NR 222 EXAM 1 STUDY GUIDE FOR 2023-2024 LATEST UPDATE, Exams of Nursing

Download NR 222 EXAM 1 STUDY GUIDE FOR 2023-2024 LATEST UPDATE and more Exams Nursing in PDF only on Docsity! NR 222 EXAM 1 STUDY GUIDE FOR 2023- 2024 LATEST UPDATE Which nursing interventions are appropriate to include in a plan of care to promote sleep for patients who are hospitalized? (Select all that apply.) 1. Give patients a cup of coffee 1 hour before bedtime. 2. Plan vital signs to be taken before the patients are asleep. 3. Turn television on 15 minutes before bedtime. 4. Have patients follow at-home bedtime schedule. 5. Close the door to patients' rooms at bedtime. - Correct answer 2. Plan vital signs to be taken before the patients are asleep. 4. Have patients follow at-home bedtime schedule. 5. Close the door to patients' rooms at bedtime. Professional Roles & Responsibility of Nurses Autonomy & Give example - Correct answer in nursing, it involves the initiation of independent nursing interventions WITHOUT medical orders EX: Independently advise pt to cough & suggest deep breathing exercises to clear lungs of pt Professional Roles & Responsibility of Nurses Accountability - Correct answer Responsibility professionally & legally for the type & quality of nursing care provided. Must remain current & competent in nursing scientific knowledge & technical skills Professional Roles & Responsibility of Nurses Caregiver - Correct answer help pts maintain & regain health, manage disease & symptoms, and attain a maximal level of function & independence through the healing process Professional Roles & Responsibility of Nurses Advocate - Correct answer Protect pts human & legal rights & provide assistance in asserting those rights if needed. Act on behalf of pt, such as safeguarding their case against errors, suggesting alternative care, securing pt healthcare rights and facilitating personal & cultural preferences. Professional Roles & Responsibility of Nurses Manager - Correct answer Nurse managers direct groups of nurses by establishing an environment for collaborative patient-centered care and safe, evidence-based quality care with positive patient outcomes. -manager coordinates the activities of members of a nursing staff in delivering nursing care and has personnel, policy, and budgetary responsibility for a specific nursing unit or agency -uses appropriate leadership styles to create a nursing environment for patients and staff that reflects the mission and values of the health care organization Professional Roles & Responsibility of Nurses Communicator - Correct answer Communicating allows you to know your patients, including their preferences, strengths, weaknesses, and needs. - routinely communicate with patients and families, other nurses and health care professionals, resource people, and the community. -Effective communication strategies are fundamental to providing high-quality care, coordinating and managing patient care, assisting patients in rehabilitation, advocating for patients, assisting patients and families in decision-making, providing patient education Professional Roles & Responsibility of Nurses Educator - Correct answer -Your ability to teach effectively improves patients' knowledge, skills, self-care activities, and ability to make informed decisions. -As an educator, you identify patients' willingness and ability to learn, explain concepts and facts about their health, describe the reason for care activities, demonstrate procedures such as self-care activities, reinforce learning or patient behavior, and evaluate the patient's progress in learning. What are the Professional Roles & Responsibility of Nurses - Correct answer Autonomy, Accountability, Advocate, Educator, Communicator, Manager, Caregiver 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 operation to the family and discusses the patient's wishes with them. The nurse is acting as the patient's: 1. Educator 2. Advocate 3. Caregiver 4. Communicator - Correct answer Advocate Contemporary nursing requires that the nurse have knowledge and skills for a variety of professional roles and responsibilities. Which of the following are examples of these roles and responsibilities? (Select all that apply.) 1. Caregiver 2. Autonomy 3. Patient advocate 4. Health promotion 5. Genetic counselor - Correct answer Caregiver Autonomy Patient Advocate Health promotion transition of a patient's care from the acute care or post-acute care agency to the patient's next environment - Correct answer True What are the barriers to effective discharge of patients? - Correct answer Barriers to effective discharge planning include ineffective communication, lack of role clarity among health care team members, and lack of resources. T/F: Nurses promote patient satisfaction through providing patient- and family-centered care and applying good interpersonal skills, including courtesy, respect, and good communication skills. - Correct answer True The school nurse has been following a 9-year-old student who has shown behavioral problems in class. The student acts out and does not follow teacher instructions. The nurse plans to meet with the student's family to learn more about social determinants of health that might be affecting the student. Which of the following potential social determinants should the nurse assess? (Select all that apply.) 1. The student's seating placement in the classroom 2. The level of support parents offer when the student completes homework 3. The level of violence in the family's neighborhood 4. The age at which the child first began having behavioral problems 5. The cultural values about education held by the family - Correct answer 2. The level of support parents offer when the student completes homework 3. The level of violence in the family's neighborhood 5. The cultural values about education held by the family A nurse is assigned to care for an 82-year-old patient who will be transferred from the hospital to a rehabilitation center. The patient and her husband have selected the rehabilitation center closest to their home. The nurse learns that the patient will be discharged in 3 days and decides to make the referral on the day of discharge. The nurse reviews the recommendations for physical therapy and applies the information to fall prevention strategies in the hospital. What discharge planning action by the nurse has not been addressed correctly? 1. Patient and family involvement in referral 2. Timing of referral 3. Determination of discharge date - Correct answer Timing of referral Which of the following are common barriers to effective discharge planning? (Select all that apply.) 1. Ineffective communication among providers 2. Lack of role clarity among healthcare team members 3. Number of hospital beds to manage patient volume 4. Patients' long-term disabilities 5. The patient's cultural background - Correct answer 1. Ineffective communication among providers 2. Lack of role clarity among healthcare team members T/F: The Affordable Healthcare Act initiative provides evidence-based, 10-year national objectives for promoting health and preventing disease. - Correct answer False: Healthy People Healthy People sets ___________ to help the United States increase its focus on health promotion and disease prevention (instead of illness care) and encourages cooperation among individuals, communities, and other public, private, and nonprofit organizations to improve health - Correct answer objectives T/F: Healthy People 2020, promotes a society in which all people live long, healthy lives - Correct answer False: Healthy People 2030 Healthy People 2030 identifies __________ __________ __________ (e.g., household food insecurity and hunger; homicides; suicides; children and adolescents with obesity), which are high-priority health issues in the United States - Correct answer leading health indicators (LHIs) Although the United States has made great progress on the LHIs, it falls behind other developed countries on key measures of health and well-being, such as.... (select all that apply) A)life expectancy B) infant mortality C) obesity D) social interactions - Correct answer A B C How does the World Health Organization (WHO) define health ? - Correct answer as a "state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity" Health is a state of being that people define in relation to their own ________, ____________, and ________________. - Correct answer values, personality, and lifestyle T/F: Health is the actualization of inherent and acquired human potential through goal- directed behavior, competent self-care, and satisfying relationships with others - Correct answer True T/F: People who are free from disease are always healthy. - Correct answer False: People who are free from disease are not necessarily healthy ________ influences our values, how we define health, what we believe about illness, where we seek health care, and the treatments we prefer. a) life b) beliefs c) finances d) culture - Correct answer D. Culture T/F: Individual perceptions and definitions of health always stay the same as individuals change. - Correct answer False: Individual perceptions and definitions of health change with age and are affected by a person's health beliefs -How do some older adults define health? -How do others define their health? - Correct answer define health by the health practices they use regularly as the absence of disease and disability, the maintenance of physical and cognitive functioning, and having connections with others What do models of health do? - Correct answer Models help explain complex concepts or ideas, such as health and illness. Models help you understand the relationships between these concepts and a patient's attitudes toward health and health behaviors. Define Health Beliefs & what are they based on? - Correct answer Health beliefs are a person's ideas, convictions, and attitudes about health and illness. They can be based on reality or false expectations, facts or misinformation, common sense or myths, or good or bad experiences. self-actualization - Correct answer Self-actualization is the highest expression of one's individual potential and allows for continual self-discovery Health-promoting behaviors result in...... (select all that apply) a)improved health b)enhanced functional ability c) less stress for the nurse d) better quality of life at all stages of development - Correct answer a)improved health b)enhanced functional ability d) better quality of life at all stages of development What are the 5 levels of Maslow's Hierarchy of Needs? - Correct answer 1)Self- actualization; 2)Self-esteem; 3)Love and belonging needs; 4)Safety and security( including physical and psychological safety) 5)Physiological: Oxygen, fluids, nutrition, body temperature, elimination, shelter, and sex. List some common holistic interventions: (6) - Correct answer Some of the most widely used holistic interventions include meditation, music therapy, reminiscence, relaxation therapy, therapeutic touch, and guided imagery Maslow's Hierarchy - Correct answer A theory that arranges the five basic needs of people—physiological, security, social, esteem, and self-actualization—into the order in which people strive to satisfy them Developmental stage, intellectual background, perception of functioning, and emotional and spiritual factors are examples of ________ __________. - Correct answer Internal Variables Considering a patient's ______ & _______stage helps you predict a patient's response to an actual illness or the threat of a future illness. - Correct answer growth and developmental What is the holistic health model? - Correct answer promotes a patient's optimal level of health by considering the dynamic interactions among the emotional, spiritual, social, cultural, and physical aspects of an individual's wellness t/f when applying the model, focus your care on a patient's needs rather than on strict adherence to the hierarchy - Correct answer true t/f A patient's subjective experience is relevant in maintaining health or assisting in healing. This is part of the Holistic Health Model. - Correct answer true t/f The Health Belief Model empowers patients to engage in their own recovery and assume some responsibility for health maintenance - Correct answer False Holistic Health Model Family practices, psychosocial and socioeconomic factors, and cultural background are examples of _______ _____. - Correct answer External variables t/f: Nurses use holistic therapies either alone or in conjunction with conventional medicine - Correct answer true What type of holistic therapy sometimes helps patients cope with the difficult side effects of chemotherapy - Correct answer Meditation What type of holistic therapy sometimes helps relieve anxiety for older patients dealing with memory loss - Correct answer reminiscence __________ & _____________ variables influence how a person thinks and acts - Correct answer Internal and external Emotional Factor (internal variable) - Correct answer A patient's degree of stress, depression, or fear influences health beliefs and practices. T/f: Health beliefs usually influence health behaviors or health practices, which positively or negatively affect a patient's level of health - Correct answer true t/f Public health focuses on health promotion, wellness, and illness prevention - Correct answer true Internal variables include a person's ...... a) developmental stage, intellectual background, perception of functioning, and emotional and spiritual factors. b)family practices, psychosocial and socioeconomic factors, and cultural background. - Correct answer a) developmental stage, intellectual background, perception of functioning, and emotional and spiritual factors. There are some religions and faiths that discourage followers from having blood transfusions. This is an example of which internal variable? - Correct answer Spiritual Factor External variables influencing a person's health beliefs and practices include a)family practices, psychosocial and socioeconomic factors, and cultural background. b)developmental stage, intellectual background, perception of functioning, and emotional and spiritual factors. - Correct answer a) family practices, psychosocial and socioeconomic factors, and cultural background. What is health promotion? - Correct answer the process of enabling people to increase control over, and improve their health helps individuals maintain or enhance their present health. It motivates people to engage in healthy activities such as routine exercise and good nutrition to reach more stable levels of health. Poverty, food insecurity, no primary health care in a community, culture, exposure to violence, and access to green spaces are examples of _______. - Correct answer Examples of SDOH A child whose parents believe in the importance of physical activity and eating healthy foods may continue to practice these health beliefs. This is an example of which variable & factor? - Correct answer External Variable Family role and practices __________include a variety of social, commercial, cultural, economic, environmental, and political factors that affect health disparities. a) LHI b) SDOH c) Code of ethics - Correct answer Social determinants of health (SDOH) ____________, ____________, & ____________help individuals, groups, and communities improve their health, decrease the incidence of disease and disability, and improve their quality of life. - Correct answer Health education, legislation, and policy 4. Action 5. Maintenance precontemplation stage of TTM - Correct answer Stage of change in the TTM where individuals do not intend to change their high-risk behaviors in the foreseeable future. -No intent to make changes within the next 6 months Patient is unaware of, not interested in, or underestimates the problem. May be defensive. "There is nothing I really need to change." Contemplation stage of change - Correct answer 2nd stage - aware of problem, thinking about making a change -May be ambivalent about the change or is thinking about making a change. "I have a problem that I think I need to work on." preperation stage of change - Correct answer -Making small changes in preparation for a change in the next month -May have tried to make changes in the past but was unsuccessful. - Patient believes that advantages outweigh disadvantages of behavior change. "I started running once, but I didn't keep it up. I think I might try again in a few weeks." t/f Risk-factor modification, health promotion, illness prevention activities, or any program that attempts to change unhealthy lifestyle behaviors is a wellness strategy. - Correct answer true action stage of change - Correct answer Begins to change behavior through practice, may experience relapse -Actively engaged in strategies to change behavior; lasts up to 6 months Committed to change. Previous habits may become barriers to change. "I am really working hard to stop smoking." Maintenance stage of change - Correct answer 5th stage- work to prevent relapse and to consolidate gains made -Sustained change over time; begins 6 months after action has started and continues indefinitely -Changes integrated into the patient's lifestyle and behaviors adopted to prevent relapse. "I need to avoid people who smoke so I won't be tempted to start smoking again." t/f Maintaining healthy lifestyles can prevent hospitalizations and potentially lower the cost of health care. - Correct answer true Define Disease - Correct answer A medical condition that causes distress for a person in the form of its symptoms is referred to as a disease. It is a generic term that includes all disorders, infections, disabilities, and deformities that can afflict human beings Define illness - Correct answer a state in which a person's physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished or impaired -A person can feel ill in the presence or absence of a disease such as cancer or multiple sclerosis T/F Illness and Disease are the same - Correct answer False chronic disease - Correct answer a disease that develops gradually and continues over a long period of time -A chronic disease usually lasts more than 6 months, is irreversible, and affects functioning in one or more systems. - person with a chronic disease is like a person with a disability in that both have varying degrees of functional limitations acute disease - Correct answer An acute disease is usually reversible and has a short duration. The symptoms appear abruptly, are intense, and subside after a relatively short period. A patient discharged a week ago following a stroke is currently participating in rehabilitation sessions provided by nurses, physical therapists, and registered dietitians in an outpatient setting. In what level of prevention is the patient participating? 1. Primary prevention 2. Secondary prevention 3. Tertiary prevention 4. Transtheoretical prevention - Correct answer 3. Tertiary prevention Based on the Transtheoretical Model of Change, what is the most appropriate response to a patient who states: "Me, stop smoking? I've been smoking since I was 16!" 1. "That's fine. Some people who smoke live a long life." 2. "OK. I want you to decrease the number of cigarettes you smoke by one each day, and I'll see you in 1 month." 3. "What do you think is the greatest reason why stopping smoking would be challenging for you?" 4. "I'd like you to attend a smoking-cessation class this week and use nicotine replacement patches as directed." - Correct answer 3. "What do you think is the greatest reason why stopping smoking would be challenging for you?" A patient has been laid off from his construction job and has many unpaid bills. He is going through a divorce from his marriage of 15 years and has been praying daily to help him through this difficult time. He does not have a primary health care provider because he has never really been sick, and his parents never took him to a physician when he was a child. Which external variables influence the patient's health practices? (Select all that apply.) 1. Difficulty paying his bills 2. Praying daily 3. Age of patient (46 years) 4. Stress from the divorce and the loss of a job 5. Family practice of not routinely seeing a health care provider - Correct answer 1. Difficulty paying his bills 5. Family practice of not routinely seeing a health care provider A nurse is conducting a home visit with a new mom and her three children. While in the home the nurse weighs each family member and reviews their 3-day food diary. She checks the mom's blood pressure and encourages the mom to take the children for a 30-minute walk every day. The nurse is addressing which level of need, according to Maslow's Hierarchy of Needs? 1. Physiological 2. Safety and security 3. Love and belonging 4. Self-actualization - Correct answer 1. Physiological Ethics - Correct answer Ethics is the study of what is right and wrong with our conduct. It concerns our obligations to individuals, groups, and society Values - Correct answer A value is a deeply held personal belief about the worth a person holds for an idea, a custom, or an object. The values that a person holds reflect cultural and social influences Morals - Correct answer Morals usually refer to judgment about behavior, based on specific beliefs, and ethics refers to the study of the ideals of right and wrong behavior. Autonomy in ethics - Correct answer -respect rights of patients to make health care decisions -Autonomy refers to freedom from external control. In health care the concept applies to respect for the autonomy of patients Beneficence - Correct answer -Doing good or causing good to be done; kindly action -Beneficence refers to taking positive actions to help others maleficence - Correct answer the act of committing harm or evil Nonmaleficence - Correct answer avoidance of harm or hurt; core of medical oath and nursing ethics Justice - Correct answer Justice refers to fairness and the distribution of resources What is standard 4 and what is involved? - Correct answer Planning -develops a plan encompassing strategies to achieve expected outcomes. What is standard 5 and what is involved? - Correct answer Implementation- work to fix pt problem When implementing patient care, you must consider an organization's efficiency and cost control goals while still focusing on competently providing timely, thoughtful, safe, patient-centered care. An 80-year-old female patient is admitted to the hospital through the emergency room with acute chest pain. Initial testing shows that the patient had a myocardial infarction. Her current vital signs are BP 156/90; HR 88; respirations 20; she is afebrile. The patient has osteoarthritis, causing chronic pain in both knees. She also has glaucoma. The patient is Bosnian and has been in the United States for 3 years. She requires a professional interpreter at bedside when explanations of treatment are provided. Which of the following factors might require you to adapt the way you assist this patient with ambulation? (Select all that apply.) 1. Patient is Bosnian 2. Had a recent myocardial infarction 3. Respirations 20 4. Osteoarthritis of both knees 5. Needs an interpreter 6. Patient is afebrile - Correct answer 2. Had a recent myocardial infarction 4. Osteoarthritis of both knees 5. Needs an interpreter A nurse is caring for a patient who is expressing pain. The patient has two analgesics ordered prn for pain and has been using cold applications on his surgical site for pain relief. The last time an analgesic was given was 4 hours ago. The patient is scheduled for a physical therapy visit in 2 hours. Which of the following demonstrate good clinical decision making during intervention? (Select all that apply.) 1. The nurse reviews the options for pain relief for the patient. 2. The nurse assesses whether the prn medication, ordered every 4 to 6 hours and given 4 hours ago, is effective and whether a newmedication is needed. 3. The nurse reviews the policy and procedure for the cold application. 4. The nurse considers how the patient might react if the pain medication is held until an hour before physical therapy. 5. The nurse delegates the assistive personnel to prepare the patient's medication. - Correct answer 1. The nurse reviews the options for pain relief for the patient. 2. The nurse assesses whether the prn medication, ordered every 4 to 6 hours and given 4 hours ago, is effective and whether a new medication is needed. 4. The nurse considers how the patient might react if the pain medication is held until an hour before physical therapy. A nurse is conferring with another nurse about the care of a patient with a Stage 2 pressure injury. The two decide to review the clinical practice guideline of the hospital for pressure injury care. The use of a clinical practice guideline achieves which of the following? (Select all that apply.) 1. Allows nurses to act more quickly and appropriately 2. Sets a level of clinical excellence for practice 3. Eliminates the need to create an individualized care plan for the patient 4. Incorporates evidence-based interventions for stage II pressure injury 5. Provides for access to patient care information within the electronic health record - Correct answer 1. Allows nurses to act more quickly and appropriately 2. Sets a level of clinical excellence for practice 4. Incorporates evidence-based interventions for stage II pressure injury Which measures does a nurse follow when being asked to perform an unfamiliar procedure? (Select all that apply.) 1. Checks scientific literature or policy and procedure 2. Determines whether additional assistance is needed 3. Collects all necessary equipment 4. Delegates the procedure to a more experienced nurse 5. Considers all possible consequences of the procedure - Correct answer 1. Checks scientific literature or policy and procedure 2. Determines whether additional assistance is needed 3. Collects all necessary equipment Which principle is most important for a nurse to follow when using a clinical practice guideline for an assigned patient? 1. Knowing the source of the guideline 2. Reviewing the evidence used to develop the guideline 3. Individualizing how to apply the clinical guideline for a patient 4. Explaining to a patient the purpose of the guideline - Correct answer 3. Individualizing how to apply the clinical guideline for a patient The nurse is caring for a patient with an abdominal obstruction. The nurse irrigates the patient's nasogastric tube and reports the amount of fluid aspirated from the patient's stomach to the health care provider. The patient has an IV infusing; the nurse changes the transparent dressing over the IV site and instructs the patient to report any tenderness at the site. Which of these interventions is an indirect care measure? 1. Irrigation of nasogastric tube 2. Changing of transparent dressing 3. Instructing patient to report tenderness at IV site 4. Report of the amount of fluid aspirated - Correct answer 4. Report of the amount of fluid aspirated A nurse working the evening shift has five patients and is teamed up with an assistive personnel. One of the assigned patients has just returned from surgery, one is newly admitted, and one has requested a pain medication. The patient who has returned from surgery just minutes ago has a large abdominal dressing, is still on oxygen by nasal cannula, and has an intravenous line. One of the other patients has just called out for assistance in setting up a meal tray. Another patient is stable and resting comfortably. Which patient is the nurse's current greatest priority? 1. Patient in pain 2. Patient newly admitted 3. Patient who returned from surgery 4. Patient requesting assistance with meal tray - Correct answer 3. Patient who returned from surgery What is standard 6 and what is involved? - Correct answer Evaluation: The registered nurse evaluates progress toward attainment of goals and outcomes. What is the 7th standard of practice? - Correct answer Ethics: The registered nurse integrates ethics in all aspect of practice. What is the 8th standard of practice? - Correct answer Advocacy: The registered nurse demonstrates advocacy in all roles and settings You are preparing a presentation for your classmates regarding the clinical care coordination conference for a patient with terminal cancer. As part of the preparation, you have your classmates read the Nursing Code of Ethics for Professional Registered Nurses. Your instructor asks the class why this document is important. Which statement best describes this code? 1. Improves self-health care 2. Protects the patient's confidentiality 3. Ensures identical care to all patients 4. Defines the principles of right and wrong to provide patient care - Correct answer 4. Defines the principles of right and wrong to provide patient care Contemporary nursing requires that the nurse have knowledge and skills for a variety of professional roles and responsibilities. Which of the following are examples of these roles and responsibilities? (Select all that apply.) 1. Caregiver 2. Autonomy 3. Patient advocate 4. Health promotion 5. Genetic counselor - Correct answer 1. Caregiver 2. Autonomy 3. Patient advocate 4. Health promotion Which SDOH has a Goal: Help people earn steady incomes that allow them to meet their health needs. - Correct answer economic stability Which SDOH has a Goal: Increase educational opportunities and help children and adolescents do well in school. - Correct answer Education Access & quality Which SDOH has a Goal: Increase access to comprehensive, high-quality health care services. - Correct answer Health Care Access & Quality Which SDOH has a Goal: Create neighborhoods and environments that promote health and safety. - Correct answer Neighborhood & Built Environment Which SDOH has a Goal: Increase social and community support. - Correct answer Social & Community Context What is sleep deprivation? - Correct answer decrease in the amount, consistency, or quality of sleep Causes of sleep deprivation - Correct answer -illness (e.g., fever, difficulty breathing, or pain) -emotional stress, -medications, -environmental disturbances (e.g., frequent interruptions in sleep during nursing care, noisy neighbors or pets), -variability in the timing of sleep as a result of shift work. - Sleep disorders such as sleep apnea or insomnia can cause sleep deprivation What type of health problems can sleep deprivation cause? - Correct answer both chronic sleep deprivation and long sleep duration are associated with obesity, type 2 diabetes mellitus, poor memory, depression, digestive problems, and the development of cardiovascular disease Factors influencing sleep - Correct answer -drugs and substances -lifestyle -usual sleep patterns -emotional stress -environment -exercise and fatigue -food and caloric intake t/f In community health and home, settings help patients develop behaviors conducive to rest and relaxation. - Correct answer true Patients benefit most from instructions based on information about their homes and lifestyles, such as which types of activities promote sleep when a person must work during the night shift or how to make the home environment more conducive to sleep. t/f - Correct answer true Important nursing interventions for promoting sleep in the hospitalized patient are to establish periods for ________ _______ &________ _______ _________. - Correct answer uninterrupted sleep and rest and to control noise levels. A nurse is developing a plan for a patient who was diagnosed with narcolepsy. Which interventions should the nurse include on the plan? (Select all that apply.) 1. Take brief naps, no longer than 20 minutes, no more than twice a day. 2. Drink a glass of wine with dinner. 3. Eat a large meal at lunch rather than dinner. 4. Establish a regular exercise program. 5. Teach the patient about the side effects of modafinil. - Correct answer 1. Take brief naps, no longer than 20 minutes, no more than twice a day. 4. Establish a regular exercise program. 5. Teach the patient about the side effects of modafinil. The nurse recognizes that which statements made by a patient indicate an understanding of behaviors that will promote sleep? (Select all that apply.) 1. "I will not watch television in bed." 2. "I will not drink caffeine later in the day." 3. "A short nap late in the evening will lead to a more restful night of sleep." 4. "I am going to start eating dinner closer to my bedtime." 5. "I will start to exercise regularly during the day." - Correct answer 1. "I will not watch television in bed." 2. "I will not drink caffeine later in the day." 5. "I will start to exercise regularly during the day." A 72-year-old patient asks the nurse about using an over-the-counter antihistamine as a sleeping pill to help her get to sleep. What is the nurse's best response? 1. "Antihistamines are better than prescription medications because prescription medications can cause a lot of problems." 2. "Antihistamines should not be used because they can cause confusion and increase your risk of falls." 3. "Antihistamines are effective sleep aids because they do not have many side effects." 4. "Over-the-counter medications when combined with sleep-hygiene measures are a good plan for sleep." - Correct answer 2. "Antihistamines should not be used because they can cause confusion and increase your risk of falls." Which sleep-hygiene actions at bedtime can the nurse delegate to assistive personnel? (Select all that apply.) 1. Giving the patient a back rub 2. Turning on quiet music 3. Dimming the lights in the patient's room 4. Giving a patient a cup of coffee 5. Monitoring for the effect of the sleeping medication that was given - Correct answer 1. Giving the patient a back rub 2. Turning on quiet music 3. Dimming the lights in the patient's room A nurse is taking a sleep history from a patient. The nurse recognizes that which statement made by the patient needs further follow-up? 1. "I feel refreshed when I wake up in the morning." 2. "I use soft music at night to help me relax." 3. "It takes me about 45 to 60 minutes to fall asleep." 4. "I take the pain medication for my leg pain about 30 minutes before I go to bed." - Correct answer 3. "It takes me about 45 to 60 minutes to fall asleep." Factors influencing activity and exercise - Correct answer developmental changes, behavior, lifestyle, environmental issues, family and social support, cultural and ethnic factors. Developmental changes (exercise & activity) - Correct answer Developmental changes. Throughout the life span the appearance and functioning of the body undergo changes affecting movement. (age) Patient's behavior (exercise & activity) - Correct answer Understanding how human behavior influences a patient's motivation and willingness to be active and exercise is critical to your success in creating a patient-centered exercise program. t/f An individual's daily lifestyle greatly influences engagement with exercise. - Correct answer true Cultural Background (exercise & activity) - Correct answer When developing a physical fitness program for culturally diverse populations, consider their education and beliefs regarding the value of exercise and their access to resources to exercise, and learn about what motivates individuals to exercise and which activities are appropriate and enjoyable. healthy ways to deal with stress are..... - Correct answer -regular rest & exercise -have a support system -manage time -guided imagery & visualization -progressive muscle relaxation therapy -assertive training (teach pt ways to comm) -journal writing -mindfulness practice When does a crisis occur? - Correct answer Crisis occurs when stress overwhelms a person's usual coping mechanisms and demands mobilization of all available resources. A crisis creates a turning point in a person's life because it changes the direction of life in some way A crisis intervention nurse is working with a mother whose child with Down syndrome is hospitalized with pneumonia and who has lost her child's disability payment while the child is hospitalized. The mother worries that her daughter will fall behind in her classes during hospitalization. Which strategies are effective in helping this mother cope with these stressors? (Select all that apply.) 1. Referral to social service process reestablishing the child's disability payment 2. Sending the child home in 72 hours and having the child return to school 3. Coordinating hospital-based and home-based schooling with the child's teacher 4. Teaching the mother signs and symptoms of a respiratory tract infection - Correct answer 1. Referral to social service process reestablishing the child's disability payment 3. Coordinating hospital-based and home-based schooling with the child's teacher 4. Teaching the mother signs and symptoms of a respiratory tract infection The nurse is evaluating how well a patient newly diagnosed with multiple sclerosis and psychomotor impairment is coping. Which statements indicate that the patient is beginning to cope with the diagnosis? (Select all that apply.) 1. "I'm going to learn to drive a car, so I can be more independent." 2. "My sister says she feels better when she goes shopping, so I'll go shopping." 3. "I'm going to let the occupational therapist assess my home to improve efficiency." 4. "I've always felt better when I go for a long walk. I'll do that when I get home." 5. "I'm going to attend a support group to learn more about multiple sclerosis." - Correct answer 3. "I'm going to let the occupational therapist assess my home to improve efficiency." 5. "I'm going to attend a support group to learn more about multiple sclerosis." A 34-year-old single father who is anxious, tearful, and tired from caring for his three young children tells the nurse that he feels depressed and does not see how he can go on much longer. Which statement would be the nurse's best response? 1. "Are you thinking of suicide?" 2. "You've been doing a good job raising your children. You can do it!" 3. "Is there someone who can help you during the evenings and weekends?" 4. "Tell me what you mean when you say you can't go on any longer." - Correct answer 4. "Tell me what you mean when you say you can't go on any longer." When assessing an older adult who is showing symptoms of anxiety, insomnia, anorexia, and mild confusion, what is the first assessment the nurse conducts? 1. The amount of family support 2. A 3-day diet recall 3. A thorough physical assessment 4. Threats to safety in her home - Correct answer 3. A thorough physical assessment When assessing an older woman who is recently widowed, the nurse suspects that the woman is experiencing a developmental crisis. Which questions provide information about the impact of this crisis? (Select all that apply.) 1. With whom do you talk on a routine basis? 2. What do you do when you feel lonely? 3. Tell me what your husband was like. 4. I know this must be hard for you. Let me tell you what might help. 5. Have you experienced any changes in lifestyle habits, such as sleeping, eating, smoking, or drinking? - Correct answer 1. With whom do you talk on a routine basis? 2. What do you do when you feel lonely? 5. Have you experienced any changes in lifestyle habits, such as sleeping, eating, smoking, or drinking? The nurse is caring for a patient who is suffering from posttraumatic stress disorder (PTSD) after a motor vehicle accident. What assessment findings reported by the patient provide cues to validate the diagnosis of PTSD? (Select all that apply.) 1. Frequent feelings of anxiety 2. Need to be around people 3. Frequent nightmares 4. Flashbacks to the accident 5. Feelings of sadness - Correct answer 1. Frequent feelings of anxiety 3. Frequent nightmares 4. Flashbacks to the accident 5. Feelings of sadness complementary therapy - Correct answer Complementary therapies are therapies used together with conventional treatment recommended by a person's health care provider. As the name implies, complementary therapies complement conventional treatments. integrative therapy - Correct answer Use of a combination of techniques from different therapies based on the therapist's judgement of which particular methods will provide the greatest benefit for the client. What type of complementary therapy requires special training? - Correct answer therapeutic touch, hypnotherapy, and chiropractic therapy, contain diagnostic and therapeutic methods that require special training Examples of complementary therapy - Correct answer relaxation; exercise; massage; reflexology; prayer; biofeedback; creative therapies, including art, music, or dance therapy; meditation; and herbs/supplements t/f When nonpharmacological therapies such as exercise, chiropractic, and herbal supplements are used in place of conventional pharmacological or other medical procedures, they are considered complementary therapies - Correct answer false: alternative therapy which therapy replaces biomedical care? - Correct answer alternative therapy What is integrative healthcare? - Correct answer integrative health care emphasizes the importance of the relationship between practitioner and patient; focuses on the whole person; is informed by evidence; and makes use of appropriate therapeutic approaches, health care professionals, and disciplines to achieve optimal health Nurses' knowledge and use of complementary therapies such as mindfulness, relaxation, and breathing techniques aid in reducing ______ and improving ______. - Correct answer reduce pain improve comfort ______ helps individuals develop cognitive skills to reduce the negative ways in which they respond to situations within their environment - Correct answer Relaxation progressive relaxation - Correct answer Progressive relaxation training teaches the individual how to effectively rest and reduces tension in the body. The person learns to detect subtle localized muscle tension sequentially, one muscle group at a tim passive relaxation - Correct answer passive relaxation is to still the mind and body intentionally without the need to tighten and relax any particular body part. One effective passive relaxation technique incorporates slow abdominal breathing exercises while imagining warmth and relaxation flowing through specific body parts such as the lungs or hands List nursing accessible therapies - Correct answer Relaxation Meditations & Breathing Imagery Which complementary therapies are most easily learned and applied by a nurse? (Select all that apply.) 1. Therapeutic massage therapy 2. Traditional Chinese medicine 3. Progressive relaxation 4. Breathwork and guided imagery 5. Therapeutic touch - Correct answer 3. Progressive relaxation 4. Breathwork and guided imagery ethics - Correct answer Ethics is the study of what is right and wrong with our conduct. It concerns our obligations to individuals, groups, and society. Morals are: - Correct answer Morals usually refer to judgment about behavior, based on specific beliefs, and ethics refers to the study of the ideals of right and wrong behavior. Values - Correct answer A value is a deeply held personal belief about the worth a person holds for an idea, a custom, or an object. The values that a person holds reflect cultural and social influences. autonomy - Correct answer Autonomy refers to freedom from external control. In health care the concept applies to respect for the autonomy of patients. It can also apply to agency respect for the autonomy of health care professionals. A commitment to respect the autonomy of others is a fundamental principle of ethical practice. beneficience and nonmaleficence - Correct answer Beneficence refers to taking positive actions to help others Nonmaleficence refers to the avoidance of harm or hurt. Professional Nursing Code of Ethics - Correct answer Guiding principles that all members of a profession accept: Advocacy responsibility accountability confidentiality Issues in healthcare ethics - Correct answer Social media Quality of life Care at the end of life Access to healthcare t/f Providing care to patients at the end of life and to those with serious illness who may be nearing end of life is a frequent source of ethical problems. - Correct answer true t/f Access to health care is an ethical issue of justice - Correct answer true In an _______ ________, a nurse faces two equally justifiable courses of action - Correct answer ethical dilemma In ____ _____the nurse feels unable to take the action that is correct. - Correct answer moral distress What are 3 approaches to ethics? - Correct answer Approaches to ethics include deontology, utilitarianism, and a relationship-based perspective. The nurse is caring for a patient who needs a liver transplant to survive. This patient has been out of work for several months, does not have health insurance, and cannot afford the procedure. Which of the following statements speaks to the ethical elements of this case? 1. The health care team should select a plan that considers the principle of justice as it pertains to the distribution of health care resources. 2. The patient should enroll in a clinical trial of a new technology that can do the work of the liver, similar to the way dialysis treats kidney disease. 3. The social worker should look into enrolling the patient in Medicaid, since many states offer expanded coverage. - Correct answer 1. The health care team should select a plan that considers the principle of justice as it pertains to the distribution of health care resources. ___1. You see an open medical record on the computer and close it so that no one else can read the record without proper access. ___2. You administer a once-a-day cardiac medication at the wrong time, but nobody sees it. However, you contact the provider and your nurse manager and follow agency procedure. ___3. A patient at the end of life wants to go home to die, but the family wants every care possible. The nurse contacts the primary care provider about the patient's request. ___4. You tell your patient that you will return in 30 minutes to give him his next pain medication. a. Advocacy b. Responsibility c. Accountability d. Confidentiality - Correct answer 1-d 2-c 3-a 4-b Resolution of an ethical problem involves discussion with the patient, the patient's family, and participants from appropriate health care disciplines. Which statement best describes the role of the nurse in the resolution of ethical problems? 1. To articulate the nurse's unique point of view, including knowledge based on clinical and psychosocial observations 2. To study the literature on current research about the possible clinical interventions available for the patient in question 3. To hold a point of view but realize that respect for the authority of administrators and health care providers takes precedence over personal views 4. To allow the patient and the health care provider private time to resolve the dilemma on the basis of ethical principles - Correct answer 1 The following are steps in the process to help resolve an ethical problem. What is the best order of these steps to achieve resolution? 1. List all the possible actions that could be taken to resolve the problem. 2. Articulate a statement of the problem or dilemma that you are trying to resolve. 3. Develop and implement a plan to address the problem. 4. Gather all relevant information regarding the clinical, social, and spiritual aspects of the problem. 5. Take time to clarify values and identify the ethical elements, such as principles and key relationships involved. 6. Recognize that the problem requires ethics. - Correct answer 6 4 5 2 1 3 Steps of the Nursing Process (ADPIE) - Correct answer 1. Assessment 2. Diagnosis 3. Planning 4. Implementation 5. Evaluation t/f The process is not linear; instead, it is an ongoing process that evolves as you care for a patient. - Correct answer true Subjective Data - Correct answer Subjective data are your patients' verbal descriptions of their health problems gathered during interviews (informal and formal). Subjective data include patient feelings, perceptions, and self-reported symptoms.