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NR222 Exams Questions with correct Answers 2023
Nursing process A series of steps that lead to accomplishing some goal or purpose. ADPIE Assessment, Diagnosis, Planning and outcome identificatio... [Show More] n, Implementation, Evaluation Assessment Includes information collection, verification, organization, interpretation, and documentation of data. Types of assessment Comprehensive-provides baseline client data. Focused-limited to a particular need or health care concern. Ongoing-includes systematic monitoring of specific problems. Subjective Data data from client's point of view, and include perceptions, feelings, and concerns. Collected by interview. Objective Data observable and measurable, obtained through both physical examination and the results of lab and diagnostic testing. Diagnosis Clinical judgment about individual, family, or community response to actual or potential health problems/life processes. Provides the basis for client care through the remaining steps. Medical Diagnosis A medical diagnosis is a clinical judgment by the physician that identifies or determines a specific disease, condition, or pathological state. Two Part Nursing Diagnosis Part one-problem statement or diagnostic label describing the client's response to actual or risk health problem or wellness condition. Part Two-etiology or the related cause or contributor to the problem. Three Part Nursing Diagnosis Part one-diagnostic label. Part two-etiology. Part three-defining characteristics, or signs and symptoms, subjective and objective data, or clinical manifestations. Types of Nursing Diagnoses Actual nursing diagnosis-indicates that problem exists. Risk nursing diagnosis-indicates that specific risk factors are present. Wellness nursing diagnosis-client's statement of desire to attain a higher level of wellness in some area of function. Planning and outcome identification Includes establishing guidelines for the proposed course of nursing action and developing the client's plan of care. Initial Planning developing a preliminary plan of care. Ongoing Planning updating the client's plan of care. Discharge Planning anticipating and planning for the client's needs after discharge. Implementing The performance of the nursing interventions identified during the planning phase. Evaluation Determines whether client goals have been met, partially met, or not met. Ongoing evaluation is essential for the nursing process to be implemented appropriately. [Show Less]
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NR 222- Questions with correct Answers 2023
A 6-month-old child from Guatemala was adopted by an American family in Indiana. The child's socialization into the American midwestern culture is best des... [Show More] cribed as: A. Assimilation. B. Acculturation. C. Biculturalism. D. Enculturation. D. Enculturation. Socialization into one's primary culture as a child is known as enculturation. A 46-year-old woman from Bosnia came to the United States 6 years ago. Although she did not celebrate Christmas when she lived in Bosnia, she celebrates Christmas with her family now. This woman has experienced assimilation into the culture of the United States because she: A .Chose to be bicultural. B. Adapted to and adopted the American culture. C. Had an extremely negative experience with the American culture. D. Gave up part of her ethnic identity in favor of the American culture. B. Adapted to and adopted the American culture. Assimilation results when an individual gradually adopts and incorporates the characteristics of the dominant culture. To enhance their cultural awareness, nursing students need to make an in-depth self-examination of their own: A. Motivation and commitment to caring. B. Social, cultural, and biophysical factors. C. Engagement in cross-cultural interactions. D. Background, recognizing her biases and prejudices. D. Background, recognizing her biases and prejudices. Cultural awareness is an in-depth self-examination of one's own background, recognizing biases and prejudices and assumptions about other people. Which of the following is required in the delivery of culturally congruent care? A. Learning about vast cultures B. Motivation and commitment to caring C. Influencing treatment and care of patients D. Acquiring specific knowledge, skills, and attitudes D. Acquiring specific knowledge, skills, and attitudes Specific knowledge, skills, and attitudes are required in the delivery of culturally congruent care. A registered nurse is admitting a patient of French heritage to the hospital. Which question asked by the nurse indicates that the nurse is stereotyping the patient? A. "What are your dietary preferences?" B. "What time do you typically go to bed?" C. "Do you bathe and use deodorant more than one time a week?" D. "Do you have any health issues that we should know about?" C. "Do you bathe and use deodorant more than one time a week?" Nurses need to avoid stereotypes or unwarranted generalizations about any particular group that prevents further assessment of the individual's unique characteristics. When action is taken on one's prejudices: A. Discrimination occurs. B. Delivery of culturally congruent care is ensured. C. Effective intercultural communication develops. D. Sufficient comparative knowledge of diverse groups is obtained. A. Discrimination occurs. Prejudices associate negative permanent characteristics with people who are different from the valued group. When a person acts on these prejudices, discrimination occurs. A nursing student is doing a community health rotation in an inner-city public health department. The student investigates sociodemographic and health data of the people served by the health department, and detects disparities in health outcomes between the rich and poor. This is an example of a(n): A. Illness attributed to natural and biological forces. B. Creation of the student's interpretation and descriptions of the data. C. Influence of socioeconomic factors in morbidity and mortality. D. Combination of naturalistic, religious, and supernatural modalities. C. Influence of socioeconomic factors in morbidity and mortality. Health disparity populations are populations that have a significant increased incidence or prevalence of disease or that have increased morbidity, mortality, or survival rates compared to the health status of the general population. Culture strongly influences pain expression and need for pain medication. However, cultural pain is: A. Not expressed verbally or physically. B. Expressed only to others from a similar culture. C. Usually more intense than physical pain. D. Suffered by a patient whose valued way of life is disregarded by practitioners. D. Suffered by a patient whose valued way of life is disregarded by practitioners. Patients suffer cultural pain when health care providers disregard values or cultural beliefs. Which of the following best represents the dominant values in American society on individual autonomy and self-determination? A. Physician orders B. Advance directive C. Durable power of attorney D. Court-appointed guardian B. Advance directive Informed consent and advance directives protect the right of the individual to know and make decisions ensuring continuity of individual autonomy and self-determination. The nurse at an outpatient clinic asks a patient who is Chinese American with newly diagnosed hypertension if he is limiting his sodium intake as directed. The patient does not make eye contact with the nurse but nods his head. What should the nurse do next? A. Ask the patient how much salt he is consuming each day B. Discuss the health implications of sodium and hypertension C. Remind the patient that many foods such as soy sauce contain "hidden" sodium D. Suggest some low-sodium dietary alternatives A. Ask the patient how much salt he is consuming each day In an Asian culture spoken messages often have little to do with their meanings. It is important for the nurse to clarify how much salt the patient is consuming in his diet. A female Jamaican immigrant has been late to her last two clinic visits, which in turn had to be rescheduled. The best action that the nurse could take to prevent the patient from being late to her next appointment is: A. Give her a copy of the city bus schedule. B. Call her the day before her appointment as a reminder to be on time. C. Explore what has prevented her from being at the clinic in time for her appointment. D. Refer her to a clinic that is closer to her home. C. Explore what has prevented her from being at the clinic in time for her appointment Present-time orientation is in conflict with the dominant organizational norm in health care that emphasizes punctuality and adherence to appointments. Nurses need to expect conflicts and make adjustments when caring for ethnic groups. A nursing student is taking postoperative vital signs in the postanesthesia care unit. She knows that some ethnic groups are more prone to genetic disorders. Which of the following patients is most at risk for developing malignant hypertension? A. Ashkenazi Jew B. Chinese American C. African American D. Filipino C. African American Certain genetic disorders are linked with specific ethnic groups such as malignant hypertension among African Americans. A community health nurse is making a healthy baby visit to a new mother who recently emigrated to the United States from Ghana. When discussing contraceptives with the new mom, the mother states that she won't have to worry about getting pregnant for the time being. The nurse understands that the mom most likely made this statement because: A. She won't resume sexual relations until her baby is weaned. B. She is taking the medroxyprogesterone (Depo-Provera) shot. C. Her husband was recently deployed to Afghanistan. D. She has access to free condoms from the clinic. A. She won't resume sexual relations until her baby is weaned. In some African cultures such as in Ghana and Sierra Leone some women will not resume sexual relations with their husbands until the baby is weaned. During their clinical post-conference meeting, several nursing students were discussing their patients with their instructor. One student from a middle-class family shared that her patient was homeless. This is an example of caring for a patient from a different: A. Ethnicity. B. Culture. C. Heritage. D. Religion. B. Culture. Culture is the context in which groups of people interpret and define their experiences relevant to life transitions. This includes events such as birth, illness, and dying. It is the system of meanings by which people make sense of their experiences. When interviewing a Native American patient on admission to the hospital emergency department, which questions are appropriate for the nurse to ask? (Select all that apply.) A. Do you use any folk remedies? B. Do you have a family physician? C. Do you use a Shaman? D. Does your family have a history of alcohol abuse? A. Do you use any folk remedies? B. Do you have a family physician? C. Do you use a Shaman? Obtain information about folk remedies and cultural healers that the patient uses. Assessment data yield information about the patient's beliefs about the illness and the meaning of the signs and symptoms. The patient for whom you are caring needs a liver transplant to survive. This patient has been out of work for several months and doesn't have health insurance or enough cash. What principles would be a priority in a discussion about ethics? A. Accountability because you as the nurse are accountable for the well-being of this patient B. Respect for autonomy because this patient's autonomy will be violated if he does not receive the liver transplant C. Ethics of care because the caring thing that a nurse could provide this patient is resources for a liver transplant D. Justice because the first and greatest question in this situation is how to determine the just distribution of resources D. Justice because the first and greatest question in this situation is how to determine the just distribution of resources Accountability, respect or autonomy and ethics of care are not necessarily wrong, but they deflect attention from the less personal but more pertinent issue that is at stake in this situation: justice. The point of the ethical principal to "do no harm" is an agreement to reassure the public that in all ways the health care team not only works to heal patients but agree to do this in the least painful and harmful way possible. Which principle describes this agreement? A. Beneficence B. Accountability C. Nonmaleficence D. Respect for autonomy C. Nonmaleficence Nonmaleficence refers specifically to the concept of avoiding harm. Beneficence refers more to generosity and goodness, accountability to keeping promises, and respect for autonomy to the commitment by providers to include patients in decisions about all aspects of care. A child's immunization may cause discomfort during administration, but the benefits of protection from disease, both for the individual and society, outweigh the temporary discomforts. Which principle is involved in this situation? A. Fidelity B. Beneficence C. Nonmaleficence D. Respect for autonomy B. Beneficence The immunization is a clear effort to provide benefit. Beneficence refers to "doing good." Fidelity refers more to keeping promises. Nonmaleficence refers to the commitment to avoid harm. Respect for autonomy refers to the commitment to include patients in the decision-making process regarding health care plans. When a nurse assesses a patient for pain and offers a plan to manage the pain, which principal is used to encourage the nurse to monitor the patient's response to the pain? A. Fidelity B. Beneficence C. Nonmaleficence D. Respect for autonomy A. Fidelity Requiring a return to the patient to evaluate the effectiveness of an intervention exemplifies keeping a promise, a concrete example of fidelity. What is the best example of the nurse practicing patient advocacy? A. Seek out the nursing supervisor in conflicting procedural situations B. Document all clinical changes in the medical record in a timely manner C. Work to understand the law as it applies to an error in following standards of care D. Assess the patient's point of view and prepare to articulate it D. Assess the patient's point of view and prepare to articulate it Seeking out the nursing supervisor, documenting clinical change in the medical record in a timely manner and working to understand the law as it applies to an error in following standards of care are not wrong; but advocacy generally refers to the nurse's ability to help speak for the patient. Successful ethical discussion depends on people who have a clear sense of personal values. When a group of people share many of the same values, it may be possible to refer for guidance to philosophical principals of utilitarianism. This philosophy proposes which of the following? A. The value of something is determined by its usefulness to society. B. People's values are determined by religious leaders. C. The decision to perform a liver transplant depends on a measure of the moral life that the patient has led so far. D. The best way to determine the solution to an ethical dilemma is to refer the case to the attending physician or health care provider. A. The value of something is determined by its usefulness to society. Utilitarianism specifically refers to the greatest good for the greatest number of people, whereas goodness is determined primarily by usefulness. The concept is easier to apply in a community where shared values allow for agreement about a definition of usefulness. The philosophy sometimes called the ethics of care suggests that ethical dilemmas can best be solved by attention to which of the following? A. Patients B. Relationships C. Ethical principles D. Code of ethics for nurses B. Relationships The foundation of the ethics of care is its attention to relationships, as distinguished from other more principal based philosophies. In most ethical dilemmas in health care, the solution to the dilemma requires negotiation among members of the health care team. Why is the nurse's point of view valuable? A. Nurses understand the principle of autonomy to guide respect for patient's self-worth. B. Nurses have a scope of practice that encourages their presence during ethical discussions. C. Nurses develop a relationship to the patient that is unique among all professional health care providers. D. The nurse's code of ethics recommends that a nurse be present at any ethical discussion about patient care. C. Nurses develop a relationship to the patient that is unique among all professional health care providers. None of these options is wrong, but the point of the question is to build confidence and even pride in the value of the special body of knowledge that a nurse acquires about patients, the result of a unique relationship with them. Ethical dilemmas often arise over a conflict of opinion. What is the critical first step in negotiating the difference of opinion? A. Consult a professional ethicist to ensure that the steps of the process occur in full. B. Gather all relevant information regarding the clinical, social, and spiritual aspects of the dilemma. C. Ensure that the attending physician or health care provider has written an order for an ethics consultation to support the ethics process. D. List the ethical principles that inform the dilemma so negotiations agree on the language of the discussion. B. Gather all relevant information regarding the clinical, social, and spiritual aspects of the dilemma. Before proceeding with discussion about any difficult situation, just as in the nursing process, participants take time to gather all relevant information as insurance for reliability and validity during the discussion. The ANA code of nursing ethics articulates that the nurse "promotes, advocates for, and strives to protect the health, safety, and rights of the patient." This includes the protection of patient privacy. On the basis of this principal, if you participate in a public online social network such as Facebook, could you post images of a patient's x-ray film if you deleted all patient identifiers? A. Yes because patient privacy would not be violated as long as the patient identifiers were removed B. Yes because respect for autonomy implies that you have the autonomy to decide what constitutes privacy C. No because, even though patient identifiers are removed, someone could identify the patient based on other comments that you make online about his or her condition and your place of work D. No because the principal of justice requires you to allocate resources fairly C. No because, even though patient identifiers are removed, someone could identify the patient based on other comments that you make online about his or her condition and your place of work Respect for patient privacy includes making the most conservative decisions possible regarding disclosure of personal health information. When an ethical dilemma occurs on your unit, can you resolve the dilemma by taking a vote? A. Yes because ethics is essentially a democratic process, with all participants sharing an equal voice B. No because an ethical dilemma involves the resolution of conflicting values and principals rather than simply the identification of what people want to do C. Yes because ethical dilemmas otherwise take up time and energy that is better spent at the bedside performing direct patient care D. No because most ethical dilemmas are resolved by deferring to the medical director of the ethics department B. No because an ethical dilemma involves the resolution of conflicting values and principals rather than simply the identification of what people want to do Voting about an outcome implies that participants simply express an opinion without regard for negotiating differences. The real goal in processing ethical dilemmas is to resolve differences, not simply to express opinion. Resolution of an ethical dilemma involves discussion with the patient, the patient's family, and participants from all health care disciplines. Which of the following describes the role of the nurse in the resolution of ethical dilemmas? A. To articulate his or her unique point of view, including knowledge based on clinical and psychosocial observations B. To await new clinical orders from the physician C. To limit discussions about ethical principals D. To allow the patient and the physician to resolve the dilemma without regard to personally held values or opinions regarding the ethical issues A. To articulate his or her unique point of view, including knowledge based on clinical and psychosocial observations Nursing plays a unique and critical role in the resolution of difficult ethical situations. The nurse is often able to contribute information not available to others on the team, the result of the special relationship that nurses build with patients. In providing this information, it is important to remain aware of one's own values and how they may differ from those of the patient and others on the health care team. A precise definition for the word quality is difficult to articulate when it comes to quality of life. Why? (Select all that apply.) A. Quality of life is measured by potential income, and average income varies in different regions of the country. B. Community values are subject to change, and communities influence definitions of "quality." C. Individual experiences influence perceptions of quality in potentially different ways, making consensus difficult. D. Placing measurable value on elusive elements such as cognitive skills, ability to perform meaningful work, and relationship to family is challenging. B. Community values are subject to change, and communities influence definitions of "quality." C. Individual experiences influence perceptions of quality in potentially different ways, making consensus difficult. D. Placing measurable value on elusive elements such as cognitive skills, ability to perform meaningful work, and relationship to family is challenging. Definitions of quality depend on individual experience and value integrated into community standards, but value refers to elements beyond monetary value. Which of the following explain how health care reform is an ethical issue? (Select all that apply.) A. Access to care is an issue of beneficence, a fundamental principal in health care ethics. B. Reforms promote the principle of beneficence, a hallmark of health care ethics. C. Purchasing health care insurance may become an obligation rather than a choice, a potential conflict between autonomy and beneficence. D. Lack of access to affordable health care causes harm, and nonmaleficence is a basic principal of health care ethics. B. Reforms promote the principle of beneficence, a hallmark of health care ethics. C. Purchasing health care insurance may become an obligation rather than a choice, a potential conflict between autonomy and beneficence. D. Lack of access to affordable health care causes harm, and nonmaleficence is a basic principal of health care ethics. Since health care reform focuses on the public good, discussions about it inevitably involve reference to all aspects of ethical discourse. Reference to ethical principles helps to shape the discussion, even when individual values differ. Access to care is an issue of justice. Which is the best method of negotiating or processing difficult ethical situations? A. Ethical issues arise between dissenting providers and can be best resolved by deference to an independent arbitrator such a chaplain. B. Since ethical issues usually affect policy and procedure, a legal expert is the best consultant to help resolve disputes. C. Institutional ethics committees help to ensure that all participants involved in the ethical dilemma get a fair hearing and an opportunity to express values, feelings, and opinions as a way to find consensus. D. Medical experts are best able to resolve conflicts about outcome predictions. C. Institutional ethics committees help to ensure that all participants involved in the ethical dilemma get a fair hearing and an opportunity to express values, feelings, and opinions as a way to find consensus. Ethics is ultimately an activity of community, resolved successfully through institutional ethics committees and not easily resolved by deference to a single expert or leader. The increasing number of ethnic groups in the United States has been influenced by what? A. Communicable diseases in disadvantaged countries B. Increasing immigration C. Homelessness D. Healthcare reform B. Increasing immigration Currently, emerging populations include ethnic minorities and persons who are homeless. Ethnic minority populations could include Asian Americans/Pacific Islanders, Blacks/African Americans, Latinos/Hispanic Americans, Native Americans, and Arab Americans. The increasing population of immigrants has been a significant contributor to the presence of increasing numbers of major ethnic groups in the United States. [Show Less]
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NR222 Correctly Answered Questions 2022/2023
patient education process of influencing the patient's behavior to effect changes in knowledge, attitudes, and skills needed to maintain and improve healt... [Show More] h Patient education includes -maintenance and promotion of health and illness prevention -restoration of health -coping with impaired functions Speak Up tips to help patients become more involved in their treatment Speak up if you have question or concerns pay attention to the care you get educate yourself about illness ask for support know which medicine you take use hospital that are acredited participate in all decisions teaching interactive process that promotes learning learning acquisition of new knowledge, behaviors, and skills learning objective describes what the learner will be able to do after successful instruction 3 domains of learning cognitive (understanding), affective(attitudes), psychomotor(motor skills) cognitive learning knowledge, remembering, comprehension, applying, analysis, synthesis, evaluation, creating affective learning Receiving, responding, valuing, organizing, and characterizing psychomotor learning Integration of mental and muscular activity, perception, set, guide response, mechanism, complex overt response, adaptation, origination attentional set the mental state that allows the learner to focus on and comprehend a learning activity motivation force that acts on or within a person, causing the person to behave in a particular way self-efficacy a person's perceived ability to successfully complete a task developmental capability Need to know a patient's level of knowledge and intellectual skills before beginning a teaching plan. learning in children depends on the child's maturation; intellectual growth moves from the concrete to the abstract as the child matures. Information presented to children needs to be understandable and based on the child's developmental stage. adult learning Adults tend to be self-diserected learners; they often become dependent in new learning situations. patient-centered physical capability To learn psychomotor skills, the following physical characteristics are necessary: size, strength, coordination, and sensory acuity. the nursing process requires assessment of all sources to date to determine a patient's total health care needs the teaching process focuses on focuses on the patients learning needs and willingness and capability to learn Learning needs - information or skill needed by the patient to perform self-care and to understand the implications of a health problem - patient's experiences that influence the need to learn - information that the family members require motivation to learn - behavior - health beliefs and sociocultural background - perception of severity and susceptibility of a health problem and the benefits and barriers to treatment - perceived ability to perform behaviors - desire to learn - attitudes about providers - learning style preference ability to learn - physical strength, movement, dexterity and coordination - sensory deficits - reading level - developmental level - cognitive function - physical symptoms that interfere Teaching environment - distractions or persistent noise - comfort of the room - room facilities and available equipment Resources for learning - willingness to have family members and others involved in the teaching plan - family members' perceptions and understanding of the illness and its implications - financial or material resources - teaching tools health literacy the cognitive and social skills that determine the motivation and ability of individuals to gain access to, understand, and use information in ways that promote and maintain good health functional illiteracy the inability to read above a fifth-grade level Nursing diagnoses for patient education -Deficient knowledge (affective, cognitive, psychomotor) -Ineffective health maintenance -Impaired home maintenance -Ineffective family therapeutic regimen management -Ineffective self-health management -Noncompliance (with medications) Planning Principles of learning determine goal and outcomes that guide choice of teaching strategies: setting priorities timing organizing teaching material use teamwork and collaboration Teaching approaches telling, participating, entrusting, reinforcing, Group instruction One-on-one discussion ,return Demonstration Analogies Role playing Simulation telling The nurse outlines the task the patient will perform and gives explicit instructions. participating the nurse and patient set objectives and become involved in the learning process together entrusting Provides the patient with the opportunity to manage self-care reinforcement using a stimulus that increases the probability for a response One-on-one instruction Most common method of instruction Group instruction economical way to teach a number of patients at one time return demonstration The chance to practice the skill Analogies supplement verbal instruction with familiar images role play people play themselves or someone else simulation the nurse poses a pertinent problem or situation for patient to solve, which provides an opportunity to identify mistakes evaluation See through the patient's eyes. Have the patient's learning needs been met? Reinforces correct behavior, changing incorrect behavior, helps educator determine adequacy of teaching. Patient outcomes nurse is Legal responsibility for providing accurate timely patient information that promotes continuity of care. Documentation teach back closed-loop communication technique that assesses patient retention of the information imparted during a teaching session [Show Less]
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NR222 Revised Questions And Answers 2023
how is nursing and art and a science? art- caring, compassion, and respect science- knowledge and skills health care advocacy groups IOM and RWJF... [Show More] What is patient centered care? the patients values, beliefs and culture What is professionalism? quality care and being responsible and accountable what does nursing require? current knowledge and practice compassion critical thinking Benner's stages of nursing proficiency Novice advances beginner competent proficient expert Nursing: Scope and Standards of Practice 1960: Documentation began Standards of Practice Standards of Professional Performance 6 standards of practice Assessment-asking questions Diagnosis-determine the problem Outcomes-what you want to see happen Planning- how you make the ideal outcome happen Implementation-carrying out the plan Evaluation-did what you plan work Standards of Professional Performance Ethics Quality of practice Professional practice evaluation Education Communication Resources Evidence-Based Practice and Research Leadership Environmental Health Collaboration What are the Code of ethics in nursing Ideals of right and wrong incorporate your own values and ethics into your practice Professional roles of a nurse Autonomy and accountability Caregiver Advocate Educator Communicator Manager Advanced Practice Registered Nurses Clinical nurse specialist Certified nurse practitioner Certified nurse midwife Certified registered nurse anesthetist Essential nursing skills(especially with nursing shortage) Time management Therapeutic communication patient education compassion/bedside skills Florence Nightingale •First practicing epidemiologist •Organized first school of nursing •Improved sanitation in battlefield hospitals Clara Barton Nurse during the Civil War; founder of the American Red Cross Mother Bickerdyke organized ambulance services and walked abandoned battlefields at night, looking for wounded soldiers. Harriet Tubman Former slave who helped slaves escape on the Underground Railroad Mary Mahoney First African American nurse Lilian Wald and Mary Brewster •opened the Henry Street Settlement, which focused on the health needs of poor people who lived in tenements in New York City. 20th century •Movement toward scientific, research-based practice and defined body of knowledge •Nurses assumed expanded and advanced practice roles •1906: Mary Adelaide Nutting, first nursing professor at Columbia Teacher's College •Army and Navy Nurse Corps established •1920s: Nursing specialization began 21st century •Changes in curriculum •Advances in technology and informatics •New programs address current health concerns •Leadership role in developing standards and policies Trends in Nursing •Evidence-based practice •Quality and Safety Education for Nurses (QSEN) •Impact of emerging technologies •Genomics •Public perception of nursing •Impact of nursing on politics and health policy Nurse education •Registered nurse education •2-year associate's degree •4-year baccalaureate degree •Graduate education •Master's degree, advanced practice RN •Doctoral degrees •Continuing and in-service education Nurse Practice Act (NPA) •Overseen by State Boards of Nursing •Regulate scope of nursing practice •Protect public health, safety, and welfare Licensure for nurses NCLEX Nursing Organizations NSNA and CSNA •Ming graduated with an associate's degree in nursing last year and received his RN credential. He currently works in a long-term care facility. Although Ming enjoys his work and has been promoted to shift supervisor on his unit, he finds that he'd like to pursue a nursing career that offers a regular schedule and more autonomy. •Ming considers returning to school for an advanced degree.•Ming is particularly drawn to the idea of becoming an advanced practice registered nurse (APRN). •Ming's career options for becoming an APRN include which of the following? (Select all that apply.) A. Physician assistant (PA) B. Clinical nurse specialist (CNS) C. Certified nurse midwife (CNM) D. Certified RN anesthetist (CRNA) Answer is B,C,D If Ming decides to choose a career as a critical care CNS, then his specialty is identified by which means? A. Population B. Setting C. Disease specialty D. Type of care E. Type of problem All are correct 1. Nursing is defined as a profession because nurses A. perform specific skills. B. practice autonomy. C. utilize knowledge from the medical discipline. D. charge a fee for services rendered. The answer is B. . Professional nursing specialty organizations seek to: A. improve standards of practice. B. expand nursing roles. C. improve the welfare of nurses in specialty areas. D. all of the above. Answer is D [Show Less]
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NR222-Exam Question with correct Answers 100%
Communication Process Tool for health-promotion interventions Basis for professional nurse-client relationship Information exchange between individu... [Show More] als Client-centered communication important Nurses who critically think make the best communicators Verbal Communication Includes spoken and written communication Think about: Conversation pace-Speak slowly and clearly Tone of voice Timing Vocabulary used-When speaking to clients, use common language (don't use complex medical terminology) Clarity of message-Effective communication is simple and direct; Clarify information when needed Nonverbal Communication Personal appearance-First impressions are largely based upon appearance Posture Facial expressions Eye contact-be aware of client's cultural background Gestures Sounds-sighs, groans, etc. Personal space Metacommunication Involves reading in between the lines Going beyond the surface content of the message to understand meaning Refers to all factors that influence communication Phases of the nurse-patient relationship-Preinteraction Phase First Phase -Before meeting the client -Review client chart and history -Anticipate potential issues or concerns Phases of the nurse-patient relationship-Orientation phase Second Phase -When the patient & nurse meet and get to know each other -Sets the tone for the relationship -Let the patient know when the relationship will end -Use AIDET -Always be courteous: knock on the door, say hello and goodbye, say "please" and "thank you" -Always introduce yourself -Calling a client by their last name is respectful; ok to call them by their first name if they ask you to ***Avoid calling client names like "honey", "sweetie" or "sweetheart" Phases of the nurse-patient relationship-Working Phase Third Phase -Set goals with client and take action to meet goals -Use therapeutic communication techniques -Encourage the client to express their feelings about their health -A friendly, warm communication style establishes trust but you have to move beyond social conversation to discuss issues concerning the client's health -Ok to be assertive, not aggressive Phases of the nurse-patient relationship-Termination Phase Fourth Phase -Evaluate goal achievement with the client -Reminisce about the relationship with the client -Achieve a smooth transition for the client to other care givers AIDET A=Acknowledge I=Introduce D=Duration E=Explanation T=Thank you Steps to Functional Communication 1. Firmly stating case -Need congruent content and metacommunication 2. Clarifying the message -Use "I" statements -Ask open ended questions -Validating/clarifying allows the nurse to recognize and acknowledge a patient's thoughts, feelings, and needs Steps to Functional Communication 3. Seeking feedback -Provides validation and confirmation of the message communicated 4. Being receptive to received feedback -Facilitates functional communication Factors in Effective Communication Listening—actively focusing on message -Nonverbal cues—influenced by culture/situation -Eye contact, head nodding, leaning forward, making facial appropriate facial expressions, uncross arms and legs, and using brief verbal statements ("tell me more about...") are nonverbal cues that you are actively listing to the individual speaking Flexibility—balance between control and permissiveness -Rules of appropriate communication Example: the RN should not answer questions about intimate details of their life in order to set a limit; however, it does not mean the nurse should refuse to answer every question about themselves. Silence—can be therapeutic -Conveying support -Silence allows the individual to reflect on what is being discussed; it lets them know the RN is willing to wait until they are ready to say more or the can be their to provide comfort and support; in general, let the patient break the silence Factors in Effective Communication Humor -Positive: Relieves tension, creates a climate of sharing -Negative: Blocks communication, inflicts emotional pain Touch -Can express concern -May be inappropriate and threatening -be aware of personal/cultural preferences of the client; ask permission Space between communicators -Varies according to type, setting, culture -Proxemics—four zones of space (intimate space, personal space, social-consultative space, and public space) -Understanding space enhances communication congruency Proxemics—Four zones of space 1. Intimate space: up to 18 inches (45.5 centimeters); used for high interpersonal sensory stimulation 2. Personal space: 18 inches to 4 feet (45.5 centimeters to 1.2 meters); appropriate for close relationships in which touching may be involved and good visualization is desired 3. Social-consultative space: 9 to 12 feet (2.7 to 3.6 meters); less intimate and personal, requiring louder verbal communication 4. Public space: 12 feet (3.6 meters) and over; appropriately used for formal gatherings, such as giving speeches The Helping or Therapeutic Relationship: Characteristics Purposeful communication -Communication focused on a particular goal Rapport -Harmony and affinity between people -Facilitated by being genuine, open, and concerned Trust -Reliance on another based on sense of safety, honesty, reliability -Facilitated by clear relationship definitions; being consistent -Strategies to promote trust: do what you have promised to do, examine behaviors that interfere with trust, define relationship and expectations The Helping or Therapeutic Relationship: Characteristics Empathy -Understand other's feelings without losing identity -Personal understanding while maintaining boundaries Goal direction -Meet need or promote growth of recipient -Goals measurable, focus on change, short- or long-term -Developed jointly by nurse/client when possible Ethics -Behavior effects others, actions involve choices that may be judged by standards of right/wrong -Nurse: Respect individual rights, support person's/family's integrity You never know what internal battles people are struggling with; be aware of your words/actions as you interact with others; each patient room you walk into will be different Therapeutic Techniques Focusing on client -Person, not nurse, focus of interaction Helping client to clarify content/meaning -Prompt further description/data -Goal: To help client describe problem and solve together Reflection -Selective paraphrasing or literal repetition -Goal: Emphasize, summarize, elicit information Therapeutic Techniques Share observations: commenting on how the client looks, sounds, or acts helps a patient communicate without the need for extensive questioning Try not to ask a lot of "why" questions; these types of questions tend to increase anxiety because they demand reasons, conclusions, analysis or causes Ok for the nurse to express emotion; makes the RN seem more human and brings people closer together -As long as you are in control of your feelings and express them in a way that does not burden the patient Barriers to Effective Communication Anxiety, attitudes, noise, activity, distance, language barriers, beliefs, touch, eye contact, appearance, emotions, body language, gestures, interruptions, distractions, illness, medication side effects Barriers to effective communication can originate with the nurse, the individual, or both Barriers to Effective Communication Anxiety -Alters perception, distorts reality Attitudes -Bias/stereotypes -Communicates negativity; distorts perceptions Barriers to Effective Communication Gaps between the nurse and individual -Gender, age, ethnicity, language -Causes difference in perception; blocks understanding -seek clarification from translators; explore ways in which perceptions may differ and how meanings can be clarified -If client does not speak English use a professional interpreter -Do not use family or visitors as interpreters Resistance -Behavior to reduce anxiety -Avoidance, anger, tardiness, changing the subject Barriers to Effective Communication Transference -The nurse reminds the client of someone Countertransference -The client reminds the nurse of someone Sensory factors -Use other senses; obtain specialized assistance Barriers to Effective Communication Failure to address concerns/needs -Identify and correct source of failure such as inadequate assessment Setting -Control/alter disturbing environmental factors Consider client's developmental level Nontherapeutic techniques Do not force your personal opinions on the client Do not change the subject Do not give false reassurance or false hope Avoid becoming defensive Avoid passive aggressive responses or behaviors Do not argue with the client Think before you speak Defensive statement: "no one here would intentionally lie to you" -Implies the client does not have the right to an opinion Older adults & Hearing loss Make sure they have their hearing aids in Get patient's attention before speaking Speak clearly, but do not shout or exaggerate lip movements Speak at a slower pace Use a quiet, will lit environment with minimal distractions Speak on the side of their "good ear" Allow time for the patient to respond and ask questions Keep communication short and to the point Communicating with visually impaired clients Check for use of glasses or contact lenses Identify yourself when you walk into the room and when you leave the room Speak in a normal tone of voice Do not rely on gestures or nonverbal communication Use indirect lighting and avoid glare Use at least 14 point font Communicating with clients who have special needs-Clients Who Are Unresponsive Call patient by name during interactions Communicate verbally and by touch Speak to them as though they can hear you Explain all procedures and sensations Provide orientation to person, place, time Avoid speaking to others about patient in their presence Communicating with clients who have special needs-Clients Who Have Difficulty Speaking Listen attentively Do not interrupt them and be patient Ask simple "yes" or "no" questions Use visual cues or communication boards Encourage client to converse Collaborate with speech therapist Let them know if you have understood them or not Nurse-Health care Team Relationship Affects client safety and the work environment Risks for miscommunication occurs most frequently during: -Shift change report -Client transfer from one unit to another Standardized reporting reduce risk of errors ISBAR Used when calling health care providers about a client I=Introduction; Identify yourself (your name, role, and location) and give a reason for calling; "I am calling because... S=Situation-Give the patient's age and gender; What is the patient's status now? -Stable (but not in danger of deterioration) -Unstable B=Background-Give the relevant details such as presenting problems and clinical history A=Assessment-Put it all together (their current condition, risks, and needs). What is your assessment? R=Recommendation-Be clear about what you are requesting; e.g. transfer/review/treatment? When should it happen? Lateral violence Leads to workplace dissatisfaction, poor teamwork, poor retention of qualified nurses, and nurses leaving the profession Lateral violence Workplace bullying Includes: -Withholding information -Making snide remarks -Raising eyebrows -Making faces Lateral violence The RN experiencing lateral violence should: -Address the behavior in a calm manner when it occurs -Describe how the behavior is affecting your functioning -Ask for the abuse to stop -Notify the manager to get support -Make a plan for taking action in the future -Document all incidences in detail Introducing yourself It is important to introduce yourself and your status to the patient. A person should be addressed by using his or her last name because this is a way of showing respect in most cultures. Lucy should also wait to be introduced to Mrs. Jonas because she does not know that she is his wife. Sharing Observations The patient does not have to be extensively questioned, and this helps a quiet or withdrawn patient to be able to respond. This is different from making assumptions based on observations. Understanding the use of therapeutic techniques Example: By sitting down and making eye contact, Lucy is using an active listening skill that indicates acceptance and respect for the patient. By asking him to clarify his statement, she is seeking more information and not just a closed-ended response. Touch is a way to show caring and connection with the patient. [Show Less]
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NR222 Questions And Answers 2023
Which statement best describes the major purpose of nursing scope and stand of practice Nursing standards provide regulation of safe and quality nursing p... [Show More] ractice What is an example of the action stage of trans theoretical model "I am really enjoying this exercise class. I feel so much better" A client experimental chemotherapy leads to kidney failure medicine DC this is an example of which ethical principle? Nonmaleficence What information should a nursing student include in his presentation about nursing standards of care (SATA) -nursing standards of care are defined and some nurse practice acts -nursing standards of care are upheld by law indicating standards for nurse -nursing standards of care used to measure nursing conduct and malpractice Nurse gives wrong medication doesn't communicate to MD/fill out an incident report at the go principal violate include Veracity Which nursing action describes the evaluation step of the nursing process? Nurse realize need to reassess 30 minutes after pain medication given to client Which statement is an example of the jacked of finding an assessment steps of nursing process? Nurse observes client with facial grimacing heart rate 100 BP 150/96 Which of the following are examples of subjective data collected during assessment phase (SATA) The client verbalized discomfort and need for pain medicine -The client complains of lack of sleep in need for sleep medication -The clients wife verbalized the clients need for a blanket Which part of the nursing process is involved in validating a reassessment of patient's pain? Evaluation Which of the following best describes the purpose of the ethics committee within a healthcare organization? Provides consolation and recommendation on complex ethical issues Which type of interview questions does the nurse first use when assessing the reason for a patient seeking health care? Open ended Describe for me a typical night sleep what do you do to fall asleep ? phase of care in nursing interview Working phase Which of the following is true about Medicare? Medicare is federally funded program Which statement reflects nightingale contribution To today's nursing practice? Establish infection control practices noting importance of handwashing Modifiable risk factors include which of the following? Select all that apply -rest and sleep -poor nutrition Which of the following best describes a food desert area An area with limited access to affordable nutritious food Which of the following activities should the nurse include as part of primary prevention Providing education about healthy food choices to promote a healthy heart A nurse offers pain medication prior to helping a client ambulate. ethical principle: Benficence Client with advanced brain tumor;Parents decide surgery, will be totally dependent post up. Ethical principle affecting client Autonomy Nurse is giving low-dose aspirin to a client diagnosed with coronary artery disease. Which level of prevention Secondary Nurse administers wrong man to a client doesn't tell anyone doesn't fill out an incident report. Ethical principle: Fidelity Wish nursing actions should the nurse include in the assessment phase of the nursing process Interview the client about current and past health history After receiving bedside report at the beginning of his shift are in follows the steps of nursing process(SATA) -planning the care to help me stated patient goal -Collecting data in assessing the patient A nurse is ambulating a client in the hall to prevent lung complications which step in the nursing process is this Implementation A nursery text to apical pulse of a client after administrating of a cardiac meds. Which part of the nursing process Evaluation Spirit of the Chamberlain care model of nursing includes which of the following (SATA) -showing respect dignity openness to understand the values of our clients -Self care care for peers and care for others Which documentation and information as most consistent with objective data The nurse observes at the lab results include a high blood glucose level Conducting a patient centered interview a first statement that a nurse would ask is which of the following Tell me what brought you to the hospital HP 2020/2030 Address is determinants of health (DOH) Which of the following best describes DOH Income, education, where people live and age Social determinants of health include which of the following Quality of education, access to healthy food, language literacy Which services are included in the Medicare insurance benefit Pays for hospice for 65/older, home health,hospital, disabled, end stage renal During hand off, RN here's the client received pain meds 12 hours ago are in administers pain med. Nursing process missed Assessment Teenager, " I like to smoke with my friends" He does not recognize that it affects his asthma, which stage of TTM Precontemplation Leading health indicators (LHI) Sound and healthy people 2020/2030 include select all that apply -access of health services -environmental health In addition to abiding by the profession standard of care, a nurse is also expected to abide by the following Code of ethnics Health teaching on smoking cessation two groups of clients with high blood pressure. Standards of nursing in level of prevention Implementation and secondary level of prevention A unit manager explains to an SN how critical thinking is utilized in the nursing process Used to determine if appropriate intervention is being performed The nurse understands which of the following statements is correct re: the implementation of safe, high quality care ? Nursing practice involves performing evidence based nursing actions Statement describing collaboration from standards of professional performance, ANA: Nurse considers inter professional partnership and teamwork Nurse checks mom's BP, recommends she take her children for daily walks. This is an example of which Maslow hierarchy Physiological Which road as a nurse demonstrate when teaching a wound care procedure Nurse educator The client states "heart disease runs in my family, my blood pressure has always been high". The client understands Risk factor A nurse asked if a client takes vitamins, herbal medications, any relaxation methods. Molded practiced Holistic model Using the health believe model to guide care, which client will be the most successful in achieving care outcomes? 22-year-old smoker, mother just diagnosed with lung cancer Which of the following activities is to be initiated first and delivering client care using the nursing process Collecting organize client data during assessment Which is an example of tertiary Level of prevention initiated by the nurse Weekly physical therapy to a client with the right sided paralysis post stroke Which statement describes the overarching goals of healthy people 2020/2030 initiative ? Select all that apply -create a social and physical environment promoting good health for all -achieve health equity eliminate disparities and improve the health of all -Attain high-quality longer lives free of preventable disease and disability Chronic illness includes which of the following -last more than six months -affects functioning and one or more systems The client has a risk factor for cardiovascular disease and the nurse initiate screening. Which level of prevention Secondary level prevention Factors affecting illness behavior include select all that apply Personal history, social situations, social norms Which of the following statements is true about social determinants of care Determined by person circumstance and environment Which nursing roll client has questions about upcoming procedure's nurse calls on call resident to speak to the client Patient advocate A nurse meets with the registered dietitian and physical therapist to develop a plan of care. QSEN competency example Team collaboration The state board of nursing overseas Estates states nurse practice act (NPA) the NPA serves which purpose (SATA) -regulates nurse scope of practice -protect public health -Protect the public from unsafe nurses A nurse is current and future practices need to be based on which of the following Current evidence-based practice Nurse use which of the following to deal with difficult situations contributing to safe and effective care(SATA) -manage stress and conflict -build a connection with peers and share stories -you self-care strategies The first professionally trained African-American nurse bringing cultural diversity and respect for an individual Mary Mahoney Healthy people 2020/2030 emphasizes which of the following The health of communities affect the health of the nation A persons her believe the sex which of the following factors select all that apply -it affects a persons behavior towards health and illness -it affects a person's attitude towards health and illness -it affects a person's idea towards health and illness Nurses use health models for which of the following reasons -to understand clients attitudes and values about health and illness -To understand and predict clients health and behaviors Which motto address is the relationship between a persons Beliefs and behaviors Health belief model Which model dress is the basic human needs first before self actualization Maslow hierarchy model [Show Less]
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assessment nurse collects comprehensive data to pertinent to the patient's health and/or the situation diagnosis nurse analyzes the assessment dat... [Show More] a to determine the diagnoses or issues accountability responsible professionally and legally for the type and quality of nursing provided, ability to answer for one's own actions caregiver Helps patients maintain and regain health, manage disease and symptoms, and attain a maximal level of function and independence through the healing process patient advocate you protect your patient's human and legal rights and provide assistance in asserting these rights if the need arises educator you explain concepts and facts about health, describe the reason for routine care activities, demonstrate procedures such as self-care activities, reinforce learning or patient behavior, and evaluate the patient's progress in learning communicator essential to the nurse-patient relationship; it allows you to know your patients including their strengths, weaknesses, and needs manager Coordinates the activities of members of the nursing staff in delivering nursing care and has personnel, policy, and budgetary responsibility for a specific nursing unit or agency Florence Nightingale Established sanitary nursing care units. Founder of modern nursing. began professional education of nursing. Clara Barton Nurse during the Civil War; founder of the American Red Cross Mother Bickerdyke organized ambulance services and walked abandoned battlefields at night, looking for wounded soldiers. Mary Mahoney First professionally trained African American nurse; brought cultural diversity and respect Lillian Wald and Mary Brewster Opened the Henry Street Settlement, focusing on the health needs of the poor Mary Nutting First Nursing professor at Columbia Teachers College. Helped move nursing into universities. health A state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity health beliefs person's ideas, convictions, and attitudes about health and illness. They may be based on factual information or misinformation, common sense or myths, or reality or false expectations positive health behaviors activities related to maintaining, attaining, or regaining good health and preventing illness negative health behaviors include practices actually or potentially harmful to health health promotion model focuses on which 3 areas (1) individual characteristics and experiences (2) behavior-specific knowledge and effect (3) behavioral outcomes, in which the patient commits to or changes a behavior health promoting behavior the desired behavioral outcome and the end point in the HPM. Health-promoting behaviors result in improved health, enhanced functional ability, and better quality of life at all stages of development health promotion model (HPM) -defines health as a positive, dynamic state, not merely the absence of disease -directed at increasing a patient's level of well-being Maslow's hierarchy of needs -model that nurses use to understand the interrelationships of basic human needs -basic human need are elements that are necessary for human survival and health internal variables a person's developmental stage, intellectual background, perception of functioning, and emotional and spiritual factors external variables a person's health beliefs and practices include family practices, socioeconomic factors, and cultural background Nursing incorporates health promotion activities, wellness education, and illness prevention activities rather than simply treating illness in three ways: -immunization programs -routine exercise and good nutrition -physical awareness, stress management, and self responsibility primary prevention True prevention that lowers the chances that a disease will develop secondary prevention Focuses on those who have health problems or illnesses and are at risk for developing complications or worsening conditions tertiary prevention Occurs when a defect or disability is permanent or irreversible risk factors characteristics or behaviors that increase the likelihood of developing a medical disorder or disease examples: -Genetic and physiological factors -age -environment -lifestyle Precontemplation stage no intention of changing behavior Contemplation stage considering a change within the next 6 months Preparation stage making small changes Action stage actively engaging in strategies to change behavior Maintenance stage maintaining a changed behavior illness A state in which a person's physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished or impaired acute illness reversible, has a short duration, and is often severe. The symptoms appear abruptly, are intense, and often subside after a relatively short period chronic illness persists, usually longer than 6 months, is irreversible, and affects functioning in one or more systems. Patients often fluctuate between maximal functioning and serious health relapses that may be life threatening illness behavior Involves how people monitor their bodies and define and interpret their symptoms Impact of Illness on the Patient and Family -Behavioral and emotional changes -Impact on body image -Impact on self-concept -Impact on family roles -Impact on family dynamics challenges to health care -Uninsured patients -Reducing health care costs while maintaining high-quality care for patients -Improving access and coverage for more people -Encouraging healthy behaviors -Earlier hospital discharges result in more patients needing nursing homes or home care national priorities partnership -Promote best practices, prevention, treatment, communication, care coordination, and intervention practices for the leading causes of mortality -Ensure person and family centered care -Make care safer and quality care affordable the institute of medicine guides nurses to transform by training, achieve higher levels of education, build partnerships with physicians, and improve information infrastructure Professional standards review organizations (PSROs) Created to review the quality, quantity, and cost of hospital care provided through Medicare and Medicaid Utilization review (UR) committees Review admissions, diagnostic testing, and treatments ordered by physicians who cared for patients receiving Medicare Patient Protection and Affordable Care Act passed in 2010, focuses on the major goals of increasing access to health care services for all, reducing health care costs, and improving health care quality. health services pyramid population based health care services, clinical preventative services, primary health care, secondary health care, tertiary health care 6 health care settings and services preventative, primary, secondary, tertiary, restorative, continuing prevenative care Reduces and controls risk factors for disease primary care -Focuses on improved health outcomes -Requires collaboration secondary and tertiary care Diagnosis and treatment of disease provided by Hospital emergency departments, urgent care centers, critical care units, and inpatient medical-surgical units restorative care -Serves patients recovering from an acute or chronic illness/disability -Helps individuals regain maximal function and enhance quality of life -consists of: home health care, rehabilitation, extended care continuing care -For people who are disabled, functionally dependent, or suffering a terminal disease -Available within institutional settings or in the home for example: Nursing centers or facilities, Assisted living, Respite care, Adult day care centers, Hospice Nursing Centers or Facilities -provide 24hr intermediate and custodial care -regulated by Omnibus Budget Reconciliation Act -clinical practice must complete MDS and RAIs assisted living Long-term care setting Home environment Greater resident autonomy No fee caps respite care Respite care provides short-term relief or "time off" for people providing home care to an individual who is ill, disabled, or frail. adult day care centers Provide a variety of health and social services to specific patient populations who live alone or with family in the community hospice -Family centered care that allows patients to live with comfort, independence, and dignity while easing the pains of terminal illness -focuses on palliative (non-curable) care Accountable care organizations (ACOs) Developed to coordinate medical care, strives to ensure that patients receive the right care at the right time, without duplication of services or incidence of medical errors Patient-centered medical home (PCMH) uses technology, teamwork, and effective communication with patients to make care culturally sensitive and accessible, gather clinical data, promote patient participation in decision making, and monitor patient outcomes issues in health care delivery - Nursing shortage - Competency - Quality and safety in health care (Pay for performance, Patient satisfaction) - Magnet Recognition Program (Nursing-sensitive outcomes) - Nursing informatics & technological advancements - Globalization of Health Care (Vulnerable Populations) Quality improvement (QI) an approach to the continuous study and improvement of the processes of providing health care services to meet the needs of patients and others and inform health care policy Performance Improvement (PI) an organization analyzes and evaluates current performance and uses the results to develop focused improvement actions federal government pays for ______________ and created professional standards review organizations (PSROs) medicare/medicaid professional standards review organizations (PSROs) review the quality, quantity, and cost of hospital care Utilization Review (UR) Committees review the admissions and identify and eliminate overuse of diagnostic and treatment services ordered by physicians caring for patients on Medicare Prospective Payment System (PPS) Eliminated cost-based reimbursement and grouped patients into diagnosis-related groups (DRGs) diagnosis-related groups (DRGs) each group has a fixed reimbursement amount with adjustments based on case severity, rural/urban/regional costs, and teaching costs capitation providers receive a fixed amount per patient or enrollee of a health care plan managed care providers receive predetermined capitalized payment for each patient enrolled Managed Care Organization (MCO) preventative measures and treatment to specific groups Preffered Provider Organization (PPO) A managed care organization of doctors, hospitals, and other providers who have an agreement with an insurer to provide health care at reduced rates to subscribers. PPO clients do not pay deductibles when using the preferred providers, but can use other providers and pay a higher co-payment as well as a deductible. medicare part A Inpatient coverage, home health, hospice medicare part B physician services, outpatient hospital services, durable medical equipment, and other services and supplies covered medicare part C Medicare Advantage medicare part D Prescription drug coverage who is covered under medicaid assisted care to low income patients long term care insurance -Insurance covered for patients under long term care -set cost for unlimited time (2yr minimum) State Children's Health Insurance Program (SCHIP) a public health insurance program, jointly funded by the federal and state governments, that provides health insurance coverage for children whose families meet income eligibility standards Health Services Pyramid 1. population based health care services 2. clinical preventive services 3. primary health care 4. secondary health care 5. tertiary health care [Show Less]
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NR222 Questions And Answers 2023
Define the three important attributes that characterize contemporary families. a. Family durability b. Family resiliency c. Family diversity a. F... [Show More] amily durability Durability is a system of support and structure that extends beyond the walls of the household. b. Family resiliency Resiliency is the ability of the family to cope with expected and unexpected stressors. c. Family diversity Diversity is the uniqueness of each family unit; each person has specific needs, strengths, and important developmental considerations. A family is defined as: a set of relationships that a patient identifies as family or a network of individuals who influence one another/s lives, whether there are actual biological or legal ties. Nuclear family: A nuclear family consists of two adults (and perhaps one or more children). Extended family: An extended family includes relatives in addition to the nuclear family. Single-parent family: In a single-parent family, one parent leaves the nuclear family because of death, divorce, or desertion, or a single person decides to have or adopt a child. Blended family: In a blended family, parents bring unrelated children from prior or foster-parenting relationships into a new, joint living situation. Alternative family: Alternative families include multi-adult households, grand families, and communal groups with children, nonfamilies, and cohabitating partners. Family caregivers: Increase in people living with chronic illnesses and the older adult population have created a greater need for family caregiving. Older adult caregivers have special needs—risk factors for poor health and emotional distress. Poverty: female single-parent families and families with unrelated individuals are especially vulnerable Homelessness: severely affects the functioning, health, and well-being of the family and its members. Children of homeless families are often in fair or poor health and have higher rates of asthma, ear infections, stomach problems, and mental illness. Domestic violence: Emotional, physical, and sexual abuse occurs toward spouses, children, and older adults across all social classes. Factors are complex and may include stress, poverty, social isolation, psychopathology, and learned family behavior. Structure: each family has a unique structure and way of functioning; each of the relationships has different demands, roles and expectations Function: what family does, such as how a family interacts to socialize younger family members, cooperates to meet economic needs, and relates to the larger society. Structure may enhance or detract from the family's ability to respond to stressors a. Rigid structure: b. Open or flexible structure: Rigid structure: An open or extremely flexible structure and consistent patterns of behavior that lead to automatic action do not exist, and enactment of roles is overly flexible. Open or flexible structure: An open or extremely flexible structure and consistent patterns of behavior that lead to automatic action do not exist, and enactment of roles is overly flexible. Identify the three levels and focuses proposed for family nursing practice. Family as context Family as patient Family as system Family as context As context—the primary focus is on the health and development of an individual member existing within a specific environment. Family as patient As patient—family needs, processes and relationships are the primary focus of nursing care. Family as system As system—you care for each family member (context), family unit (patient) using all resources available Hardiness: the internal strengths and durability of the family unit. Resiliency: the family's ability to return to a previous, healthy level of functioning after a disruptive or stressful event has occurred a. Genetics: may or may not result in actual development of a disease. Sometimes identification of genetic factors and counseling help family members decide whether to test for the presence of a disease and/or to have children. Chronic illness and/or trauma: influences an entire family economically, emotionally, socially, and functionally. It also affects a family's decision-making and coping resources. End-of-life care: the families need for information, support, assurance, and presence is great. Each family approaches and copes with end-of-life decisions differently. Three factors underlie the family approach to the nursing process. Name them. a. assess all individuals within their family context b. assess the family as patient c. assess the family as a system Identify and define the areas to include in a family assessment. a. family structure—determines members of the family, relationship among family members, and the context of the family b. developmental assessment—determines how the families adapt during predictable and unpredictable changes and difficult times c. family functioning—addresses how individuals behave in relation to one another; includes instrumental aspects that are routine activities A comprehensive, culturally sensitive family assessment is critical in order to: a. Understand the family life b. Understand the current changes within it c. Understand the family's overall goals d. Understand the family's expectations Give some examples of nursing diagnoses applicable to family care: a. Conflicting caregiver attitude b. Impaired family coping c. Risk for caregiver stress d. Impaired family process e. Risk for parent child attachment f. Family able to participate in care planning e. Family knowledge of disease When planning family-centered care, the goals and outcomes are: need to be concrete and realistic, compatible with the family members developmental stages and acceptable to family members and their lifestyle. Health promotion: Interventions to improve or maintain the physical, social, emotional, and spiritual well-being of the family unit and its members Acute care: be aware of the implications of early discharge for patients and their families Discharge planning: be sure the family caregiver is prepared for discharge and knows where to obtain necessary supplies. Communication: help the family members to maintain open lines of communication with you and the interprofessional health care team to anticipate your patient's and family member's needs Restorative and continuing care: to maintain patients' functional abilities within the context of the family A married couple has three children. The youngest child has graduated from college and is moving to a different city to take a job. The other two children left the home several years ago. What developmental tasks does the nurse expect this family to experience at this point in time? (Select all that apply.) 1. Take on parenting roles 2. Making room for the wisdom of older adults 3. Refocusing on marital issues 4. Determining new focus on recreational activities 5. Developing intimate relations with others Answer: 3, 4 Family structure can best be described as: 1. A complex set of relationships 2. A basic pattern of predictable stages 3. The pattern of relationships and ongoing membership 4. Flexible patterns that contribute to adequate functioning Answer: 3. Rationale: Ongoing membership of the family and the pattern of relationships, which are often numerous and complex When planning care for a patient and using the concept of family as patient, the nurse: 1. Includes only the patient and his or her significant other 2. Considers the developmental stage of the patient and not the family 3. Understands that the patient's family will always be a help to the patient's health goals 4. Realizes that cultural background is an important variable when assessing the family Answer: 4. Rationale: Is critical in forming an understanding of family life, current changes in family life, overall goals and expectations, and planning family-centered care Interventions used by the nurse when providing care to a rigidly structured family include: 1. Attempting to change the family structure 2. Providing solutions for problems as they arise 3. Exploring with the family the benefits of moving toward more flexible modes of action 4. Administering nursing care in a manner that provides minimal opportunity for change Answer: 3. Rationale: Very rigid structures impair functioning. [Show Less]
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NR 222- Exam Questions with correct Answers
You are participating in a clinical care coordination conference for a patient with terminal cancer. You talk with your colleagues about using the nursing ... [Show More] code of ethics for professional registered nurses to guide care decisions. A nonnursing colleague asks about this code. Which of the following statements best describes this code? A. Improves self-health care B. Protects the patient's confidentiality C. Ensures identical care to all patients D. Defines the principles of right and wrong to provide patient care D. Defines the principles of right and wrong to provide patient care When giving care, it is essential to provide a specified service according to standards of practice and to follow a code of ethics. The code of ethics is the philosophical ideals of right and wrong that define the principles you will use to provide care for your patients. The code serves as a guide for carrying out nursing responsibilities to provide quality nursing care and the ethical obligations of the profession. An 18-year-old woman is in the emergency department with fever and cough. The nurse obtains her vital signs, auscultates her lung sounds, listens to her heart sounds, determines her level of comfort, and collects blood and sputum samples for analysis. Which standard of practice is performed? A. Diagnosis B. Evaluation C. Assessment D. Implementation C. Assessment Assessment is the collection of comprehensive data pertinent to the patient's health and/or the situation. A patient in the emergency department has developed wheezing and shortness of breath. The nurse gives the ordered medicated nebulizer treatment now and in 4 hours. Which standard of practice is performed? A. Planning B. Evaluation C. Assessment D. Implementation D. Implementation Implementation is completing coordinating care and the prescribed plan of care. A nurse is caring for a patient with end-stage lung disease. The patient wants to go home on oxygen and be comfortable. The family wants the patient to have a new surgical procedure. The nurse explains the risk and benefits of the surgery to the family and discusses the patient's wishes with the family. The nurse is acting as the patient's: A. Educator B. Advocate C. Caregiver D. Case manager B. Advocate An advocate protects the patient's human and legal right to make choices about his or her care. An advocate may also provide additional information to help a patient decide whether or not to accept a treatment or find an interpreter to help family members communicate their concerns. Evidence-based practice is defined as: A. Nursing care based on tradition B. Scholarly inquiry of nursing and biomedical research literature C. A problem-solving approach that integrates best current evidence with clinical practice D. Quality nursing care provided in an efficient and economically sound manner C. A problem-solving approach that integrates best current evidence with clinical practice Evidence-based practice integrates best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care. The examination for registered nurse licensure is exactly the same in every state in the United States. This examination: A. Guarantees safe nursing care for all patients B. Ensures standard nursing care for all patients C. Ensures that honest and ethical care is provided D. Provides a minimal standard of knowledge for a registered nurse in practice D. Provides a minimal standard of knowledge for a registered nurse in practice Registered nurse (RN) candidates must pass the NCLEX-RN® that the individual State Boards of Nursing administer. Regardless of educational preparation, the examination for RN licensure is exactly the same in every state in the United States. This provides a standardized minimum knowledge base for nurses. Contemporary nursing requires that the nurse has knowledge and skills for a variety of professional roles and responsibilities. Which of the following are examples? (Select all that apply.) A. Caregiver B. Autonomy and accountability C. Patient advocate D. Health promotion E. Lobbyist A. Caregiver B. Autonomy and accountability C. Patient advocate D. Health promotion E. Lobbyist Each of these roles includes activities for the professional nurse. Each of these is used in direct care or is part of professionalism that guides nursing practice. Some nurses are lobbyists, but being a lobbyist is not expected of all professional nurses Advanced practice registered nurses generally: A. Function independently B. Function as unit directors C. Work in acute care settings D. Work in the university setting A. Function independently Advanced practice registered nurse functions independently as a clinician, educator, case manager, consultant, and researcher within his or her area of practice to plan or improve the quality of nursing care for the patient and family. Health care reform will bring changes in the emphasis of care. Which of the following models is expected from health care reform? A. Moving from an acute illness to a health promotion, illness prevention model B. Moving from illness prevention to a health promotion model C. Moving from an acute illness to a disease management model D. Moving from a chronic care to an illness prevention model A. Moving from an acute illness to a health promotion, illness prevention model Health care reform also affects how health care is delivered. There is greater emphasis on health promotion, disease prevention, and management of illness. Which of the following nursing roles may have prescriptive authority in their practice? (Select all that apply.) A. Critical care nurse B. Nurse practitioner C. Certified clinical nurse specialist D. Charge nurse B. Nurse practitioner Nurse practitioners and certified clinical nurse specialists encompass the role and preparation of the advanced practice registered nurse. According to the American Nurses Association standards of practice, prescriptive authority may be granted to these nurses. A critical care nurse is using a computerized decision support system to correctly position her ventilated patients to reduce pneumonia caused by accumulated respiratory secretions. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency? A. Patient-centered care B. Safety C. Teamwork and collaboration D. Informatics D. Informatics Using decision support systems is one example of using and gaining competency in informatics. A nurse is caring for an older-adult couple in a community-based assisted living facility. During the family assessment he notes that the couple has many expired medications and multiple medications for their respective chronic illnesses. They note that they go to two different health care providers. The nurse begins to work with the couple to determine what they know about their medications and helps them decide on one care provider rather than two. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency? A. Patient-centered care B. Safety C. Teamwork and collaboration D. Informatics B. Safety Helping the patients understand the consequences and complications of multiple medications helps to build the competency in safety. ID: 514968103 The nurses on an acute care medical floor notice an increase in pressure ulcer formation in their patients. A nurse consultant decides to compare two types of treatment. The first is the procedure currently used to assess for pressure ulcer risk. The second uses a new assessment instrument to identify at-risk patients. Given this information, the nurse consultant exemplifies which career? A. Clinical nurse specialist B. Nurse administrator C. Nurse educator D. Nurse researcher D. Nurse researcher The nurse researcher investigates problems to improve nursing care and to further define and expand the scope of nursing practice. He or she often works in an academic setting, hospital, or independent professional or community service agency. Nurses at a community hospital are in an education program to learn how to use a new pressure-relieving device for patients at risk for pressure ulcers. This is which type of education? A. Continuing education B. Graduate education C. In-service education D. Professional Registered Nurse Education C. In-service education In-service education programs are instruction or training provided by a health care agency or institution. An in-service program is held in the institution and is designed to increase the knowledge, skills, and competencies of nurses and other health care professionals employed by the institution. Which of the following are components of the paradigm of nursing? A. The person, health, environment, and theory B. Health, theory, concepts, and environment C. Nurses, physicians, health, and patient needs D. The person, health, environment/situation, and nursing D. The person, health, environment/situation, and nursing The nursing paradigm focuses on person, health, environment/situation, and nursing. All the elements interact with one another, with the patient being central. A theory is a set of concepts, definitions, relationships, and assumptions that: A. Formulate legislation. B. Explain a phenomenon. C. Measure nursing functions. D. Reflect the domain of nursing practice. B. Explain a phenomenon. Theories are designed to explain a phenomenon such as self-care or caring. A theory is a way of seeing through a "set of relatively concrete and specific concepts" and the propositions that describe or link the concepts. A patient with diabetes is controlling the disease with insulin and diet. The nursing health care provider is focusing efforts to teach the patient self-management. Which of the following nursing theories is useful in promoting self management? A. Neuman B. Orem C. Roy D. Peplau B. Orem Orem's theory of self-care provides a solid theoretical background for self-management for a variety of diseases. This theory shows the nurse how to direct the patient toward self-management to promote health and/or sustain wellness. While working in a community health clinic, it is important to obtain nursing histories and get to know the patients. Part of history taking is to develop the nurse-patient relationship. Which of the following apply to Peplau's theory when establishing the nurse-patient relationship? (Select all that apply.) A. An interaction between the nurse and patient must develop. B. The patient's needs must be clarified and described. C. The nurse-patient relationship is influenced by patient and nurse preconceptions. D. The nurse-patient relationship is influenced only by the nurse's preconceptions. A. An interaction between the nurse and patient must develop. B. The patient's needs must be clarified and described. C. The nurse-patient relationship is influenced by patient and nurse preconceptions. The nurse-patient relationship is influenced only by the nurse preconceptions; is incorrect because the focus is only on the nurse. Theory-based nursing practice uses a theoretical approach for nursing care. This approach moves nursing forward as a science. This suggests that: A. One theory will guide nursing practice. B. Scientists will decide nursing decisions. C. Nursing will only base patient care on the practice of other sciences. D. Theories will be tested to describe or predict patient outcomes D. Theories will be tested to describe or predict patient outcomes There are multiple theories for the practice of nursing; these theories are tested to develop the evidence to describe or predict patient outcomes. To practice in today's health care environment, nurses need a strong scientific knowledge base from nursing and other disciplines such as the physical, social, and behavioral sciences. This statement identifies the need for which of the following? A. Systems theories B. Developmental theories C. Interdisciplinary theories D. Health and wellness models C. Interdisciplinary theories As the health system evolves and the health care needs of the patient focus on health promotion, illness prevention, and treatment, more disciplines are involved in patient care. To be effective in practice nurses need to be aware of theoretical approaches of care arising from other disciplines and from nursing. Which of the following theories describe the life processes of an older adult facing chronic illness? A. Systems theories B. Developmental theories C. Interdisciplinary theories D. Health and wellness models B. Developmental theories Developmental theories describe and predict behavior and development at various phases of the life continuum, as in the phase of older adulthood. Match the following components of systems theory with the definition of that component. A. Feedback B. Input C. Content D. Output 1. Data entering the system 2. End product 3. Data related to system functioning 4. Product and information obtained from the system A. Feedback----3. Data related to system functioning B. Input----- 1. Data entering the system C. Content-----4. Product and information obtained from the system D. Output---- 2. End product A patient is admitted to an acute care area. The patient is an active business man who is worried about getting back to work. He has had severe diarrhea and vomiting for the last week. He is weak, and his breathing is labored. Using Maslow's hierarchy of needs, identify this patient's immediate priority. A. Self-actualization B. Air, water, and nutrition C. Safety D. Esteem and self-esteem needs B. Air, water, and nutrition The immediate priority is air, water, and nutrition. The patient needs to have sufficient air exchange, which might require oxygen administration. In addition the patient needs to have appropriate fluid balance and some nutritional supplement. Match the following theories with their definitions. A. Grand theory B. Middle-range theory C. Descriptive theory D. Prescriptive theory 1. Addresses specific phenomena and reflect practice 2. First level in theory development and describes a phenomenon 3. Provides a structural framework for broad concepts about nursing 4. Linked to outcomes (consequences of specific nursing interventions) A. Grand theory---- 3. Provides a structural framework for broad concepts about nursing B. Middle-range theory----1. Addresses specific phenomena and reflect practice C. Descriptive theory---- 2. First level in theory development and describes a phenomenon D. Prescriptive theory----4. Linked to outcomes (consequences of specific nursing interventions) Which of the following is closely aligned with Leininger's theory? A. Caring for patients from unique cultures B. Understanding the humanistic aspects of life C. Variables affecting a patient's response to a stressor D. Caring for patients who cannot adapt to internal and external environmental demands A. Caring for patients from unique cultures Leininger's theory of transcultural nursing focuses on the patient's culture and the impact of culture heritage on health care needs and interventions. A nurse is applying Henderson's theory as a basis for theory based-nursing practice. Which other elements are important for theory-based nursing practice? (Select all that apply.) A. Knowledge of nursing science B. Knowledge of related sciences C. Knowledge about current health care issues D. Knowledge of standards of practice A. Knowledge of nursing science B. Knowledge of related sciences D. Knowledge of standards of practice Regardless of which particular nursing theory is selected, the nurse must use knowledge from nursing and related sciences, experience, and standards of practice when providing care. Which of the following statements apply to theory generation? (Select all that apply.) A. Builds scientific knowledge base of nursing B. Discovers relationships of phenomena to practice C. Tests specific phenomena D. Identifies observations about a phenomenon A. Builds scientific knowledge base of nursing B. Discovers relationships of phenomena to practice D. Identifies observations about a phenomenon Theory-generating research identifies observations or describes phenomena. It contributes to the scientific knowledge base of nursing. Relationships of the phenomena to practice and testing specific phenomena are part of the theory-testing research activities Which of the following statements about theory-based nursing practice is incorrect? A. Contributes to evidence-based practice B. Provides a systematic process for designing nursing interventions C. Is not linked to nursing outcomes D. Guides the nurse's assessment C. Is not linked to nursing outcomes Theory-based nursing practice does reflect nursing outcomes. For example, prescriptive theories address specific nursing interventions and predict the patient response. As an art nursing relies on knowledge gained from practice and reflection on past experiences. As a science nursing relies on (select all that apply): A. Experimental research. B. Nonexperimental research. C. Research from other disciplines. D. Professional opinions. A. Experimental research. B. Nonexperimental research. C. Research from other disciplines. As a science, nursing relies on knowledge gained through research from nursing and other disciplines and scientifically tested knowledge applied in the practice setting. The nurse is participating at a health fair at the local mall giving influenza vaccines to senior citizens. What level of prevention is the nurse practicing? A. Primary prevention B. Secondary prevention C. Tertiary prevention D. Quaternary prevention A. Primary prevention Primary prevention is aimed at health promotion and includes health-education programs, immunizations, and physical and nutritional fitness activities. It can be provided to an individual and includes activities that focus on maintaining or improving the general health of individuals, families, and communities. It also includes specific protection such as immunization for influenza. A patient experienced a myocardial infarction 4 weeks ago and is currently participating in the daily cardiac rehabilitation sessions at the local fitness center. In what level of prevention is the patient participating? A. Primary prevention B. Secondary prevention C. Tertiary prevention D. Quaternary prevention C. Tertiary prevention Tertiary prevention involves minimizing the effects of long-term disease or disability by interventions directed at preventing complications and deterioration following the myocardial infarction. Tertiary-prevention activities are directed at rehabilitation rather than diagnosis and treatment. Care at this level aims to help patients achieve as high a level of functioning as possible, despite the limitations caused by illness or impairment. This level of care is called preventive care because it involves preventing further disability or reduced functioning. Based on the transtheoretical model of change, what is the most appropriate response to a patient who states: "Me, exercise? I haven't done that since junior high gym class, and I hated it then!" A. "That's fine. Exercise is bad for you anyway." B. "OK. I want you to walk 3 miles 4 times a week, and I'll see you in 1 month." C. "I understand. Can you think of one reason why being more active would be helpful for you?" D. "I'd like you to ride your bike 3 times this week and eat at least four fruits and vegetables every day." C. "I understand. Can you think of one reason why being more active would be helpful for you?" The patient's response indicates that the patient is in the precontemplation stage and does not intend to change his behavior in the next 6 months. In this stage the patient is not interested in information about the behavior and may be defensive when confronted with it. Asking an open-ended question may stimulate the patient to identify a reason to begin a behavior change. Nurses are challenged to motivate and facilitate change in health behavior when working with individuals. [Show Less]
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NR222 Exam Questions and Answers 100%
While providing care to a patient, the nurse is responsible, both professionally and legally. Which concept does this describe? A. Autonomy B. Accounta... [Show More] bility C. Patient advocacy D. Patient education B. Accountability A nurse is using a guide that provides principles of right and wrong to provide care to patients. Which guide is the nurse using? A. Standards of practice B. Standards of professional performance C. Quality and safety education for nurses D. Code of ethics D. Code of ethics A patient is scheduled for surgery. When getting ready to obtain the informed consent, the patient tells the nurse, "I have no idea what is going to happen. I couldn't ask any questions." The nurse does not allow the patient to sign the permit and notifies the health care provider of the situation. Which role is the nurse displaying? A. Manager B. Patient educator C. Patient advocate D. Clinical Nurse Specialist C. Patient advocate Which nurse most likely kept records on sanitation techniques and the effects on health? A. Florence Nightingale B. Mary Nutting C. Clara Barton D. Lillian Wald A. Florence Nightingale Technological advances in health care: A. Make a nurses' job easier B. Depersonalize bedside patient care C. Threaten the integrity of the health care industry D. Do not replace sound personal judgement D. Do not replace sound personal judgement A patient who needs nursing and rehabilitation following a stroke would most benefit from receiving care at: A. Primary care center B. Restorative care setting C. Assisted-living center D. Respite center B. Restorative care setting A nurse is providing a community service by taking blood pressure at a local grocery store. What level of prevention is the nurse practicing? A. Primary B. Secondary C. Tertiary D. Behavioral A. Primary A patient who had an MI 4 weeks ago... is now participating in a daily cardiac rehabilitation session at a local gym. What levell of prevention is the patient participating in? A. Primary B. Secondary C. Tertiary D. Quaternary prevention C. Tertiary After evaluating a patient's external variables, the nurse concludes that the health benefits and practices can be influenced by: A. Emotional factors B. Intellectual Background C. Developmental stage D. Socioeconomic factors D. Socioeconomic factors According to Maslow's hierarchy of needs, which of these needs would the patient seek to meet first? A. Self-actualization B. Self-esteem C. Shelter D. Love and Belonging C. Shelter A 22 year-old is diagnosed with syphillis. What intervention would be an example of secondary prevention? A. Administer a dose of Penicillin IM B. Interviewing the patient about his sexual activity C. Testing for chlamydia D. Educating the patient on the use of condoms C. Testing for chlamydia Sally has decided to set aside 30 minutes a day to walk after work next week. Sally is in what risk factor modification? A. Pre-contemplation B. Contemplation C. Preparation D. Action E. Maintenance C. Preparation A nurse identifies multiple risk factors for her elderly patient. Which of the following would be considered a modifiable risk factor? A. Smoking 2 packs a day B. Widowed and lives alone C. History of falls D. Family history of heart disease A. Smoking 2 packs a day The nursing process organizes your approach while delivering nursing care. To provide the best professional care to patients, nurses need to incorporate nursing process and: A. Decision making B. Problem solving C. Intellectual standards D. Critical thinking skills D. Critical thinking skills Which action should the nurse take when using critical thinking to make clinical decisions? A. Make decisions based on intuition B. One established way to provide care C. Consider what is important in a given situation D. Read and follow the health care provider's orders C. Consider what is important in a given situation Which action indicates a registered nurse is being responsible for making clinical decisions? A. Applies clear textbook solutions to patients' problems B. Takes immediate and thoughtful or contemplative action when a patient's condition worsens C. Uses only traditional methods of providing care to patients D. Formulates standardized care plans for solely for groups of patients B. Takes immediate and thoughtful or contemplative action when a patient's care worsens A patient continues to report post surgical incision pain at a level of 9 out of 10 after pain medication is given. The next dose of pain medicine is not due for another hour. What should the critically thinking nurse do first? A. Explore other options for pain relief B. Discuss the surgical procedure and reason for the pain C. Explain to the patient that nothing else has been ordered D. Offer to notify the health care provider after morning rounds are completed A. Explore other options for pain relief A patient is admitted to the hospital with shortness of breath. As the nurse assesses this patient, the nurse is using the process of: A. Evaluation B. Data collection C. Problem identification D. Testing a hypothesis B. Data collection The nursing process organizes your approach to delivering nursing care. To provide care to your patients, you will need to incorporate nursing process and: A. Decision making B. Problem solving C. Interview process D. Intellectual standards B. Problem solving A nurse has already set the agenda during a patient-centered interview. What will the nurse do next? A. Begin with introductions B. Ask about the chief concerns or problems C. Explain that the interview will be over in a few minutes D. Tell the patient "I will be back to administer medications in 1 hour." A. Begin with introductions While completing an admissions database, the nurse is interviewing a patient who states, "I am allergic to latex." Which action will the nurse take first? A. Immediately place the cation in isolation B. Ask the patient to describe the type of reaction C. Proceed to the termination phase of the interview D. Document the latex allergy on the medication administration record B. Ask the patient to describe the type of reaction The nurse is using critical thinking skills during the first phase of the nursing process. Which action indicates the nurse is in the first phase? A. Completes a comprehensive database B. Identifies pertinent nursing diagnoses C. Intervenes based on priorities of patient care D. Determines whether outcomes have been achieved A. Completes a comprehensive database After assessing a patient, a nurse develops a standard formal nursing diagnosis. What is the rationale for the nurse's action? A. To form a language that can be encoded only by nurses B. To distinguish the nurse's role from the physician's role C. To develop critical judgement based on other's intuition D. To help nurses focus on the scope of medical practice B. To distinguish the nurse's role from the physician's role A nursing diagnosis: A. Identifies nursing problems B. Does not change during the course of a patient's hospitalization C. Is derived from the physician's history and physical examination D. Is a statement of a patient response to a health problem that requires nursing intervention. A. Identifies nursing problems When planning patient care, a goal can be described as: A. A statement describing the patient's accomplishments without a time restriction. B. A realistic statement predicting any negative responses to treatments C. A specific statement describing a desired change in patient behavior with a time frame D. An identified long-term nursing diagnosis C. A specific statement describing a desired change in patient behavior with a time frame The following statements are on a patient's nursing care plan. Which of the following statements is written as an outcome? A. The patient will verbalize a decreased pain level less than 3 on a 0 to 10 scale by the end of this shift B. The patient will demonstrate increased mobility in 2 days C. The patient will demonstrate increased tolerance to activity by discharge D. The patient will understand needed dietary changes by discharge A. The patient will verbalize a decreased pain level less than 3 on a 0 to 10 scale by the end of this shift The nurse recognizes that another term for a collaborative nursing intervention is _____ intervention. A. Dependent B. Independent C. Interdependent D. Physician-initiated Interdependent A registered nurse administers pain medication to a patient suffering from fractured ribs. What type of nursing intervention is this nurse implementing? A. Collaborative B. Independent C. Interdependent D. Dependent D. Dependent Mr. Bagley is placed on isolation precautions. Isolation precautions as a treatment intervention are an example of which type of care? A. Direct B. Indirection C. Prevention D. Safety B. Indirect A nurse is caring for a patient and performs several interventions. Which action by the nurse is an independent nursing intervention? A. Turning every 2 hours B. Administering a medication C. Inserting an indwelling catheter D. Starting an intravenous line A. Turning every 2 hours A nurse is providing nursing care to patients after completing a care plan from diagnoses. In which step of the nursing process is the nurse? A. Assessment B. Planning C. Implementation D. Evaluation C. Implementation A patient is recovering from a leg fracture after a fall reports having dull pain in the affected leg and rates it as a 7 on a 0 to 10 scale. The patient is not able to walk around the room with crutches because of leg discomfort. Which nursing intervention is priority? A. Assist the patient to walk in the room with crutches B. Obtain a walker for the patient C. Consult physical therapy D. Administer pain medication D. Administer pain medication Which action indicates a nurse is using critical thinking for implementation of nursing care to patients? A. Determines whether an intervention is correct and appropriate for the given situation B. Reads over the steps and performs a procedure despite lack of clinical competency C. Establishes goals for a particular patient without assessment D. Evaluates the effectiveness of interventions A. Determines whether an intervention is correct and appropriate for the given situation A nurse determines that the patient's condition has improved and has met expected outcomes. Which step of the nursing process is the nurse exhibiting? A. Assessment B. Planning C. Implementation D. Evaluation D. Evaluation The nurse is evaluating whether a patient's turning schedule was effective in preventing the formation of pressure ulcers. Which finding indicates success of the turning schedule? A. Staff documentation of turning the patient every 2 hours B. Presence of redness only on the heels of the patient C. Prevent's eating 100% of all meals D. Absence of skin breakdown D. Absence of skin breakdown A nurse has instituted a turn schedule for a patient to prevent skin breakdown. Upon evaluation, the nurse finds that the patient has a stage II pressure ulcer on the buttocks. Which action will the nurse take? A. Reassess the patient and situation B. Revise the turning schedule to increase the frequency C. Delegate turning to the nursing assistive personnel D. Apply medication to the area skin that is broken down A. Reassess the patient and situation The nursing process involves which of the following steps in the clinical decision-making process? (select all that apply) A. Identifying patient needs B. Diagnosing the disease process C. Determining priorities of care D. Setting goals E. Performing nursing interventions F. Evaluating effectiveness of medical treatments A, D, E Gathering, verifying, and communicating data about the patient to establish a database is an example of which competent of the nursing process? A. Evaluation B. Diagnosis C. Planning D. Assessment D. Assessment A nurse is completing an assessment. Which findings will be the nurse report as subjective data? (select all that apply) A. Patient's temperature B. Patient's wound appearance C. Patient describing excitement about discharge D. Patient pacing the floor while awaiting test results E. Patient's expression of fear regarding upcoming surgery C. Patient describing excitement about discharge E. Patient's expression of fear regarding upcoming surgery The nurse is gathering data on a patient. Which data will the nurse report as objective data? A. States "doesn't feel good" B. Reports a headache C. Respirations 16 D. Nauseated C. Respirations 16 [Show Less]
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