PMHNP Exam 131 Questions with Verified Answers
The Nurse Practice Act of every state - CORRECT ANSWER -Provides title protection (who may be called a
... [Show More] nurse practitioner)-Defines advanced practice
-Prevailing state laws that define the scope of practice (what NPs may do)
-Places restrictions on practice-Sets NP credentialing requirements (e.g., edu requirements,certification)
Statutory law - CORRECT ANSWER -Rules and regulations differ for each state
-May further define scope of practice and practice requirements
-May provide restrictions in practice unique to specific state
Scope of practice - CORRECT ANSWER -Defines NP roles and actions
-Identifies competencies assumed to be held by all NPs who function in a particular role
-Varies broadly from state to state
-Advanced practice PMHNP standards are identified in Psychiatric-Mental Health
Nursing: Scope and Standards of Practice
Standards of practice - CORRECT ANSWER - Authoritative statements regarding the quality and type of practice that should be provided
-Provide a way to judge the nature of care provided
-Reflect the expectation for the care that should be provided to clients with various illnesses
-Reflect professional agreement focused on the minimum levels of acceptable performance
-Can be used to legally describe the standard of care that must be met by a provider
-May be precise protocols that must be followed or more general guidelines that recommend actions
HIPAA - CORRECT ANSWER -The first national comprehensive privacy protection act
-Guarantees clients four fundamental rights:
1. To be educated about HIPAA privacy protection,
2. To have access to their own medical records,
3. To request amendment of their health information to which they object,
4. To require their permission for disclosure of their personal information.
The Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009 - CORRECT ANSWER -Incentive payments for sharing specific EHR data
-Meaningful use incentives
-EHR can improve both individual and population-based health outcomes.
-EHR can improve quality, safety, efficiency, effectiveness, and outcomes (E-prescribing, computerized physician order sets, tracking care and avoiding duplication of services)
Exceptions to guaranteed confidentiality - CORRECT ANSWER -When appropriate persons or organizations determine that the need for information outweighs the principle of confidentiality
-If a client reveals an intent to harm self or others
-Info given to attorneys involved in litigation
-Releasing records to insurance companies
-Answering court orders, subpoenas, or summonses
-Meeting state requirements for mandatory reporting of diseases or conditions
-Tarasoff principle: Duty to warn a potential victim of imminent danger of homicidal clients
-In cases of child or elder abuse
Elements of informed consent - CORRECT ANSWER -Nature and purpose of proposed tx or procedure
-Risks or discomforts and benefits of tx
-Risks and benefits of not undergoing tx
-Alternative procedures or tx
-Diagnosis and prognosis
-Provider must document in the medical record that informed consent has been obtained from the client.
-PMHNP is responsible for ensuring that the client is cognitively capable of giving
informed consent.
Ethical principles:
Justice - CORRECT ANSWER Doing what is fair; fairness in all aspects of care
Ethical principles:
Beneficence - CORRECT ANSWER Promoting well-being and doing good
Ethical principles:
Nonmaleficence - CORRECT ANSWER Doing no harm
Ethical principles:
Fidelity - CORRECT ANSWER Being true and loyal
Ethical principles:
Autonomy - CORRECT ANSWER Doing for self
Ethical principles:
Veracity - CORRECT ANSWER Telling the truth
Ethical principles:
Respect - CORRECT ANSWER Treating everyone with equal respect
Nine provisions in the 2015 the American Nurses Association (ANA) publication, "Code of Ethics for Nurses with Interpretive Statements" - CORRECT ANSWER 1. Nurse practices with compassion and respect for inherent dignity, worth, and unique attributes of everyone.
2. Nurse's primary commitment is to client, whether individual, family, group, community, or population.
3. Nurse promotes, advocates for, and protects the rights, health, and safety of client.
4. Nurse has authority, accountability, and responsibility for nursing practice, makes decisions, and takes action consistent with obligation to promote health and provide optimal care.
5. Nurse owes same duties to self as to others: responsibility to promote health and safety, preserve wholeness of
character and integrity, maintain competence, and continue personal and professional growth.
6. Nurse, through individual and collective effort, estab, maintains, and improves ethical enviro of work setting and conditions of employment that are conducive to safe, quality health care.
7. Nurse, in all roles and settings, advances profession through research and scholarly inquiry, professional standards devel, and generation of both nursing and health policy.
8. Nurse collaborates with other health professionals and public to protect human rights, promote health diplomacy, and reduce health disparities.
9. Profession of nursing, collectively through its professional organizations, must articulate nursing values, maintain integrity of profession, and integrate principles of social justice into nursing and health policy.
Malpractice insurance - CORRECT ANSWER -Provides financial protection against claims of malpractice
-Coverage for negligent professional acts
-Coverage for highly technical or professional skills required by NPs
-Recommended universally
-Does not protect NPs from charges of practicing outside their legal scope of practice
-Provides NPs their own legal rep to advocate for them even if agency also carries malpractice liability insurance protection
Four elements of negligence that must be established to prove malpractice: - CORRECT ANSWER 1. Duty: NP had a duty to exercise reasonable care when undertaking and providing tx to client.
2. Breach of duty: NP violated applicable standard of care in treating client's condition.
3. Proximate cause: Causal relationship btwn breach in standard of care and client's injuries.
4. Damages: Client experiences permanent and substantial damages from breach in standard of care.
Commitment process of forcing a person to receive involuntarily evaluation or treatment - CORRECT ANSWER Process may differ from state to state but basic criteria include:
-Person has a diagnosed psychiatric disorder,
-Person is harmful to self or others as a consequence of the disorder,
-Person is unaware or unwilling to accept the nature and severity of the disorder,
-Tx likely to improve functioning.
Commitment process of forcing a person to receive involuntarily evaluation or treatment - CORRECT ANSWER Process may differ from state to state but basic criteria include:
-Person has a diagnosed psychiatric disorder,
-Person is harmful to self or others as a consequence of the disorder,
-Person is unaware or unwilling to accept the nature and severity of the disorder,
-Tx likely to improve functioning.
Involuntary admission - CORRECT ANSWER -Admission to a hospital or other treatment facility against the person's will
-Clients maintain all civil liberties except the ability to come and go as they please
-Amount of time clients can be kept against their wishes varies by state
Voluntary admission - CORRECT ANSWER -Admission to a hospital or other treatment facility that a person desires or agrees to
-Client maintains all civil liberties
-Client consents to potential confinement within the structure of a hospital setting
It is important for NPs to engage in the following scholarly activities: - CORRECT ANSWER -Publishing
-Lecturing or presenting
-Preceptorship
-Continuing education
Mentoring - CORRECT ANSWER -A process in which a more experienced NP agrees to guide and support a junior colleague in the role, competencies, and skills
-Requires mutual respect and an interactive process of learning
-Needs involvement by both the mentor and the mentee in the relationship
Client Advocacy - CORRECT ANSWER -Stand up for clients' rights and empower them to become their own advocates
-Reduce the stigma of mental illness
-Help clients receive available services
-Promote mental health by participating in one or more of these professional organizations:
American Nurses Association (ANA), American Psychiatric Nurses Association (APNA), International Society of Psychiatric Nurses (ISPN)
Responsibilities in Health Policy - CORRECT ANSWER -Advanced practice nurses have a legal and ethical responsibility to be a client advocate.
-Participation in local, state, national, and international health policy activities
-Involvement: Testify at a public meeting, lobby, or work with the media to bring awareness to an issue
-Phases of policy-making: formulation, implementation, and evaluation
Case Management - CORRECT ANSWER -System of controlled oversight and authorization of services and benefits provided to clients:
-Consists of coordinating care, ensuring quality outcomes, monitoring plan of care,
and doing advocacy
-Overall goal is to promote quality, cost-effective outcomes
Risk Management - CORRECT ANSWER -Activities or systems designed to recognize and intervene to reduce the risk of injury to clients
-Appropriate interventions implemented to reduce non-healthy behaviors in clients
and high-risk situations
-Recognition and intervention to reduce subsequent claims against healthcare providers
Durable power of attorney for health care or healthcare proxy - CORRECT ANSWER -Legally binding in all 50 states
-Designates, in writing, an agent to act on behalf of a person should he or she become unable to make healthcare decisions
-Not limited to terminal illness; also covers other aspects of illness, such as financial decisions during a person's illness
-Should be considered as an aspect of relapse planning for clients with chronic psychiatric disorders
Living will - CORRECT ANSWER -Document prepared while client is mentally competent to designate
preferences for care if client becomes incompetent or terminally ill
-Not legally binding in all states
Sexual identity - CORRECT ANSWER How people identify psychologically on a continuum between female and male and to whom they are sexually or affectionately attracted
Gender identity - CORRECT ANSWER A person's identity along a continuum between normative constructs of masculinity and femininity
-Influences of gender identity may consist of biological and social factors.
-Biological factors may include pre- and postnatal hormone levels and gene expression.
-Social factors may include gender messages from family, mass media, and cultural attitudes.
The following are a few characteristics of a therapeutic relationship: - CORRECT ANSWER -Focused on the client's needs, and are goal-directed, theory-based, and open to supervision.
-Genuineness
-Acceptance
-Nonjudgment
-Authenticity
-Empathy
-Respect
-Professional boundaries
Transference - CORRECT ANSWER Displacement of feelings for significant people in the client's past onto the PMHNP in the present relationship
Countertransference - CORRECT ANSWER The nurse's emotional reaction to the client based on her/his past experiences
Phases of a therapeutic nurse-client relationship:
Introduction (Orientation)
-Nursing Action
-Common client behaviors - CORRECT ANSWER 1st stage
Nursing Action:
-Creating a trusting environment
-Estab professional boundaries
-Estab the length of anticipated interaction
-Providing diagnostic eval
-Setting mutually agreed-upon
treatment objectives
Common client behaviors:
-Initial hesitancy by the client to
participate fully in assessment
and treatment planning (approach
avoidance)
Phases of a therapeutic nurse-client relationship:
Working (Identification and Exploitation)
-Nursing Action
-Common client behaviors - CORRECT ANSWER 2nd stage
Nursing Action:
-Clarifying client expectations and
mutually set goals
-Implementing treatment plan
-Monitoring health
-Undertaking preventative health
care
-Measuring outcomes of care
-Evaluating outcomes of care
-Reprioritizing plan and objectives as indicated
Common client behaviors:
-Transference—client
(countertransference—nurse)
-Client resistance to care
practices
-Client resistance to change
Phases of a therapeutic nurse-client relationship:
Termination (Resolution)
-Nursing Action
-Common client behaviors - CORRECT ANSWER 3rd stage
Nursing Action:
-Reviewing client's progress toward
objectives
-Establishing long-term plan of care
-Focusing on self-management
strategies
-Disengaging from relationship
-Referring client to other services as needed
Common client behaviors:
-Client resistance to termination
-Regression
-Reemergence of symptoms or
problems
ERIK ERIKSON'S STAGES OF HUMAN DEVELOPMENT:
Trust vs. mistrust - CORRECT ANSWER -Infancy (Birth-1 year)
-Ability to form meaningful relationships, hope about the future, trust in others
-Failure= Poor relationships, lack of
future hope, suspicious of
others
ERIK ERIKSON'S STAGES OF HUMAN DEVELOPMENT:
Autonomy vs. shame and doubt - CORRECT ANSWER -Early childhood (1-3 years)
-Self-control, self-esteem, willpower
-Failure= Poor self-control, low self-esteem, self-doubt, lack
of independence
ERIK ERIKSON'S STAGES OF HUMAN DEVELOPMENT:
Initiative vs. guilt - CORRECT ANSWER - Late childhood (3-6 years)
-Self-directed behavior, goal
formation, sense of purpose
-Failure= Lack of self-initiated
behavior, lack of goal orientation
ERIK ERIKSON'S STAGES OF HUMAN DEVELOPMENT:
Industry vs. inferiority - CORRECT ANSWER -School-age (6-12 years)
-Ability to work; sense of
competency and achievement
-Failure= Sense of inferiority;
difficulty with working, learning
ERIK ERIKSON'S STAGES OF HUMAN DEVELOPMENT:
Identity vs. role confusion - CORRECT ANSWER -Adolescence (12-20 years)
-Personal sense of identity
-Failure= Identity confusion, poor
self-identification in group
settings
ERIK ERIKSON'S STAGES OF HUMAN DEVELOPMENT:
Intimacy vs. isolation - CORRECT ANSWER -Early adulthood (20-35 years)
-Committed relationships,
capacity to love
-Failure= Emotional isolation,
egocentrism
ERIK ERIKSON'S STAGES OF HUMAN DEVELOPMENT:
Generativity vs. self-absorption or
stagnation - CORRECT ANSWER -Middle adulthood (35-65 years)
-Ability to give time and talents to others, ability to care for others
-Failure= Self-absorption, inability to grow and change as a person, inability to care for others
ERIK ERIKSON'S STAGES OF HUMAN DEVELOPMENT:
Integrity vs. despair - CORRECT ANSWER -Late adulthood (>65)
-Fulfillment and comfort with life, willingness to face death, insight and balanced perspective on
life's events
-Failure= Bitterness, sense of dissatisfaction with life, despair over impending death
Psychodynamic (Psychoanalytic) Theory:
Basic Tenets - CORRECT ANSWER -Sigmund Freud
-Intrapsychic conflict among the structures of the mind
-Initially designed to explain neurosis and conditions of high anxiety such as phobias and hysteria
-Assumes all behavior is purposeful and meaningful.
-Principle of Psychic Determinism: Even apparently meaningless, random, or accidental behavior is actually motivated by underlying unconscious mental content.
-Most mental activity is unconscious—urges, feelings, and fantasies that would be unacceptable to the person's values if consciously experienced.
-Conscious behaviors and choices are affected by unconscious mental content.
-Childhood experiences shape adult personality.
Psychodynamic (Psychoanalytic) Theory:
The Id - CORRECT ANSWER -Contains primary drives or instincts, urges (hunger, sex, or aggression), or fantasies
-Drives are largely unconscious, sexual, or aggressive in content, and infantile in nature
-Operates on the pleasure principle; seeks immediate satisfaction
-Is present at birth and motivates early infantile actions
-The id says, "I want"
Psychodynamic (Psychoanalytic) Theory:
The Ego - CORRECT ANSWER -Contains concept of external reality
-Rational mind; responsible for logical and abstract thinking
-Functions in adaptation
-Mediates between the demands of drives and environmental realities
-Operates on the reality principle
-Begins to develop at birth as infant struggles to deal with environment
-Responsible for use of defense mechanisms
-The ego says, "I think, I evaluate"
Psychodynamic (Psychoanalytic) Theory:
The Superego - CORRECT ANSWER -Contains sense of conscience or right versus wrong
-Aspirations, ideals, and moral values
-Regulated by guilt and shame
-Begins to fully develop around age six as a child comes into contact with external authority figures such as other parents, schoolteachers, coaches, or religious figures
-The superego says "I should or ought"
FREUD'S PSYCHOSEXUAL STAGES OF DEVELOPMENT:
Oral stage - CORRECT ANSWER -0-18 months
-Sucking, chewing, feeding, crying
Failure:
Schizophrenia, Substance abuse, Paranoia
FREUD'S PSYCHOSEXUAL STAGES OF DEVELOPMENT:
Anal stage - CORRECT ANSWER -8 months-3 years
-Sphincter control, activities of
expulsion and retention
Failure:
Depressive disorders
FREUD'S PSYCHOSEXUAL STAGES OF DEVELOPMENT:
Phallic stage - CORRECT ANSWER -3-6 years
-Exhibitionism, masturbation with
focus on Oedipal conflict, castration anxiety, and female fear of lost maternal love
Failure:
Sexual identity
disorders
FREUD'S PSYCHOSEXUAL STAGES OF DEVELOPMENT:
Latency stage - CORRECT ANSWER -6 years-puberty
-Peer relationships, learning, motor-skills development, socialization
Failure:
Inability to form
social relationships
FREUD'S PSYCHOSEXUAL STAGES OF DEVELOPMENT:
Genital stage - CORRECT ANSWER -Puberty forward
-Integration and synthesis of
behaviors from early stages, primary genital-based sexuality
Failure:
Sexual perversion disorders
TYPICAL AGE OF ONSET FOR COMMON PSYCHIATRIC DISORDERS:
Intellectual Disability - CORRECT ANSWER Infancy—usually evident at birth
TYPICAL AGE OF ONSET FOR COMMON PSYCHIATRIC DISORDERS:
Attention deficit hyperactivity disorder - CORRECT ANSWER Early childhood (age 12)
TYPICAL AGE OF ONSET FOR COMMON PSYCHIATRIC DISORDERS:
Schizophrenia - CORRECT ANSWER 18 to 25 years for men
25 to 35 years for women
TYPICAL AGE OF ONSET FOR COMMON PSYCHIATRIC DISORDERS:
Major depression - CORRECT ANSWER Late adolescence to young adulthood
TYPICAL AGE OF ONSET FOR COMMON PSYCHIATRIC DISORDERS:
Dementia - CORRECT ANSWER Most common after age 85
DEFENSE MECHANISMS:
Denial - CORRECT ANSWER Avoidance of unpleasant realities by unconsciously ignoring their
existence
DEFENSE MECHANISMS:
Projection - CORRECT ANSWER Unconscious rejection of emotionally unacceptable personal
attributes, beliefs, or actions by attributing them to other people,
situations, or events
DEFENSE MECHANISMS:
Regression - CORRECT ANSWER Return to more comfortable thoughts, behaviors, or feelings use
in earlier stages of development in response to current conflict, stress, or threat
DEFENSE MECHANISMS:
Repression - CORRECT ANSWER Unconscious exclusion of unwanted, disturbing emotions, thoughts, or impulses from conscious awareness
DEFENSE MECHANISMS:
Reaction formation - CORRECT ANSWER Often called overcompensation; unacceptable feelings, thoughts,
or behaviors are pushed from conscious awareness by displaying
and acting on the opposite feeling, thought, or behavior
DEFENSE MECHANISMS:
Rationalization - CORRECT ANSWER Justification of illogical, unreasonable ideas, feelings, or actions by developing an acceptable explanation that satisfies the person
DEFENSE MECHANISMS:
Undoing - CORRECT ANSWER Behaviors that attempt to make up for or undo an unacceptable action, feeling, or impulse
DEFENSE MECHANISMS:
Intellectualization - CORRECT ANSWER Attempts to master current stressor or conflict by expansion of knowledge, explanation, or understanding
DEFENSE MECHANISMS:
Suppression - CORRECT ANSWER Conscious analog of repression; conscious denial of a disturbing
situation, feeling, or event
DEFENSE MECHANISMS:
Sublimation - CORRECT ANSWER Unconscious process of substitution of socially acceptable,
constructive activity for strong unacceptable impulse
DEFENSE MECHANISMS:
Altruism - CORRECT ANSWER Meeting the needs of others in order to discharge drives, conflicts, or stressors
Cognitive Theory - CORRECT ANSWER -Jean Piaget
-Human development evolves through cognition, learning,
and comprehending.
-Four stages of cognitive development:
Sensorimotor, Preoperational, Concrete Operations, Formal Operations
Piaget's theory of cognitive development:
Sensorimotor - CORRECT ANSWER -Birth-2 years
-Critical achievement:
Object permanence- the ability to understand that objects have an existence independent of the child's involvement with them
Piaget's theory of cognitive development:
Preoperational - CORRECT ANSWER -2-7 years
-More extensive use of language and symbolism; magical thinking
Piaget's theory of cognitive development:
Concrete Operations - CORRECT ANSWER -7-12 years
-Child begins to use logic; develops concepts of reversibility and conservation
-Reversibility: realization that one thing can turn into another and
back again (e.g., water and ice)
-Conservation: ability to recognize that although the shape of an object may change, it will still maintain characteristics that enable it to be recognized as that object (e.g., clay)
Piaget's theory of cognitive development:
Formal Operations - CORRECT ANSWER -12 years-adult
-Ability to think abstractly; thinking
operates in a formal, logical manner
Interpersonal Theory:
Basic Tenets - CORRECT ANSWER -Harry Sullivan
-Behavior occurs because of interpersonal dynamics.
-Interpersonal relationships and experiences influence one's personality development, which is called the self-system (the total components of personality traits).
-Understanding behavior requires understanding the relationships in the person's life.
-Two drives for behavior: satisfaction (basic human drives such as sleep, sex, hunger);
security (conforming to social norms of a person's reference group).
-When the person's need for satisfaction and security is interfered with by the self-system, mental illness occurs.
-Humans experience anxiety and behavior is directed toward relieving the anxiety, which then results in interpersonal security.
Hierarchy of Needs Theory - CORRECT ANSWER -Abraham Maslow
-Certain needs more important to than others
-Person will attempt to meet more important needs before satisfying other needs
Hierarchy of needs:
-Survival (Water, Air, Food, Sleep)
-Safety and security needs (Protection from harm: emotional and physical)
-Love and belonging (Affection, intimacy, and companionship)
-Self-esteem (Sense of worth)
-Self-actualization (Achieving one's potential, Being all that one can be)
Health Belief Model - CORRECT ANSWER Marshall Becker
Healthy people do not always take advantage of screening or
preventative programs because:
-Perception of susceptibility
-Seriousness of illness
-Perceived benefits of treatment
-Perceived barriers to change
-Expectations of efficacy
Transtheoretical Model of Change:
Precontemplation - CORRECT ANSWER 1st stage
The person has no intention to change.
Transtheoretical Model of Change:
Contemplation - CORRECT ANSWER 2nd stage
Person is thinking about changing; is aware that there is a problem but not committed to changing.
Transtheoretical Model of Change:
Preparation - CORRECT ANSWER 3rd stage
Person has made the decision to change; is ready for action.
Transtheoretical Model of Change:
Action - CORRECT ANSWER Person is engaging in specific, overt actions to change.
Transtheoretical Model of Change:
Maintenance - CORRECT ANSWER Person is engaging in behaviors to prevent relapse.
Motivational Interviewing - CORRECT ANSWER -Miller & Rollnick
-Focused, goal-directive therapy
-Builds on the Transtheoretical Model of Change
-Motivation is elicited from the client
-Nonconfrontational, nonadversarial
Self-Efficacy and Social Learning Theory - CORRECT ANSWER -Albert Bandura
-Behavior is the result of cognitive and environmental factors.
-People learn by observing others, relying on role-modeling.
-Self-efficacy is the perception of one's ability to perform a certain task at a certain level of accomplishment.
-Behavioral change and maintenance are functions of outcome expectations and efficacy expectations.
Theory of Cultural Care - CORRECT ANSWER Madeline Leininger
-Regardless of the culture, care is the unifying focus and the essence of nursing.
-Health and well-being can be predicted through cultural care.
Theory of Self-Care - CORRECT ANSWER Dorothy Orem
Self-care: Activities that maintain life, health, and well-being
Therapeutic Nurse-Client Relationship Theory or Interpersonal Theory - CORRECT ANSWER -Hildegard Peplau
-First significant psychiatric nursing theory
-Based in part on interpersonal theory (Sullivan, 1953)
-Sees nursing as an interpersonal process in which all interventions occur within the context of the nurse-client relationship
-The therapeutic nurse-client relationship is central to nursing and includes 3 phases: orientation, working, termination
-Promoting adaptive responses is the goal of nursing
-Behavior represents the person trying to adapt to internal or environmental forces
Caring Theory - CORRECT ANSWER -Jean Watson
-Caring is an essential component of nursing.
-"Carative factors" guide the core of nursing and should be implemented in health care.
-Carative factors are those aspects of care that potentiate therapeutic healing and relationships.
Arbitration - CORRECT ANSWER Process in which a third party reviews evidence from both sides and makes a decision to settle the case
Professional civility - CORRECT ANSWER Behavior that shows respect toward another person
Research utilization - CORRECT ANSWER -Process of synthesizing, disseminating, and using research-generated knowledge to make a change in practices; a subset of the broader evidence-based practice
Process includes:
-Critique research
-Synthesize the findings
-Apply the findings
-Measure the outcomes
- Make an evidence-based decision regarding implementation
Develop a clinical question using the PICO method - CORRECT ANSWER P = patient, population of patients, problem
I = intervention
C = comparison (another treatment or therapy, placebo)
O = outcome
Critique the research evidence:
Quantitative hierarchy - CORRECT ANSWER 1. Randomized controlled trials (RCT), meta-analysis, or systematic review
2. Evidence-based guidelines based on systematic review
3. Evidence from RCT without randomization
4. Evidence from systemic review of descriptive and qualitative studies
5. Evidence from expert opinion or committee reports
Critique the research evidence:
Qualitative hierarchy - CORRECT ANSWER 1. Evidence from systematic reviews of descriptive and qualitative studies
2. Evidence from a single descriptive or qualitative study
3. Evidence from expert opinion or committee
4. Evidence-based guideline based on systematic review of RCTs
5. Evidence from well-designed controlled trials without randomization
6. Systematic reviews or meta-analysis
7. Evidence from at least one well-designed RCT
Internal validity - CORRECT ANSWER The independent variable (the treatment) caused a change in the dependent variable (the outcome)
External validity - CORRECT ANSWER The sample is representative of the population and the results can be generalized
Descriptive statistics - CORRECT ANSWER Used to describe the basic features of the data in the study; numerical values that summarize, organize, and describe observations; can be generated by either quantitative or qualitative studies
Mean - CORRECT ANSWER Descriptive statistics:
Average of scores
Standard deviation - CORRECT ANSWER Descriptive statistics:
Indication of the possible deviations from the mean
Variance - CORRECT ANSWER Descriptive statistics:
How the values are dispersed around the mean; the larger the variance, the larger the dispersion of scores
Inferential statistics - CORRECT ANSWER Numerical values that enable one to reach conclusions that extend beyond the immediate data alone; generated by quantitative research designs
t test - CORRECT ANSWER Inferential statistics:
Assesses whether the means of two groups are statistically different from each other
Analysis of variance (ANOVA) - CORRECT ANSWER Inferential statistics:
Tests the differences among three or more groups
Pearson's r correlation - CORRECT ANSWER Inferential statistics:
Tests the relationship between two variables
Probability - CORRECT ANSWER Inferential statistics:
Likelihood of an event occurring; lies between 0 and 1; an impossible event has a probability of 0, and a certain event has a probability of 1
P value - CORRECT ANSWER Inferential statistics:
Also known as level of significance; describes the probability of a particular result occurring by chance alone (if P = .01, there is a 1% probability of obtaining a result by chance alone)
Institutional Review Boards (IRBs) ensure that - CORRECT ANSWER -Risks to participants are minimized
-Participant selection is equitable
-Adverse events are reported and risks and benefits are reevaluated
-Informed consent is obtained and documented
-Data and safety monitoring plans are implemented when indicated
-The rights and welfare of human research participants are protected, and has the authority to approve, require modifications, or disapprove of any research activities.
-All investigators or persons involved in research studies must take and pass a test on protection of human participants
Institute of Medicine's quality aims - CORRECT ANSWER Safe
Effective
Client-centered
Timely
Efficient
Equitable
The Donabedian Model for quality addresses: - CORRECT ANSWER Structure
Process
Outcome
Quality Improvement means - CORRECT ANSWER -Agency-specific projects that aim to improve systems, decrease cost, improve productivity, and health outcomes
-Provides standardized method to identify gaps in practice and systems to evaluate ways to improve structure, function, and resources in care delivery within complex health systems
-Institute of Medicine's quality aims
-Examine internal processes
-New knowledge is specific to an organization
What is the PDSA cycle related to QI? - CORRECT ANSWER Plan: Plan the change
Do: Carry out the plan
Study: Examine the results
Act: Decide what actions will improve the process
ANA Position Statement (2010) on just culture of safety - CORRECT ANSWER -Supports collaboration efforts among state boards of nursing, professional organizations, patient safety centers, and health systems to develop Just Culture initiatives
-Holds people accountable for their behaviors and investigates errors
-Goal of creating open and fair learning environment to design safe systems and manage choices
-Mindset that affects work environment to proactively look for system breakdowns and identify ways to improve systems
Rights of clients - CORRECT ANSWER -Confidentiality
-Least restrictive treatment
-Give consent for treatment and withdraw consent at any time
Four components of health policy: - CORRECT ANSWER 1. Process: formulation, implementation, and evaluation
2. Policy reform: changes in programs and practices
3. Policy environment: arena the process takes place in (government, media, public)
4. Policy makers: key players and stakeholders
Responsibilities of each branches of law r/t health policies - CORRECT ANSWER Executive- implement law
Legislative- initial formulation
Judicial- interpret law
What is a Neuron and what are its components? - CORRECT ANSWER -Nerve cells
-Basic cellular unit of the nervous system
-Microprocessor of the brain responsible for conducting impulses from one part of the body to another
Components of the neuron:
-Cell body: soma; made up of the nucleus and cytoplasm within
cell membrane
-Stem or axon: Transmits signals away from the neuron's cell body to connect with other neurons and cells
-Dendrites: Collect incoming signals from other neurons and send the signal toward the neuron's cell body
Central Nervous System (CNS) - CORRECT ANSWER consists of the brain and spinal cord
Peripheral Nervous System (PNS) - CORRECT ANSWER -Peripheral nerves that connect the CNS to receptors, muscles, and glands
-Includes cranial nerves just outside the brain stem
-Comprises the somatic nervous system and the autonomic nervous
system
Somatic nervous system - CORRECT ANSWER -Part of CNS
-Conveys information from the CNS to skeletal muscles; responsible for voluntary movement
Autonomic nervous system - CORRECT ANSWER -Part of CNS
-Regulates internal body functions to maintain homeostasis; conveys information from the CNS to smooth muscle, cardiac muscle, and glands;
-Responsible for involuntary movement; divided into the sympathetic nervous system and the parasympathetic nervous system
Sympathetic nervous system - CORRECT ANSWER -Part of ANS
-Excitatory division; prepares the body for stress (fight or flight); stimulates or increases activity of organs
Parasympathetic nervous system - CORRECT ANSWER -Part of ANS
-Maintains or restores energy; inhibits or decreases activity of organs
Left hemisphere - CORRECT ANSWER -Cerebrum
-Dominant in most people; controls most right-sided body functions
Right hemisphere - CORRECT ANSWER -Cerebrum
Controls most left-sided body functions
Corpus callosum - CORRECT ANSWER -Cerebrum
-Both hemispheres connected by a large bundle of white matter
-Area of sensorimotor information exchange between the two hemispheres
Frontal lobe function and problems - CORRECT ANSWER -Cerebrum
-Motor function: Responsible for controlling voluntary motor activity of specific muscles
-Premotor area: Coordinates movement of multiple muscles
-Association cortex: Allows for multimodal sensory input to trigger memory and lead to decision-making
-Seat of executive functions: Working memory, reasoning, planning, prioritizing, sequencing behavior, insight, exibility, judgment, impulse control, behavioral cueing, intelligence, abstraction
-Language (Broca's area): Expressive speech
-Personality variables: The most focal area for personality development
-Problems in the frontal lobe can lead to personality changes, emotional, and intellectual changes
Temporal lobe functions - CORRECT ANSWER -Cerebrum
-Language (Wernicke's area): Receptive speech or language
comprehension
-Primary auditory area
-Memory
-Emotion
-Integration of vision with sensory information
-Problems in the temporal lobe can lead to visual or auditory hallucinations, aphasia, and amnesia
Occipital lobe functions and problems - CORRECT ANSWER -Cerebrum
-Primary visual cortex
-Integration area: Integrates vision with other sensory information
-Problems in the occipital lobe can lead to visual field defects, blindness, and visual hallucinations
Parietal lobe functions and problems - CORRECT ANSWER -Cerebrum
-Primary sensory area
-Taste
-Reading and writing
-Problems in the parietal lobe can lead to sensory-perceptual disturbances and agnosia [Show Less]