSWER USDA (US... [Show More] dept of agriculture) What does the scope of school nursing practice describe? - CORRECT ANSWER The who, what, where when and how of school nursing practice What are the standards of school nursing? - CORRECT ANSWER The authoritative statements of the duties school nurses are expected to perform competently What legal document describes school nurse delegation? - CORRECT ANSWER State Nurse Practice Act Impetigo - CORRECT ANSWER Begins as a single lesion which spreads to secondary lesions that crust or scale. Staph bacteria skin infection. Honey colored crust Pinworm - CORRECT ANSWER A student who is tired, can't sit still, itching bottom Describe the primary objective of the school nurse - CORRECT ANSWER to protect and promote student health, facilitate optimal development and advance academic success. Goal is to strengthen the educational process through improvement of the health status and learning of students Sickle cell anemia - CORRECT ANSWER may cause painful events in hands feel and or long bones. Treatment oxygen and fluids. Monitor for fever, cough, rapid heartbeat that accompany an acute chest syndrome Adolescents are commonly deficient in which vitamins - CORRECT ANSWER Calcium, Iron, Vit D Connors Rating Scale - CORRECT ANSWER ADHD short form Similar to the Vanderbilt Assessment Scales. Practitioner must purchase rights Tanner staging - CORRECT ANSWER staging of sexual maturity Denver Developmental Screening Test (DDST) - CORRECT ANSWER To chart normal progress between the ages of 1 mo. to 6 yrs. To identify children who are NOT developing normally. Does not measure intelligence Wechsler Adult Intelligence Scale - CORRECT ANSWER the WAIS is the most widely used intelligence test; contains verbal and performance (nonverbal) subtests How often is PPT review required? - CORRECT ANSWER Annually What to do if suspected hearing loss? - CORRECT ANSWER Conduct audiometric screening Cleaning product for Norovirus, C Diff - CORRECT ANSWER 5-6% hypochlorite solution (chlorine bleach) Amblyopia (lazy eye) - CORRECT ANSWER If corrected early, affected eye can have normal vision. Treatment before kindergarten Ethical and professional behavior is guided by responsibility to who? - CORRECT ANSWER the student chicken pox communicability - CORRECT ANSWER 1-2 day before and 4-5 day after onset of rash When is an adolescent considered obese? - CORRECT ANSWER BMI >95% for age >120% IBW (Ideal Body Weight) Are active Tuberculosis patients always symptomatic? - CORRECT ANSWER active TB may be asymptomatic and only diagnosed with chest x-ray Does a positive mantoux test indicate presence of disease? Why or why not? - CORRECT ANSWER Anyone who has been exposed to TB may have positive Mantoux test Does BCG vaccine prevent TB? - CORRECT ANSWER No but may decrease incidence of sever disease When is an adolescent with active TB no longer infections? - CORRECT ANSWER Beyond 2 weeks of medication therapy What happens if BP cuff too small - CORRECT ANSWER Will give a high reading. Opposite also true. Should have a bladder length 80% of the arm circumference, length to width 2:1, How long can Hepatitis B Virus survive on surfaces? - CORRECT ANSWER 1 week Signs of MDMA intoxication - CORRECT ANSWER jaw clenching, teeth grinding, N&V, muscle cramping, blurred vision, inc HR what does snorting drugs cause - CORRECT ANSWER nose bleeds and nasal lesions Osgood-Schlatter disease - CORRECT ANSWER inflammation or irritation of the tibia at its point of attachment with the patellar tendon. Can cause a painful, bony bump on shinbone below knee. Occurs in children and adolescent experiencing growth spurt during puberty. Swelling over ANTERIOR tibial tuberosity Contraindications of second pertussis dose - CORRECT ANSWER encephalopathy within 7 days of first dose or anaphylaxis Guanfacine (Intuniv, Tenex) - CORRECT ANSWER non stimulant ADHD med (antihypertensive) BP should be taken for student Kehr's sign - CORRECT ANSWER Referred pain down the left shoulder; indicative of a ruptured spleen. Wilms tumor - CORRECT ANSWER malignant tumor of the kidney occurring in childhood. One of the cancers more common to children prior to school age Shoulder tenderness and inability to shrug shoulder against resistance most likely due to which nerve affected - CORRECT ANSWER Accessory (spinal accessory) nerve tongue piercing - CORRECT ANSWER Piercing any oral structure presents a risk of local post procedural infection because of the presence of pathogens in the oral cavity. Tongue piercing poses greatest risk to damage to tooth structure. Who approves AED - CORRECT ANSWER FDA A diabetic in PE class with HA, diaphoretic, confused, unable to swallow - CORRECT ANSWER admin glucagon bed bugs - CORRECT ANSWER small, flat, reddish-brown insects that may live around or near areas where people sleep and that feed on the blood of people and animals. Linear clusters of reactions, generally nocturnal, use heat to treat. Often 3 erythematous papules along a vein. They are active at night. peak flow meter - CORRECT ANSWER if 80% or above best average no action needed Goal during mass casualty event - CORRECT ANSWER Greatest good for the greatest number through triage. Level 1 immediate, correctable, life threatening. Level 2 - serious but not life threatening. Level 3 - non emergent, walking wounded, minimal care. Level 4 dead or mortally wounded. For example would prioritized long bone fracture with compromise over cardiac arrest Sect. 504 Rehabilitation Act of 1973 - CORRECT ANSWER assures student has equal right to participate in educational and extra curricular activities as their non disabled peers IDEA - CORRECT ANSWER Federal law that mandates IEP>. Individuals with Disabilities Education Act. Requires LEAST restrictive environment with in class support to the max extent possible Skin sign of meningitis - CORRECT ANSWER petechia 5ths Disease/ Erythema Infectiosum - CORRECT ANSWER -sx-Parvovirus B19): SLAPPED CHEEK (erythema of check), lace like rash -dx-dangerous in SICKLE cell pt (other anemias) -tx- self limiting People at risk - weak immune system bc of cancer, organ transplant, HIV. Can cause chronic anemia scarlet fever - CORRECT ANSWER Group A strep illness, bright red rash covers most of body Carotenemia - CORRECT ANSWER yellowing of the skin that results from excess beta-carotene/Vit A in the body Cutaneous fungal infections - CORRECT ANSWER Ringworm and Athlete's foot Fungus grows on keratin in skin -Cephalocaudally -Proximodistally - CORRECT ANSWER Development occurs cephalocaudally (head to toe) and proximodistally (trunk to extremities) Preschool children can jump off step - CORRECT ANSWER 12 inches high when can kids sit in the front seat? - CORRECT ANSWER 13 Booster Seat until - CORRECT ANSWER 8 years old, 80 pounds Precocious Puberty Girls - CORRECT ANSWER for caucasian girls before 7, african american before 6yo. May be caused by pituitary tumor Precocious Puberty Boys - CORRECT ANSWER Development of secondary sexual characteristics before the age of 9. May be caused by pituitary tumor Delayed puberty may be caused by - CORRECT ANSWER lack of gonadotropins (pituitary gland) Shortest time period you can give HBV vaccines - CORRECT ANSWER 6 months Paiget - CORRECT ANSWER cognitive development Ericson - CORRECT ANSWER psychosocial Kohlberg - CORRECT ANSWER Moral development (preconventional - concern of self, conventional - rules to be good person, postconventional - rules for the good of all of us) Erikson Psychosocial Stages - CORRECT ANSWER 1-3Autonomy vs. Shame and Doubt, 3-6Initiative vs. Guilt, 6-11 Industry vs. Interiority, 12-17 Identify vs. Role Confusion Piaget's stages of cognitive development - CORRECT ANSWER 2-7 preoperational (world revolves around them, one thing at a time, fairies), 7-11 concrete operational (can use logic, group objects), 11 and older - formal operational (abstract thought, predict outcomes) When does moral development begin? - CORRECT ANSWER age 9 When do kids first lose teeth - CORRECT ANSWER age 6. Perm teeth in by 12 earliest normal puberty - CORRECT ANSWER 8 years old When does puberty start for boys - CORRECT ANSWER age 11. Sperm devp around age 13 before growth spurt and pub hair Apical pulse location - CORRECT ANSWER Mid-clavicular Over 7 yo Fifth intercostal space and it is called PMI- point of maximum impulse (4th intercostal space under 7yo) What to document for murmur - CORRECT ANSWER rhythm, rate quality of sound Normal HR - CORRECT ANSWER Up to 8 75-115 8-11 70-110 teens 60-100 Book says 6-10 yo 65-125. Just remember higher for younger child Respiratory Rate - CORRECT ANSWER 3-7yo 20-25 8-11 yo. 14-22 over 12 12-20 Or remember average 15-20 Which arm for BP - CORRECT ANSWER 1. Dominant first 2. other arm 3. Use highest BP arm next time Blood Pressure - CORRECT ANSWER 3yo 90/40 7yo 97/57 11 104/61 teens 113/64 Retake BP how often if abnormal with HA, flushing, weak pulse, bounding pulse, pallor, dizziness - CORRECT ANSWER 5 min Bell of stethoscope is used for - CORRECT ANSWER soft, low-pitched sounds McKinney-Vento Act - CORRECT ANSWER the nation's first law to provide assistance to homeless persons, including free public education for children. School stability (can remain in school for duration of academic year), transportation is required. Homeless = children, youth who lack a fixed regular and adequate nighttime residence including sharing a residence, motel or campgrounds Freud's stages of development - CORRECT ANSWER oral stage, anal stage, phallic stage, latency stage, genital stage Maslow's Hierarchy of Needs - CORRECT ANSWER (level 1) Physiological Needs, (level 2) Safety and Security, (level 3) Relationships, Love and Affection, (level 4) Self Esteem, (level 5) Self Actualization 6 steps of nursing process (ADOPIE) - CORRECT ANSWER Assessment, diagnosis (nursing), outcome identification, planning, implementation, evaluation. FIRST step ASSESSMENT ALWAYS. Hib - CORRECT ANSWER Haemophilus influenzae type B - Not given after 5yo HBV - CORRECT ANSWER hepatitis B vaccine TIPS for head injury - CORRECT ANSWER Time of Injury, Impact position, Positional assessment, Saw it? Federal Car Seat Regulations - CORRECT ANSWER Booster seat until 4'9" and 8-12 years old, under 13 back seat MMR first dose - CORRECT ANSWER after 12months Tdap - CORRECT ANSWER 11-12 years old Meningococcal - CORRECT ANSWER 11-12 years - Menactra Live viruses - CORRECT ANSWER MMR and Varicella (weakened/attenuated form of virus). Small risk of causing weak case of disease Killed/inactivated vaccines - CORRECT ANSWER made from protein or other small piece taken from virus Vision Screening - CORRECT ANSWER Chart with lines, numbers and symbols at eye level, arch of foot on line, passing 20/40 for K, 20/30 for 1st and up. Screens for Visual acuity, color discrimination and extraoccular movememnt Refractive errors - CORRECT ANSWER Most common vision problem in children Greatest cause of death for children 5-9 years old - CORRECT ANSWER 1)accidents/unintentional injury 2) cancer 3) congenital malformations 4) homocide Greatest cause of death for children 10-14 years old - CORRECT ANSWER 1)accident 2) cancer 3) suicide 4) homicide Greatest cause of death for children 15-19 years old - CORRECT ANSWER 1) accident 2) homicide 3) suicide 4) Cancer hearing screening pass - CORRECT ANSWER 1000, 2000, 4000 (Hertz/pitch) pass at 20/25db (loudness). Can be affected by cerumen impacted Prevention (primary, secondary, tertiary) - CORRECT ANSWER Primary - for everyone! immunizations, info on health promotion, health fair. Secondary for those at risk to a condition (vision screening, referring to dr). Tertiary - prevent additional disability, maximize capabilities (devp IHP for seizures, transition back to school, staff training) Insulin types - CORRECT ANSWER Novolog - fast acting, to cover for meals. Lantus - long acting - all day control Calcium needs for kids - CORRECT ANSWER 4-8 yo 1000mg, 9-18 1300mg. also needs sunlight, weigh bearing exercises, broccoli, cheese, yogurt. When fractures occur bone density screening recommended pneumothorax - CORRECT ANSWER air in the pleural cavity caused by a puncture of the lung or chest wall S/s liver laceration - CORRECT ANSWER Rt upper quad tenderness, guarding signs of blood loss, shock s/sx of bowl perforation - CORRECT ANSWER abd pain, N&V Treatment of abd injuries - CORRECT ANSWER bend knees and hips, place pillow or blanket, treat for shock When do you need stitches - CORRECT ANSWER when wound 1 inch, edges don't fall together State Board of Nursing develops state Nurse Practice Act - CORRECT ANSWER LAW. Denotes what a nurse can and cannot do, intent to protect public ANA (American Nurses Association) - CORRECT ANSWER - professional organization for RNs in the US - deals with professional scope and standards of practice - addresses ethics, public policy, and economic/general welfare of nurses - mission = advance profession of nursing NBCSN - CORRECT ANSWER provides cert exam voluntary Primary Assessment - CORRECT ANSWER ABCDE (Airway, breathing, circulation, disability and exposure) Secondary Assessment - CORRECT ANSWER EFGHI: expose, farenheit (temp), get VS, H head assessment I- inspect and isolate if infection or immune compromised CIAMPEDS (mneumonic for pediatric triage) - CORRECT ANSWER Chief complaint, Immunizations/Isolation, Allergies, Medications/Medical history, Parent's impression of the situation, Events surrounding, Diet/Diapers, Symptoms associated with illness/injury Treatment of Shock - CORRECT ANSWER lay supine with legs slightly elevated CPR rescue breathing rate - CORRECT ANSWER 12-20 bpm for child, 10-12 for adult Respiratory arrest - CORRECT ANSWER under 8 yo - 1 min rescue breath then 911, over 8 call first Heimlich - CORRECT ANSWER heel of one hand in middle of abd slightly over navel with other hand on top. Thrust up 5 times Treatment of burns - CORRECT ANSWER apply room temp water 2-5 min, remove clothes/jewelry, no ointment Hemorage - CORRECT ANSWER rapid weak pulse, cool moist skin, pale, bluish, excessive thirst, low BP, restless, unconscious How often to assess head injury/spinal cord injury - CORRECT ANSWER every 5 min What do you do with body parts torn from body - CORRECT ANSWER wrap in clean damp cloth and place in sealed plastic bath with cold water (not ice) transport with child How much does fever increase respiratory rate or heart rate - CORRECT ANSWER increase 10 pulse beats and 4 breaths per min for every degree of fever Sign of CHF in child - CORRECT ANSWER inc in RR, resp congestion, dry cough, SOB, crackels, diaphoresis Anemia - CORRECT ANSWER Most common abnormal blood condition in children. a symptom, not a disease, impaired production, poor diet, pica, blood loss, kidney disease. Symptoms - pallor, inc HR/RR, muscle weakness, fatigue, dizzy, HA, dec attention, jaundice Hemophilia - CORRECT ANSWER A hereditary disease where blood does not coagulate to stop bleeding. Non contact sports only Peptic Ulcer Disease cause - CORRECT ANSWER H. pylori. Seen in boys 12-18 Hep A and E transmission - CORRECT ANSWER fecal-oral. Can live up to 3 hours on objects. Boil or disinfect with bleach 5 rights of delegation - CORRECT ANSWER right procedure, situation, personnel, training, oversight. RN retains accountability for the task and outcome Student Health Record - CORRECT ANSWER part of cumulative education record in public school. Protected by FERPA Burns (degrees) - CORRECT ANSWER 1st -- minor damage/epidermis -- ERYTHEMA. Sunburn 2nd- Partial-thickness- painful superficial/Papillary dermis-- BLISTERS deep/reticular dermis -- RUPTURED blisters 3rd -Full/destroy-dermal appendages - no* sensation white, leathery, charred Call EMS if 10% of body burned (1% = students palm) HEEADSSS is: - CORRECT ANSWER home, education/employment, eating, activities, drugs, sexuality, suicide, safety prominent bone for otoscope exam - CORRECT ANSWER Malleus prominent bone Addison's disease - CORRECT ANSWER a condition that occurs when the adrenal glands do not produce enough cortisol or aldosterone Cushing's syndrome - CORRECT ANSWER caused by prolonged exposure to high levels of cortisol, causes swelling Graves disease - CORRECT ANSWER (hyperthyroidism) bulging eyes, nervous, weight loss, heat intolerance, insomnia Hypothyroidism symptoms - CORRECT ANSWER Fatigue, lethargy. Modest weight gain with anorexia. Dry, coarse skin and cold intolerance. Swelling of face, hands, and legs. Constipation. Weakness, muscle cramps, arthralgias, paresthesias, impaired memory and hearing. Prader-Willi Syndrome - CORRECT ANSWER genetic disorder, obesity, intellect disability, short When does eye anatomy mature - CORRECT ANSWER last of the senses, around 6 strabismus - CORRECT ANSWER crossed eyes appendicitis - CORRECT ANSWER RLQ pain and rebound tenderness. Pain may inc with cough and walk. N&V Romberg test - CORRECT ANSWER -ask client to stand with feet at comfortable distance apart, arms at sides, and eyes closed -expected finding: client should be able to stand with minimal swaying for at least 5 seconds Backpack should weigh less - CORRECT ANSWER than 10-15% body weight Immunization exemptions - CORRECT ANSWER seizure, life threatening allergy, pregnant, immunosuppressed, religious or philosophical, Tinea Capitis (Scalp Ringworm) - CORRECT ANSWER Rounded, patchy hair loss on scalp, leaving broken-off hairs, pustules, and scales on skin. Caused by fungal infection. Fragile X Syndrome - CORRECT ANSWER a disorder produced by injury to a gene on the X chromosome, producing mild to moderate mental retardation, autism, prominent jaw, forehead, ears. In males rheumatic fever - CORRECT ANSWER after strep pharyngitis. Symptoms include joint pain with redness and swelling, rash, low fever Myopia - CORRECT ANSWER nearsightedness Nystagmus - CORRECT ANSWER repetitive rhythmic movements of one or both eyes Spinal screenings take place - CORRECT ANSWER Twice between 5th and 9th grades Spine disorders - CORRECT ANSWER scoliosis (curve), lordosis (swayback - spine sucked forward, anterior convexity of spine), kyphosis (humpback - upper back, posterior convexity) CPR: single rescuer compression/ventilation ratio - CORRECT ANSWER 30:2 CPR second rescuer - CORRECT ANSWER 15 compressions to 2 breaths If pulse but no breathing - CORRECT ANSWER give breaths every 3 seconds and check pulse every 2 min Use AED immediately - CORRECT ANSWER if you saw the child go down. Otherwise use it after 5 cycles of CPR CPR switch with second rescuer - CORRECT ANSWER Every 5 min if possible How long until epi pen effects are gone? - CORRECT ANSWER 20 minutes Lead is toxic at blood levels abover - CORRECT ANSWER 10mcg/dl symptoms of pneumothorax - CORRECT ANSWER dyspnea (pain with respiration), dec lung sounds on affected side, anxiety, movement of trachea to one side of the midline of the throat, any open chest wound sucking air. hypergylcemia symptoms - CORRECT ANSWER thirst, urination, fruity breath, flushing, irritability, drowsiness, unconsciousness (call EMS if unconscious) Hypoglycemia symptoms - CORRECT ANSWER hunger, fatigue, weakness, sweating, headache, dizziness, low bp, cold or clammy skin If unconscious give glucagon most common childhood cancer - CORRECT ANSWER leukemia muscular dystrophy - CORRECT ANSWER group of hereditary diseases characterized by degeneration of muscle and weakness. Most are in wheel chair by late teens and dies in 20's Achondroplasia - CORRECT ANSWER dwarfism., bowed legs, spine is curved osteogenesis imperfecta - CORRECT ANSWER brittle bone disease Juvenille Rheumatoid Arthritis - CORRECT ANSWER peak ages onset of 2-5 and 9-12 years old usually occurs in girls cerebral palsy - CORRECT ANSWER paralysis caused by damage to the area of the brain responsible for movement. May be seizures, intellectual disability or attention deficit disorders Tourette's syndrome - CORRECT ANSWER effects boys 4x's as much as girls, associated with OCD, ADHD, Impulse control, anxiety and depression febrile seizures - CORRECT ANSWER Seizures that result from sudden high fevers, particularly in children. Usually less than 7 yo status epilepticus - CORRECT ANSWER A condition in which seizures recur every few minutes or last more than 30 minutes. Up to 75% of children having first seizure will have status epilepticus. Infection and metabolic disorders usually trigger. Call EMS if first seizure over 5 min or known epileptic over 10 min signs of shunt malfunction (hydrocephalus) - CORRECT ANSWER -Irritability -Headache -Diplopia -Nausea/vomiting -Lethargy -Loss of milestones -Change in seizure pattern -Decreased level of consciousness -They also will sometimes show signs of infection and not a blockage Mantoux test - CORRECT ANSWER TB test, read 48-72 hours. 15mm positive w/o risk factors, 10mm positive with risk factors. Common Cold - CORRECT ANSWER Symptoms 2-8 days after exposure and last up to 10 days Chicken pox - CORRECT ANSWER rash develops 10-21 days after exposure and person is infective 24-48 hours before rash until they scab over viral meningitis - CORRECT ANSWER usually self limiting within 7-10 days and is less severe than bacterial meningitis Disaster Preparedness should prepare to care for students for - CORRECT ANSWER 3 days How much time in between doses of same live vaccine? - CORRECT ANSWER 4 weeks Can a student get all vaccines needed to start school in one sitting? - CORRECT ANSWER Yes and then attend school the next day. Youth Risk Behavior Surveillance System (YRBSS) - CORRECT ANSWER National Youth Behavior Survey conducted by the CDC. Given by states every 2 years to a selection of students in 9-12 grade. It elicits info about tobacco, alcohol, drug use, risky behaviors School Health Index (SHI) - CORRECT ANSWER made by CDC to improve health promotion programs Most effective hand hygiene? - CORRECT ANSWER antibacterial soap for 30 seconds, paper towels. Alcohol foams, gels must have 60-95% alcohol Fungal infections - CORRECT ANSWER should be treated for 24 hours then covered well during sports match treatment of avulsed tooth - CORRECT ANSWER handle by crown, put in Hanks balanced salt solution or milk, normal saline, water and student and tooth transported to dentist Dietary requirements for children - CORRECT ANSWER 4-8 years old kids need 1400-1600 cal. Goes up from there. Teen girls 2000 boys 2400-2800 Underweight BMI - CORRECT ANSWER less than 5 percentile. Normal 5-84% What governs staff health information? - CORRECT ANSWER HIPPA Piercing care - CORRECT ANSWER If it swells or itches, remove metal causing reaction. Otherwise wash twice a day with abx soap and rotate piercing. Do not use alcohol or hydrogen peroxide Title X (The Education Amendment Act of 1972) - CORRECT ANSWER schools cannot discriminate against pregnant or parenting teen Determining malpractice - CORRECT ANSWER school nurses' actions are judged on the basis of whether the nurse performed as a prudent person would do. Determined by using American Nurses association and NASN practice standards. Failure to act properly is negligence Consent for screenings - CORRECT ANSWER If parent consents but child does not do not do it and notify parents of the refusal. Document Scope of school health services - CORRECT ANSWER seek to remove all health barriers to education Consequence of violations of confidentiality - CORRECT ANSWER HIPPA violations can be fined, FERPA violations can lose federal financial assistance Heat Exhaustion Treatment - CORRECT ANSWER loosen clothing, give sips of fluids, move to cool area, apply cool water to skin, seek medical attention if worsens Treatment of draining would - CORRECT ANSWER cover before athlete returns to play Most crucial nursing diagnosis - CORRECT ANSWER Anxiety and Fear. Must be addressed prior other problems. Adolsecents who are anxious or depressed are at risk for poor developmental outcomes menstrual dysfunction - CORRECT ANSWER most common adolsecent female reproduction problem Audiometer (pure-tone) - CORRECT ANSWER measures decibles and Hertz (frequency and intensity) Scoliosis - CORRECT ANSWER often left shoulder higher than right, right rib hump, slight curve of spinal column at waist when bends. Lateral spinal curvature greater than 10 degrees zoonotic transmission in classroom pets - CORRECT ANSWER reptiles, amphibians, live poultry Treatment of snakebite - CORRECT ANSWER Keep affected area below the heart to slow the spread of venom, cover with loose fitting dry bandage most frequent cause of cardiopulmonary arrest in children - CORRECT ANSWER respiratory conditions Who prohibits sharing medical info in schools? - CORRECT ANSWER FERPA, not HIPPA Most common causes of spinal cord injuries in children - CORRECT ANSWER vehicle accidents and sports injuries Ronchi - CORRECT ANSWER loud rumbling sounds heard on auscultation of bronchi obstructed by sputum. like snoring. Low pitched bubbling or gurgling on inspiration Hep B vaccine - CORRECT ANSWER Birth within 12 hours, then 1-2 months but before 6 weeks then 2-4 weeks after that, then 8 weeks after that. Remember required spacing and do not have to start over to complete the series linear papularvesicular lesions - CORRECT ANSWER poison ivy puritic maculopapular lesions that become vesicular - CORRECT ANSWER varicella hyperopia - CORRECT ANSWER A condition in which visual images come to a focus behind the retina of the eye and vision is better for distant than for near objects -- called also farsightedness. myopia - CORRECT ANSWER Light rays entering eyes focus in front of the retina making distant objects out of focus (nearsighted ness) Conductive hearing loss - CORRECT ANSWER from mechanical dysfunction that interferes with sound waves (including chronic or frequent otitis media) sensorineural hearing loss - CORRECT ANSWER the most common form of hearing loss, also called nerve deafness; caused by damage to the cochlea's receptor cells or to the auditory nerves. Head injury, prolonged music, rubella cause this. Hand-foot-mouth disease - CORRECT ANSWER Coxsackie virus. Blisters in mouth and hands but can be afebrile. Can return to school after fever gone and no draining lessions. Children can spread the virus even w/o symptoms and may be in stools for weeks after symptoms Treatment of insect stings - CORRECT ANSWER Do not remove with tweezers. Can use flat edge like ID card, soap, water, ice. Monitor for anaphylaxis. Herpes simplex lesions - CORRECT ANSWER contagious, reoccur, can spread on skin to skin contact even when no sore visible Signs of CHF - CORRECT ANSWER Visible swelling of the legs, ankles, eyelids, face, and (occasionally) abdomen. Abnormally fast breathing. Shortness of breath or labored breathing. - Wheezing Fatigue. Nausea. Falling asleep when feeding or becoming too tired to eat. Lack of appetite. Tension pneumothorax treatment in school setting - CORRECT ANSWER Scabies - CORRECT ANSWER intense itching, especially at night Lowest contraceptive failure rate - CORRECT ANSWER Birth control pills, then diaphragm, then condom cleft lip and palate - CORRECT ANSWER may have speech and language problems, ear infections hypovolemic shock - CORRECT ANSWER shock resulting from blood or fluid loss. Tachycardia, cool, clammy skin, low BP, general weakness vision impairment - CORRECT ANSWER normal (20/10-20/25), moderate (20/70-20/100), legal blindness (20/200) with best conventional correction [Show Less]
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Unit 6: Chapter 4- Nursing Licensure and Certification 86 Questions with Verified Answers,GRADED A
Unit 6: Chapter 4- Nursing Licensure and Certification 86 Questions with Verified Answers Nursing Pins - CORRECT ANSWER Today, the school of ______ id... [Show More] entifies graduates from a particular school of nursing. Philopsphy, Beliefs, and Aspirations - CORRECT ANSWER The pin's emblems and tex symbolize _______, _____, and ______ of the nursing program. Achievement, learning and skill - CORRECT ANSWER Nurses wear their pins proudly as evidence of their ______, ______, and skill. Registry - CORRECT ANSWER Florence Nightingale started this practice when she created a list of the graduates of the St. Thomas School of Nursing in England. This list became known as the ______ of graduate nurses. This list proclaimed to all the skills and knowledge of graduates. Licensure of Nursing (Purpose of the Licensure) - CORRECT ANSWER As nursing programs proliferated, variations developed among the programs. And another system was necessary to distinguish those sufficiently trained to provide nursing care from the untrained or lesser-trained individuals. Graduate nurses, physicians, and hospitals met to resolve this and the outcome was criteria for the _______ in the United States. Protection of the Public - CORRECT ANSWER What is the primary purpose of licensure? Dr. Henry Wentworth Acland - CORRECT ANSWER As early as 1864, _______ encouraged licensure of English nurses. However it wasn't until 1896 that attempts were made to license nurses in the US. American Nurses Association (ANA) - CORRECT ANSWER A key advocate for the standards of licensure was the Nurses Associated Alumnae of the United States and Canada which later became ________. Failed for lack of broad-based support - CORRECT ANSWER Did the early attempts at nursing licensure fail or succeed. Why? 1901 (The International Council of Nurses passed a resolution that each nation and state examine and license its nurses) - CORRECT ANSWER What year was the first time that the licensure was successful? North Carolina, New Jersey, New York, and Virginia - CORRECT ANSWER What four states were the first to institute permissive licensure? 2 - CORRECT ANSWER Under permissive licensure educational standards were set a minimum of ___ years of training for nurses. They could not use the title of RN - CORRECT ANSWER What happened when a nurse did not pass the examination? Protect Public from unskilled practitioners, and to provide legal sanctions to protect the title RN - CORRECT ANSWER What were these early regulations served to do? 1923 - CORRECT ANSWER In 20 years, ______, all states had instituted examinations for permissive licensure. 1915 - CORRECT ANSWER When was the first models act published? Models Act - CORRECT ANSWER The _______ are revised and updated as nursing practices advances. For example for NCSBN approved the most RECENT revision of this and administrative rules in 2004. Model Nurse Practice Act - CORRECT ANSWER The _______ is composed of many sections including a definition of nursing and the scope of practice for the RN, descriptions of advance practiced nursing, requirements for prescriptive authority of nurses, nursing education, compact guidelines, ad processes for disciplinary actions against nurses who violate sections of the act. New York - CORRECT ANSWER ____ was the first state to require mandatory licensure, although requirement was not in place until 1947. NCSBN - CORRECT ANSWER After WWII the ANA formed the ______. This council was composed of a representative of each state and jurisdiction in the US. This council advocated a standardized examination for licensure. 1950 - CORRECT ANSWER These varied activities culminated in the National League for Nursing administering the first State Board Test Pool examination in ______. (year) 1982 - CORRECT ANSWER The next major event in licensure efforts occurred in ______ with the development of the first NCLEX examination. 1994 - CORRECT ANSWER Paper and pencil testing was replaced with computerized adaptive testing in _____. the National Council of State Board of Nursing - CORRECT ANSWER What does NCSBN stand for? NCSBN - CORRECT ANSWER To ensure public protection, NCSBN member borard jurisdiction require a candidate for licensure to pass an examination that measures the competencies needed to perform safely and effectively as a newly licensed, entry- level nurse. NCLEX- LPN NCLEX- RN - CORRECT ANSWER What are the two test exams called? RN - CORRECT ANSWER The legal title, ____, is reserved for those meeting the requirements to practice nursing. Only those who are licensed may use this title. Nurse Practice Act (NPA) - CORRECT ANSWER o Each state develops rules and regulations to govern the practice of nursing within that state: written and passed by legislator State - CORRECT ANSWER Each state or jurisdiction establishes laws regulating practice within its borders. Therefore, it is imparatice for the nurse to know and understand the definition of nursing in the ______ that he or she practices. Yes - CORRECT ANSWER Can a state revise their nurse practice act? No; they must know all the practices and regulations for the state of Virginia because that state may have different policies than the state of Louisiana. - CORRECT ANSWER If a nurse is licensed in Louisiana, can they go to Virginia and practice nursing without any licensure in the state of Virginia. -transcript of course work, diploma, or letter from dean - statements regarding the mental and physical health status of the applicant - review of prior legal convictions - CORRECT ANSWER To verify an applicant's graduation from a nursing program what is necessary? NCLEX-RN - CORRECT ANSWER Regardless of individual state requirements, all nurse practice acts require candidates to successfully complete the ____ licensure examination before they can practice. Submitting a letter to the second state board of nursing - CORRECT ANSWER Nurses who are licensed in one jurisdiction may apply for licensure in a second jurisdiction by _____________. - current license to practice - any restrictions imposed on the license by the first state - CORRECT ANSWER What must a nurse show to receive a license in another state or jurisdiction? 2 to 3 years, as well as any specific requirements for renewal of licensure - CORRECT ANSWER Each nurse practice act includes the requirements and information necessary to renew one's nursing license. These regulations define a length of time a license is valid, generally from _____, as well as any _________. No; All nurses are expected to continue education in various ways depending on the state or jurisdiction policies - CORRECT ANSWER Are only RNs expected to remain competent to practice through various means of continuing education? California - CORRECT ANSWER What was the first state to institute mandatory continuing education education for renewal of licensure? 20 to 40 hours 2 to 3 year period - CORRECT ANSWER The number of hours to renew licensure varies depending on the jurisdiction, but it ranges from ____ to ____ hours over a ___ to ___ year period. Louisiana State Board of Nursing - CORRECT ANSWER What does LSBN stand for? Baton Rouge - CORRECT ANSWER Where is the LSBN located? January $80.00 - CORRECT ANSWER The LSBN state that the renewal for RN is in ____ of every year and the current cost is $_____. 5 contact hours - CORRECT ANSWER According to the LSBN website, the current amount of continuing education credit required for annual RN license renewal for the full-time RN working more than 1600 hours per year is _____ contact hours 10 contact hours - CORRECT ANSWER According to the LSBN website, the current amount of continuing education credit required for annual RN license renewal for the part-time RN working less than 1600 hours but more than 160 hours per year is _____ contact hours 15 contact hours - CORRECT ANSWER According to the LSBN website, the current amount of continuing education requirement for annual RN license renewal for part-time or unemployed RN working less than 160 hours per year is _____ contact hours. Governor's - CORRECT ANSWER An important section of every nurse practice act is the designation of a regulatory board of nurses and consumers to administer the act. In most cases, the members are appointed by the ______ office. Restrictions on License or Suspension or revocation of license - CORRECT ANSWER Actions that violate the act, or other state federal laws can have a consequence on a nursing licenses depending on the actions. What are things that can happen if violated? Veterans Administration or US public Health Service - CORRECT ANSWER The ______ or the _____ employs thousands of nurses, who serve in many jurisdictions as well as outside the US boundaries. Military and government nurses - CORRECT ANSWER What nurses are the only ones that it is not necessary to obtain a nursing license in each jurisdiction that they practice in. Other jurisdictions without additional licensure requirements - CORRECT ANSWER The military/government nurse will take the NCLEX-RN exam. And on successful completion, as an employee of the US government, he or she may practice in ________. Evidence of completing their original educational program and restrictions of their license - CORRECT ANSWER When a nurse in a foreign country move into the United States, they must show ________ and ______ to begin the process of being able to practice in the United States. English NCLEX-RN - CORRECT ANSWER The foreign nurse needs to demonstrate competency in _____ and be able to take and pass the ______. The exam is given in English and tests the knowledge required to practice in this country. International Council of Nurses - CORRECT ANSWER If a US nurse wants to practice in another country, the ________ or the nursing regulatory board of the country in which they want to practice in will help them achieve this. The ______ (same term as blank above) is composed of representatives or organized nursing worldwide and assists nurses in obtaining licensure in another country. Sunset Act - CORRECT ANSWER The _____ are intended to ensure that legislation is current and reflects the needs of the public. When these are included in the nurse practice act, the act must be renewed by a specific date, and if it is not it is rescinded.. It allows the practice act to be consistent with current nursing practice. NCL (a multistage license) - CORRECT ANSWER Nurses practicing in an ____state are responsible for following the laws and regulations of each state in which they practice, although they are not required to apply for multiple individual state license. Multistate License - CORRECT ANSWER A ______ allows you to practice in home state and other states without applying go multiple licenses To ensure that nurses were competent to remain in practice - CORRECT ANSWER Why is continuing education mandatory? - designated number of clinical hours - portfolios of achievement in clinical practice or exemplars of practice - CORRECT ANSWER Consortiums of nurses in a number of states are examining other alternatives besides continuing education for renewal of licensure. These requirements may include: Licensure - CORRECT ANSWER ____ establishes a minimal of levels of practice. Certification - CORRECT ANSWER _____ recognizes excellence in one practice. Licensure - CORRECT ANSWER _____ is granted and governed by legislation and administration through state boards of nursing. Certification - CORRECT ANSWER ____ is awarded by nongovernmental agencies. Anesthesia - CORRECT ANSWER The first field of nursing practice to certify advanced practitioners was nurse ______ in 1946. Midwives - CORRECT ANSWER Similarly, in 1961 the American College of Nurse _____ began to certify _____. University of Wisconsin- Milwaukee - CORRECT ANSWER As certification programs developed, it became apparent that program standardization was necessary. So in 1975, the ANA convened a national study group at the ______ to explore the certification issue. DNP (all master's level certification) - CORRECT ANSWER This certification will assure patients and public that a nurse has achieved a standardized and advanced level of clinical competency Certification - CORRECT ANSWER With the development of additional advanced practice roles, all states have included requirements of ______ in their regulations for advanced practice nurses in all speciality roles. - Contact both ANCC and the speciality organization in his or her area of practice to determine the education, experience, and examination requirements necessary to become certified. - And to contact the state boards of nursing in the state(s) in which he or she wishes to practice and obtain information on legal requirements to practice in those jurisdictions. - After gathering info, the nurse will develop a plan of action to complete the coursework, clinical practice requirements, and examinations. - CORRECT ANSWER What are the steps to certification that a nurse needs to do? Expanded Role - CORRECT ANSWER On completion of all the certification requirement agencies, the advanced practice nurse mat practice in an _______. Yes; As the health care environment changes, so must the professional and legal issues of scope and practice and the independence of advanced nursing practice. - CORRECT ANSWER Do nurses in advanced practice face changing educational requirements for licensure and re-licensure? 7 - CORRECT ANSWER How many total students were involved in disciplinary actions regarding their clinical education? Carllene MacMillan, RN, MN - CORRECT ANSWER The current Vice President of the "Board of Nursing" is... Demetrius Porche, DNS, APRN, PH.D, FNP - CORRECT ANSWER The current President of the "Board of Nursing" is ..... The plea of guilty to criminal matter - CORRECT ANSWER According to the board report on diciplinary actions dated September 11, 2012, Jeannette Marie Stansbury is denied approval for 5 years to enter or progress in a clinical nursing course based on Additional Acts - CORRECT ANSWER Activities beyond those taught in basic nursing education programs. Unlicensed Assistive Personnel - CORRECT ANSWER An unlicensed individual who is trained to function in an assistive role to the licensed nurse in the provision of patient activities as delegated by the nurse. Assessing Health Status - CORRECT ANSWER Gathering information relative to physiologic, behavioral, sociologic, spiritual and environmental impairments and stregnths of an individual by means of the nursing history, physical exam, and observation in accordance with the board's Legal Standards of Nursing Practice. R.N. Applicant - CORRECT ANSWER A person who has completed the educational requirements and whose application to take the required examination for licensure as a registered nurse has been accepted by the board. Student Nurse - CORRECT ANSWER A person who is engaged in learning experiences in a program of study leading to candidacy for licensure to practice as a registered nurse. The term applies only when the person is participating in an integral part of the program of study, and not when that person is engaged in an employment situation. Accountability - CORRECT ANSWER Being anserable to ones actions or inactions. Assignment - CORRECT ANSWER Designating nursing activities to be performed by an indiviual consistent with his/her licensed scope of practice. Specialized Knowledge and Skills - CORRECT ANSWER Required for the practice of nursing means the current theory and practice taught in basic nursing education programs preparing persons for R.N. licensure as well as information in the biological, physical and behavioral sciences. Charge of driving while intoxicated. - CORRECT ANSWER According to the board report on diciplinary actions dated September 11, 2012, Nancy Rae Price's RN license has been suspended due to 94.70% - CORRECT ANSWER According to the 2011 "Annual Report", the percentage of student's from UL Lafayette passing the NCLEX RN in 2010 is... Natalie Marie Gerdes - CORRECT ANSWER According to the board report of disciplinary actions has been "approved to take the NCLEX-RN, to be issued a probated temporary work permit and a probated license after successfully passing the licensing examination, for a minimum of of 3 years"? Protect the consumers of health care in Louisiana while allowing a Registered Nurse recovering from a substance use disorder and/or a medical, mental or physical condition to maintain licensure while being closely monitored by the Board through a structured agreement or order. - CORRECT ANSWER What is the purpose of the Recovering Nurse Program [Show Less]
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Oncology Certification Nursing Exam 125 Questions with Verified Answers,100% CORRECT
Oncology Certification Nursing Exam 125 Questions with Verified Answers infiltration - CORRECT ANSWER passage or escape of IV administered drugs into ... [Show More] the tissue extravasation - CORRECT ANSWER leakage of drugs capable of causing tissue damage into the subcutaneous or subdermal tissue or other unintended sites. irritation - CORRECT ANSWER a localized inflammatory reaction at the infusion or injection site flare reaction - CORRECT ANSWER a local allergic reaction along a vein caused by irritating drugs. infusion reactions - CORRECT ANSWER reactions mediated by the immune system (hypersensitivity, anaphylaxis, cytokine release syndrome) DNA-binding vesicants - CORRECT ANSWER vesicant binds to nucleic acids in the DNA of healthy cells in the tissue, causing cell death. the dead cells then release complexes, which are taken up by adjacent healthy cells. this process causes a continuing cycle of tissue damage as the vesicant is retained in the tissue for a long period of time. NON-DNA binding vesicants - CORRECT ANSWER the vesicant has an indirects effect on healthy cells. it does not bind to cellular DNA. it is metabolized in the tissue and is more easily neutralized. cabazitaxel (jevtana) - CORRECT ANSWER a taxane where infiltration has not caused skin or tissue impairment Docetaxel (taxotere) - CORRECT ANSWER extravasation may cause hyperpigmentation, erythema and tenderness. paclitaxel (taxol) - CORRECT ANSWER injection site reactions, including reactions secondary to extravasation, usually mild and consist of erythema, tenderness, skin hyperpigmentation or swelling at injection site. seen more often with 24 hour infusions than with 3 hour infusions. severe reactions such as phlebitis, cellulitis, induration, skin exfoliation, necrosis and fibrosis have been reported. onset has been delayed by a week to 10 days. recall reactions - CORRECT ANSWER recurrence of skin reactions at the site of previous extravasation following paclitaxel injection at a different site. docetaxel and paclitaxel - CORRECT ANSWER classified as exfoliants or drugs that may cause inflammation and peeling of skin without causing underlying tissue death. factors affecting tissue damage severity following a vesicant extravasation - CORRECT ANSWER 1. DNA binding vesicants cause greater tissue damage than non-dna binding vesicants 2. the higher the concentration and greater amount of a vesicant the more damaged caused. 3. location of the extravasation such as those with little subcutaneous tissue and overlying veins, arteries and nerves are likely to have more damage. 4. older age, comorbidity and impaired immunocompetence cause more damage. risk factors for peripheral extravasation - CORRECT ANSWER 1. small, fragile veins 2. previous multiple venipunctures 3. sensory deficits 4. application of topical skin numbing agents prior to venipuncture 5. limited vein selection d/t lymph node dissection 6. impaired cognition, altered mental status or somnolence 7. probing during IV catheter insertion 8. administration site in areas prone to movement 9. use of rigid IV devices. 10. prior treatment with irritating or sclerosing drugs 11. administration of a vesicant peripherally when the manufacturer stipulates it should be administered via a central line. possible etiologies of peripheral extravasations - CORRECT ANSWER 1.vein wall puncture, piercing or trauma. 2. dislodgement of the catheter from a vein 3. administration of a vesicant in a vein below a recent venipuncture site. 4.administration of a vesicant in a vein below or recent or non-healed vesicant extravasation site. 5. inadvertent intramuscular or subcutaneous vesicant administration. Risk factors for extravasation from central VADs - CORRECT ANSWER 1. difficulty encountered during device insertion 2. inadvertent slicing, piercing or nicking of catheter prior to insertion 3. device misplacement with catheter tip outside of the venous system. 4. insufficient length of non coring needle (implanted port) 5. presence of a fibrin sheath or thrombus at the catheter tip. 6.catheter migration 7. long dwell time of catheters inserted using a subclavian approach, in which the catheter is placed between the clavicle and first rib possible etiologies of extravasations from central VADs - CORRECT ANSWER 1. inadvertent misplacement of catheter tip outside of the venous system during insertion procedure. 2. vein perforation during insertion 3. post insertion vein erosion, catheter leakage, rupture or fracture. 4. separation of the catheter from a portal body. 5. incomplete insertion of a non coring needle into an implanted port 6. non coring needle dislodgement from an implanted port. 7. backflow of vesicant along the catheter to the venotomy site secondary to fibrin sheath or thrombus at the catheter tip. signs and symptoms of vesicant extravasation - CORRECT ANSWER 1. vein irritation and flare reactions may mimic signs of vesicant extravasation. 2. vein irritation and flare reactions only occur in peripheral chemo administration 3. if it happens in CAD it is d/t catheter tip placement outside of the venous access device or erosion of the vein wall. 4. this may cause SOB and shock to secondary blood loss. additional signs and symptoms of vesicant extravasation - CORRECT ANSWER 1. IV flow rate that slows or stops 2. resistance during IV bolus vesicant administration 3. leaking around the IV catheter or implanted port needle. consequences of untreated vesicant extreavasation - CORRECT ANSWER 1. blistering (usually happens within 3 to 5 days. 2. peeling and sloughing of skin (usually begins 2 weeks after extravasation) 3. tissue necrosis (usually evident two or three weeks after extravasation. 4. DNA binding vesicants stay in the tissue for a long time, the area of necrosis becomes larger and deeper over time. 5. non-dna binding vesicants are more easily metabolized in the tissue. it is localized and improves over time. 6. damage to tendons, nerves and joints 7. functional and sensory impairment of the affected area. 8. disfigurement 9. loss of limb. Flare reaction - CORRECT ANSWER 1. itchy blotches or hives; pain and burning uncommon 2. raised red streak, blotches or hive-like erythema along the vessel; diffuse or irregular pattern. 3. usually appears suddenly and dissipates within 30-90 minutes. 4. swelling unlikely. 5. blood return usually noted but not always intact. 6. flush vein slowly w/ saline and observe for resolution of flare, usually within 45 minutes. 7. an antihistamine may be used to treat a flare reaction and for premedication w/ subsequent cycles. 8. do not resume the infusion through the IV site until flare reaction resolves completely. 9. document the flare reaction. Vessel irritation - CORRECT ANSWER 1. aching and tightness 2. erythema and dark discoloration along vessel. 3. usually appears within minutes after injection. coloration may only appear later in the process. 4. swelling is unlikely. 5. blood return usually noted but not always intact. initial management of extravasation - CORRECT ANSWER assess the site and patient symptoms at the first sign of extravasation, during the time the IV device is assessed and after initial management steps to take when a vesicant extravasation occurs or is suspected. - CORRECT ANSWER 1. immediately stop administering the vesicant and IV fluids 2. disconnect the IV tubing from the IV device. do not remove the IV device or non coring port needle 3. attempt to aspirate residual vesicant from the IV device or port needle using a small ( 1-3 ml) syringe. 4. remove the peripheral IV device or port needle. 5. initiate appropriate management measures according to policy. Grading for adverse event of infusion site extravasation - CORRECT ANSWER grade 1: painless edema grade 2: erythema with associated symptoms ( edema, pain, induration, phlebitis) grade 3: ulceration or necrosis, severe tissue damage; operative intervention indicated. grade 4: life-threatening consequences; urgent intervention indicated grade 5: death. mechlorethamine hydrochloride (nitrogen mustard, Mustargen) - CORRECT ANSWER 1. alkylating agent 2. apply cold pack for 6-12 hours following sodium thiosulfate antidote injection 3. sodium thiosulfate neutralizes mechlorethamine to form non toxic thioesters that are excreted in the urine. 4. to prepare 1/6 (4.14 g) molar solution of sodium thiosulfate per 100 ml of sterile water for injection 5. inject 2 ml of the sodium thiosulfate solution for each milligram of mechlorethamine suspected to have extravasated. inject the solution SC into the extravasation site using a 25 gauge or smaller needle. dose may be divided into 3-4 syringes to inject around the site of extravasation. the needle should be changed with each new injection. 6. assess the extravasation area for pain, blister formation and skin sloughing periodically. 7. instruct patients to monitor extravasation site and ot report fever, chills, blistering skin sloughing and worsening pain. 8. instruct patient to report arm or hand swelling and stiffness. Trabectedin (Yondelis) - CORRECT ANSWER 1. apply cold pack for 15-20 minutes at least 4 times/ day for the first 24 hours. 2. no known antidote or treatment exists. 3. assess the extravasation area for pain, blister formation and skin sloughing periodically. Anthracenedione (Mitoxantrone, Novantrone) - CORRECT ANSWER 1. apply cold pack for 15-20 minutes at least 4 times/day for the first 24 hours. 2. no known antidote or treatment exists. 3. extravasation typically causes blue discoloration of the infusion site area and may require debridement and skin grafting. 4. assess the extravasation area for pain, blister formation, and skin sloughing periodically as needed antitumor antibiotics (anthracyclines) ex. daunorubicin, cerubidine, doxorubicin (adriamycin), Epirubicin (Ellence), Idarubicin (Idamycin) - CORRECT ANSWER 1. apply cold pack but remove at least 15 minutes prior to dexrazoxane treatment. 2. dexrazoxane for injection is the treatment. 3. the recommended dose of dexrazoxane is based on the patient's body surface area. day 1: 1,000 mg/m; day 2: 1,000 mg/m, day 3: 500 mg/m. the maximum recommended dose is 2,000 mg on days 1 and 2 and 1,000 mg on day 3. the dose should be reduced 50% in patients with creatinine clearance values < 40 ml/min. 4. prepare each 500 mg vial of dexrazoxane must be mixed with 50 ml diluent. the patients dose is then added to a 1,000 ml normal saline infusion bag for administration. 5. storage: store at room temperature between 15 C -30 C. 6. initiate the first dexrazoxane infusion asap and within 6 hours of the anthracycline extravasation. 7. infuse dexrazoxane over 1-2 hours in a large vein in an area other than the extravasation area. the same arm should be used only when the patient's clinical status precludes us of the unaffected arm and a large vein above the extravasation site should be used for dexrazoxane administration. 8. dimethyl sulfoxide should not be applied to the extravasation area. assess the extravasation area for pain, blister formation, and skin sloughing. 9. instruct patients w/ peripheral extravasation to report arm or hand swelling or stiffness. instruct patients about treatment side effects such as: N/V, diarrhea, stomatitis, bone marrow suppression, elevated liver enzyme levels, infusion site burning. 10. monitor patients complete blood count and liver enzyme levels. antitumor antibiotics ex. dactinomycin (actinomycin D, cismegen) Daunorubicin and cytarabine (cyxeos), doxorubicin hydrochloride liposome (doxil), Mitomycin (mutamycin) - CORRECT ANSWER 1. apply cold pack for 15-20 minutes at least 4 times/day for the first 24 hours. 2. no known antidotes or treatment exists. 3. assess the extravasation area for pain, blister formation and skin sloughing. plant alkaloids and microtubule inhibitors. ex. Vinblastine( velban), vincristine (oncovin) - CORRECT ANSWER 1. apply warm pack for 15-20 minutes at least 4 times/day for the first 24-48 hours. elevate extremity. (peripheral extravasations) 2. antidote: hyaluronidase. it degrades hyaluronic acid and promotes drug dispersion and absorption 3. prepare per package insert. do not dilute. use solution provided. store at room temperature. 4. administer 150 units of hyaluronidase solution as 5 separate injections, each containing 0.2 ml of hyaluronidase, subcutaneously into the extravasation site using a 25 gauge or smaller needle. 5. assess the extravasation area for pain, blister formation and skin sloughing. 6. instruct patients to monitor the extravasation site and to report fever, chills, blistering, skin sloughing and worsening pain. 7. instruct patients w/ peripheral extravasation to report arm or hand swelling or stiffness. Taxanes Ex. cabazitaxel (jevtana), docetaxel (taxotere), paclitaxel (taxol), paclitaxel protein-bound particles for injectable suspension (abraxane) - CORRECT ANSWER 1. apply cold pack for 15-20 minutes at least 4 times/day for the first 24 hours. 2. no known antidotes or treatment exists. 3. assess the extravasation area for pain, blister formation, and skin sloughing. instruct patients to monitor for extravasation site and to report fever, chills, blistering, skin sloughing and worsening pain. 4. instruct patients w/ peripheral extravasation to report arm or hand swelling and stiffness. key elements of vesicant extravasation documentation - CORRECT ANSWER 1. date and time of extravasation 2. type and size of peripheral venous access device or type of CVAD. 3. number and locations of venipuncture attempts. 4. description and quality of blood return before and during vesicant administration. 5. vesicant administration technique 6. concentration and estimated amt of extravasated vesicant. 7. symptoms reported by patient. 8. description of administration site that include date and time 9. assessment of extremity for range of motion and discomfort with movement 10. immediate nursing interventions 11. extravasation antidote or treatment administered. 12. follow up recommendations 13. patient teaching. dexrazoxane injection antidote. - CORRECT ANSWER 1. the only antidote that has a 98% efficacy for treating anthracycline extravasation 2. patient follow up is key 3. assess pts receiving IV dex on each day of the 3 day treatment and again for 4-7 days after completing treatment. 4. assess pts receiving other treatments on the day after the suspected extravasation and again 4-7 days after. 5. assessment may include inspection and measurement of the extravasation area, skin integrity, presence of pain or other symptoms, arm and hand mobility and sensation. 6. obtain follow up photos 7. educate pts to protect the extravasation area from sunlight, monitor the site, and report fever, chills, blistering, skin sloughing and worsening pain. irritants - CORRECT ANSWER 1. agents that inflame and irritate peripheral veins 2. examples include: bleomycin, carboplatin, carmustine, dacarbazine, etoposide, floxuridine, gemcitabine, ifosfamide, liposomal daunorubicin liposomal, doxorubicin streptozocin and topotecan. measures to reduce irritation during infusion - CORRECT ANSWER 1. increase dilution when possible and/or infusion w/ concurrent fluid administration 2. administer via larger rather than smaller peripheral. eins for peripheral infusions. 3. apply a warm pack to the administration site. 4. assess the administration site and monitor for pain, redness, and swelling in patients receiving irritating agents. Bendamustine hydrochloride (bendeka, treanda) - CORRECT ANSWER 1. irritant (usually), vesicant rarely 2. infiltration may cause painful erythema 3. infiltration include hospitalization for erythema, marked swelling and pain. 4. precautions should be taken to avoid extravasation. 5. apply cold pack for 15-20 minutes at least 4 times/day for 24 hours. 6. assess infiltrated area for pain, blister formation and skin sloughing. 7. instruct patients to monitor the infiltration site and to report fever, chills, blistering, skin sloughing and worsening pain. Irinotecan (Camptosar) - CORRECT ANSWER 1. irritant (usually) 2. exfoliative dermatitis may occur 3. flush skin with sterile water and apply cold pack for 15-20 minutes at least 4 times/day for the first 24 hours. 4. assess the infiltrated area for pain, blister formation and skin sloughing 5. instruct pt to monitor for infiltration site and to report fever, chills, blistering, skin sloughing and worsening pain 6. topical flushing of the skin with sterile water and application of ice Melphalan (Alkeran0 - CORRECT ANSWER 1. irritant usually, vesicant rarely 2. infiltration may cause local tissue damage 3. apply cold pack for 15-20 minutes 4 times/day for 24 hours. 4. assess for pain, blister formation, skin sloughing 5. instruct pt to monitor the infiltration site and to report fever, chills, blistering, skin sloughing and worsening pain. 6. administer over 15-20 minutes into a fast running IV solution into an injection port on the IV tubing. do not administer by direct injection into a peripheral veing. Oxaliplatin (Eloxatin) - CORRECT ANSWER 1. irritant usually, vesicant rarely 2. infiltration can lead to redness, swelling, pain and necrosis. 3. a warm pack may reduce local pain and inflammation 4. apply warm pack for 15-20 minutes at least 4 times/day for the first 24 hours. 5. elevate extremity for peripheral extravasation 6. high dose dexamethasone (8 mg twice daily for up to 14 days) 7. assess the infiltrated area for pain, blister formation and skin sloughing. 8. instruct patients to monitor the infiltration site and to report fever, chills, blistering, skin sloughing and worsening pain. 9. instruct patients to report arm or hand swelling and stiffness. 10. reports describe induration, edema, red-brown skin discoloration, hyperpigmentation and rare cases of tissue necrosis. Vinorelbine (Navelbine) - CORRECT ANSWER 1. irritant usually, vesicant rarely 2. extravasation may cause local tissue extravasation 3. apply warm pack for 15-20 minutes at least 4 times/day for the first 24-48 hrs 4. elevate extremity for peripheral extravasations 5. assess for pain, blister formation and skin sloughing 6. instruct patients to monitor the site and report fever, chills, blistering, skin sloughing and worsening pain. 7. instruct patients with peripheral extravasation to report arm or hand swelling and stiffness. Vinorelbine (Navelbine) - CORRECT ANSWER 1. both an irritant and a vesicant 2. reports have described skin discoloration, chemical phlebitis, localized rash, urticaria, blistering and rarely, skin sloughing. 3. rapid IV infusion over 6-10 minutes followed by a flush of more than 75-125 ml of fluid may reduce vinorelbine-induced irritation. drugs associated with hypersensitivity reactions and cytokine release syndorme - CORRECT ANSWER 1. blinatumomab 2. axicabtagene ciloleucel 3. tisagenlecleucel 4. interferon alpha 5. interferon beta 6. interferon gamma 7. aldesleukin 8. denileukin diftitox 9. ibritumomab tiuxetan 10. tositumomab 11. brentuximab 12. cetuximab 13. rituximab 14. alemtuzumab 15. bevacizumab 16. gemtuzumab ozogamicin 17. trastuzumab 18. ipilimumab 19. ofatumumab 20. panitumumab Anaphylaxis - CORRECT ANSWER 1.hypersensitivity reaction that is a systemic allergic reaction. can be life threatening. 2. reported with rituximab, trastuzumab and cetuximab. 3. flushing, itching, angioedema, cough, nasal congestion, SOB, wheezing sensation of choking, change in voice quality, tachycardia, fainting, hypo or hypertension, loss of consciousness, N/V. cramping/diarrhea, impending sense of doom, tunnel vision and back/chest or pelvic pain. risk factors for hypersensitivity and anaphylaxis - CORRECT ANSWER 1. administration of chemotherapy or immunotherapy agent 2. pre existing allergies to food, drugs and bee stings. 3. premedicate with fosaprepitant 4. previous exposure to the agent with mild symptoms of allergy 5. failure to administer known effective prophylactic medication 6. first 5 to 15 minutes from the start of the infusion. cytokine release syndome - CORRECT ANSWER 1. life threatening systemic inflammatory reaction after infusion of agents targeting the immune system 2. develops after cells are damaged and complement pathways are activated which results in an increase in systemic inflammatory cytokines and interleukins. 3. occurs with chimeric antigen receptor T cell therapy and agents such as rituximab and flinatumomab and may result in organ failure or death. S/S of CRS - CORRECT ANSWER 1. mild: fevers (days to weeks), tachycardia, chills, nausea, anorexia, myalgia, and headaches. 2. life threatening: capillaries leak fluid, which results in third spacing into the lungs and interstitial tissue, leading to intravascular depletion. can occur as late as 7 days after completion of the infusion. can result in thrombocytopenia and increased risk of thrombosis. AKI can occur w/ CRS as a result of changes d/t decrease in renal blood flow. CAR T cell therapy - CORRECT ANSWER 1. form of immunotherapy using genetically modified CD19 positive T cells to produce receptors called chimeric antigens in the tx. of B cell malignancies. 2. the T cells are isolated and modified using a lentiviral vector to cause apoptosis of CD19-positive cells commonly expressed on B-cell lymphomas and acute lymphoblastic leukemia. 3. CRS is the main complication experienced after cell infusion. it is seen within the first 12 hours to 3 days in patients with leukemia and 2-10 days in patients with lymphoma. 4. tocilizumab is a mAb used to treat CRS. it targets interleukin-6 and resolves symptoms within 24-48 hours. 5. first infusion of rituximab: greater than 50% incidence. preadministration guidelines to prevent hypersensitivity reactions, anaphylaxis and infusion reactions. - CORRECT ANSWER 1. obtain and record baseline VS 2. review pts allergy hx. 3. administer premedications 4. ensure emergency equipment and meds 5. obtain provider orders for emergency treatment before drug administration 6. monitor for reactions- majority of reactions. occur during the first or second exposure. emergency management of anaphylaxis - CORRECT ANSWER 1. stop drug infusion immediately and remove the allergen 2. maintain an IV line w/ normal saline or another appropriate solution 3. state with patient. notify the teamf 4. place the pt in comfortable position and assess the airway. maintain in upright position if SOB or nausea. have the pt lie flat and elevate legs if hypotensive. 5. monitor VS every 12 minutes until pt is stable, then every 5 minutes for 30 minutes, then every 15 minutes. 6. maintain airway, assessing the patient for increasing respiratory tract edema. give oxygen if needed. 7. administer emergency meds 8. provide emotional support 9. document all treatments and the patient's response. 10. symptoms of anaphylaxis may recur hours after initial intervention so pt should remain in hospital and monitored. clinical management of CRS - CORRECT ANSWER 1. stop infusion and observe the patient until symptoms resolve, usually within 30 minutes. 2. administer corticosteroid 3. resume infusion at a slower rate after resolution of symptoms and titrate the rate slowly. 4. for severe reactions, administer emergency meds. clinical management of localized hypersensitivity reaction - CORRECT ANSWER 1. observe and evaluate symptoms 2. administer diphenhydramine, ranitidine or corticosteroids, 3. monitor VS at least every 15 minutes for 1 hr. 4. document the episode and pt. response. protection - CORRECT ANSWER defense against foreign pathogens Homeostatisis - CORRECT ANSWER elimination of damaged or dead cells and initiation of tissue repair surveillance - CORRECT ANSWER inhibition of tumor growth innate immunity - CORRECT ANSWER 1. first line of defense 2. does not generate immunologic memory. 3. components include: physical barriers, mechanical barriers, chemical barriers, inflammatory barriers and complement activation 4. acute-phase protein production-recruit phagocytes to site of infection or tissue injury. 5. production of large granular lymphocytes (kill and digest pathogens) Adaptive or Acquired Immunity - CORRECT ANSWER 1. secondary line of defense 2. involves immunologic memory, specificity and collaboration of B cells and T cells 3. three types: cell mediated, regulatory T cells and humoral immunity humoral immunity - CORRECT ANSWER B cells produce antibodies after exposure to specific antigens; type of adaptive immunity, the result if the production of immunoglobulins or antibodies. cell-mediated immunity - CORRECT ANSWER type of immunity produced by T cells that attack infected or abnormal body cells; involves cytotoxic T cells and helper T cells. regulatory T cells - CORRECT ANSWER 1.limit the activity of other immune effector cells. 2. prevent the onset of immunity to normal tissue of the body and limit the inflammatory response. 3. absence of Tregs may trigger inflammatory disorders involving bowel, skin and liver. Cells of the immune system - CORRECT ANSWER 1. Made up of leukocytes a) Granulocytes (Neutrophils, eosinophils, basophils) b) Lymphocytes (T-Cells, B-Cells, natural killer cells) c) Monocytes (precursor to macrophage) d) Dendritic cells (antigen presenting cells; APC) 2. Produced in the bone marrow myeloid cells - CORRECT ANSWER 1.myeloid immune cells called granulocytes and include neutrophils, eosinophils and basophils. 2.neutrophils are the first responders, phagocytosing infection and initiating inflammation. 3. give rise to red blood cells and platelets. Lymphoid cells - CORRECT ANSWER T cells and B cells helper t cells - CORRECT ANSWER coordinate the immune response and cell mediated immunity. Cytotoxic T cells - CORRECT ANSWER A type of lymphocyte that kills infected body cells and cancer cells TREgs/ suppressor T cells - CORRECT ANSWER interfere with the development of an immune reaction when recognizing an antigen. primary role is to modulate the severity of inflammation produced infection and prevent autoimmunity. memory t cells - CORRECT ANSWER Remember antigen and quickly stimulate immune response on reexposure B lymphocytes - CORRECT ANSWER form in the bone marrow and release antibodies that fight bacterial infections IgM - CORRECT ANSWER first antibody produced IgA - CORRECT ANSWER present in body secretions and helps to prevent infections. IgD - CORRECT ANSWER may have some antibody function for penicillin, diphtheria and insulin IgE - CORRECT ANSWER allergic reactions memory cells - CORRECT ANSWER General term for lymphocytes that are responsible for immunological memory and protective immunity. natural killer cells - CORRECT ANSWER A type of white blood cell that can kill tumor cells and virus-infected cells; an important component of innate immunity. cytotoxic T lymphocyte antigen 4 - CORRECT ANSWER 1. ligands of CTLA-4 bind to antigen presenting cells 2. this downregulates T cell activity 3. CTLA-4 expression decreases the activation of T cells 4. it sends inhibitory signals to the T cells 5. it enhances Treg's immunosuppressive activity Programmed cell death protein 1- PD-1 - CORRECT ANSWER 1. an inhibitory receptor on T cells 2. interacts with its ligand, programmed cell death-ligand 1 3. the interaction inhibits T cell proliferation and cytotoxic function 4. induces T cell regulatory function. 5. induces T cell apoptosis 6. PD-L1 overexpression in tumors in correlated with poor prognosis. Epidermal growth factor receptors (EGFR) - CORRECT ANSWER 1. membrane bound surface proteins 2. three components: extracellular portion that binds circulating growth factors; a transmembrane portion; intracellular portion that interacts with cell signal transduction pathways. 3. communicate extracellular growth signals through the internal cell signal transduction pathways to the cell nucleus, this causes gene activation. 4. this activation is termed dimerization 5. occurs thru interaction with circulating growth factors or by a neighboring EGFR. 6. they are a member of the ErbB family of membrane-bound tyrosine kinase receptors. 7. often mutated or overexpressed in malignant tumors. 8. mutations occurs in the pathway with the absence of the correct extracellular growth signal, resulting in tumor growth. cytokines - CORRECT ANSWER proteins secreted by cytotoxic T cells to aid in antigen destruction chemokines - CORRECT ANSWER A chemical secreted by blood vessel endothelium and monocytes during an immune response to attract phagocytes to an area phases of immune response - CORRECT ANSWER 1. antigen recognition 2. lymphocyte activation 3. effector phase 4. contraction 5. memory antigen recognition - CORRECT ANSWER circulating antibodies recognize a foreign antigen, which activates the immune system. lymphocyte activation - CORRECT ANSWER B or T cells are activated to proliferate and differentiate into effector lymphocyte. effector phase - CORRECT ANSWER foreign antigen is inactivated or destroyed contraction - CORRECT ANSWER T cell expansion is inhibited or activated cells are eliminated by apoptosis, facilitating the immune system's return to a resting state and limiting tissue damage and chronic inflammation memory - CORRECT ANSWER lymphocytes that survive the immune response become memory cells that can recognize a former antigen and initiate a rapid response. immune interaction with targets - CORRECT ANSWER immune system interacts with the body by recognizing and evaluating characteristic structures on circulating cells. immune surveillance - CORRECT ANSWER immune system identifies cancerous and or precancerous cells and eliminates them before they cause harm; if this fails a tumor forms angiogenesis - CORRECT ANSWER development of new blood vessels grading and differentiation - CORRECT ANSWER GX-grade cannot be assessed G1-well-differentiated G2-moderately-differentiated G3-poorly-differentiated G4-undifferentiated Staging - CORRECT ANSWER T=tumor- local involvement, invasion N=nodes-lymph node involvement M=metastasis-distant Stage 1 - CORRECT ANSWER early disease, tumor confined to one area; node negative Stage 2 - CORRECT ANSWER early disease tumor spread to moveable ipsilateral nodes stage 3 - CORRECT ANSWER locally advanced disease tumor spread to the superficial structures. involvement of ipsilateral internal lymph nodes stage 4 - CORRECT ANSWER advanced or metastatic disease, metastasis present at distant sites, such as bone, liver, lungs, and brain including supraclavicular lymph node involvement. characteristics of cancer cells - CORRECT ANSWER 1. abnormal cell proliferation 2. lack of controlled growth and division 3. ability to spread and invade other tissue 4. can involve any bodily tissue 5. evade natural cell death. Treatments - CORRECT ANSWER 1. surgery 2. radiation therapy 3. chemotherapy/hormonal therapies 4. biotherapy/targeted therapies adjuvant therapy - CORRECT ANSWER Assisting primary treatment. Drugs are given early in the course of treatment, along with surgery or radiation to attack deposits of cancer cells that may be too small to be detected by diagnostic techniques. neoadjuvant therapy - CORRECT ANSWER a cancer treatment that precedes other treatment, such as administering chemotherapy or radiation therapy to a patient before surgery chemoprevention - CORRECT ANSWER the use of natural or synthetic substances such as drugs or vitamins to reduce the risk of developing cancer, or to reduce the chance that cancer will recur myeloablation - CORRECT ANSWER Procedure involving the elimination of the hematopoietic system, including its components residing in the bone marrow, often achieved through the application of a toxic drug and whole-body radiation immunosuppression - CORRECT ANSWER treatment to repress or interfere with the ability of the immune system to respond to stimulation by antigens-stem cell transplant combination therapy - CORRECT ANSWER The administration of two or more antimicrobial medications simultaneously to prevent the growth of mutants that might be resistant to one of the antimicrobials dose intensity - CORRECT ANSWER dose over total delivery time dose density - CORRECT ANSWER Chemotherapy - shorter interval between doses. (limitation= toxicity) dose reduction - CORRECT ANSWER Every long-term or life-long therapy should have "*reduce dose to lowest required*" as part of the dosing strategy This is to *reduce the adverse effects* goals of cancer therapy - CORRECT ANSWER Prevention Cure Control Palliation phases of clinical trials - CORRECT ANSWER Phase 1: small number of healthy volunteers to measure safety, toxicity, and pharmacokinetics Phase 2: small number of sick volunteers with disease of interest to measure treatment efficacy, optimal dosing, and adverse effects Phase 3: large number of randomly assigned either to treatment under investigation of to the best available treatment (or to placebo group to compare the new treatment to the current standard of care or placebo Phase 4: Postmarketing surveillance trial of patients after approval to detect rare or long-term adverse effects alkylating agents - CORRECT ANSWER cell cycle non-specific breaks DNA helix strand, thereby interfering with DNA replication Cisplatin (Platinol) - CORRECT ANSWER alkylating agent nephrotoxicity-monitor Cr, hydration, I's & O's, weights, diuretics, replace K+, Mg GI-N/V, acute and delayed Neurologic-peripheral neuropathies, ototoxicity vesicant potential make sure you have blood return cisplatin makes the kidneys go splat Carboplatin (Paraplatin) - CORRECT ANSWER alkylating agent myelosuppression-thrombocytopenia, neutropenia GI-N/V irritant to veins hypersensitivity reaction dosing based on AUC doses 6-8 of carbo has an increased risk for hypersensitivity reaction. Cyclophosphamide (Cytoxan) - CORRECT ANSWER alkylating agent hemorrhagic cystitis-irritates the bladder, hydration, administer oral dose in the am GI-N/V myelosuppression secondary malignancies-increased risk for leukemia/breast cancer or other cancers. acroline-eats away at the bladder lining. mesna-med to protect the bladder daily UA for blood, give hydration Ifosfamide (flex) - CORRECT ANSWER alkylating agent GU-hemorrhagic cystitis-daily UA for blood, mesna infusion, hydration, BUN, Cr. GI-N/V Cutaneous-alopecia Myelosuppression Neurologic-neuro checks-confusion, coordination irritant to veins. mesna is always given with ifosfamide. can give methylene blue to help with neurologic confusions. neuro checks especially in older patients. Melphalan (Alkeran) - CORRECT ANSWER nitrogen mustard alkylating agent myelosuppression N/V Mucositis-irritates mucosal-hold ice in mouth while giving this therapy to help decrease the mucositis. be aware of blood counts bone marrow transplant Oxaliplatin (Eloxaitin) - CORRECT ANSWER alkylating agent peripheral neuropathy-made worse with cold myelosuppression ideal to use with D5W irritant with vesicant potential to veins cannot have ice or cold drinks for 3-5 days after administration and should also avoid cold air. check blood cts before giving, may have to hold drug. Bendamustine - CORRECT ANSWER alkylating agent (nitrogen mustard) used in tx of CLL, NHL bone marrow suppression rash irritant with vesicant-like properties nausea-pre med with zofran/dex hypersensitivity reaction including anaphylaxis. this is more common with second or subsequent cycles. hepatic and renal impairment clinical pearls of alkylating agents - CORRECT ANSWER 1. hypersensitivity may occur with late doses of carboplatin (6-8) 2. tumor lysis syndrome-high tumor burden 3. assess BUN/creatinine, CBC w. differential 4. highly emetogenic lots of N/V 5. if oral route is given, administer in the am. 6. mesna (bladder protectant) is required for doses of ifosfamide, cytoxan. 7. for tumor lysis syndrome-give allopurinol to decrease of for prevention 8. also respuricase with help with tumor lysis syndrome 9. does not discriminate between cancer and non-cancer cells. 10. baseline audiogram for high dose cisplatin 11. alopecia 12. avoid exposure to cold during treatment of eloxatin (oxaliplatin) antimetabolites - CORRECT ANSWER 1. act in S phase-cell cycle specific 2. common side effects include: myelosuppression, GI toxicities, cutaneous toxicities 3. routes: IV, SC, PO, IM, intrathecal, intraarterial. Azacitidine (Vodaza) - CORRECT ANSWER antimetabolite myelosuppression monitor Cr N/V/D erythema at injection site-do not use ice on site and bruising divide doses > 4 ml into two syringes contraindicated in patients with sensitivity to Mannitol drug is thick and causes bruising roll drug between hands to warm Capecitabine (Xeloda) - CORRECT ANSWER antimetabolite oral route: take on full stomach with plenty of water GI toxicities-N/V, mucositis, diarrhea, hepatotoxicity cutaneous-hand-foot syndrome-monitor for redness, tingling and numbness myelosuppression, anemia potential drug interaction with warfarin often taken at home-pt education is important Clofarabine (Clolar) - CORRECT ANSWER antimetabolite bone marrow suppression risk for tumor lysis syndrome N/V/D hepatotoxicity renal toxicity potential for inflammatory response/ capillary leak syndrome with capillary leak syndrome-altered mental status, swelling and hypotension. may give dexamethasone for side effects; increased risk for older patients. monitor K+. Mg, uric acid, Cr and BUN Cytarabine (ARA-C; Cytosar-U) - CORRECT ANSWER antimetabolite myelosuppression N/V, mucositis, diarrhea, hepatotoxicity cutaneous-rash, alopecia high doses--> keratitis: eye drops-drug comes out in tears. cerebellar toxicity-check handwriting and gait. can cross the blood brain barrier (walking, balance, coordination) 2 cerebellar assessments on day getting the drug. Fluorouracil (5-FU) - CORRECT ANSWER antimetabolite GI cancer pts. IV form of xeloda myelosuppression N/V, mucositis, diarrhea cutaneous-alopecia, rashes, dry skin, hyperpigmentation, nail changes, photosensitivity irritant-central line for continuous infusions may take infusion home with pump, good pt education needed. lose hair, eyelashes and eyebrows. Gemcitabine (Gemzar) - CORRECT ANSWER antimetabolite myelosuppression N/V flu-like symptoms-achy, feverish specific infusion rate-ordered to go in about an hour and a half if you go in longer, increased risk of side effects. called the gentle gem causes burning in PIV-warm blanket, increase fluid rate w/ med sarcome-given over hour and a half. don't do central line for lower doses. Methotrexate - CORRECT ANSWER antimetabolite can be given for ALL intrathecally hides in pockets of fluid/protein-lots of side effects given for RA and ectopic pregnancy N/V, mucositis, diarrhea, hepatotoxicity rashes, alopecia, photosensitivity hypersensitivity, fever, chills high dose: renal-hydration to alkalinize urine avoid folic acid, NSAIDS, sulfa drugs during infusion check methotrexate levels and leucovorin rescue neurological checks rescue drug= glucarpidase (Voraxaze) IV=bright yellow color/ urine is the same color check UA for ph > 7/8 leucovorin brings down methotrexate levels. confusion protect kidneys given sodium bicarb or acetate or dramox. - CORRECT ANSWER [Show Less]
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OB inpatient certification practice 352 Questions with Verified Answers,100% CORRECT
OB inpatient certification practice 352 Questions with Verified Answers After delivery, progesterone levels fall causing what acid/base change? - CORR... [Show More] ECT ANSWER Increase pco2 With what disorder would AFP be elevated? - CORRECT ANSWER Esophageal atresia, neural tube defects Women with a history of GDM have increased risk of diabetes at what rate? - CORRECT ANSWER Onset within 20 years in 35-60% Glucose screen is done when? - CORRECT ANSWER 24-28 weeks If a mother has Insulin dependent diabetes during pregnancy, what electrolyte imbalance is the neonate at risk for? - CORRECT ANSWER Magnesium deficiency In which trimester is new onset of GHTN most common? - CORRECT ANSWER 3rd trimester In a pregnancy complicated by hypertension, what is a sign of deteriorating status? - CORRECT ANSWER Increased serum creatinine What difference can be expected between manual and electronic diastolic BP? - CORRECT ANSWER Manual are 5-7 mm HG higher On admission to L&D , a woman has 2+ reflexes. After IV mag, DTRs are absent. What is your immediate nursing intervention? - CORRECT ANSWER Stop mag and notify provider With no apparent HSV lesions what is the recommendation? - CORRECT ANSWER Oral acyclovir 4 weeks prior to delivery +IgG antibodies in PP period? - CORRECT ANSWER The recurrence is unlikely, no further action is required. (IgG chronic, IgM is active) The most common rheumatic valvular lesion in pregnancy is? - CORRECT ANSWER Mitral stenosis Cardiac defect with most complications in labor? - CORRECT ANSWER Mitral stenosis Methamphetamines are expected to last? - CORRECT ANSWER 7-24 hrs What is recommended L/S ratio? - CORRECT ANSWER 2:1 - lungs are probably mature 3:1 - indicative of maturity What causes a sinusoidal FHR tracing? - CORRECT ANSWER Fetal anemia What is the parenteral analgesic with most rapid peak effect? - CORRECT ANSWER Fentanyl What neonatal complication is increased with cesarean delivery? - CORRECT ANSWER Respiratory morbidity A woman who has a c/s is more likely to be re-hospitalized with what pp complication? - CORRECT ANSWER Wound infection During the postpartum period, low levels of placental lactogen, estrogen, cortisol, growth hormone and insulinase result in? - CORRECT ANSWER Lower glucose levels Due to the catabolic process of involution postpartum, which lab value is expected to be elevated postpartum? - CORRECT ANSWER BUN Avg weight loss with delivery? - CORRECT ANSWER 12 lbs Where would you expect to palpate fundus 24h pp? - CORRECT ANSWER 1cm below umbilicus What is the term for lochia appearing 3-10 days pp and pink or brown in colora - CORRECT ANSWER Lochia serosa The process of involution that allows for healing of the placental site preventing scarring is? - CORRECT ANSWER Exfoliation True or false 2500cc urine 2 days pp is a normal physiologic response to delivery - CORRECT ANSWER True If pp woman's fundus is deviated from midline first RN intervention is? - CORRECT ANSWER Empty bladder Why is UTI common in 1st few weeks pp? - CORRECT ANSWER Dilated ureters and renal pelvis By which pp day has circulating blood volume diminished secondary to diuresis, returning to prepregnancy volume? - CORRECT ANSWER Day 5 What intervention can increase physiological jaundice? - CORRECT ANSWER Delayed cord clamping A woman is 12 days pp and has WBC of 25,000. This indicates? - CORRECT ANSWER Expected range What is the antidote for Coumadin? - CORRECT ANSWER Vitamin k What is antidote to MAg? - CORRECT ANSWER Calcium glucinate What med for malignant hyperthermia? - CORRECT ANSWER Dantrolene sodium Uterotonic med contraindicated for elevated BP? - CORRECT ANSWER Methergine Following delivery, insulin requirements I'd diabetic woman.... - CORRECT ANSWER Decrease rapidly Rhinitis and nasal stuffiness increase in pregnancy are due to? - CORRECT ANSWER Estrogen A newly delivered postpartum woman received terbutaline and corticosteroids during labor is at risk for what potential drug interaction? - CORRECT ANSWER Hyperglycemia Antidote for heparin? - CORRECT ANSWER Protamine sulfate Two IV anti hypertensives that may be used to treat severe maternal hypertension? - CORRECT ANSWER Hydralazine, labatelol Severe BP values - CORRECT ANSWER Over 160 sbp or over 110 dbp Another name for hydralazine? - CORRECT ANSWER Apresoline Another name for labatelol? - CORRECT ANSWER Trandate, normodyne At 12 hrs pp a breastfeeding mom is 180/114, what does the RN anticipate the provider will order? - CORRECT ANSWER Labatelol A common side effect of pitocin is? - CORRECT ANSWER Anti diuretic effect/water intoxication CDC requirement for a TDAP for a pt who had tetanus shot two years ago? - CORRECT ANSWER Administer prior to d/c. All pts should have booster in pregnancy Pp woman has order for rubella vaccine and Rh immune globulin. The nurse knows they should be given? - CORRECT ANSWER At the same time Unsensitized Rh- mom whose baby is Rh+ should? - CORRECT ANSWER Receive 300 mcg of rhogham within 72hrs of delivery A pp woman has large hemorrhoid. She may be instructed to? - CORRECT ANSWER Gently attempt to push back into rectum After birth pains usually last? - CORRECT ANSWER 2-3 days A woman readmitted for wound infection shows signs of sleep disturbance, irritability, agitation and confusion. The nurse suspects? - CORRECT ANSWER Post partum psychosis What is the chance of pregnancy when using the lactational amenorrhea method (LAM) at 12 months? - CORRECT ANSWER Can approach 7% Woman wants to use breastfeeding as a contraceptive. The best response is? - CORRECT ANSWER What have you heard or read about this method? When teaching a pt about the use of the sponge, the pt should be advised to leave in place for how many hours following intercourse? - CORRECT ANSWER 6 hours The hormone responsible for stimulation of the alveolar cells to produce milk? - CORRECT ANSWER Prolactin The lactation initiation stage is dependent on? - CORRECT ANSWER A cascade of hormones Compared to term breast milk, preterm breast milk is composed of? - CORRECT ANSWER Higher protein content In comparison to mature breast milk, the relative content of transitional breast milk has? - CORRECT ANSWER Increased protein content Immunoglobulin secreted in breast milk is - CORRECT ANSWER IgA Not getting recommended 2500-2700 kcal per day while breastfeeding can lead to? - CORRECT ANSWER Decreased milk production Minimum number of kcal for breastfeeding woman is? - CORRECT ANSWER 1800 kcal A 36 hr old BF infant has nursed 8 times in the last 24hrs on one breast per feeding. The infant has had 2 wet diapers and 2 moderate sized green BM. The baby has rhythmic suck with audible swallow during feeds. This baby is? - CORRECT ANSWER Eating well and as expected for this age It is important to breastfeed at night in the early weeks when lactation is being established because? - CORRECT ANSWER Prolactin levels are highest at night Most common reason fore sore nipples when breastfeeding? - CORRECT ANSWER Improper latch A pt reports sore nipples. The nurse knows that the characteristics of the pain will help to? - CORRECT ANSWER Identify the cause A pp woman who is breastfeeding delivered 48 hours ago and is reporting breast engorgement. The cause of this engorgement is? - CORRECT ANSWER Vascular changes Pp breastfeeding mom states baby is not satisfied after feeding. States the baby nurses 15 min on each breast then screams. Appropriate intervention? - CORRECT ANSWER Observe the baby at the breast during feeding A nursing mom needs an antihypertensive. A good choice is? - CORRECT ANSWER Nifedipine A woman on methadone wants to breastfeed. She should be advised that? - CORRECT ANSWER Supervised methadone is considered safe The type of neonatal jaundice caused by inadequate breast milk intake is? - CORRECT ANSWER Breastfeeding jaundice Extracellular fluid as % of body weight for a term neonate is? - CORRECT ANSWER A approx 40% Soy based formula is recommended for infants who have? - CORRECT ANSWER Galactosemia Which of the following may indicate a delay in bonding? - CORRECT ANSWER When baby is fussy, mom sends to nursery The phase of maternal adjustment that typically starts on the 2nd or 3rd day pp where the mother focuses on care of the baby and resumes control of her body is? - CORRECT ANSWER Taking hold Lasts about ten days Mothering tasks take priority Emphasis on present Impatient and drive. To organize self Teach baby care The phase of maternal adjustment for the first day or two after birth. Mothers need rest and "mothering". - CORRECT ANSWER Taking in Primary concern is own needs, sleep and food. Talkative about birth experience. Perceptive, passive, teach self care The phase of maternal adjustment in which couples try to return to pre baby relationship and siblings get to know baby - CORRECT ANSWER Letting go Must accept baby as separate person Establish new norms for family A nurse makes a home visit to pt who is overwhelmed from nursing baby all the time. Physical assessment of mom and baby are normal. The nurse knows this a manifestation of? - CORRECT ANSWER Postpartum blues Maternal role attainment? - CORRECT ANSWER Occurs within 3-10 months following birth A fathers reaction to stress - CORRECT ANSWER Is just as important as the mothers reaction Resources for adoptive vs biological parents are? - CORRECT ANSWER Less available Which of the following is true for a mother following the loss of one infant of a multiple birth? - CORRECT ANSWER There is usually less support for grieving parents because the frequent response is they should be thankful for the survival of the living child A supportive intervention for the parents of a dying infant is? - CORRECT ANSWER Offer to stay with family until asked to leave The grief response associated with permanent, progressive, recurring and cyclic loss is? - CORRECT ANSWER Chronic sorrow When speaking to parents about impending neonatal death, the most appropriate term to use is? - CORRECT ANSWER Natural death A pp pt is diagnosed with sheehans syndrome. This is caused by? - CORRECT ANSWER Pituitary necrosis. Damage is from lack of oxygenation caused by massive blood loss and severe low BP during or after birth. Causes permanent hypopituitarism, sometimes called "postpartum hypopituitarism". Rare in industrialized nations Clinical signs of hemorrhage such as BP 90/70, pulse 118, and tachypnea can be seen when blood loss reaches - CORRECT ANSWER 1500ml 1 hour after delivery of fetal demise, pt becomes tachypnecic, cold, and begins to lose consciousness. Labs are crit 28, fibrinogen 350, plt 75,000. What is the most likely issue? - CORRECT ANSWER Hemorrhage Obstetric hemorrhage is defined by what parameter? - CORRECT ANSWER Hemodynamic status of the patient G5 with large newborn for GA is likely to have what complication - CORRECT ANSWER Hemorrhage 48 hrs post c/s, RN notes pt left calf and foot are cool and pale. Left pedal pulse is diminished and there is a decrease in capillary refill. Homans sign is neg bilaterally. Pt reports l leg tenderness. Most important initial intervention is? - CORRECT ANSWER Place pt on bed rest and elevate left leg Pt diagnosed with pp infection denies pain but seems confused, agitated. VS T 99.9, BP 98/50, p 125. Urine output is decreased. Most likely diagnosis? - CORRECT ANSWER Septic shock Most persistent fevers after childbirth are caused by? - CORRECT ANSWER Genital tract infections 4 hrs pp, pt reports severe vulvar pain and severe rectal pressure. Most likely symptoms for? - CORRECT ANSWER Vulvar hematoma What kind of follow up for pt with GDM? - CORRECT ANSWER Will test blood sugars at 6 weeks then q 3 years from delivery Pp psychosis generally presents by what time frame? - CORRECT ANSWER Within 2 weeks from delivery Pp pt c/o HA and heartburn. She has not voided in 4 hrs. Bladder scan shows empty bladder. RN is concerned about? - CORRECT ANSWER Preeclampsia Following c/s for abruption a clot observation test is initiated. Placing a small amt of blood in a test tube for 30 min yields a soft clot that dissolves easily. This is consistent with? - CORRECT ANSWER Hypofibrinogenemia A pt is 24hr pp, BP 100/60, T 99. Lochia has steady flow of red bleeding since delivery without odor or pain. RN should consider? - CORRECT ANSWER Pp hemorrhage What are the characteristics of a dizygotic pregnancy? - CORRECT ANSWER 2 placentas, 2 chorions, 2 sacs Assigning a ten min apgar is done when? - CORRECT ANSWER When 5 min < 7 To differentiate peripheral from acrocyanosis in a 2 hr old neonate, the best action to initiate is? - CORRECT ANSWER Warm infant and observe for improvement in color Serum glucose levels fluctuate for how many hours following birth? - CORRECT ANSWER 2 Increased perfusion of the newborns liver is initiated by closure of the? - CORRECT ANSWER Ductus venosus 36 week infant apgars 8/8 and appears to be physiologically stable. RN notes infant has assumed a fetal tuck position, yawns and engages in finger splays. These are signs of? - CORRECT ANSWER Stress The RN auscultates lung sounds on one hour old newborn after nsvd. Moist sounds are heard on auscultation. This is a? - CORRECT ANSWER Normal finding, fluid will absorb naturally At birth the most potent stimulus for closure of the patent ductus arteriosis is? - CORRECT ANSWER PO2 In the fetus, patentcy of the ductus arteriosis is maintained by? - CORRECT ANSWER Low oxygen tension and prostaglandin E When resuscitating a neonate with suspected diaphragmatic hernia, the most appropriate intervention is? - CORRECT ANSWER Insertion of an endotracheal tube should be done as quickly as possible to prevent gas from entering the intestines During neonatal resuscitation finger placement using the two thumb method for external cardiac compression should be where? - CORRECT ANSWER On the lower 3rd of the sternum How should a baby with mec staining who is responsive be managed? - CORRECT ANSWER No suction if baby is active and does not require resuscitation A neutral thermal environment helps support basic physiologic function and growth in the neonate by? - CORRECT ANSWER Conserving metabolic activity The process that triggers the metabolism of brown fat in the neonate occurs for what purpose? - CORRECT ANSWER Thermoregulation The initial process a newborn uses to regulate heat is? - CORRECT ANSWER Non shivering thermogenesis A newborn with hypothermia should be assessed for? - CORRECT ANSWER Metabolic acidosis When performing a GA assessment the RN should recognize that a finding that correlates with advancing GA is? - CORRECT ANSWER Resistance with scarf sign maneuver During GA assessment a 90degree square window sign is consistent with? - CORRECT ANSWER Preterm Assessment of newborn GA should be done? - CORRECT ANSWER Within 4 hrs of birth In assessing reflexes of a term infant, the nurse lifts the newborn slightly from the bed and slow.y lowers the baby back to the surface. What is the expected response? - CORRECT ANSWER Fingers for a C and arms returning to chest as if in embrace - Moro reflex The most distinct characteristic of active sleep state in the neonate is? - CORRECT ANSWER Rapid eye movement The finding of a 3rd fontanelle along the sagittal suture suggests? - CORRECT ANSWER Congenital anomaly (downs) In the assessment of the BP of the newborn which of the following is true regarding upper and lower extremities? - CORRECT ANSWER A slight difference is normal If a neonate has CHF, the nurse should recognize that this is a manifestation of? - CORRECT ANSWER Underlying disease Infants with hr <90 or > 200 should be first evaluated with? - CORRECT ANSWER Electrocardiogram Gases ph 7.29, p02 22mmhg, pCO2 47, base excess -4 - CORRECT ANSWER Normal values Decrease in 02 concentration that is responsible for the initiation of newborn respirations occurs in the? - CORRECT ANSWER Brain A normal breathing pattern in a 2 hour old neonate may include? - CORRECT ANSWER Episodic breathing Which of the following diagnoses is a result of delayed reabsorption of fetal lung fluid production? - CORRECT ANSWER Transient tachypnea of the newborn A newborn is noted to have cyanosis when quiet but is pink when crying. The most likely diagnosis is? - CORRECT ANSWER Choanal atresia On physical exam of the newborn abdomen a normal finding is? - CORRECT ANSWER Lower edge is palpated up to 2.5 cm below the right costal margin in the midclavicular line A preterm pts at 30 weeks received indocin. Her baby should be observed for? - CORRECT ANSWER Necrotizing enterocolitis If a newborn is born with a port wine stain the RN should watch for problems involving what system? - CORRECT ANSWER Neurologic A new mother asks about a mark that looks like a bruise. Physical exam reveals large gray non blanching macules over buttocks. This is most likely? - CORRECT ANSWER Mongolian spot In a 32 week neonate expected muscle development would include? - CORRECT ANSWER A good grasp reflex To assess the fontanelles a newborn should be in what position? - CORRECT ANSWER Sitting What is craniotabes? - CORRECT ANSWER Finding of softening or thinning of the skull. Can be normal esp preterm but may be first sign of rickets/ vit d deficiency Craniotabes is typically found in what region of the skull? - CORRECT ANSWER Parietal and occipital The primary mechanism of action of glucagon when given for tx of hypoglycemia is? - CORRECT ANSWER Stimulation of glycogen release from the liver A neonate has scrotal swelling which is soft, nontender and transilluminates and there are no palpable masses. The the most likely diagnosis? - CORRECT ANSWER Hydrocele After delivery, a newborn exhibits flaccidity of both the lower arm and hand. The birth was complicated by shoulder dystocia and subsequent forceps. The expected diagnosis? - CORRECT ANSWER Klumpkes paralysis Breastfeeding mom asks when iron supplements should be given to her baby? - CORRECT ANSWER Adequate in breastfeeding until about 6 months of age Hygiene care of the uncircumcised neonate? - CORRECT ANSWER Avoid retraction of the foreskin until separation naturally occurs AAP recommends supplementation of 400IU of vitamin D/day for breastfed and partially breastfed infants. - CORRECT ANSWER Within a few days of birth PP d/c instructions given to mother whose newborn received Hep B at birth include flu vaccines to be given at what age? - CORRECT ANSWER 2&4 months Neonate born to a mom with HBsAg+ should have? - CORRECT ANSWER Hep B immunoglobulin and Heb B vaccine within 12 hours of birth A few hours after administering eye prophylaxis to the newborn, The nurse notes edema and a greenish yellow discharge. This reaction is due to? - CORRECT ANSWER Silver nitrate 1 day old neonate demonstrates temp. Instability, lethargy, and poor muscle tone. Sepsis is suspected. The nurse anticipates that prophylactic antibiotics prescribed is? - CORRECT ANSWER Ampicillin and gentamicin Natal teeth are often seen in? - CORRECT ANSWER Native population A newborn is diagnosed with cyanotic heart disease. This would indicate which of the following? - CORRECT ANSWER Epsteins anomaly The most appropriate diagnostic procedure to confirm a pneumothorax is? - CORRECT ANSWER X-ray A mother calls the mother baby unit 2 weeks following delivery and reports that her baby is crying inconsolably for periods of 1-2 hours. Otherwise the baby is healthy and eating well. The nurse should explain that if the baby has colic, it is? - CORRECT ANSWER Generally resolved with continued behavior After delivery, a term neonate begins gagging on secretions and has episodes of vomitting. An orogastric tube is passed and 30ml of gastric aspirated is obtained. The maternal hx is likely to include? - CORRECT ANSWER Polyhydramnios At birth the newborn is noted have absent breath sounds on the left with heart sounds shifted to the right, the abdomen is noted to be scaphoid and ventilation is difficult. The most likely diagnosis? - CORRECT ANSWER Diaphragmatic hernia The delivery record of a newborn pt reports hydramnios in the 3rd trimester. The newborn should be closely assessed for anomalies of the? - CORRECT ANSWER Intestinine When the nurse examines the umbilical cord of a newborn, she notes an umbilical cord hernia. This is more commonly seen in ethnic populations? - CORRECT ANSWER African Americans Pts whose neonate in pavlik harness (for hip dysplasia) should be taught at discharge that the harness? - CORRECT ANSWER Should not exceed 1 hour per day Non-symmetrical crease over the back of the thigh. The Barlow maneuver is performed to? - CORRECT ANSWER Detect a dislocated hip Diagnostic study used to r/o brachial plexus injury in the neonate is? - CORRECT ANSWER U/s Which clinical event can increase the neutrophil count? - CORRECT ANSWER Prolonged crying A hematological change in pregnancy that predisposes a pt to venous thrombosis is i - CORRECT ANSWER Hypercoagulability A physiologic change that predisposes pregnant women to venous thrombosis is - CORRECT ANSWER Venous stasis A pregnant woman with New York heart association NYHA class II cardiac disease is symptomatic with - CORRECT ANSWER Mild exertion A newborn of an insulin defendant mother is at risk for? - CORRECT ANSWER Polycythemia Generalized petechiae could be a sign of? - CORRECT ANSWER Clotting disorder Physiologic jaundice is d/t a combination of increased bilirubin load to the liver and? - CORRECT ANSWER Decreased excretion of bilirubin A neonate at 36 weeks weighing 3000 grams is at risk for? - CORRECT ANSWER Jaundice The appropriate management of a breastfeeding newborn with physiologic jaundice is? - CORRECT ANSWER Frequent effective breastfeeding A woman and her infant are being d/c'd 12 hrs after birth. Metabolic screening for PKU was done at 6 hours of age on d/c the nurse should advise that the 2nd screening be obtained? - CORRECT ANSWER Within 1-2 weeks A newborn born to a mom who is an insulin controlled diabetic, a common malformation that the newborn should be evaluated for is? - CORRECT ANSWER Cardiomegaly GBS+, what other organisms are currently the most common pathogens seen in neonatal sepsis? - CORRECT ANSWER E. Coli Which of the following tests would be appropriate for a newborn whose mom has HIV? - CORRECT ANSWER DNA and polymerase chain reaction test 48 hours of age Congenital varicella syndrome is characterized by? - CORRECT ANSWER Early death In the newborn a tense fontanelle is a? - CORRECT ANSWER Late meningitis A woman diagnosed with chlamydia delivers a newborn who is treated with erythromycin ointment. The woman should be advised to watch for what symptoms once they are home? - CORRECT ANSWER Persistent cough, rales and wheezes Informed consent rests on the assumption of competence and? - CORRECT ANSWER Capacity The foundation for nursing education, practice and documentation is? - CORRECT ANSWER Nursing process The means of insuring enforcement of the nursing practice act is through the? - CORRECT ANSWER State board of nursing Most medical and nursing errors occur because of? - CORRECT ANSWER Non-adherence system failures Validity as applied to a research instrument demonstrates? - CORRECT ANSWER Degree to which the instrument measures what it was purported to measure Parasympathetic vs sympathetic work together to regulate variability - CORRECT ANSWER Pokey slow = p, s= stimulus When the sympathetic nervous system is dominant, fetal variability.... - CORRECT ANSWER Decreases Cord compression can cause accelerate true or false - CORRECT ANSWER True Overshoot/shoulder - CORRECT ANSWER No longer a term. Cause by umbilical vein compression Cerebral blood flow interruption causes - CORRECT ANSWER Early decal think head compression Vagal response As fetus matures which branch of the nervous system has more influence over FHR variability - CORRECT ANSWER Parasympathetic takes over after 32 weeks Max 24 hour IV dose labetelol - CORRECT ANSWER 220 Hyperventilation is caused by what hormone? - CORRECT ANSWER Progesterone Fetal attitude - CORRECT ANSWER Relation of fetal parts to each other - I.e. Flexed or not flexed Leopolds 1 st manueveur - CORRECT ANSWER Presentation FLM using lamellalar body count - CORRECT ANSWER 30,000-50,000 = mature Nitrazine - CORRECT ANSWER Blue 7.1 rupture 7.5 blood or mucus Burr cells - CORRECT ANSWER Hemolysis on smear = HELLP Gaskin manueveur - CORRECT ANSWER All 4's for shoulder Normally during pregnancy, maternal sitting and standing blood pressure readings - CORRECT ANSWER Decrease, then increase What happens to maternal PaO2 and PaCO2 during pregnancy? - CORRECT ANSWER PaO2 increases and PaCO2 decreases The slight increase in pH that occurs during pregnancy is due to - CORRECT ANSWER An increase in ventilatory rate During pregnancy, serum urea and creatinine levels - CORRECT ANSWER Decrease During pregnancy cardiac out put increases approx - CORRECT ANSWER 30-50% By term blood flow to the uterus is approximately - CORRECT ANSWER 500ml/min Metabolic changes in pregnancy are - CORRECT ANSWER Anabolic -1st half, catabolic 2nd half The primary determinant of volume hemostasis - CORRECT ANSWER Renal sodium Increased absorption of calcium is due to increased - CORRECT ANSWER Vitamin D (or calciferol) Placental production of this hormone requires interaction of the mother, fetus and placenta - CORRECT ANSWER Estriol The 5 diabetogenic hormones of pregnancy - CORRECT ANSWER Prolactin, estrogen, progesterone, human placental lactogen, cortisol Congenital cardiac disease occurs in what approximate percentage of live births? - CORRECT ANSWER 0.8% Mitral and aortic stenosis are examples of cardiac diseases caused by - CORRECT ANSWER Rheumatic fever During pregnancy, predicted values of peak expiratory flow rates are - CORRECT ANSWER Unchanged During a asthma exacerbation there is - CORRECT ANSWER Increased peripheral vascular resistance A complication seen in up to 26% of women with varicella pneumonia in the first 20weeks of gestation is - CORRECT ANSWER Intrauterine infection The prenatal diagnostic screening test most accurate in multiple gestations is - CORRECT ANSWER Nuchal translucency Multiple congenital anomalies have been associated with maternal obesity such as - CORRECT ANSWER Cleft lip and palate Fetal programming refers to - CORRECT ANSWER Process in which an in utero stimulus establishes a permanent fetal response that can lead to increased susceptibility to disease throughout life Uterine crontactility may be what in overweight and obese women - CORRECT ANSWER Decreased Extremely obese women have a what % higher risk of stillbirth than a woman of normal weight - CORRECT ANSWER 40% The normal length of the pre gravid cervix is - CORRECT ANSWER 3.5 to 4 cm Bishop score evaluates - CORRECT ANSWER Dilation Effacement Station Consistency Position Oxygen is transferred from mother to fetus by - CORRECT ANSWER Passive diffusion Most fetal dysthymias are benign. The exception is which dysthymia that may lead to fetal congestive heart failure? - CORRECT ANSWER Supraventricular tachycardia The greatest complication of tocolytic therapy for women with multiple gestations is - CORRECT ANSWER Pulmonary edema Pain in 1st stage of labor is caused by - CORRECT ANSWER Cervical and lower uterine segment stretching and traction on ovaries, Fallopian tubes and uterine ligaments The release of maternal catecholamines during labor results in - CORRECT ANSWER Uterine hypoperfusion and decreased blood flow to the placenta Baroreceptors mediate what kind of decel - CORRECT ANSWER Variable Normal metabolic changes during the postpartum period include increased levels of - CORRECT ANSWER Plasma renin and angiotensin II Peak cardiac output at birth occurs at - CORRECT ANSWER 10 to 15 minutes Intrauterine infection should be suspected when newborn has elevated - CORRECT ANSWER IgM Maternal transmission of which antibodies protects the newborn from bacterial and viral infections for which the mother has already produced antibodies - CORRECT ANSWER IgG Non shivering thermogenesis generates heat In the newborn through - CORRECT ANSWER Brown fat Tears are normally absent in a baby until - CORRECT ANSWER 4 to 6 months Newborn femoral pulses should characteristically be decreased or absent in - CORRECT ANSWER Hip dysplasia A persistent newborn heart rate of less than 100 is consistent with - CORRECT ANSWER Congenital Heart block In the neonate blood pressure in the lower extremities is usually - CORRECT ANSWER Higher than in the upper extremities To measure fontanelles accurately a ruler or measuring tape is placed - CORRECT ANSWER Diagonally Bone to bone Bowel sounds are expected to be present in the newborn - CORRECT ANSWER After passage of the first meconium stool The most common abnormal neck finding in newborns - CORRECT ANSWER Cystic hygroma Popping sensations (similar to indenting a ping pong ball) felt when palpating the parietal or occipital bones of the newborn are called - CORRECT ANSWER Craniotabes The anterior fontanelle normally closes at - CORRECT ANSWER 18 months The posterior fontanelle normally closes at about - CORRECT ANSWER 2 to 4 months Apnea refers to pauses in respiration that last - CORRECT ANSWER 20 seconds or longer Newborns cam clearly see an object that is - CORRECT ANSWER 8 to 10 inches away What is phimosis - CORRECT ANSWER The inability to completely retract the foreskin of the penis An asymmetric neck deformity in which the head is noted to be pulled toward the affected side, with the chin pointing towards the opposite shoulder, due to injury to the sternocleidomastoid - CORRECT ANSWER Torticollis What causes acrocyanosis - CORRECT ANSWER Vasomotor instabilty - worsens if chilled The onset of milk production in a postpartum woman is triggered by - CORRECT ANSWER Sudden decrease in progesterone The hormone responsible for milk ejection - CORRECT ANSWER Oxytocin In order to prevent damage to the fetus, syphyllis should be treated by... - CORRECT ANSWER 16-18 weeks gestation The ischial tuberosity diameter considered adequate for delivery of the fetal head is - CORRECT ANSWER 11 cm Distance between the anterior surface of the sacral prominence and the anterior surface of the inferior margin of the symphysis pubis - CORRECT ANSWER Diagonal conjugate - should be more than 12.5 cm Distance between the anterior surface of the sacral prominence and the posterior surface of the inferior margin of the symphysis pubis - CORRECT ANSWER True conjugate - 10.5-11cm How much weight should a pregnant pt with twins or triplets gain - CORRECT ANSWER 25-35 lbs Damage to brachial plexus (c5-c7) - CORRECT ANSWER Erb palsy Before compressing the uterus to expel clots it is essential to: - CORRECT ANSWER Make sure uterus is contracted . Applying external pressure on a non contracted uterus may result in uterine inversion Newborn polycythemia - CORRECT ANSWER Hematocrit over 65%. Occurs in response to hypoxia or intrauterine transfusion. Risk factors include preeclampsia, post dates, poorly controlled GDM, twin to twin transfusion, delayed umbilical cord clamping, chromosomal disorders One factor that predisposes an epileptic woman to seizures during pregnancy - CORRECT ANSWER Sleep deprivation Long term inhaled corticosteroid therapy to treat asthma has been implicated in increased incidence of - CORRECT ANSWER Preeclampsia A 24 yr old Caucasian woman at 28 weeks gestation presents for regular prenatal visit. According to the American diabetes association, what is the appropriate screening for gestational diabetes? - CORRECT ANSWER No need for testing What is the most common maternal congenital cardiac lesion with a left-to-right shunt that is detected during pregnancy? - CORRECT ANSWER Mitral stenosis During pregnancy which of the following cardiovascular parameters decreases by at least 20% - CORRECT ANSWER Systemic vascular resistance A pt has been moved to the surgery suite for a cesarean birth. There is an internal fetal scalp electrode in place. This should be removed when the - CORRECT ANSWER Abdominal prep is initiated Ultrasound for antepartum testing uses high frequency sound waves to produce an image that varies based on - CORRECT ANSWER Density of the structure under the transducer A fetus at 36 weeks receives a BPP score of 6. The amniotic fluid was scored as normal. The expected management is - CORRECT ANSWER Repeat the test in 24 hours A woman at 37 weeks with no risk factors and no complications to date. She calls because she thinks the baby is not moving as much as previously. She should be instructed to - CORRECT ANSWER Come in for evaluation Which FHR pattern characteristic determines fetal oxygen reserve? - CORRECT ANSWER Presence of variability With an fse with artifact, what nursing intervention is appropriate? - CORRECT ANSWER Auscultate to r/o arrhythmia Which fetal monitoring pattern is characteristic of cephalopelvic disproportion, especially when seen at the onset of labor? - CORRECT ANSWER Early decel Vagal stimulation would be manifested as what type of FHR pattern? - CORRECT ANSWER Early A risk of aminofusion is - CORRECT ANSWER Uterine overdistension A fetal hr pattern that can occur with a prolapsed cord is? - CORRECT ANSWER Prolonged Palpating the uterus is best performed by using the - CORRECT ANSWER Fingertips At a prenatal visit, a woman's uterus is palpated at the xiphoid process. This would normally be found at how many weeks gestation? - CORRECT ANSWER 36 In evaluating a cord blood gas, if the ph is low, what other blood gas parameter is used to determine if the acidosis is respiratory or metabolic? - CORRECT ANSWER HCO3 For what gestational ages would you test FFN? - CORRECT ANSWER 22-35 In post term preg, the most important u/s parameter is - CORRECT ANSWER AFI One theory of labor initiation is an increase in? - CORRECT ANSWER Progesterone A pt had an unsuccessful external cephalic version. How soon can this be repeated? - CORRECT ANSWER 7 days if <37 weeks, reactive tracing, adequate fluid During the bearing down phase of 2nd stage labor , the nurse should help facilitate the woman's perineum to stretch by? - CORRECT ANSWER No action An episiotomy is selectively used for? - CORRECT ANSWER Abnormal FHR pattern Compared to a mediolateral episiotomy, a midline episiotomy results in? - CORRECT ANSWER Less blood loss A newborn is at higher risk of jaundice when? - CORRECT ANSWER Delivery is assisted by vacuum extraction When a vacuum procedure is unsuccessful the max number of attempts or pop offs recommended before declaring the procedure unsuccessful is? - CORRECT ANSWER 3 in 20 minutes The risk of water intoxication is decreased during induction of labor if oxytocin is given in a - CORRECT ANSWER Balanced electrolyte solution The mechanism of action of sterile water injections for labor pain - CORRECT ANSWER Gate control theory Discontinuing an epidural when a woman has the urge to push may - CORRECT ANSWER Lead to dysfunctional uterine activity A characteristic of velementous cord insertion is - CORRECT ANSWER Lack of whartons jelly What type of breech has the highest risk of cord prolapse - CORRECT ANSWER Footling A 36 weeks woman needs cpr for cardiac arrest. Recommended action to facilitate cardiac output during resuscitation is - CORRECT ANSWER Uterine displacement A placental condition that occurs when the fetal vessels course through the amniotic membranes and are present at the cervical os is - CORRECT ANSWER Vasa previa When 2nd stage labor lasts longer than 2 hours with normal FHR current recommendations are to - CORRECT ANSWER Continue to watch if there is evidence of descent One absolute contraindication to epidural anesthesia is - CORRECT ANSWER Coagulapathy A woman with hydramnios is experiencing abdominal pain and dyspnea. Treatment with indomethacin will - CORRECT ANSWER Decrease fetal urine production Research has shown that administration of IV fluids during preterm labor - CORRECT ANSWER Increases risks when combined with tocolytics A clinical sign of plancental abruption is - CORRECT ANSWER Pain with ctx not congruent with ctx intensity A pt with previa is scheduled for c/s. The RN can anticipate what kind of incision - CORRECT ANSWER Low segment vertical Treating the preterm pt with bed rest increases - CORRECT ANSWER Glucose intolerance FDA warns against oral or injectible terbutaline longer than 72 hrs due to - CORRECT ANSWER Cardiac complications and death While the exact mechanism of action is not fully known, mag sulfate inhibits smooth muscle contractions by direct effect on myometrial - CORRECT ANSWER Calcium activity Neurological injury in a twin who survives the IUFD of the co-twin is most likely due to - CORRECT ANSWER Significant hypotension at the time of the demise The interactive process of the father with the newborn is termed - CORRECT ANSWER Engrossment Maternal contraindication to breastfeeding - CORRECT ANSWER HIV, Is infected with human T-cell lymphotropic virus type I or type II Active untreated tuberculosis Current AWHONN recommendation for umbilical cord cleaning are initially - CORRECT ANSWER Sterile water, then plain water What neonatal complication is reduced with vaginal delivery - CORRECT ANSWER Respiratory morbidity A woman with hx of anencephaly should be advised to supplement her diet with foods high in folate along with what dose of folic acid - CORRECT ANSWER 4.0 mg 2nd Leopold - CORRECT ANSWER Palpate fetal back 3rd Leopold - CORRECT ANSWER Determine if engaged 4th Leopold - CORRECT ANSWER Fetal descent and fetal attitude 1st Leopold manuever - CORRECT ANSWER To determine presenting part at the fund us Respiratory acidosis - CORRECT ANSWER Results from a build up of CO2 in the blood by lungs retaining Main cause of respiratory acidosis - CORRECT ANSWER Apnea, poor ventilation In respiratory acidosis - CORRECT ANSWER CO2 is increased, bicarbonate (HCO3-)is either normal (uncompensated) or increased (compensated) Respiratory alkalosis is - CORRECT ANSWER Hyperventilation is the main cause,resulting in a loss of CO2 Metabolic acidosis - CORRECT ANSWER Increased production of H+ by the body or increased excretion of bicarb by the kidney Metabolic acidosis main causes - CORRECT ANSWER Hypoxia, lactic acidosis, ketoacidosis, and chronic renal failure Labs in metabolic acidosis - CORRECT ANSWER PH is low, bicarb is decreased, CO 2 decreased, O2 increased In metabolic acidosis, - CORRECT ANSWER Due to respiratory compensation (hyperventilation)', Co2 decreased, O2 increased In metabolic alkalosis - CORRECT ANSWER Kidneys retain HC03, causes dehydration, labor, disease The pt in triage is diagnosed with PTL the RN should expect the physician will order? A) betamethasone 12mg, IM B) discharge with orders for off work C) mgsulfate IV and pro cardio PO - CORRECT ANSWER Betamethasone 12mg IM The new pt in triage is a 32 week 18yo G3P0110 African American woman. She presents with complaints of intermittent lower back pain. You are awaiting the FFN results. What other hx factors may be contributory? A. Further obstetrical hx details B. Non gynecologic surgery hx c. 6 week u/s result from the ER - CORRECT ANSWER Further obstetrical history details The tocolytic that is contraindicated in the diabetic woman is A. Mag sulfate B. Nifedipine C. Terbutaline (beta-mimetic) - CORRECT ANSWER Terbutaline (beta-MIMETICS) A woman received mag sulfate during labor GHTN. What effect can this have on the newborn? - CORRECT ANSWER Muscle weakness Prenatal hx shows a quad screen with a maternal serum alpha protein (MSAFP) lower than normal and higher than normal HCG and inhibin A. The nurse can expect what diagnosis of the newborn? - CORRECT ANSWER Trisomy 21 What is associated with elevated maternal serum alpha protein? - CORRECT ANSWER Neural tube defects Subsequent to a massive hemorrhage after delivery of a macerated fetus, a woman appears to stabilize. Suddenly a 1hr postpartum, her respirations become shallow and rapid. She states she feels cold and begins to lose consciousness. Lab tests are: Hct 34, fibrinogen 350, plt 125,000. The most appropriate management includes - CORRECT ANSWER Blood products Pt diagnosed with a pp infection states she has no pain. She seems confused and agitated. 98/50, pulse 125, and output is decreased - CORRECT ANSWER Septic shock A postpartum pt is diagnosed with sheehans syndrome which is caused by - CORRECT ANSWER Postpartum necrosis A woman 4 hours postpartum reports sudden, excruciating vulvar pain and severe rectal pressure. This pt is likely exhibiting symptoms of - CORRECT ANSWER Vulvar hematoma Functional closure of the ductus arteriosis occurs as a result of - CORRECT ANSWER Increased arterial oxygen tension A woman with hydramnios is experiencing abdominal pain and dyspnea. Treatment with indomethacin will - CORRECT ANSWER Decrease fetal urine production A pregnant woman on a continuous mag sulfate infusion for preeclampsia exhibits the following: rr 14, decreased deep tendon reflexes clonus absent - CORRECT ANSWER Maintain the infusion rate A woman with a BMI of 18 gains 25 pounds during her pregnancy. The pregnancy is at increased risk for - CORRECT ANSWER Low birthweight infant Within the first two days after birth, progesterone levels fall causing what acid base change - CORRECT ANSWER Increased PaCO2 and low ph What acid base change is normal in pregnancy? - CORRECT ANSWER Slight alkalosis, elevated ph due to decrease PaCO2 Compared to the value seen in the 3rd trimester, the catabolic process of involution causes an increase in which of the following values postpartum? - CORRECT ANSWER BUN The cause of sudden late onset postpartum hemorrhage secondary to retained placental fragments is due to - CORRECT ANSWER Necrotic tissue separation from the uterus The insulin requirement for most breastfeeding women is - CORRECT ANSWER Decreased You are caring for a new mother in the recovery room who delivered by c/s at 35weeks. She has a personal history of Tetraology of Fallot. Your nursing care - CORRECT ANSWER Vital signs including lung sounds and assessment of pedal edema What % of women with gestation Htn will develop proteinuria - CORRECT ANSWER 25% In the absence of proteinuria, preeclampsia can be diagnosed with new onset of any of the following: - CORRECT ANSWER Plt < 100,00, serum creatinine > 1.1 or doubling of serum creating conc. In absence of other renal disease, elevated liver enzymes to 2x normal Severe pre-e = any ONE of the following > 20 weeks - CORRECT ANSWER BP 160 or 110 at least 4 hrs apart while on bed rest, plt < 100,000, 2x normal liver functions or severe ft upper quad or epigastric pain unresponsive to meds and not accountable to alt diagnoses or both, creatinine greater than 1.1 or double normal, pulmonary edema, new onset cerebral or visual disturbances Superimposed pre-e - CORRECT ANSWER Must have prior diagnoses of CHTN or before 20 weeks Superimposed pre-e diagnosed when - CORRECT ANSWER New onset proteinuria after 20wks, sudden change in proteinuria, sudden change in BP requiring dose inc, change in symptoms, inc ALT, AST, plt <100,000, rt upper quad pain, severe ha, pulmonary congestion or edema, renal insuff (creatinine 1.1 or double) Eclampsia - CORRECT ANSWER New onset grand mal sx in pt with pre-e HELLP - CORRECT ANSWER Hemolysis - abnormal peripheral smear (shistocytes, burr cells), LDH > 600, total bilirubin >= 1.2, elevated liver enzymes, serum asparate amniotransferase>70, low pots< 150,000 Secondary causes of hypertension - CORRECT ANSWER Cortisol, pituitary tumor, glucocorticoid meds, sleep apnea, meth/cocaine, renal artery stenosis Path physiology of Htn - CORRECT ANSWER Starts early in placental development with incomplete trophoblastic invasion into maternal spiral arteries that perfume the placenta. Results in tortuous vessels, high resistance, I paired p,acetal functioning and decreased placental perfusion Pathophysiology of tachysystole - CORRECT ANSWER Constriction of spiral arterioles and decreased blood flow in the intervillous space, risk for fetal hypoxemia and metabolic acidemia Acidosis - CORRECT ANSWER Increase in hydrogen ions in tissue Metabolic acidosis - CORRECT ANSWER Low bicarb (base excess) in the presence of normal (PCO2) Respiratory acidosis - CORRECT ANSWER High pco2 with normal bicarb Asphyxia - CORRECT ANSWER Hypoxia with metabolic acidosis Cord ph - arteries - CORRECT ANSWER From fetus - deoxygenated Cord ph - vein - CORRECT ANSWER To fetus oxygenated FHR tones of baby in ROP position best assessed over - CORRECT ANSWER Right lower quad Crettas - CORRECT ANSWER Think alphabet in order of badness Doppler flow - rising s/d ratios - CORRECT ANSWER Reflect blood flow resistance to placenta, demonstrates dismissed vessel flow volume [Show Less]
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Unit 6 - Regulation of Nursing Practice 93 Questions with Verified Answers,100% CORRECT
Unit 6 - Regulation of Nursing Practice 93 Questions with Verified Answers 2 ways nursing is recognized. - CORRECT ANSWER pins and registries Nursi... [Show More] ng pins symbolize the school's ______, _____ and ______. - CORRECT ANSWER philosophy, beliefs and aspirations Nursing pins are evidence of _____, ______ and ______. - CORRECT ANSWER achievement, learning and skills ______ ______ started the practice of keeping a list or 'registry' of all graduates in 1860 - CORRECT ANSWER Florence Nightingale Provided institutions & clients with a means to ascertain the skills & knowledge of graduates. - CORRECT ANSWER Registries As nursing programs increased, the need to demonstrate a certain level of nursing skill and knowledge evolved which lead to the purpose of ______. - CORRECT ANSWER licensure Graduate ______, ______, and _____ set criteria for licensure of nurses in the US. - CORRECT ANSWER nurses, physicians, and hospitals What was and still is the primary purpose of the licensure. - CORRECT ANSWER protection of the public In 1867, Dr. _____ ______ encouraged licensure of English nurses. - CORRECT ANSWER Henry Wentworth Acland In ____, attempts were made to license nurses in the US but failed due to lack of hospitals, physicians, nurses, and broad-based support. - CORRECT ANSWER 1896 In ____, international council of nurses passed a resolution that each nation and state examine and license its nurses. - CORRECT ANSWER 1901 In 1903, _____ _____, ___ _____, ____ ____, and ______ were the first to institute permissive licensure - CORRECT ANSWER north Carolina, new jersey, new york, and Virginia The licenses in 1903 were _____. - CORRECT ANSWER voluntary In 1903, it was permitted but not required that nurses become ______. - CORRECT ANSWER registered In 1915, the first _____ _____ _____ were published which were revised and updated as nursing practice advanced. - CORRECT ANSWER model practice acts In ____, all states had instituted examinations for permissive licensure. - CORRECT ANSWER 1923 In 1923, each states' exams varied in length, content, and format and included ____, ____, and ______ components. - CORRECT ANSWER written, oral, and practice The two purposes of the early regulations was.... - CORRECT ANSWER 1. protect the public from unskilled practitioners 2. Provide legal sanctions to protect the title of RN In _____, mandatory licensure- a requirement that all nurses must be licensed. - CORRECT ANSWER 1947 _____ _____ was the first state to pass the mandatory requirement of licensure in 1947. - CORRECT ANSWER New York In 1947, American Nurses Association (ANA) formed the _____ _____ of ______ ______ of ______ (_______). - CORRECT ANSWER National Council of State Boards of Nursing (NCSBN) In 1947, nursing groups moved to standardize nursing ______ testing procedures. - CORRECT ANSWER licensure In 1950, _____ exams for licensure were set. - CORRECT ANSWER standardized In _____, the National League for Nursing (NLN) administered the first State board test pool examination. - CORRECT ANSWER 1950 In ____, development of first National council licensure examination-Registered Nurse (NCLEX-RN). - CORRECT ANSWER 1982 The _______ test was revised to include all nursing content in one section of the exam and the format was changed to present questions in a nursing process format in 1982. - CORRECT ANSWER NCLEX-RN In 1994, the paper and pencil test was replaced by _____ _____ ______ (____). - CORRECT ANSWER Computerized Adaptive Testing (CAT). The ____ _____ of _____ _____ of _____ was established to ensure public protection and required a candidate for licensure to pass an examination that measures the competencies needed to perform safely an effectively as a newly licensed, entry-level nurse. - CORRECT ANSWER National Council of State Boards of Nursing Council composed of a representative of each state and jurisdiction in the US. - CORRECT ANSWER National Council of State Boards of Nursing The National Council of State Boards of Nursing was formed after _____ _____ ____ by the ANA. - CORRECT ANSWER WWI What are the two exams given by the National Council of State Boards of Nursing? - CORRECT ANSWER NCLEX-RN and NCLEX-PN Each state develops ____ and _____ to govern the practice of nursing within that state. - CORRECT ANSWER rules and regulations Nurse Practice Acts are written and passed by ______. - CORRECT ANSWER legislature American Nurses Association (ANA) and later the National Council of State Boards of Nursing (NCBN) provided a _____ for nurse practice acts. - CORRECT ANSWER template What are the 5 components of Nurse Practice Acts? - CORRECT ANSWER Purpose of Act, Definition of Nursing and Scope of Practice, Licensure Requirements, Renewal of Licensure, and Mandatory Continuing Education. The purpose of Nurse Practice Acts are for the protection of the _____ and ____ of citizens. - CORRECT ANSWER health and safety The purpose of the Nurse Practice Acts are to protect the title of _____. - CORRECT ANSWER RN Each act outlines the activities nurses may _____ perform within the jurisdiction. - CORRECT ANSWER legally Many states define _____ practice nursing within one definition of nursing but some define it separately. - CORRECT ANSWER advanced States establish ____ regulating practice within its borders. - CORRECT ANSWER laws Some nurses may be asked to complete tasks that are out of their ____ and this is the responsibility of the nurse to know otherwise. - CORRECT ANSWER jurisdiction The initial requirement for licensure is graduation from ____ _____ and accredited ______ program. - CORRECT ANSWER high school; nursing Some licensure requirements may require a statement regarding the _____ and _____ health status of the applicant. - CORRECT ANSWER mental and physical Licensure requirements include the review of prior ____ convictions. - CORRECT ANSWER legal Licensure requirements include recreational _____ abuse stipulations. - CORRECT ANSWER drug Licensure requirements include statements form the school of _____ attesting the eligibility of the candidate for licensure. - CORRECT ANSWER nursing Licensure requirements include a successful completion of the _______ exam. - CORRECT ANSWER NCLEX-RN Licensure requirements include the individual specifying the _____ in which the intend to practice. - CORRECT ANSWER states The renewal of licensure is the defined length of time a license is valid (__-__ years), as well as any specific licensing renewal requirements. - CORRECT ANSWER 2-3 years ______, in 1976, was the first state to issue requirements of continuing education for renewal of licensure, and some states followed suit. - CORRECT ANSWER California Information on mandatory continuing education can be found in the section on ______ ______. - CORRECT ANSWER license renewal Members of the Board of Nursing are appointed by the ______ office, and any interested individual may submit names to the governor for consideration. - CORRECT ANSWER governor's One duty of the Board of Nursing is to ____ and ____ licensure and take _______ action when provisions of the act are violated. - CORRECT ANSWER grant and renew; disciplinary One duty of the Board of Nursing is to administer the state's _____ _____ ____. - CORRECT ANSWER nurse practice act What does LSBN stand for? - CORRECT ANSWER Louisiana State Board of Nursing What is the regulatory board for the state of LA? - CORRECT ANSWER LSBN Where is the Louisiana State Board of Nursing located? - CORRECT ANSWER Baton Rouge, LA When is the annual license renewal for RNs? - CORRECT ANSWER January every year How much does the annual license renewal for RNs cost? - CORRECT ANSWER $80 If an RN is under full time employment, he or she should have greater than _____ hours with ___ contact hours. - CORRECT ANSWER 1600; 5 If an RN is under part time employment, he or she should have less than ____ hours but greater than ____ and ___ contact hours. - CORRECT ANSWER 1600, 160; 10 If an RN is under part time unemployment, he or she should have less than ____ hours and ____ contact hours. - CORRECT ANSWER 160; 15 As a US government employee, nurses have to be licensed in only _____ state to practice across the country. - CORRECT ANSWER one Internationally educated nurses account for ____% of the US registered nurse workforce. - CORRECT ANSWER 8.1% Nurses who receive education in another country must take a special ______ administered by the Commission on Graduates of Foreign Nursing Schools before applying for a license to practice in this country. - CORRECT ANSWER exam Nurses interested in ______ practice must contact either the International Council of Nurses or the nursing regulatory board of the country in which they wish to practice. - CORRECT ANSWER international ____ Legislations are intended to ensure that legislation is current and reflect the needs of the public. - CORRECT ANSWER Sunset _____ _____ _____ represents the aims and concerns of many individuals and groups. - CORRECT ANSWER Nurse Practice Acts The wide array of many ________ personnel practicing in health care present a challenge to RNs working with them because questions arise as to who can delegate what. - CORRECT ANSWER unlicensed One ______ license allows you to practice in your home state & other participant states without applying for multiple licenses. - CORRECT ANSWER multistate Nurses with _____ licenses are still responsible for following laws and regulations of each state in which they practice. - CORRECT ANSWER multistate ______ ______ _____ greatly facilitates interstate practice, telehealth programs, and moment of nurses to areas of shortage. - CORRECT ANSWER Nurse License Compacts Maintains a national database with information on individual nurses' practice & disciplinary actions. - CORRECT ANSWER Nurse License Compact _____ maintains a list of current NLC states. - CORRECT ANSWER NCSBN A nurse licensed in one state that wants to obtain licensure to practice in a second state that is not a participant of NLC must first check with the ____ related to licensure the endorsement. - CORRECT ANSWER NPA A nurse licensed in one state that wants to obtain licensure to practice in a second state that is not a participant of NLC can expect to pay the ____ ____ fee and follow procedures of endorsement of their initial license before practicing. - CORRECT ANSWER state license Licensure establishes _____ levels of practice. - CORRECT ANSWER minimal Certification recognizes _____ in practice. - CORRECT ANSWER excellence In the _____, advanced clinical courses were designed. - CORRECT ANSWER 1970s _____ is granted and governed by legislation and administered through the state boards of nursing. - CORRECT ANSWER Licensure Certification is awarded by ______ agencies. - CORRECT ANSWER nongovernmental First field to certify advanced practitioners were nurse ______ in 1946. - CORRECT ANSWER anesthesia ______- central organization for certification of nurses. - CORRECT ANSWER ANCC Logo of the ANCC is "______. ______. _____." - CORRECT ANSWER "Innovate. Involve. Inspire" Certifying exams by the ANCC is open to exams with a variety of _______ backgrounds [advanced practice, BSN, AND, Diploma]. - CORRECT ANSWER educational ________ began as a voluntary effort controlled by professional nursing organizations. - CORRECT ANSWER Certification What are the 2 purposes of certification? - CORRECT ANSWER Protection of the public and scope of practice is well defined The first step to certification is to become informed of specific ______ in a chosen field. - CORRECT ANSWER requirements The second step of certification is the nurse should contact the ____ and specialty organization in his or her area of practice to determine the education, experience, and examination requirements. - CORRECT ANSWER ANCC On completion of requirements, nurse may practice in an _____ role. - CORRECT ANSWER expanded A current issue in certification is the changing ______ requirements for licensure and relicensure - CORRECT ANSWER educational A current issue in the certification is the _______ for nursing services. - CORRECT ANSWER reimbursement A current issue in the certification is the question of which ________ will credential and regulate advanced practice nursing. - CORRECT ANSWER organizations [Show Less]
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School nursing certification review, ch 8|26 Questions with Verified Answers,100% CORRECT
School nursing certification review, ch 8|26 Questions with Verified Answers American Nurses Association Code for nurses: - CORRECT ANSWER outlines stan... [Show More] dards for professional behavior of nurses 1. gives common guidelines for making ethical decisions 2. outlines nurse's responsibility to the client & profession of nursing 3. stresses then nurse's obligation to the client, including protection of client form incompetent, unethical or illegal practices Code of Ethics of the National Association of School Nurses is based upon ANA's document - CORRECT ANSWER 1. Addresses client care 2. Addresses professional competency 3. Addresses professional responsiblities 4. addresses professional endorsements 5. The basic premise of the code is the moral and ethical conduct of the school nurse Nurse Practice Act - CORRECT ANSWER -each state has its own set of rules and regulations to carry out the provisions of nursing regulate the practice of nursing by requiring a license to sell certain svcs to the public is established to protect the public by defining & regulating the practice failure to follow NPA may result in litigation &/or loss of one's nursing license Standards of practice - CORRECT ANSWER purpose is to fulfill profession obligation to provide a means of improving the quality of care are agreed-upon levels of practice developed by the profession to characterize, to measure, and to provide guidance for achieving excellence *is the principle that is depicted as surrounding all others in the Framework; it is foundational to the practice of school nursing. 1. clinical competency 2. clinical guidelines 3. Cod of ethics 4. critical thinking 5. evidence-based practice 6. NASN postion statements 7. nurse practice act 8, scope and standards of practice Scope of practice - CORRECT ANSWER typically articulated w/ the standards of practice is a description of the framework of who, what, why, when and how practice occurs Standards of school nursing practice include: - CORRECT ANSWER standards of practice and standards of professional performance were developed by NASN, but jointly approved by NASN & ANA standards of practice (standards 1-6) - CORRECT ANSWER 1. Assessment 2. Diagnosis 3. Outcomes identification 4. Planning 5. Implementation 5A. Coordination of care 5B. health teaching and health promotion 6. Evaluation Standards of professional performance (standards 7-18) - CORRECT ANSWER 7. ethics 8. culturally congruent practice 9. communication 10. collaboration 11. leadership 12. education 13. evidence based practice & research 14 quality of practice 15. professional practice evaluation 16 resource utilization 17. Environmental health 18 program management supervision - CORRECT ANSWER act of monitoring, coaching or controlling delegated tasks by the person in charge who retains accoutability for the task involves directing and influencing an individual's activity Delegation - CORRECT ANSWER process by which responsiblity & authority for performing a task, function, activity or decision is transfered to another individual who accepts that authority & responsibility the 5 rights - CORRECT ANSWER 1. Right task 2. Right circumstance 3.right person 4. Right direction/communication 5.right supervision/evaluation student health records - CORRECT ANSWER are part of the cumulative educational record in public schools under FERPA FERPA (Family Educational Rights and Privacy Act) - CORRECT ANSWER also known as Buckley Amendment applies to public schools and state or local education agencies that receive fed ed funds protects paper & computerized records *personal nursing documentation on students kept by the RN in a separate location and not shared w/ others are not considered eduation records and may not be reviewed by parent or student HIPPA (Health Insurance Portability and Accountability Act) - CORRECT ANSWER prevents denial of health insurance for pre-existing conditions does not address the uninsured does not regulate the price of health insurance A healthcare provider is expressly permitted to disclose protected health info about an individual to a healthcare provider for that provider's treatment of the individual A policy - CORRECT ANSWER carries the greatest legal status in the lielihood of litigation b/c it is a broadly written framework for activities offically affirmed by a governmental agency, ie a school board protocol - CORRECT ANSWER is an operational guideline for the implementation of a policy and guides decision making is always written, agreed on by several relevant parties, and typically is not subject to approval by the board of education. Procedure - CORRECT ANSWER written step by step description of how to accomplish something are developed and critiqued by nurses is usually not subject to administrative approval process - CORRECT ANSWER a familiar, established, but unwritten way of doing things has the least legal clout Wold & Dagg's conceptual framework for school nursing - CORRECT ANSWER public health systemic process tools helping relationships adaptation student care plans - CORRECT ANSWER documents individualize for students that outline healthcare activities of the school healthcare team IHP - CORRECT ANSWER nursing document created and used by the school nurse EAP - CORRECT ANSWER is developed from the IHP, by the school nurse for use by the school staff board of nursing - CORRECT ANSWER established thru the nurse practice act statute has authority for specific functions, ie, awarding/repealing license, establishing regulations it's mission is to protect the public Licensure - CORRECT ANSWER license to practice nursing is a legal credential conferred by a gov agency applicant must meet provisions of state law it is responsiblity of the RN to comply w/ requirements listed in the state Certification - CORRECT ANSWER the documented validation of specific qualifications demonstrated by the individual RN in the provision of professional nursing care in a defined area of practice Applicants must demonstrate practice beyond that required fro license as a RN Some states mandate an approved state School Nurse Certification and/or national school nurse certification to determine compentency & eligiblity to practice as a school nurse Certification benefits the practioner, employer and public the Framework for 21st Century School Nursing Practice - CORRECT ANSWER was developed by NASN is a conceptual framework that paints a current picture of school nursing aligns w/ WSCC model by using a whole child approach to student health all are surrounded by the 5th principle, nursing standards of practice 1. standards of practice 2. care coordinaiton 3. leadership 4. quality improvement 5. community/public health [Show Less]
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Holistic Nursing certification Exam 21 Questions with Verified Answers,100% CORRECT
Holistic Nursing certification Exam 21 Questions with Verified Answers Holistic nursing process - CORRECT ANSWER The moral ideal of nursing in which t... [Show More] he nurse brings one's whole self into a relationship with the whole self of the person being cared for in order to protect that person's vulnerability, preserve her or his humanity and dignity, and reinforce the meaning and experience of oneness and unity Self- knowledge - CORRECT ANSWER the primary source of information needed in the caring process. Includes beliefs, cultural values, folk/ health practices, life perspectives Wellness - CORRECT ANSWER integrated, congruent functioning aimed toward reaching one's highest potential, positive and affirming, a conscious, self-directed, and evolving process of achieving full potential. Multi dimensional and holistic, encompassing lifestyle, mental and spiritual well-being,and the environment Allopathic/ traditional therapies - CORRECT ANSWER medical, surgery, invasive and noninvasive diagnostic treatment procedures, including medications Cultural competence - CORRECT ANSWER the ability to deliver health care with knowledge of and sensitivity to cultural factors that influence the health behavior of the person Environment - CORRECT ANSWER everything that surrounds the person, both the external and the internal environment as well as patterns not yet understood Holistic communication - CORRECT ANSWER a free flow of verbal and nonverbal interchange between and among people and significant beings such as pets, nature, and God/life force/ absolute/ Transcendent that explores meaning and ideas leading to mutual understanding and growth Intention - CORRECT ANSWER the conscious awareness of being in the present moment to help facilitate the healing process, a volitional act of love Healing - CORRECT ANSWER the emergence of right relationship at one or more levels of the body-mind-spirit Transpersonal - CORRECT ANSWER that which transcends the limits and boundaries of individual ego identities and possibilities to acknowledge and appreciate something greater Art of nursing - CORRECT ANSWER the creative mediation and expression of all patterns of knowing in nursing in transformative, aesthetic, and caring holistic nursing actions Attitudes - CORRECT ANSWER feelings arising out of thoughts , emotions, and behaviors, associated with a particular person, idea, or object Beliefs - CORRECT ANSWER a subset of attitudes that indicate faith in a particular person, idea, or object Self-responsibilty - CORRECT ANSWER the ability to choose behaviors that are congruent with personal values Values - CORRECT ANSWER endowment of a particular person, idea, object, or behavior with worth, truth, or beauty Aesthetic knowing - CORRECT ANSWER has 2 components: knowledge of the experience toward which the art form is directed, and knowledge of the art form itself Concept - CORRECT ANSWER an abstract idea or notion Conceptual model - CORRECT ANSWER a group of interrelated concepts described to suggest relationships among them Framework - CORRECT ANSWER a basic structure; the context in which theory is developed; the structure that permits theory to be understood Metaparadigm - CORRECT ANSWER concepts that identify the domain of a discipline Model - CORRECT ANSWER a representation of interactions between and among concepts [Show Less]
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Intro to Professional Nursing Practice 21 Questions with Verified Answers,100% CORRECT
Intro to Professional Nursing Practice 21 Questions with Verified Answers Components of nurse practice acts include: A. definition of professional nur... [Show More] sing B. certification requirements C. education requirements D. current NCLEX-RN plan - CORRECT ANSWER A. definition of professional nursing When one differentiates between licensure and certification, it should be known that: A. licensure recognizes advanced practice competence and knowledge B. certifications recognizes entry-level competence and knowledge C. certification requires only successful completion of a standardized examination, whereas licensure requires completion of a set number of clinical hours to be completed during the nursing education process D. licensure is administered via state boards of nursing, whereas certification is granted by nongovernmental agencies - CORRECT ANSWER D. licensure is administered via state boards of nursing, whereas certification is granted by nongovernmental agencies When analyzing the data from her research study, a nurse researcher finds that nurses who work under indirect sunlight have 20% fewer headaches, which are less severe than reported by those who work under fluorescent lighting. Which step of scientific inquiry does this action by the nurse researcher represent? A. Hypothesis B. Method C. Data collection D. Evaluation - CORRECT ANSWER D. evaluation For a theory to be reliable and acceptable for guiding nursing practice, another nurse should be able to duplicate the theory. Which criterion for theory acceptance deals with replication? A. Fruitfulness B. Relevance C. Accuracy D. Simplicity - CORRECT ANSWER D. simplicity A nurse is checking orders at the front desk when a visitor asks the room number of his father. The nurse leaves the chart open while looking up the room number on the computer, allowing the visitor to read the patient's recent x-ray film report. Which law would protect this client from others having access to his or her medical information? A. Health Insurance Portability and Accountability Act of 1996 B. Patient Self-Determination Act of 1990 C. Emergency Medical Treatment and Active Labor Law D. Americans with Disabilities Act of 1990 - CORRECT ANSWER A. Health Insurance Portability and Accountability Act of 1996 (HIPA) While assisting in the labor room, a nurse is helping to stimulate a newborn infant who has a low Apgar score. The nurse stumbles, allowing the baby to fall to the floor, resulting in the infant's death. This situation is referred to as: A. criminal negligence B. sentinel event C. res ipsa loquitur D. a negligent act - CORRECT ANSWER B. sentinel event What practice today were the foci of the care delivered by Florence Nightingale? Select all that apply. A. changing bed linens B. filtering air/air exchanges C. frequent ambulation D. balanced diet E. support by family members - CORRECT ANSWER A. changing bed linens B. filtering air/air exchanges _______ is directed toward attesting to or endorsing the demonstrated knowledge base and clinical practice behaviors associated with high quality performance in an area of specialization. A. Certification B. Specialized accreditation C. Bachelor's degree D. License - CORRECT ANSWER A. certification In 1965, the American Nurses Association (ANA) designated the associate degree as the education entry point into profession nursing practice. True or False. - CORRECT ANSWER False. In 1965, the ANA designated the baccalaureate degree as the educational entry point into professional nursing practice. What caused the accelerated BSN program to emerge after the 1990s? Short answer. - CORRECT ANSWER As the nursing shortage gained national recognition during the 1980s and 1990s, accelerated BSN programs emerged to hasten the time to graduation for select groups of students. The clinical nurse leader (CNL) is a master's-prepared nurse who oversees the care coordination of a distinct group of patients and actively provides direct patient care in complex situations. True or false. - CORRECT ANSWER True The media has played a huge role in the way the nursing profession has been portrayed. Which of the following ways have nurses been most commonly portrayed? Select all that apply. A. Sexualized roles B. Harsh disciplinarians with an unyielding, even sadistic, worldview C. Female-only profession D. Images of inter-professional critical thinking and decision making between nurses and colleagues E. Heroes and heroines - CORRECT ANSWER A. sexualized roles B. harsh disciplinarians with an unyielding, even sadistic, worldview C. female-only profession E. heroes and heroines The nursing profession consists of individuals with unique values and experiences. However, there is only one set identity for nurses. True or False. - CORRECT ANSWER False. There is no set identity in nursing because the profession consists of individuals with unique values and experiences. According to Gardner, there are 10 lessons in collaboration. Name at least five of these lessons. Short answer. - CORRECT ANSWER 1. know thyself 2. learn to value and manage diversity 3. develop constructive conflict resolution skills 4. use personal power to create win-win situations 5. master interpersonal and process skills 6. recognize that collaboration is a journey 7. leverage all multidisciplinary forums 8. appreciate that collaboration can occur spontaneously 9. balance autonomy and unity in collaborative relationships 10. remember that collaboration is not required for all decisions __________________ is a vital aspect of plans designed to increase the effectiveness of delivery of health care. - CORRECT ANSWER Inter-professional collaboration The role of nurse __________ is essential to ensure universal access to care and for the improvement of public health. A. mentor B. educator C. manager D. advocate E. researcher - CORRECT ANSWER D. advocate The early Nightingale model had "pupil" nurses training on hospital wards under the direction of a nursing superintendent. This "pupil" nurse provided: A. hospitals with an inexpensive workforce B. hospitals with a skilled workforce C. working-class women with an opportunity for employment outside the home that was an alternative to factory work D. all of the above - CORRECT ANSWER D. all of the above The training in hospital-based schools was arduous, requiring long days of patient service on the wards, after which students attended classes. In addition to providing direct patient care, students performed which tasks? Select all that apply. A. housekeeping tasks B. prepared meals C. drove deliveries D. cleaned the wards and operating rooms E. sterilized instruments F. surgery G. assisted physicians - CORRECT ANSWER A. housekeeping tasks B. prepared meals D. cleaned the wards and operating rooms E. sterilized instruments G. assisted physicians Community health nursing was later developed. Why was this important to the nation and to the nursing profession? Short answer. - CORRECT ANSWER The development of community health nursing was important to the nation and to the nursing profession because it brought essential health services to the public outside the hospital environment. Community health nursing also provided nurses with unique opportunities to integrate epidemiological knowledge and sanitation practices, as well as nursing science, into the care and education of the public. What was the purpose of the Association of Collegiate Schools of Nursing in 1935? A. ensure equality between gender and ethnicity within the nursing career B. establish collegiate nursing programs in American universities C. create specialties within the nursing profession D. provide a union for hospital nurses - CORRECT ANSWER B. establish collegiate nursing programs in American universities. The concept of the intensive care unit (ICU) was initiated because of all of the following factors except: A. newly constructed hospitals had private rooms and long hallways, and patients could no longer be seen from a central nurses' station B. progress in physiologic monitoring and drug development during the 20th century radically changed the practice of medicine and nursing C. the 20th century brought forth new disease processes and sicker patients - CORRECT ANSWER C. the 20th century brought forth new disease processes and sicker patients [Show Less]
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Medical-Surgical Nursing Certification Exam Study 15 Questions with Answers,100% CORRECT
Medical-Surgical Nursing Certification Exam Study 15 Questions with Answers A patient with mitral valve disease is admitted to a medical unit with fever... [Show More] , chills, SOB, malaise and a newly developed cardiac murmur. Based on the patient's new diagnosis of endocarditis, the nurse will begin preparing him for discharge by teaching about: a. lifestyle modifications. b. warfarin (Coumadin) therapy. c. self-administration of IV antibiotics. d. the need for fluid restrictions. - CORRECT ANSWER c. self-administration of IV antibiotics. A patient with hypercholesterolemia was prescribed pravastatin (Prevachol). The nurse should teach the patent about which of the following side effects for this medication? a. Muscle weakness b. Flushing c. Itching d. Hypotension - CORRECT ANSWER a. Muscle weakness Ms. Parsons, age 65, is transferred to a medical telemetry unit after several days in the coronary care unit for treatment of an acute MI. Ms. Parsons remains very anxious, with occasional episodes of chest pressure. Which medication does the nurse prepare for Ms. Parsons to decrease her anxiety and improve cardiac output? a. Nitroprusside (Nipride) b. Diazepam (Valium) c. Morphine sulfate (MS) d. Dopamine (Intropin) - CORRECT ANSWER c. Morphine sulfate (MS) The nurse's assessment of Mr. Harrison's response to digoxin will include which of the following as the most common early indicator of toxicity. a. Anorexia b. Diarrhea c. Headache d. Confusion - CORRECT ANSWER a. Anorexia The nurse is also aware that some of Mr. Harrison's medications can increase serum digitalis concentrations and thus the risk for digoxin toxicity. These include: a. calcium carbonate (Tums) b. cholestyramine (Questran) c. sulfasalazine (Azulfidine) d. amiodarone (Cordarone) - CORRECT ANSWER d. amiodarone (Cordarone) The nurse teaches Ms. Pratt about the use of nitroglycerin. Following teaching, it is most important for the patient to: a. indicate she will call for help if three nitroglycerin tablets don not relieve her chest pain. b. identify flushing and dizziness as common side effects of the drug. c. verbalize understanding that nitroglycerin will help prevent her from having a myocardial infarction (MI) d. confirm she will not take the drug unless she is experiencing chest pain. - CORRECT ANSWER a. indicate she will call for help if three nitroglycerin tablets don not relieve her chest pain. A 68 year old female is admitted with a diagnosis of heart failure and ischemic cardiomyopathy. Her cardiac history includes three previous MIs and three coronary artery bypass grafts. The patient's appetite is unchanged. Which dietary restriction would be the highest priority for this patient? a. Low cholesterol b. Reduced calorie c. Low fat d. Restricted sodium - CORRECT ANSWER d. Restricted sodium A 65 year old male is diagnosed with right-sided heart failure and admitted to the medical-surgical unit. Based on this diagnosis, the nurse will expect assessment to include which of the following findings: a. Dyspnea on exertion and bibasilar crackles b. Dependent edema and hepatic engorgement c. Distended veins and systolic murmur d. Cool extremities and weak peripheral pulses - CORRECT ANSWER b. Dependent edema and hepatic engorgement The priority nursing intervention for a patient with suspected MI is : a. auscultating for adventitious breath sounds. b. monitoring fluid and electrolyte status. c. preventing thrombi and emboli. d. providing appropriate analgesia. - CORRECT ANSWER d. providing appropriate analgesia. A patient scheduled for heart catheterization learns the right radial artery will be accessed rather than the femoral artery. The patient asks the nurse, "Could you tell me about the two access options?" The nurse's response is based on knowledge that: a. femoral catheterization has less risk of internal bleeding. b. external bleeding can be easily controlled with radial catheterization. c. the patient is able to sit up immediately following femoral catheterization. d. the patient can resume normal activity immediately after radial catheterization. - CORRECT ANSWER b. external bleeding can be easily controlled with radial catheterization. A male patient tells the nurse he has stopped taking his beta blocker because it interfered with his social life. Which comment by the nurse is most appropriate in response to the patient's statement: a. "Often these drugs can cause fatigue, but a dosage adjustment can correct this side effect." b. "What exactly do you mean by social life?" c. "Many men stop taking their blood pressure medications due to changes in sexual functioning . Have you had this problem?" d. "Never stop taking blood pressure medication suddenly because this can be dangerous." - CORRECT ANSWER c. "Many men stop taking their blood pressure medications due to changes in sexual functioning . Have you had this problem?" Which noninvasive diagnostic procedure would the nurse anticipate the physician will order to assess possible blockage in a patient's coronary arteries? a. Mitigated angiographic scan (MUGA) b. Echocardiography c. Chest radiography d. Computed tomography angiogram (CTA) - CORRECT ANSWER d. Computed tomography angiogram (CTA) The nurse is caring for a patient with a history of three previous MIs and three coronary artery bypass grafts. An echocardiogram reveals an ejection fraction of 15%. The nurse prepares to teach the patient about which medication that will be ordered during the acute phase of heart failure? a. Dobutamine (Dobutex) b. Amlodipine (Norvasc) c. Atenolol (Tenormin) d. Captopril (Capoten) - CORRECT ANSWER a. Dobutamine (Dobutex) The nurse is caring for multiple patients with a diagnosis of coronary artery disease. The identifies which of the following as at the greatest risk for early onset of the disease? a. Hispanic male b. Asian female c. African-American female d. Caucasian male - CORRECT ANSWER c. African-American female A patient with rheumatic fever has been told the infection could reoccur. The nurse teaches the patient to seek medical attention for which of the following symptoms that suggest reinfection? a. Shortness of breath at rest b. Unexplained weight loss c. Excessive fatigue d. lower-extremity ecchymosis - CORRECT ANSWER c. Excessive fatigue [Show Less]
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Ambulatory nurse certification exam 38 Questions with Verified Answers,100% CORRECT
Ambulatory nurse certification exam 38 Questions with Verified Answers The nursing process is foundational to the process of patient education. Which ... [Show More] of the following describes the evaluation phase of patient education? a. Tailoring teaching, learning strategies, and interventions. b. Measuring learning attained and level of self-efficacy. c. Determining readiness to learn and learning needs? d. Mutually setting goals and outcomes expected. - CORRECT ANSWER B. Measuring learning attained and level of self-efficacy For patients with chronic pain, educational interventions should include: a. Masking nonverbal indications of pain to reduce the anxiety of their family and other caregivers. b. Learning to tolerate mild to moderate pain without interventions to avoid addiction to pain medications. c. Recognizing distraction and relaxation techniques are rarely helpful in reducing pain significantly. d. Understanding the length of action of various medications and which can be taken together or alternately. - CORRECT ANSWER D. Understanding the length of action of various medications and which can be taken together or alternately. Patients with chronic illnesses need to develop the ability to deal with all the disease and its treatment entail. Core skills for chronic disease self-management include: a. Understanding the evidence-based guidelines. b. Becoming familiar with community and Internet resources. c. Problem solving, decision making, and taking actions. d. Focusing on the health issues that contribute to emergency department visits or hospitalizations. - CORRECT ANSWER C. Problem-solving, decision making and taking actions. The Patient Protection and Affordable Care Act of 2010 (PPACA) encourages health care providers to focus on efforts such as implementing evidence-based educational programs and encourage patient self-efficacy. What is the best definition of patient self-efficacy? a. The patient plays a central role in preventing and managing his or her illness. b. Health plans cover preventive services and wellness care, making them more affordable to patients. c. Nurses and other providers of health care are responsible for reinforcing patients' and families' responsibility for health care. d. The patient's perception of his or her own ability to attain health care goals. - CORRECT ANSWER d. The patients perception of his or her own ability to attain health care goals. The Centers for Disease Control recently set a goal to reduce the number of unintended pregnancies in the United States by 30% in the next few years. Nurses providing counseling should consider for the following: a. Unintended pregnancies are most common in women in their 20's. b. All contraceptive methods also protect against sexually transmitted diseases. c. Cultural and ethnic beliefs may affect family planning options. d. With sufficient education about the contraceptive method chosen, follow-up may not be necessary. - CORRECT ANSWER c. Cultural and ethnic beliefs may affect family planning options. In counseling about childhood or adolescent drinking, which of the following should be considered? a. The physical and psychological effects of alcohol use. b. Consumption of alcohol during pregnancy can lead to severe physical and mental problems for the infant. c. Risky drinking has been defined as more than four drinks per occasion for males and more than three drinks per occasion for females. d. Speaking frequently with a child about drinking is likely to alienate him or her and may have a negative rather than positive effect on behavior. - CORRECT ANSWER a. The physical and psychological effects of alcohol use. Childhood obesity has become a national health problem in the United States. Topics important to include in counseling for the parents of school-aged children include: a. Diets high in energy are also high in nutritional value. b. Provide a variety of foods, including grains, fruits, and vegetables. c. School-aged children will automatically choose the right nutrients for themselves if they see their parents and other role models doing so. d. A multivitamin is important to supplement a child's diet at this age. - CORRECT ANSWER b. Provide a variety of foods, including grains, fruits, and vegetables. Mr. McIntire is a 37 year old patient who has a 25 pack a year history of smoking. Today, he has told his physician he is ready to quit. Ryan, the ambulatory care nurse, has been asked to assist Mr. McIntire. Which of the following describes a potential method to assist this patient to quit smoking? a. Explain that relapsing is part of the process. b. Advise Mr. McIntire about the harms of smoking, which impact nearly every organ in the body. c. Set specific goals and a quit date. d. Use motivational interviewing to help him understand his ambivalence about quitting. - CORRECT ANSWER c. Set specific goals and a quit date. A 53 year old man has recently been diagnosed with diabetes. The provider has sent him to the nurse for instruction about glucose monitoring at home. The patient arrives for teaching as scheduled, but has not yet purchased the electronic monitoring device. Which of the following would be the best nursing action at this time? a. Assess the patient's current understanding and his interest in learning about self-monitoring his glucose. b. Demonstrate the procedure using the glucose-monitoring device used in the office. c. Have the office assistant give him written materials about glucose control and schedule him to return another day to discuss. - CORRECT ANSWER a. Assess the patients current understanding and his interest in learning about self-montoring his glucose. Primary prevention of HIV and other sexually transmitted diseases (STDs) would include the following: a. Use of condoms and avoidance of anonymous partners. b. Vaccination against herpes, hepatitis and meninogococcal infections.. c. Prophylactic antibiotics for any oral sex. d. Annual health screenings. - CORRECT ANSWER a. use of condoms and avoidance of anonymous partners. One of the developmental considerations for teaching an adolescent is : a. They tend to build on past life experiences which may be relevant to the new learning. b. They are reflecting on unsatisfactory life aspects. c. One should anticipate negative responses, but support autonomy by involving them in decision-making whenever possible. d. Parents are strong role models for the development of health habits at this stage. - CORRECT ANSWER c. One should anticipate negative responses, but support autonomy by involving them in decision-making whenever possible. An ambulatory nurse should teach adults the importance of routine screening for which of the following? a. Lung cancer b. Ovarian cancer c. Colorectal cancer d. bladder cancer - CORRECT ANSWER c. Colorectal cancer Legal mandates for professional nurses to educate patients include: a. The Joint Commission's requirements b. State's nurse practice acts. c. American Nurses Association's standards of practice. d. American Hospital Association's list of patient rights. - CORRECT ANSWER b. State's nurse practice acts. As an advocate for patients, an ambulatory care nurse may provide coordination of care across service lines and venues. Patient education by the nurse related to this role may include: a. Expressing his or her voice in the allocation of health resources. b. Evaluating services available and applying process improvement to decrease inefficiencies and resolve gaps. c. Increasing outreach efforts in the community. d. Orienting the patient to services available that may meet their needs. - CORRECT ANSWER d. Orienting the patient to services available that may meet their needs. Ms. Brown, a 21 year old university student, has been diagnosed with hepatitis A. she insists she is able to return to classes. An important aspect of her patient education includes: a. Hepatitis A is contagious and she needs to take precautions to prevent its transmission to others. b. Hepatitis A is a reportable disease, so she needs to contact the health department. c. She probably contracted this illness because has not been taking good care of herself, with proper rest and nutrition. d. Smoking or secondhand smoke exposure will delay her recovery. - CORRECT ANSWER a. Hepatitis A is contagious and she needs to take precautions to prevent its transmission to others. What is the most important factor to consider in choosing printed materials for patient education? a. Age of the patient b. Developmental stage of the patient c. Patient readiness to learn d. Literacy level of the patient - CORRECT ANSWER d. Literacy level of the patient Following a breast biopsy under moderate sedation, the nurse is preparing to discharge the patient. What patient education is the most important for the patient's safety in the next few hours? a. How to take care of the wound and identify signs of infection. b. How to obtain the biopsy results. c. Eating and drinking lightly until the nausea from the sedation subsides. d. Avoiding driving or operating machinery for the rest of the day. - CORRECT ANSWER d. Avoiding drinking or operating machinery for the rest of the day. If a patient is screened and found to have hypertension and dyslipidemia, what lifestyle recommendations should be considered? a. Plan for a screening stress electrocardiogram every 5 years. b. Manage weight through diet and exercise. c. Avoid constipation through fluids and high fiber foods to prevent straining to have a bowel movement. d. Because of the risk of kidney damage, drink the equivalent of eight glasses of water daily. - CORRECT ANSWER b. Manage weight through diet and exercise. Healthy people 2020 identifies nationwide priorities for health improvement. Included is an objective that health care providers address health literacy needs by several actions, including: a. Asking the patient to describe how he or she will follow the instructions provided. b. Facilitating access to specialized health services. c. Addressing the patient's emotional readiness to learn. d. Providing more written materials and/or internet resources. - CORRECT ANSWER a. Asking the patient to describe how he or she will follow the instructions provided. A telephone triage RN receives a call from a 45 year old woman complaining of a "migraine headache". The nurse determines this patient has many knowledge deficits related to headaches and their management. What would be an appropriate rationale for deferring the education to another time? a. Migraine headaches are more common in some ethnic minorities, and the nurse is unsure about this woman's ethnic background. b. The patient may not be physically or emotionally ready to learn since she is in significant pain. c. Patients with migraine headaches need to be seen and evaluated by a provider urgently, so the nurse needs to facilitate an urgent appointment or emergency room visit. d. She is unable to provide this patient with the clinic's standard teaching sheet for migraine headaches. - CORRECT ANSWER b. The patient may not be physically or emotionally ready to learn since she is in significant pain. Aspirin therapy has recently been approved for primary prevention of cardiovascular events. However, the risk-to-benefit ratio should be assessed because aspirin is known to increase risk of: a. Hot flashes in post-menopausal women. b. Bronchospasm in patients with asthma c. Gastrointestinal bleeding d. Gall bladder information - CORRECT ANSWER c. Gastrointestinal bleeding Which of the following is cited frequently as a barrier to patient counseling in ambulatory care? a. Lack of interest by patients b. Time constraints for clinicians and the episodic nature of interactions. c. Inability to overcome language barrier and low literacy. d. Lack of community resources and printed materials. - CORRECT ANSWER b. Time constraints for Clinicians and episodic nature of interactions Motivational interviewing has been described as a patient-centered and collaborative method of changing behavior. A feature of motivational interviewing involves individuals who: a. Learn by observing others b. Change behavior in response to reinforcements; increasing rewards for healthy behaviors and decreasing rewards for unhealthy ones. c. Take health related action if they perceive susceptibility to and severity of an illness can be reduced by taking the action. d. Have self-eficacy and can be guided to evaluate their own behavior and generate their own behavior and generate their own solutions to change. - CORRECT ANSWER d. Have self-eficacy and can be guided to evaluate their own behavior and generate their own solutions to change. In providing health education about weight management to a large group, which instructional method is most likely to be successful? a. Case study b. Role playing c. Powerpoint presentation and discussion. d. Simulation exercises - CORRECT ANSWER c. Powerpoint presentation and discussion Whitney, a 24- year-old African American, presented in labor for her first baby, having had no prenatal care. She does not want any extra tests done on her baby, and does not see the reason for hang the baby tested for sickle cell disease, since she had her husband are both healthy. Her nurse would best explain the reason for the testing by saying: a. One in 10 African Americans has sickle cell trait, and 1 in 325 has sickle cell disease. b. Whitney may have sickle cell disease and not know it, because the chronic anemia and vasocculsive effects of sickle cell disease usually occur when a woman is older. c. Although she and her husband may be healthy they may still have sickle cell trait, which could result in disease in their baby. d. There are four major variants of the disease, and she or her husband may have one of the milder forms. - CORRECT ANSWER c. Although she and her husband may be healthy they may still have sickle cell trait which could result in disease in their baby. The goal of performance improvement is to: a. Identify root causes of problems and errors. b. Validate existing knowledge and to generate new knowledge. c. Measure and report the health status of patients. d. Improve the delivery of care. - CORRECT ANSWER d. Improve the delivery of care The ambulatory infusion center has collected data about environmental contamination with chemotherapeutic agents to evaluate their preventive practices and spill management. The findings indicate detectable levels of the agents on the floor in the area of the IV pole near infusion chair#1, but no measurable chemotherapeutic agents elsewhere in the infusion suite. This degree of variation in the data may be called: a. Common-cause variation b. Internal benchmarking c. Special-cause variation d. Prospective data - CORRECT ANSWER C. Special - cause variation The purpose of a rating system for levels of evidence in evidence-based practice guidelines is to: a. Indicate the optimal treatment plan that promotes the best patient outcomes. b. Allow the reviewer to estimate the quality and strength of the evidence. c. Enhance the adoption of best practices d. Demonstrate the strength of the link to national standards. - CORRECT ANSWER b. Allow the reviewer to estimate the quality and strength of the evidence. Which of the following is true about evidence-based practice? a. Relies on established clinical practices from within an organization and the personal experiences of clinicians as the basis for designing practice protocols. b. Integrates research evidence with clinical experience to support the best recommended guideline for practice. c. Best evidence comes from a single descriptive or qualitative study. d. Evidence-based practice measures the outcomes or results of care. - CORRECT ANSWER b. Integrates research evidence with clinical experience to support the best recommended guideline for practice. Questions 30- 32 use this scenario: The group practice is purchasing an office building and renovating it for ambulatory care for both family medicine and medical specialities. It is not adjacent to the hospital, but is in an area that is considered "low crime" and otherwise safe. From a nursing perspective, which of the following is most important regarding the exterior of the building? a. Conveniently accessible via public transportation. b. Signage at the street is visible and clearly describes the facility. c. The parking lot and curbs do not pose fall hazards and allow for wheelchair and stretcher access. d. The facade and landscaping are attractive and congruent with the environment. - CORRECT ANSWER c. The parking lot and curbs do not pose fall hazards and allow for wheelchair and stretcher access. The waiting area for all the specialities is planned for one centralized location, with check in windows for each clinical unit. Privacy of the check in and registration areas is supported by partitioning and sound proofing. A play area for children is planned in one cluster of seating. What other layout issue for the entrance, check-in, and waiting areas would be most important from a nursing perspective? a. The space is warm and welcoming. b. The patient's entrance is separate from the staff entrance. c. There are bulletproof glass enclosures around the cashiers. d. There is a separate waiting space for patients with potentially communicable diseases. - CORRECT ANSWER d. There is a separate waiting space for patients with potentially communicable diseases. Prior to final approval of the space plan, the nurse manager identifies several additional clinical concerns. Which of the following is most important to safe patient care? a. Appropriate containers to hold dirty instruments for transport, disposal, or reprocessing. b. A flag or light system for communicating the status of the exam and treatment rooms. c. Standarized exam room layouts d. Space for patient teaching and nursing interventions in close proximity to the telephone work space. - CORRECT ANSWER a. appropriate containers to hold dirty instruments for transport, disposal or reprocessing. In managing the budget of an outpatient clinic, which of the following would be considered a direct and variable cost of providing patient services? a. Rent of the suite of offices and exam rooms b. Cost of the human resources department, which manages hiring, payroll, and benefits. c. Cost of the vaccines and other stock medications. d. Liability insurance. - CORRECT ANSWER C. Cost of the vaccines and other stock medications The general surgery physician group is planning to hire a bariatric surgeon to provide surgical interventions for patients who are morbidly obese. Which of the following facilities and equipment changes would be most important for staff safety? a. Hallway and doorway clearance will accommodate extra-wide wheelchairs? b. The area to discharge the patient from the clinic is near the exit of the building. c. Patient transfer and lift devices are provided. d. There are hallway safety rails installed. - CORRECT ANSWER c. patient transfer and lift devices are provided. When doing a check on the emergency cart's defibrillator, the nurse finds it fails to charge rapidly to the appropriate level. In contacting the equipment maintenance department, she learns there have been similar issues with several defibrillators in the facility. After assuring well-functioning equipment is in place in the patient care areas, what is the most important action she should take next? a. Assure a report is submitted to the manufacturer and the food and drug administration regarding the equipment failure. b. Negotiate with the manufacturer for replacement or reimbursement for the defective equipment. c. Educate other personnel about the policy regarding use of defibrillators. d. Reassess how many defibrillators and other types of emergency equipment need to be available for patient emergencies across the facility. - CORRECT ANSWER a. Assure a report is submitted to the manufacturer and the food and drug administration regarding the equipment failure. The growth in ambulatory care in the past 20 years has been primarily driven by: a. Increased payment by health maintenance organizations for the use of new technology in outpatient settings. b. Changes in reimbursement that have made it more cost effective to provide care in outpatient settings. c. Patient preferences to have their care delivered in outpatient settings whenever possible. d. Increased demand for services overall, as people are living longer with chronic illness. - CORRECT ANSWER b. changes in reimbursement that have made it more cost effective to provide care in outpatient setting. Which of the following is true about determining staffing in ambulatory care? a. Benchmarking surveys provide ratios that are useful in all ambulatory care specialties. b. There are several well-researched and validated formulas and tools in the literature for determining staffing in ambulatory care. c. Factors that influence staffing include payer mix, types of patient encounters, and requirements for each encounter. d. Primary care clinics and surgical specialty clinics have very similar staffing requirements. - CORRECT ANSWER c. factors that influence staffing include payer mix, types of patient encounters, and requirements for each encounter. Andrew Kim, RN, works as a member of a primary care team. There are multiple other roles on the team, including physicians, nurse practitioners, a clinical pharmacist (PharmD), medical assistants, clerks, and a social worker. A young female patient presents with a conflict in her family, and anxiety that her husband is leaving them. What would Andy's best action be? a. Briefly assess and recommend the social worker's assistance to the patient. b. Refer to outpatient psychiatry for crisis intervention. c. determine if the patient is seeing a counselor' d. Ask the physician to provide the assessment and support functions this patient might require. - CORRECT ANSWER a. Briefly access and recommend the social workers assistance to the patient. [Show Less]
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Test 1- Standards of Nursing Practice/Healthcare Delivery 94 Questions with Verified Answers
Test 1- Standards of Nursing Practice/Healthcare Delivery 94 Questions with Verified Answers The practice of nursing is regulated by: - CORRECT ANSWER... [Show More] State Nurse Practice Acts What organization has legal authority to allow graduates of approved schools of nursing to take the licensing exam? - CORRECT ANSWER State Boards of Nursing Who accredits hospitals and healthcare organizations - CORRECT ANSWER Joint Commision (JCAHO) Who deals with legal stuff? - CORRECT ANSWER The state board. Who provides the NCLEX? - CORRECT ANSWER NCSBN Who represents nurses? - CORRECT ANSWER American Nurses Association Nursing Education - Practical/Vocational - LPN/LVN - CORRECT ANSWER Usually about 1 year to 18 months in length. Requires the NCLEX PN exam to become licensed. Work under the direction of a registered nurse or primary care provider. Work in long term care settings or physician's offices . Don't usually see them in hospitals or acute care settings. Nursing Education - Registered Nursing - Diploma - CORRECT ANSWER 3 year program typically hospital based. Main form until the 1960s. Modeled after the Nightingale Schools of Nursing. Hardly see any of these any more. Pretty intensive programs. A lot of clinical time. Because it was hospital based, you didn't have any degree, just a diploma. Nursing Education - Registered Nursing - ADN - CORRECT ANSWER 2 year nursing program. Emerged during the nursing shortage of WWII. Nursing Education - Registered Nursing - BSN - CORRECT ANSWER 8+ semesters where you do nursing and other college courses. Nursing Education - Graduate - Master's Degree - CORRECT ANSWER 2 to 3 year program for advanced practice nurses to function in a more independent role. Nursing Education - Graduate - Doctoral degree - CORRECT ANSWER DNP is intended to prepare nurses for advanced clinical practice. DNS and PHD are more research based. Clinical Nurse Specialist (CNS) - CORRECT ANSWER Sometimes called a ClinSpec. Have expertise in an area of clinical specialization. Work in hospital or clinical setting but the role is varied. Nurse Practitioner (NP) - CORRECT ANSWER Provide primary care to different populations depending on the specialty. Can work independently. Assess, diagnose, and treat disease and illness. Prescribe medications and can do treatment. Can provide approximately 80% of the care by physicians. Can not do surgery or deliver babies. Medicare will only reimburse 80% (but this is changing). Certified Registered Nurse Anesthetist (CRNA) - CORRECT ANSWER Provide anesthesia and do pre-op screenings as well as post - op. Pricey malpractice insurance. Certified Nurse Midwife -CNM - CORRECT ANSWER Different from someone who just calls themselves a midwife but isn't actually certified. Specializes in women's health. Provide pre natal care, perform uncomplicated deliveries, and provide post natal care. Other Advanced Practice Roles include - CORRECT ANSWER Nurse educators, nurse researchers, and nurse entrepreneurs. Continuing Education (CE) - CORRECT ANSWER Professional strategy to maintain current clinical knowledge. 36 states require continuing education courses to maintain license. Arizona is not one of them. Debate as to whether or not requiring continuing education will actually help nurses keep current. Many feel that it is more of an internal motivation. In - Service Education - CORRECT ANSWER Programs offered at the work site. Provide education at the work site that is usually specific to the facility. Examples include computer education, fire safety, or specialty specific work. Lifelong Learning - CORRECT ANSWER As Florence Nightingale emphasized, you need to stay up to date with nursing education and there are many ways to stay up to date. National Counsel of State Boards of Nursing (NCSBN) - CORRECT ANSWER Non - profit organization through which boards of nursing interact and council on common issues; Develops NCLEX exam; Promotes uniformity in the regulation of nursing practice; Manages Nurse Licensure Compact. Nurse Licensure Compact - CORRECT ANSWER There are 25 states and 6 pending. If a state participates in the compact, it means that if you get licensed in the compact state and you want to go work in a different compact state, you don't have to pay for an additional license. Arizona is part of the compact. State Boards of Nursing - CORRECT ANSWER Define the practice of nursing; Establish Criteria that allow one to be considered an RN or LPN. Determine scope of practice for nurses; Have legal authority to allow graduates of approved schools of nursing to take the NCLEX. Arizona State Board of Nursing Functions - CORRECT ANSWER Issue/Renew nursing licenses/NA certificates; Investigate complaints; Certify NPs, CNSs, and school nurses; survey rn/lpn/na programs; monitor nurses with board stipulations; conduct CANDO program Board Stipulations - CORRECT ANSWER nurses who have gotten in trouble but are allowed to keep their license are monitored by the state board of nursing. CANDO - CORRECT ANSWER Nurses who are addicted and they continue practicing but need to be in the 3 year program. Licensure - CORRECT ANSWER Procedure varies among states (graduate from accredited school and pass NCLEX); Licenses can be revoked Reasons why license can be revoked - CORRECT ANSWER Unprofessional conduct (failure to adhere to standards of care, patient abandonment, driving while intoxicated, child abuse, practicing outside of scope, etc); Malpractice/Negligence (being physically unsafe); Fraud (documenting home health visits that did not happen, falsifying medical records, cheating or assisting others to cheat); Conviction of a felony (if less than 5 years, the applicant is ineligible to apply for certification. If more than 5 years, case by case basis), Misdemeanor (provide information with application; case by case); Mental incapacity (mentally incompetent to a degree that is or might be dangerous. Mental illness that causes distortion of reality); Failure to report (mandated to report certain things like unprofessional conduct, physical or mental impairment, self report felony conviction or misdemeanor charge). Nurse Practice Acts - CORRECT ANSWER Laws established by each state to regulate nursing practice; Designed to protect patients or society; Define minimum education, required certification, and practice guidelines. Scope of Practice - CORRECT ANSWER Nurses must know and perform within their scope of practice; agency policies and procedures should follow scope of practice and standards of car; legal consequences for operating outside of scope. Standards of Practice - CORRECT ANSWER What a reasonable and prudent nurse would do in a similar situation; AKA standards of care, standards of professional performance, and clinical guidelines. Standards of Practice Derived From - CORRECT ANSWER Nurse practice acts - (mandatory standards- laws; Professional organizations (voluntary standards) Other Guidelines for Nursing Practice- Institutional Policies and Procedures - CORRECT ANSWER Remember that they should follow the scope of practice and standards of care for nurses and cant exceed it. Other Guidelines for Nursing Practice- Code of Ethics - CORRECT ANSWER International Council of Nurses (ICN) Code - respect for human rights and support nurses who refuse to perform things that conflict with care; American Nurses Association (ANA) Code -ethical obligations and duties of everyone that enters nursing Other Guidelines for Nursing Practice- Patient Care Partnership - CORRECT ANSWER Like a patient bill of rights. Given to every patient when they come in. Informs them of what they should expect during their stay as far as their rights and responsibilities and what they should receive. Federal Laws and Regulations Guiding Nursing Practice-Emergency Medical Treatment and Act of Labor Act (EMTALA) - CORRECT ANSWER Ensure public access to emergency services regardless of their ability to pay. Also called the "anti dumping law". Federal law that requires that all patients who come to the ER must be screened first regardless of whether they have insurance. Patients used to be just sent to the county hospital. Patients can not be transferred from private to public until they are deemed stable. Federal Laws and Regulations Guiding Nursing Practice-Americans with Disabilities Act (ADA) - CORRECT ANSWER Ensures equal opportunitiy for persons with disabilities for employment. Holds true for nursing profession. HIV is considered a disability. If you are a healthcare worker with HIV, it is you right whether or not you want to disclose that. And you cannot refuse care if a patient is HIV positive. Federal Laws and Regulations Guiding Nursing Practice-Patient Self Determination Act - CORRECT ANSWER Requires that healthcare agencies provide information for patients to make decisions in their care. Must have policy and procedure information about advance directives. Federal Laws and Regulations Guiding Nursing Practice-Health Insurance Portability and Accountability Act (HIPAA) - CORRECT ANSWER Defines the patient's rights in regards to protecting health information. State Laws and Regulations Guiding Nursing Practice-Nurse Practice Acts - CORRECT ANSWER Law that looks over nurse practices. Looked over by the state board of nursing. State Laws and Regulations Guiding Nursing Practice- Mandatory Reporting Laws - CORRECT ANSWER Vary by state. As a nurse, you have to abide by your state mandatory reporting laws. In Arizona, you have the duty to report any incident of unsafe practice, unprofessional conduct, and abuse and neglect of a vulnerable person. State Laws and Regulations Guiding Nursing Practice-Good Samaritan Laws - CORRECT ANSWER Protect nurses who provide emergency care off duty like stopping at the scene of an accident. Requirements for this law to work is that the assistance has to be voluntary. Also covers the failure to act. Informed Consent - CORRECT ANSWER Grants freedom from bodily contact by another person unless consent is given. Required every time a patient comes in. A patient signs the form for admission and routine treatment and also any time there is a special procedure like surgery. Must be complete (needs full explanation of the procedure, risks, benefits, costs, consequences, etc), clear (the patient must understand), and voluntary (no threat of not consenting) Consent in the event of an emergency - CORRECT ANSWER It is assumed that if you are able to consent, you would. Nurse's Role in Consent - CORRECT ANSWER Sign the consent as a witness. Not legally responsible to explain treatment (physician's responsibility) Competence for Consent - CORRECT ANSWER The patient needs to understand the consent and have the ability to make the decision. If not, state law determines who is next of kin. Advance Directives - CORRECT ANSWER Gives individuals the right to receive treatment, make decisions about what you want or don't want prior to you not being able to make those decisions on your own. Wishes in the event that you are unable to communicate them. Advance Directives- DNR/DNAR - CORRECT ANSWER No attempts are going to be made if they stop breathing. Physician writes the order that the patient does not want resuscitation or else it will be attempted. Advance Directives-Living Will - CORRECT ANSWER What healthcare measure should or should not be provided if they become incapacitated. Do you want a feeding tube and if so, how long? As a patient, you can change this at any point. Advance Directives-Durable Power of Attorney for Healthcare - CORRECT ANSWER Appoint someone to make medical decisions for you at the point that you cant make your own decisions. Negligence - CORRECT ANSWER Failure to perform as a reasonable, prudent nurse would OR performing an act that a reasonable prudent nurse under similar circumstances would not do; Failure to follow standards of practice; No intent to harm is present (even if you don't intend to hurt them, you can still be negligent) Malpractice - CORRECT ANSWER Professional form of negligence; Students are held to the same standards as RNs. If someone takes a nurse to court and files a suit to prove malpractice, four elements are necessary to collect damages: - CORRECT ANSWER Existence of a duty (a nurse has a duty to the patient); Breach of duty (prove that there was some sort of breach); Causation (prove that the nurses act or failure to act caused an injury); Damages (if no injury occurred, they can not prove their case but they can still file a complaint with the state board of nursing) Assault - CORRECT ANSWER Threat or attempt to make bodily contact with someone without consent. Battery - CORRECT ANSWER An assault that is carried out. Example of Assault/Battery - CORRECT ANSWER You tell the patient that they need to change into their gown and you come back and they are still in their street clothes and you tell them "if you don't change out into the gown, I will do it for you" would be assault. Actually doing it would be battery. Morals - CORRECT ANSWER Private, personal, or group standards of right and wrong. Ethics - CORRECT ANSWER A systematic study of tight and wrong conduct in situations where there are issues of morals or values Bioethics - CORRECT ANSWER The application of ethical principles to healthcare Nursing Ethics - CORRECT ANSWER Ethical questions that arise out of nursing practice. Value Neutrality - CORRECT ANSWER An attempt to understand one's own values regarding an issue and when to know when to put them aside, when necessary, to become nonjudgemental when providing care to clients. Beneficence - CORRECT ANSWER The duty to do or promote good. Nonmaleficence - CORRECT ANSWER The twofold duty to do no harm and promote good. Autonomy - CORRECT ANSWER A person's right to choose and his ability to act on that choice. Justice - CORRECT ANSWER the obligation to be fair Fidelity - CORRECT ANSWER Faithfulness Veracity - CORRECT ANSWER The duty to tell the truth Accountability - CORRECT ANSWER To be accountable for actions Confidentiality - CORRECT ANSWER The process of keeping information private or secrete. Ethical Issues in Health Care - CORRECT ANSWER AIDS, Abortion, Allocation of healthcare goods and services, Confidentiality/privacy, End-of-life issues, informed consent, organ donation, reproductive technology, compelling unwanted treatment Primary and Preventative Care - CORRECT ANSWER Services to keep the patient well and prevent illness. A lot of the focus is on patient education and screening/early detection. Focus on health promotion, disease prevention, patient education, and screening/early detection. Examples include a healthcare provider's office and a mobile clinic. Secondary Care - CORRECT ANSWER Majority is considered acute care. Focus on diagnosis and treatment of illness, health restoration. Acute care is immediate and short term care including that done by hospitals, surgery centers, and urgent care. The nurse's role in acute care include direct care providers, managers of a unit, supervisors, educators, etc. Teritiary Care includes - CORRECT ANSWER Restorative care (rehabilitative care and home health care) and Continuing Care (long term care/extended care, hospice, and respite care) Tertiary Care - Restorative Care- Rehabilitative care (sub acute care) - CORRECT ANSWER Comprehensive impatient care for the patient that is over the acute phase of the illness but still needs medical care and/or rehab; Goal oriented treatment- rendered immediately after or instead of acute hospitalization. Requires more intensive skilled nursing care than what they would get in LTC. Usually transitional - after the hospital but before they o home or continue to LTC. Tertiary Care - Restorative Care- Home health - CORRECT ANSWER Appropriate when someone needs care that exceeds the care that the patient, family, or friends can provide. Most rapidly growing because it is really cost driven. Can significantly save on health expenses. Primary goal is the promotion of self care. Serves an increasing number of older adults with chronic illnesses but we are trying to help them get to the point where they can continue to take care of themselves at home. Nurses role: provide direct care but the big focus is family education. Tertiary Care - Continuing Care - Long term care (LTC)/extended care - CORRECT ANSWER Skilled nursing facilities: ongoing skilled nursing care to patients who need assistance with ADLs. Different types like nursing homes, behavioral health facilities, rehab, assisted living, etc. Usually anticipated that it is going to be more than a month. Sometimes indefinitely. Tertiary Care - Continuing Care - Hospice - CORRECT ANSWER Palliative and supporting care for dying patients and their families; goal is to promote comfort and quality of life. Tertiary Care - Continuing Care - Respite Care - CORRECT ANSWER Gives primary caregivers time away from responsibilities Regulatory Agencies- Arizona Department of Health Services (state department) - CORRECT ANSWER Speaking specifically about their division of license services. Licenses and monitor health care and child care facilities. They can shut facilities down. Regulatory Agencies - Joint Commission (JCAHO) - CORRECT ANSWER Accrediting body. Voluntary process that the organization can prove an acceptable standard of practice. Required for medicare reimbursement and most insurance. Healthcare Microsystem - CORRECT ANSWER Functional unit within a larger system; Consists of all front line staff and resources working together to improve patient outcomes Nursing roles and Responsibilities - Provider of Care - CORRECT ANSWER Provide patient centered care, follow scope of practice, and directly care for patients. Nursing roles and Responsibilities - Manager of Care - CORRECT ANSWER Nurse often serves as a coordinator for different members of the healthcare team and seek assistance appropriately. Nursing roles and Responsibilities - Member of a Profession - CORRECT ANSWER We have to uphold a professional image and ensure that nursing is seen as the profession it is. Nursing roles and Responsibilities - Patient Advocate - CORRECT ANSWER Involves speaking on behalf of the patient in order to protect his or her right to obtain needed information and services. Outlined in code of ethics for nurses. National League of Nurses (NLN) - CORRECT ANSWER Establish and maintain a universal standard for nursing education. American Nurses Association (ANA) - CORRECT ANSWER National and professional organization that represents RNs. Do a lot of lobbying and manage standards of nursing to promote quality care. Arizona Nurses Association (AZNA) - CORRECT ANSWER Division within ANA. Student nurses association of Arizona (SNAAZ) - CORRECT ANSWER Under the student nurses association. Examples of Being a Patient Advocate - CORRECT ANSWER Respecting patient's right to refuse, maintaining confidentiality, and verifying and questioning orders. Common Areas Requiring Patient Advocacy - CORRECT ANSWER End of life decisions, technological advances, and medical errors. Delegation - CORRECT ANSWER Appointing a person to act on one's behalf; transfer responsibility while retaining accountability. 5 Rights of Delegation - CORRECT ANSWER Right task, Right circumstance, Right peron, right direction/communication, right supervision/evaluation Acronym to remember 5 rights - CORRECT ANSWER TCPDS. Take Care. Please Delegate Safely. (T)ask, (C)ircumstance, (P)erson, (D)irection, (S)upervision. [Show Less]
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Ambulatory Certification Prep - Nursing World Sample Test 25 Questions with Verified Answers
Ambulatory Certification Prep - Nursing World Sample Test 25 Questions with Verified Answers The ambulatory care nurse is teaching a patient who is ne... [Show More] wly diagnosed with diabetes, and cautions the patient against taking nonsteroidal anti-inflammatory medication, because of the: A Additional stress on kidney function. B Additional stress on liver function. C Effect on the liver when combined with an oral hypoglycemic agent. D Interference with insulin absorption. - CORRECT ANSWER Additional stress on kidney function. The most effective strategy for improving patient adherence to the care regimen is to: A Involve the patient's family in the treatment plan. B Partner with the patient in the teaching/learning process. C Reinforce that the patient must follow the plan of care. D Schedule more frequent follow-up visits. - CORRECT ANSWER Partner with the patient in the teaching/learning process. The ambulatory care nurse's decision to delegate duties depends primarily upon A Expertise in clinical pathways. B Self-awareness skills. C Staffing needs. D State regulatory mandates. - CORRECT ANSWER State regulatory mandates. A graduate nursing student is collecting data for a research study and requests a patient's chart. The ambulatory care nurse initially determines: A The purpose of the research study. B The specific data requested by the nursing student. C Whether informed consent has been obtained. D Whether the nursing supervisor has approved the study. - CORRECT ANSWER Whether informed consent has been obtained. A patient with inspiratory and expiratory wheezing from increased asthma attacks requests an adjustment to the prescribed asthma medication. The ambulatory care nurse: A Administers a rescue inhaler. B Asks whether the patient is currently wheezing. C Determines that patient's peak flow measurement. D Refers the patient for a chest x-ray. - CORRECT ANSWER determines that patient's peak flow measurement. The primary responsibility of nursing case management within the home health care setting is to: A Ensure that care is closely monitored. B Ensure that medications are reconciled. C Provide continuity of care. D Provide education on disease self-management. - CORRECT ANSWER provide continuity of care. A patient undergoes an excision of a sebaceous cyst. The ambulatory care nurse provides the patient with specific written and verbal instructions about wound care, signs and symptoms of infection, and when to follow up for suture removal. The nurse demonstrates skill in following up with this patient, post-procedure, by: A Calling the patient, according to facility policy, to evaluate the patient's condition. B Calling the patient to remind him or her not to drive until the next appointment. C Mailing the patient a card reminding him or her to schedule an annual physical. D Mailing the patient a survey to assess the facility's performance. - CORRECT ANSWER calling the patient, according to facility policy, to evaluate the patient's condition. A benefit of protocol use during telephone triage is to: A Develop a flexible treatment plan. B Enhance decision making. C Increase patient compliance. D Provide personalized patient care. - CORRECT ANSWER Enhance decision making. A 20-year-old patient calls the clinic about a friend who has been excessively drinking alcohol all day. The ambulatory care nurse first determines whether the friend is: A Combative. B Exhibiting labored breathing. C Hallucinating. D Slurring his or her speech. - CORRECT ANSWER Exhibiting labored breathing. An older adult patient asks for renewal of a medication for tremors, describing the medication as an oval, pink pill with a scored line in the middle. The pharmacy is closed. The ambulatory care nurse attempts to assist in identifying the medication by: A Advising the patient to call back and schedule an appointment with a social worker. B Informing the patient that he or she may not request a medication renewal until the next scheduled visit. C Setting up an appointment for the patient to see a mental health provider, to rule out dementia. D Using an online resource such as RxList.com or Medscape.com to search for medications that fit the patient's description. - CORRECT ANSWER Using an online resource such as RxList.com or Medscape.com to search for medications that fit the patient's description. A self-management priority for a patient with asthma is to provide quick relief therapy for: A Bronchospasm. B Hives. C Triggers. D Wheezing. - CORRECT ANSWER Bronchospasm The ambulatory care nurse demonstrates knowledge of factors involved in obtaining an accurate medication reconciliation during a patient's office visit, when he or she says: A "Holistic products do not need to be included on the record." B "Medications prescribed by other providers do not need to be included on the record." C "Natural products may interact with other drugs." D "Over-the-counter products and herbal supplements are not considered medications." - CORRECT ANSWER Natural products may interact with other drugs." After a stroke, a patient is referred to a rehabilitation facility. The effects of stroke include aphasia, left-sided paresis, and difficulty swallowing. Which consultation service does the ambulatory care nurse prioritize for this patient? A Occupational therapy. B Physical therapy. C Social services. C Speech therapy. - CORRECT ANSWER Speech therapy. As the case manager of a patient's treatment activities, the ambulatory care nurse meets with each team member. The nurse observes that the primary care provider's plan for the patient is inconsistent with the team leader's plan of intervention. To achieve a consistent approach, the nurse: A Calls a team meeting, so that all members can share their understanding of the patient's needs. B Conducts a literature review for treatment plan options. C Contacts the primary care provider and tells him or her of the disparate approaches. D Monitors the inconsistencies and presents them to the unit manager. - CORRECT ANSWER Calls a team meeting, so that all members can share their understanding of the patient's needs. A 15-year-old mother who has a three-month-old infant develops a nonemergent illness requiring hospitalization. The consent for admission and treatment is properly signed by the: A Ethics committee. B Infant's grandparent. C Infant's mother. D Mother's legal guardian. - CORRECT ANSWER Infant's mother. Which diagnostic measurement, for a 74-year-old African-American male patient with diabetes mellitus, indicates the need for a multidisciplinary team approach? A A blood pressure of 118/60 mm Hg. B A low-density lipoprotein level of 100 mg/dL. C A microalbuminuria less than 30 mcg/mg. D A serum creatinine level of 2.2 mg/dL. - CORRECT ANSWER A serum creatinine level of 2.2 mg/dL. The ambulatory care nurse meets with a patient with chronic renal failure, whom the health care team thinks is an excellent candidate for home hemodialysis. Using the principles of therapeutic communication, the nurse asks the patient: A "Are you aware that nurses will come to your home to help with your care?" B "Did you know that it is possible to have a dialysis machine in your home?" C "Is there anyone in your home who might be willing to help care for you?" D "Would you like to hear the plan of care that we chose for you during our case conference today?" - CORRECT ANSWER "Did you know that it is possible to have a dialysis machine in your home?" A middle-age patient, who comes to the clinic in dirty clothes with a foul odor, reports feeling scared and stalked. To build trust and rapport, what is the ambulatory care nurse's most appropriate action? A Assuring the patient that he or she will be seen today. B Offering the patient something to drink and a safe place to relax, before interviewing him or her. C Recommending that the patient talk with a social worker today. D Suggesting that the patient find a homeless shelter, or seek help at the public health clinic. - CORRECT ANSWER Offering the patient something to drink and a safe place to relax, before interviewing him or her. An ambulatory care nurse demonstrates cultural competency by: A Learning the patient's health beliefs. B Practicing the patient's customs. C Speaking to the patient in his or her native language. D Teaching the patient what he or she needs to know. - CORRECT ANSWER Learning the patient's health beliefs. The Hispanic-American parent of an 11-year-old patient reports that the child has fainted on several occasions. Upon questioning the parent, the ambulatory care nurse learns that a curandera, or shaman, has administered blood pressure medication to the normotensive child to treat evil spirits. To successfully care for the child, the nurse's action is to: A Administer IV fluids. B Evaluate the parent's beliefs about illness and healing. C Interview the patient and the parent separately. report the family to Child Protective Services. - CORRECT ANSWER Evaluate the parent's beliefs about illness and healing. An ambulatory clinical practice council (CPC) provides an important venue in which the ambulatory care nurse can: A Discuss focused outpatient, nursing-sensitive indicators. B Participate in developing ambulatory care operating budgets. C Participate in developing evidence-based ambulatory care practice changes. D Receive information from various hospital-wide committees. - CORRECT ANSWER Participate in developing evidence-based ambulatory care practice changes. The school nurse examines a 14-year-old male student who reports feeling feverish for days. The student has a temperature of 102°F (38.9°C), a cough, and a generalized red, blotchy rash. After notifying the student's parents and sending him home from school, the nurse's next action is to: A Hold an immunization clinic. B Notify the parents of all students of a potential measles outbreak. C Report a suspected case of measles to the local health department. D Review the records of all students to determine their immunization status. - CORRECT ANSWER Report a suspected case of measles to the local health department. Which question demonstrates advocacy within the health care organization for ambulatory care nursing? A "How does the ambulatory care nurse ensure that patients sign their advance directives?" B "How does the ambulatory care nurse formulate a discharge plan on the day of discharge?" C "How does the ambulatory care nurse manage care for the patient and family as defined by the profession?" D "How does the ambulatory care nurse provide quality care in a cost-containment environment?" - CORRECT ANSWER "How does the ambulatory care nurse provide quality care in a cost-containment environment?" The most appropriate method for teaching insulin self-administration to a patient who is newly diagnosed with type 2 diabetes is to: A Enroll the patient in a group class on diabetes. B Offer a brief demonstration and request a return demonstration. C Provide the patient with written instructions on insulin administration. D Show a video that demonstrates insulin self-administration. - CORRECT ANSWER Offer a brief demonstration and request a return demonstration. Which activity is an example of secondary prevention? A Administering an inactivated poliovirus vaccine. B Conducting screening tests for visual defects. C Fitting a prosthetic limb. D Providing a walker to prevent falls. - CORRECT ANSWER Conducting screening tests for visual defects. [Show Less]
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Nursing Professional Development Certification Review 54 Question with Verified Answer,100% CORRECT
Nursing Professional Development Certification Review 54 Questions with Verified Answers Behaviorist Learning Theory - CORRECT ANSWER Produces the desir... [Show More] ed behavior change with + stimulus/environment-Ed role provides (+ this )John Watson developed-focuses on observable measurement-learning occurs with repetition practice and immediate reinforcement Cognitive Learning Theory - CORRECT ANSWER Learner directed active process of information learning based on experiences, learning style, perceptions ,social influences Ed role: to consider all the above when presenting content Humanist Learning Theory - CORRECT ANSWER Individuals are unique, autonomous, and wants to grow in a + way. self directed learning and life experiences are needed; self evaluation, internal motivation, self concept, self discovery, changes personality, attitude, and behavior.Ed role: To facilitate learning rather than serve as source of all information Brain Based Learning Theory - CORRECT ANSWER Requires to use all components of the brain engagement goal is to be transferred to long term memory. Utilizes application, practice, booster learning, reflection, information should be meaningful Ed role: use videos , case studies that evoke emotion to facilitate memory Multiple Intelligence Learning Theory/Styles - CORRECT ANSWER 8 different types = bodily-kinesthetic ,spatial linguistic, logical mathematical, musical, interpersonal, intrapersonal naturalist. moral , spiritual, intelligences ( Howard Gardner) Ed role: to use profile to design meaningful learning Psychodynamic Learning Theory - CORRECT ANSWER (Alfred Alder)-Individual psychology; maintains self assertion limitations can lead to inferiority complex- developing personality, working toward superiority, psychologically healthy, unity of personality-unconscious and conscious work together to reach "perfect self" Peck Learning Theory - CORRECT ANSWER Developed from Erickson's developmental theory-stages of life affect learning-important tasks needed in middle age and older adult Attribution Learning Theory - CORRECT ANSWER (Bernard Weiner) focuses on explaining behavior-people attribute cause of behavior classified as: locus of control (internal/external), stability of causes, and ability to control causes. Cognitive Dissonance Learning Theory - CORRECT ANSWER (Leon Feininger) When you know cognitive knowledge but still do not do the behavior change-. Smoker example Theory of Social Learning - CORRECT ANSWER (Bandura) Learning develops from observation and organizing and rehearsing behaviors modeled. Conditions needed: attention, retention, reproduction, motivation. Example preceptor The Health Belief Model (HBM) Learning Theory - CORRECT ANSWER Used to predict health behavior -states a person tries to avoid negative consequences 6 perceptions: susceptibility, severity, benefit, barriers, action cues, self efficacy. Education focuses on negative consequences to change behavior . Example quit smoking to avoid HF,PD Learning Theory of Reasoned Action - CORRECT ANSWER (Fishbein/Ajzen) based on idea that actions can be predicted according to the person's attitude toward the action and perceptions of action. concepts: attitude, subjective norms, behavioral intention. Learning Theory Planned Behavior - CORRECT ANSWER (Ajzen) evolved from Reasoned Action theory-more successful in predicable action added concept of perceived behavior control beliefs are central and interact with intention, action, confidence to make + outcome looks at emotions such as fear, etc.. in predicting Adult Learner Strategies (Knowles-Theory of Andragogy) - CORRECT ANSWER Ed Role: recognize other responsibilities may interfere with readiness to learn and participation need to be flexible in schedule, teaching strategies, and options to make it convenient to learner. Adults want to be a part of planning, bring experiences, need to value KSA, give time to work through learning, provide positive feedback, assess motivation, respond to behavioral cues Voluntary learner, problem centered, knowledable, self directed Principles of Adult Learning (Knowles) - CORRECT ANSWER practical and goal oriented-Self directed responsible for own learning, knowledgeable-bring life experiences, Motivated-respond to both intrinsic and extrinsic motivators- self esteem, promotion; Relevancy oriented -need to explain how information will be applied-clear objectives Teaching Definition - CORRECT ANSWER An art and science in which structured , sequenced information and experiences are transmitted to produce learning. Leaning Definition - CORRECT ANSWER Occurs when a person changes behavior, mental processing, or emotional functioning as a result of exposure to new knowledge or experiences Benner's Novice to Expert Model - CORRECT ANSWER Novice-no background or experience, Advanced beginner- some experience needs extensive experience, Competent-2-3 yrs sense of mastery performs day to day unless major variation occurs, Proficient-global aspects of situations recognizes variations and knows how to modify plans, Expert- intuitively grasps each situation and problem solves creatively and effectively. VARK Assessment of Sensory Learning Style - CORRECT ANSWER Visual, Auditory, Read/Write, Kinesthetic tool to measure sensory learning Ed Role should use this information to develop approp learning. Myers & Briggs - CORRECT ANSWER Personality learning styles- Extraversion/Introversion, Sensing/Intuition, Thinking/Feeling, Judging/Perceiving Dunn and Dunn Learning Style - CORRECT ANSWER 5 stimuli elements affect learning: Environmental, emotional, sociological, physical, and psychological Right Brain/Left Brain/Whole Brain - CORRECT ANSWER (Roger Sperry) right and left brain hemispheres have different functions. Left brain 70%; right brain creative, drawing, images, lags in organization, enjoys change, Left brain: critical analytical, likes talking and writing, enjoys stability, organized, time oriented prefers algebra. Field Independent and Field Dependent learning style - CORRECT ANSWER people are categorized by group embedded figures test (GEFT) ; Field independ- internal frame of reference unaffected by peer pressure, learn by organized materials, impressionable prefer lecture -Field depend- more externally focused easily affected by peer pressure ,social, prefer discussion Kolb's Learning Styles-Model - CORRECT ANSWER Adults refine learning over time; meaning attached to learning four modes: concrete, experience (feeling) , reflective observation(watching), abstract conceptualization(thinking), and active (doing)-Diverger (feeling and watching) /Assimilator (watching and thinking)/Converger (thinking and doing)/Accommodator(doing and feeling) Audio/Visual Tutorial teaching model - CORRECT ANSWER Effective for supplementary material and for independ study Independent Study teaching model - CORRECT ANSWER Geared toward self paced web based or paper may include audio visual Goal focused teaching model - CORRECT ANSWER Learners presented with a goal and all content aimed at achieving goal Guided focus teaching model - CORRECT ANSWER Learner takes places outside of formal classroom materials provided or recommended Anchored teaching model - CORRECT ANSWER Activities based on problem solving in relation to realistic case studies Collaborative teaching model - CORRECT ANSWER Learners work together to complete a learning activity or project Project based teaching model - CORRECT ANSWER learners develop materials regarding a topic Problem based teaching model - CORRECT ANSWER learners work in teams to solve problems Cognitive Apprenticeship teaching model - CORRECT ANSWER Instructors model and learners analyze and apply processes Simulations teaching model - CORRECT ANSWER Learners actively participate in simulated activities Direct Instruction teaching model - CORRECT ANSWER Instructor-focused presentation Cooperative teaching model - CORRECT ANSWER Small teams work together through activities to master a subject with each member responsible for self -learning Benjamin Bloom's Taxonomy -Learning styles - CORRECT ANSWER 3 types of learning -Cognitive-knowledge/comprehension, Affective-valuing accepting, Psychomotor-sensory to learn tasks , performs Clinical Ladder - CORRECT ANSWER Often uses Benner novice to expert with categories such as leadership, education, clinical practice,research, and professional development-NPD can use this to engage clinical nurses in education, mentor nurse in professional practice. Baby Boomers (1946-1964) - CORRECT ANSWER Enjoy learning and have a passion to achieve success and want to make a difference in the world. Value teamwork and personal gratification in the workplace. Respond best when treated as equals, life experiences incorporated in learning and team activities. Generation Xers (1965-1980) - CORRECT ANSWER "latch key" generation-value work place balance, flexibility, and loyalty to self. Prefer self directed learning o n their terms and stimulating visual or live activities that are fun Millennials-Generation Y ( 1981-2001) - CORRECT ANSWER Grew up globally and with technology-comfortable with diversity. Highly motivated and recognize that knowledge and skills increase their job marketability. little company loyalty. Enjoy varied educational strategies for creative interactive exercises. Information Processing Model of Memory - CORRECT ANSWER Sensory memory, working memory, and long term memory. It is important to gain the learner's attention and help the learner recall previous learning. Repetition and explanation can help to facilitate encoding and asking for demonstrations of skills and providing feedback can reinforce learning and aid in retrieval. leadership and Communication -SMART Goals - CORRECT ANSWER Specific, Measureable, Attainable, Realistic, Timely,-Evaluate and revise when needed Leadership and Communication-SWOT -Analysis - CORRECT ANSWER Strengths, Weaknesses, Opportunities, Threats Ethical and Legal-Just Culture - CORRECT ANSWER Model that recognizes that individual practioners should not be held accountable for system failings over which they have no control. It does not tolerate conscious disregard of clear risks to patients or gross misconduct. Evaluation Definition - CORRECT ANSWER Systematic,ongoing process based on criteria-used to improve effectiveness of educational programs and to make sure meet the standards of accreditors. Needed for benefit-cost ratio of learning. organized, thorough assessment of educational endeavors. Assigns worth, value and merit to the educational program. Evaluation Type-Competency Based - CORRECT ANSWER Assessment of a nurse's demonstrated ability to satisfactorily perform specific behaviors essential to the role of the nurse and requirements of the job description Criterion-referenced evaluation type - CORRECT ANSWER Evaluation of behaviors in light of specific predetermined criteria such as AHA-BLS Norm Referenced Evaluation type - CORRECT ANSWER Evaluation of the achievement of a learner compared to that of other learners-reported as scores such as SAT Formative or Process Evaluation type - CORRECT ANSWER Evaluation of the design process with the purpose of making changes to achieve the goals of the program or to improve outcomes. Measures-student achievement and satisfaction, Curriculum trained observer, Program faculty and course evaluations Summative or Outcome Evaluation type - CORRECT ANSWER Evaluation that occurs upon completion of the learning activity and is used to determine final outcomes; provides information to determine program adoption, continuation or expansion. Link quality to mission, goals, and objectives, quality indicators, patient safety indicators, benchmarking Evaluation Method-Kirkpatrick's Four Levls - CORRECT ANSWER Reaction, Learning, Behavior, and Results Evaluation Method-RSA Model-five levels - CORRECT ANSWER (Robert S. Abruzzese) Process, Content, Outcome, Impact, Total Program Evaluation Method- CIPP Model - CORRECT ANSWER (Stufflebeam) Formative as you go and Summative at the end; Context-data planning, prioritizing, Input-internal and external resources, Process-Is it being done?, Product -outcomes of success [Show Less]
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Ch 3 &4. Nursing Licensure and Certification Exam 22 Questions with Verified Answers,100% CORRECT
Cherry & Jacob Ch 3 &4. Nursing Licensure and Certification Exam 22 Questions with Verified Answers 1. The advanced practice nurse who is seeking inform... [Show More] ation about requirements for practice in a specialized area should contact the: a. American Nurses Association (ANA). b. National League for Nursing (NLN). c. American Nurses Credentialing Center (ANCC). d. National Council of State Boards of Nursing (NCSBN). - CORRECT ANSWER ANS: C The nurse should contact the ANCC to determine the education, experience, and examination requirements that must be met if one is to become certified. p. 63 |p. 71 2. The primary purpose of licensure for RNs is to: A. prevent others from using the title nurse. B. demonstrate a specialized body of knowledge. C. protect the public. D. enhance recognition for the profession. - CORRECT ANSWER ANS: C Protecting the public is one of the essential purposes of the state board of nursing, which regulates licensure. p. 65 3. Nurse practice acts: A. are written and passed by legislators. B. cannot be influenced by special interest groups. C. reflect only the concerns of RNs. D. are affected by the practice of dentists. - CORRECT ANSWER ANS: A Just as other sections of state codes are written and passed by legislators, so is the nurse practice act of each state. p. 69 4. To ensure that nursing legislation is current and is reviewed by specific dates, if a nurse practice act fails to be reviewed, it is automatically rescinded under which law? A. Nurse review act B. Sunset legislation C. Mandatory revocation D. Grandfathering - CORRECT ANSWER ANS: B Sunset legislation may be included in a state's nurse practice act, and this means that the act must be reviewed by a specific date; if not, it is automatically rescinded. p. 70 5. Current trends in telecommunications and increased mobility of nurses have led to the approval of a mutual recognition model of nursing regulation, in which nurses are allowed to practice in states that are compact states without obtaining a license in each state. On which website would a nurse find a list of current compact states? A. National League for Nursing (NLN) B. National Council of State Boards of Nursing (NCSBN) C. American Association of Colleges of Nursing (AACN) D. Commission on Collegiate Nursing Education (CCNE) - CORRECT ANSWER ANS: B The NCSBN website contains this information. pp. 70-71 6. The first field of nursing to certify advanced practitioners was the field of: A. adult nurse practitioners. B. nurse-midwifery. C. clinical nurse specialist. D. nurse anesthesia. - CORRECT ANSWER ANS: D In 1946, nurse anesthesia became the first field of nursing practice to certify advanced practitioners. pp. 71-72 7. A graduate of a nursing school in the United States plans to practice nursing in Paris, France. To request licensure to practice in Paris, the nurse: A. must contact the Graduates of Foreign Nursing Schools to complete a special examination. B. realizes that education in the United States is so generalized that he or she is eligible to practice in other countries without additional licensure. C. is required to take a language proficiency examination for the primary language of that particular country, as well as a cultural assessment test, prior to licensure. D. should contact the International Council of Nurses or the nursing regulatory board of that country. - CORRECT ANSWER ANS: D A nurse who is interested in practicing internationally may contact the International Council of Nurses or the nursing regulatory board of the country in which he or she wishes to practice. p. 69 8. A nurse who is licensed in Georgia and moves to Oregon: A. just check Oregon's nurse practice act related to licensure for endorsement. B. will automatically be grandfathered in as a licensed registered nurse. C. may request certification in Oregon rather than licensure, so as not to have to retake the NCLEX-RN®. D. should contact the American Nurses Credentialing Center to determine whether he or she is eligible to practice in an another state. - CORRECT ANSWER ANS: A Endorsement refers to the original program whereby a nurse who is licensed in one state can apply and seek licensure in another without undergoing repeat examination, in accordance with the nurse practice act of that state. p. 68 9. When practicing in a compact state: A. the nurse must abide solely by the practice act of the largest state. B. patients' rights in relation to the nurse practice act are protected by the mutual recognition model. C. the nurse must pay for a license in all states that participate in the mutual recognition model. D. the nurse must refer to the nurse practice act for the list of skills that can be performed. - CORRECT ANSWER ANS: B Nurses who practice in a compact state are responsible for following the laws and regulations of each state in which they practice. pp. 70-71 10. When participating in a nurse licensure compact, the nurse: A. is held responsible for complying with the nursing practice laws in the state where practicing at the time care is rendered. B. must purchase a license in each state but does not retake the licensure examination. C. determines residency based on the state where educated as registered nurse. D. may practice using one license in any state or territory in the United States that recognizes the NCLEX as the source of licensure. - CORRECT ANSWER ANS: A The nurse is accountable for practicing according to the state practice laws where patient care was provided, although disciplinary action is the responsibility of the state of the nurse's residency. pp. 70-71 11. A new graduate from a master's entry program in nursing announces, "I just passed my clinical nurse leader certification examination." Certification as a clinical nurse leader: A. is granted by the state board of nursing. B. denotes minimum level of knowledge and skills to practice safely. C. allows independent nursing practice, often in primary care. D. recognizes achievement of advanced skills and knowledge. - CORRECT ANSWER ANS: D Certification provides validation of achievement of advanced education and competence. p. 71 12. A nurse holds a license in one state but wishes to practice in a second state that is not participating in a nurse licensure compact agreement. The nurse is granted licensure on payment of a fee but does not retake the licensure examination. The nurse obtains licensure in the second state: A. by licensure and by endorsement. B. through mandatory continuing education. C. by the statutory process known as being grandfathered. D. through sunset legislation. - CORRECT ANSWER ANS: A Licensure by endorsement allows a nurse licensed in one state to obtain licensure to practice in a second state without examination. p. 68 13. A nurse practicing in the early 1900s was awarded a permissive license. These licenses: A. were voluntary; however, a nurse who failed the examination could not use the title RN. B. required a maximum of 1 year of formalized nurse training. C. allowed nurses who did not pass the licensure examination to still practice. D. allowed nurses the choice of taking a written or oral licensure examination. - CORRECT ANSWER ANS: A These permissive licenses permitted but did not require nurses to become registered. p. 65 14. A group of registered nurses with ADN degrees are concerned that the minimum educational standard for licensure as a registered nurse is being raised to the bachelor's (BSN) level. After contacting the American Nurses Association, they learn they will be "grandfathered" in. Under the "grandfather clause," nurses with associate degrees will: A. Be required to complete a bridge program to earn a BSN and then be tested only on material that was not part of the ASN curriculum. B. Continue to use the title "registered nurse." C. Have 10 years to obtain a BSN or the license will be revoked. D. Use whatever title is established for associate degree nurses. - CORRECT ANSWER ANS: B All ASNs licensed before the change would be "grandfathered" in, allowing them to use the title of RN. p. 63 15. Who establishes the "rules" for nursing practice? A. Individual state boards of nursing B. Employer, based on area of practice C. United States Department of Health and Human Services D. Local health officials - CORRECT ANSWER ANS: A The State Practice Act of each state establishes the rules for practice within that state. pp. 68-69 16. A nurse is completing the degree requirements for an advanced practice role as a nurse practitioner and is concerned about certification requirements. Which statement concerning certification for advanced practice is true? A. All states require certification for all specialty roles that are identified as advanced practice. B. Nurse anesthetists and nurse-midwives are the only advanced practice role that require certification in the state nurse practice acts. C. Scope of practice remains unclear in state nurse practice acts due to the increasing number of new advanced practice roles. D. Certification is automatic when the nurse applies for an advanced practice license. - CORRECT ANSWER ANS: A All states require evidence of certification in the specialty area, and many require periods of practice in the specialty prior to awarding certification status. p. 68 17. Nurses in Tennessee, Mississippi, and Arkansas gather for a conference related to improving quality and safety in practice and nursing education. They are awarded continuing education (CE) credit for participation and evaluation of the conference. One nurse from California states, "I need these CEs to renew my license." The nurse from Mississippi replies, "You do not need CEs for license renewal or advance practice certification renewal." Which statement about CEs would help these nurses? A. All states require proof of continuing education for renewal of license with the number of hours varying. B. The purpose of continuing education is to ensure competence of the workforce after graduation, but each state determines if CEs are required. C. Continuing education is required if nurses work across state lines. D. Initial licensure provides evidence of a minimum safety and competence, so it is illegal for states to require continuing education for renewal of license. - CORRECT ANSWER ANS: B CE is important to ensure continued competency, and each state determines if CEs are mandatory for renewal and how many units are needed. p. 68 18. A nurse who wishes to practice in another state: *(select all that apply)* A. Must retake the NCLEX-RN for that state. B. Should determine whether the state is a compact state. C. May obtain licensure by endorsement. D. Must revoke licensure in the current state because nurses cannot be licensed in more than one state concurrently. - CORRECT ANSWER ANS: B, C If the state is a member of a compact state, that state has established an agreement with other states under which nurses are permitted to practice within the state without additional licensure. Licensure by endorsement refers to the original program whereby nurses who are licensed in one state seek licensure in another state without repeat examination. p. 68 19. Which statements concerning licensure as a registered nurse are correct? *(select all that apply)* A. Nurses who graduate from different types of nursing education programs are granted different types of licenses, those with a baccalaureate degree having the most expanded role. B. A nursing license cannot be revoked, only suspended. C. Each nurse practice act describes requirements for initial licensure. D. It is illegal for states to ask about the mental or physical status of an applicant. E. Students who graduate in the top 10% of their class are exempt from taking the NCLEX-RN for licensure. F. Candidates for licensure must present proof of graduation as required by the state. - CORRECT ANSWER ANS: C, F A section of each nurse practice act describes requirements and procedures that are necessary for initial licensure. Candidates for licensure must submit evidence of graduation as defined by each state. pp. 67-68 20. A group of graduates were just notified that they had successfully passed the licensure examination. During the orientation process at the hospital, one asks, "I am looking at my license, but I don't really know the duties performed by the board of nursing." The staff development nurse explains that the board of nursing: *(select all that apply)* A. Grants nursing licensure. B. Constructs the licensure examination. C. Assigns disciplinary action when the nurse acts in a manner that results in harm to a patient. D. Members are appointed. E. Conducts certification examinations for advanced practice nurses. - CORRECT ANSWER ANS: A, C, D The board of nursing ensures that nursing licenses are granted and renewed. The board of nursing assigns disciplinary action when provisions of the nurse practice act are violated. Members are appointed. pp. 68-69 21. A nursing student is in the final term of an Associate Science of Nursing (ASN) program and is preparing for licensure. Prior to licensure the candidate must provide evidence of: (select all that apply) A. Graduation from a nursing program. B. Graduation from high school or high school equivalency. C. Evidence of current malpractice insurance. D. Evidence of plan to continue study to obtain a minimum of a BSN within 2 years. E. Validation of skills competence provided by a certifying agency. - CORRECT ANSWER ANS: A, B Candidates for licensure must provide evidence of graduation through transcripts of course work or letter from the Dean/Director of the nursing program. All candidates must show evidence of graduating from high school or earning a GED. pp. 67-68 22. The primary purpose of licensure is protection of the ___________. - CORRECT ANSWER ANS: public p. 65 License - CORRECT ANSWER Permission to engage in an activity; a professional license allows the holder to engage in a specific activity for compensation Nurse practice acts (NPAs) - CORRECT ANSWER State or territorial statutes that define the legal limits for the practice of nursing within that state or territory and explicitly identify the requirements for licensure Delegation - CORRECT ANSWER The process y which a registered nurse directs another person to perform nursing skills and activities that the person would not normally carry out while still retaining accountability for those activities Nurse Licensure compact (NLC) - CORRECT ANSWER A form of interstate compact specific to nurse licensure that provides an agreement between two or more states for the purpose of recognizing nurse licensure between and among a group of participating states. States must enter into one in order to achieve mutual recognition Mutual recognition model - CORRECT ANSWER A model that allows a nurse to have one license in his or her state of residency with the ability to practice (electronically or physically) across state lines in other states that participate in this model if there are no restrictions on his or her license and that person acknowledges that he or she is subject to each state's practice laws and rule Licensure - CORRECT ANSWER The process by which a state or governmental agency grants permission to an individual to engage in a given profession for compensation Certification - CORRECT ANSWER "A process by which a nongovernmental agency or association certifies that an individual licensed to practice a profession has met certain predetermined standards specified by that profession for specialty practice" Standard of care - CORRECT ANSWER The degree of care, expertise, and judgement exercised by a reasonable person under the same or similar circumstances. Depicts a standard or measure of behavior that describes how a nurse is expected to act or professionally conduct him or herself according to an accepted reasonable practice of nursing care State board of nursing (BON) - CORRECT ANSWER Provides a governmental oversight, state specific licensing/regulatory body that set standards for safe nursing care, decides the scope of practice for nurses with in the states jurisdiction and issues a license to qualified nurse within a state that the board regulates Functions of the state boards of nursing - CORRECT ANSWER Issue licenses and manage for new process. Establish nursing practice standards. Regulate advanced practice nursing. Approved operation of nursing education programs. Investigate complaints against licensed practitioners. Whole disciplinary hearings, suspending are revoking licensure if necessary. Promulgate all rules related to the regulation of nursing practice. NLC and advance practice RN compact - CORRECT ANSWER Are model pieces of legislation designed to advance public protection and access to care through mutual recognition of one state-based license that is enforced locally and recognized nationally Uniform licensure requirements (URLs) - CORRECT ANSWER Standards for licensure, provides additional protection for the public; successful graduation from high school/GED, successful graduation from nursing school, application for licensure, payment of fees, criminal background check. Simply passing the and NCLEX does not grant licensure. Magnet status - CORRECT ANSWER Is an award given by American nurses credentialing center at hospitals that satisfy specific criteria based on the strength and quality of nursing the facility. Based on strength and quality of nursing. Licensure - CORRECT ANSWER Legal certification Certification - CORRECT ANSWER Granting of credentials that indicate specialize level of competency Nurse Practice Act (NPA) - CORRECT ANSWER State or territorial that shoots that define the legal limits for the practice of nursing within that state or territory and explicitly identify the requirements for licensure Six critical elements of nurse practice acts - CORRECT ANSWER Authority and composition of a BON. Educational program standards. Scope of nursing practice with accompanying standards. Types of licenses and titles. Licensure requirements. Grounds for disciplinary action. [Show Less]
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