NR 222 Exam 1 Study Guide 30 Questions with Answers
ANA Scope and Standards, 5 tenets of nursing
***Remember*** Care If Poly Comes Long - CORRECT
... [Show More] ANSWER 1- Caring and Health are central to practice. (C)
2- Nursing practice is individualized. (I)
3- RN's use the nursing process to plan and provide individualized care. (P)
4- RN's coordinate care by establishing partnerships. (C)
5- A strong link exists between the work environment and the RN's ability to provide quality health care and achieve optimal outcomes. (L)
NANDA (Nursing Diagnosis) Definition - CORRECT ANSWER North American Nursing Diagnosis Association
-Identifies nursing functions
-Creates classification system
-Establishes diagnostic labels
List the 6 steps in nursing process ADOPIE - CORRECT ANSWER -Assessment
-Diagnosis
-Outcome/objective
-Plan
-Implementation
-Evaluate
Nursing process VS Medical Diagnosis - CORRECT ANSWER -Nursing dx deals with human response to actual or potential health problems; usually in tandem or built from the medical diagnosis.
-Medical dx deals with disease or a medical condition.
Ethics Provision 1
**Remember**Respect Really Never Rights Relationships - CORRECT ANSWER 1.1 Respect for Human Dignity
(A fundamental principle that underlies all nursing practice is respect for the inherent dignity, worth, unique attributes, and human rights of all individuals The need, and right, for health care is universal)
1.2 Relationships with Patients
(Nurses establish relationships of trust and provide nursing services according to need, setting aside any bias or prejudice)
1.3 The Nature of Health
(Nurses respect the dignity and rights of all human beings regardless of the factors contributing to the persons health status)
1.4 The Right to Self-Determination
(Patients have the moral and legal right to determine what will be done with and to their own person)
1.5 Relationships with Colleagues and Others,
(Respect for persons extends to all individuals with whom the nurse interacts).
Models of Health - CORRECT ANSWER Clinical
- Absence of illness or signs or sts of disease. Pt's may not seek out preventative care or services. People only seek help if they are experiencing signs and symptoms of an illness. Dangerous
Role Performance
- Inability of a person to perform social roles such as work or family obligations. Persons operating in this model are those being seen for occupational or school related physical exams, or physician excused absences. Prevents from ADL's
Adaptive
- The ability to adjust positively to social, mental, and physiological change. Illness occurs when the person is unable to adapt.
Eudemonistic - Emphasizes the interactions between physical, social, psychological, & spiritual aspects of life. Goal attainment & Meaning.May seek out alternative therapies, council of priest, rabbi, or minister.
Reasons why the Clinical model was adopted by the American health care system. More Expensive? - CORRECT ANSWER American Healthcare is more a disease management as oppose to preventive. There's also a fee for service for doctors, so they rather treat chronic illnesses versus prevent them. PCP make $300 when educating a pt but an MD doing a procedure can make up to $1500
Reasons why the Eudemonistic model is a better, more cost effective model to use today? - CORRECT ANSWER It looks at function of the human more holistic. It looks at preventing not controlling the disease. Prevention is cheaper than curing. Holistic approach to health is always more effective.
Healthy People 2020- What are the Overarching goals? What is the differences from Healthy People 2010? - CORRECT ANSWER 2020 Emphasize priorities to improve the health of individuals, groups, and communities in the U.S.
Overarching Goals
-Attain high-quality, longer lives free of preventable disease, disability, injury, and premature death.
Achieve health equity, eliminate disparities, and improve the health of all groups.-Create social and physical environments that promote good health for all.
Promote quality of life, healthy development, and healthy behaviors across all life stages.
2010
- Increase quality and years of healthy life-Eliminate health disparities: wide variations in health services and health status among certain population groups.
Levels of Prevention
-Give two examples of each - CORRECT ANSWER -Primary Prevention: Health Promotion and Specific Protection. Immunizations, smoking cessation, exercise, nutrition, & environmental controls (at risk).
-Secondary Prevention: Early Diagnosis, Prompt Treatment, and Disability limitation. Screening procedures, & dental exams
-Tertiary Prevention: Restoration and Rehabilitation. Return to optimal function, rehab, outreach programs, end-of-life care.
Health Education
Any combination of planned learning experiences based on sound theories that provide individuals, groups, and communities the opportunity to acquire the information and the skills needed to make quality health decisions." - CORRECT ANSWER -Teaching to appropriate literacy levels
-Health Education Models for Change
Define these terms and give an example related to nursing for each - CORRECT ANSWER -Fidelity, an agreement to keep promises
-The ethical principal that requires loyalty, fairness, truthfulness, advocacy, and dedication in relationships. It includes promise keeping, truth telling, and fulfilling commitments.
Example: You show fidelity in keeping your promise to discuss additional pain medication for your patient when they ask for it.
-Nonmaleficence, Avoidance of harm or hurt
The bioethical principle that specifies a duty not to inflict harm and balances unavoidable harm with benefits of good achieved.
-Maleficence, act of harm or being evil
-Autonomy, Informed consent and confidentiality, freedom from external control over actions (to a point), and initiating interventional methods on your own (within limits).
Rational self-legislation and self-determination that is grounded in informedness, voluntariness, consent, and rationality.
-Justice, Fairness
A bioethical principle with various types or domains of justice, including distributive, retributive, restorative, transitional, intergenerational, and procedural. Bioethics is chiefly concerned with distributive justice. Distributive justice deals with the equitable distribution of social burdens and benefits in society. When this allocation occurs under conditions of scarcity, it raises questions of rationing. The formal principle of justice states that equals shall be treated equally, and un-equals unequally, in proportion to their relevant differences.
-Veracity, truthfulness & accuracy
Understand the difference between these three types of insurance and how people gain access to these health insurances in the Private Sector - CORRECT ANSWER -HMO, Health Maintenance Organization. Delivers comprehensive health and treatment services to a large group of enrolled individuals who prepay a fixed fee. Usually gain access through an employer. In an HMO plan, individuals pay low out-of-pocket expenses, but must see a PCP first in order to be referred to a specialist. For all types of HMOs, a fixed amount of money is available each year for health care, based on the capitation fee and the number of members enrolled
-PPO, Preferred provider organization. Contracted providers provide services for discounted price. Additional consumer cost if non-PPO provider.Contracted providers in the PPO agree to deliver services to members for a fee-for-service pre-negotiated rate (unlike an HMO), which is usually discounted.
-Members must receive care exclusively from providers w/in the PPO network or incur additional costs.
-POS, Point of Service plans; they allow members to use providers outside of their individual HMO network for an additional fee or higher copay.
Usually gain access through an employer.
-IPA, Independent Practice Associations: Organizations composed of independent physicians that provide health care to members of an HMO in their private offices, eliminating the expense of the staff model HMO, which furnished and owned the facility in which care was provided.
Usually gain access through an employer via their HMO plan.
Understand the difference between Medicare and Medicaid and Social Security Act: Who gains access? - CORRECT ANSWER MEDICARE,
A federal program, paid through taxes, that finances medical care for people that fall into the following categories:
-People over 65
-The disabled
-People with end stage renal disease
-Persons on hospice
MEDICAID
A federal program that is managed jointly by both federal and state funds. Eligibility is determined by the state, and benefits very by state. Available to the following persons:
-Low-income individuals
-Families and Children
**There are no age requirements, but there is a 5 year limit.
Social Security Act,
How do you correctly write a nursing diagnosis? What are the three main parts? - CORRECT ANSWER p (problem) related to e(etiology) as evidence by s(symptoms)
problem (nursing diagnosis): impaired swallowing
etiology (cause): neuromuscular impairment (this is the damage, in nursing/medical language, that happens as a result of the cva)
symptoms (evidence, proof): choking, gagging, delayed swallowing
What makes a goal S.M.A.R.T. (patient centered)? - CORRECT ANSWER Specific
Measurable
Achievable
Realistic
Time frame
-Specific: Be specific in your goal or even just stating their chief complaint
ex: Respiratory rate will be 20/min by 8/22
-Measurable: objective data that is measurable. You need to be able to measure or observe patient response to nursing care.
ex: Patient respiration less than 20 per minute s/p pain med.
-Achievable: Make the goal achievable
-Realistic: Set goals and outcomes that a patient can realistically reach
-Time Frame: Set a realistic time frame to achieve the goal in.
Trans-theoretical Model of Change - CORRECT ANSWER Determining where a person is in the relation to making a behavior change
**Stages, REMEMBER** PCP Always Means Restraints.
1). Precontemplation-Not considering making a change
2).Contemplation-Aware but not considering a change in the near future (possibly in the next 6 months)
3). Preparation-Planning to act soon (making small preparations to act w/in the next month)
4). Action-Takes action to initiate the change (lasts up to 6 months)
5). Maintenance-Sustained commitment to behavior change
6). Relapse -Reverted to old behavior
What is the Health Belief Model? - CORRECT ANSWER Assist the nurse in formulating an action plan
Addresses the relationship between a person's beliefs and behaviors; helps you understand factors influencing patients' perceptions, beliefs, and behavior to plan care that will most effectively help patients maintain or restore health and prevent illness.
HIPAA definition and the RN's Role - CORRECT ANSWER HIPAA,Health Insurance Portability and Accountability Act.
-The law encompasses three related rules that govern the access, transfer, use and disclosure of legally protected health information:
RN's role is to preserve the privacy of patients' private health information.
Nurse Practice Acts (Vary by states, enforced by BON) - CORRECT ANSWER Represents all laws that regulate a nurse's scope of practice in the state or states of America in which she is licensed to work.
- Laws protect pt's from harm & lay the rules and regulations for the specific level of a nurse's educational and licensure requirements.
-Also regulates, educational program standards, requirements for licensure, types of titles and licenses, protection of titles, & grounds for disciplinary action, other violations,
Scope of Practice for - CORRECT ANSWER -RN, nursing assessment, development of a plan of nursing care, administration of medication or delegation of medication, delegation of nursing interventions, advocating for clients, evaluation of responses to interventions & effectiveness of POC, Communicating & collaborating w/other health care professionals, procurement & application of new knowledge/technologies, health education and counseling, participating in devel of policies/procedures/systems.
-RN vs. LPN.
The LPN is a nurse with limitations and restrictions compared to the Registered Nurse•Cannot do initial assessments of client condition and complaints •Cannot interpret client clinical data or act independently on such data •Cannot triage •Cannot create, initiate or alter nursing goals or establish nursing care plans •Cannot do initial client education regarding client condition, surgeries or complaints •Cannot administer IV chemotherapy •Cannot administer any direct IV fluid bolus or push medications except for saline and heparin flushes
-RN vs. assistive personnel
Assessing, evaluating or problem solving •Developing a nursing care plan •Performing sterile or invasive procedures or techniques •Inserting urinary catheters •Delivering nasogastric or gastrostomy tube feedings •Administering oxygen •Performing tracheal suctioning, tracheostomy care or respiratory care •Administering medications, immunizations or blood or blood products of practice
Roles of the Nurse - CORRECT ANSWER -Advocate, help individuals obtain what they are entitled to receive through the health care system, try to make the system more responsive to individual and community needs, and help persons develop the skills to advocate for themselves. In the role of advocate, the nurse strives to ensure that all persons receive high-quality, appropriate, safe, and cost-effective care.
-Care manager, The nurse acts as a care manager to prevent duplication of services, maintain quality and safety, and reduce costs.
-Consultant, provides knowledge about health promotion and disease prevention to individuals and groups.
-Deliverer of services, delivery of direct services such as health education, flu shots, and counseling in health promotion.
-Educator, based on a perception of desirable individual behavior, to structurally planned teaching according to individual needs.
-Healer, The role of healer requires the nurse to help individuals integrate and balance the various parts of their lives.
-Researcher, To provide optimal health care, nurses need to use evidence-based findings as their foundation for clinical decision-making.
QSEN - CORRECT ANSWER Quality and Safety Education for Nurses
- It represents an initiative in the nursing field to align nursing education and nursing best practices in quality and safety standards.
- Formed in response to calls for improved quality and safety in nursing.
Evidence based practice - CORRECT ANSWER When nurses or other clinicians use research findings and the best evidence possible to make decisions, the outcome is termed evidence-based practice.
Safety - CORRECT ANSWER Minimize risk of harm to patients and providers through both system effectiveness and individual performance.
Patient Centered Care - CORRECT ANSWER Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient's preferences, values, and needs.
Quality Improvement - CORRECT ANSWER Use data to monitor the outcomes of care processes and use improvement methods to design and test changes to continuously improve the quality and safety of health care systems.
Teamwork and Collaboration - CORRECT ANSWER Function effectively within nursing and interprofessional teams, fostering open communication, mutual respect, and shared decision making to achieve quality patient care.
Five Rights of Delegation - CORRECT ANSWER 1. Right task
2. Right circumstances
3. Right person
4. With the right directions and communication
5. Under the right supervision and evaluation
Ethics - CORRECT ANSWER Per ANA, "nursing encompasses the prevention of illness, the alleviation of suffering, and the protection, promotion, and restoration of health in the care of individuals, families, groups, and communities" [Show Less]