NR 222 Final Exam Study Guide, Exams of Nursing

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Page 1 NR 222 Final Exam Study Guide 2023-2024 Latest Healing Touch - Correct answer need to be trained Therapeutic Touch - Correct answer you do not need to be trained Communication throughout the nursing process - Correct answer Assessment • Verbal interviewing and history taking • Visual and intuitive observation of nonverbal behavior • Visual, tactile, and auditory data gathering during physical examination • Written medical records, diagnostic tests, and literature review Nursing Diagnosis • Intrapersonal analysis of assessment findings • Validation of health care needs and priorities via verbal discussion with patient • Documentation of nursing diagnosis Planning • Interpersonal or small-group health care team planning sessions • Interpersonal collaboration with patient and family to determine implementation methods • Written documentation of expected outcomes • Written or verbal referral to health care team members P a g e 1 | 24 Page 2 Implementation • Delegation and verbal discussion with health care team • Verbal, visual, auditory, and tactile health teaching activities • Provision of support via therapeutic communication techniques • Contact with other health resources • Written documentation of patient's progress in medical record Evaluation • Acquisition of verbal and nonverbal feedback • Comparison of actual and expected outcomes • Identification of factors affecting outcomes • Modification and update of care plan • Verbal and/or written explanation of care plan revisions to patient Emotional Intelligence (EI) - Correct answer is an assessment and communication technique that allows nurses to better understand and perceive the emotions of themselves and others. enables a nurse to use self-awareness, motivation, empathy, and social skills to build therapeutic relationships with patients if a nurse understands a patient's perceptions and motivations, he or she can help the patient make healthy behavior changes. Patients feel more comfortable addressing their poor health habits when this approach is used. This can lead to enhanced self-care behaviors and improved patient outcomes Levels of communication - Correct answer Intrapersonal Interpersonal Small Group P a g e 2 | 24 Page 5 • Encourage and help the patient set goals. • Take action to meet the goals set with the patient. • Use therapeutic communication skills to facilitate successful interactions. • Use appropriate self-disclosure and confrontation. Termination Phase During the ending of the relationship: • Remind the patient that termination is near. • Evaluate goal achievement with the patient. • Reminis Motivational Interviewing - Correct answer is a technique that holds promise for encouraging patients to share their thoughts, beliefs, fears, and concerns with the aim of changing their behavior. MI provides a way of working with patients who may not seem ready to make behavior changes that are considered necessary by their health practitioners. It can potentially be used to evoke change talk, which links to improved patient outcome Lateral Violence - Correct answer Between nursing colleagues. Includes both overt and covert physical, verbal, and emotional abuse by one nurse against another. Elements of professional communication - Correct answer Appearance Courtesy Use of Names trustworthiness Autonomy and Responsibility P a g e 5 | 24 Page 6 Assertiveness Focus on Older Adults - Correct answer Tips for Improved Communication with Older Adults Who Have Hearing Loss • Make sure the patient knows that you are talking. • Face the patient, be sure that your face/mouth is visible to him or her, and do not chew gum or talk while chewing. • Speak clearly but do not exaggerate lip movement or shout. • Speak a little more slowly but not excessively slow. • Check if patient uses hearing aids, glasses, or other adaptive equipment. • Choose a quiet, well-lit environment with minimal distractions. • Allow time for the patient to respond. Do not assume that patient is being uncooperative if he or she does not reply or takes a long time to reply. • Give the patient a chance to ask questions. • Keep communication short and to the point. Ask one question at a time. Communication with Non-English-Speaking Patients - Correct answer Implications for Patient- Centered Care • Understand your own cultural values and biases. • Assess the patient's primary language and level of fluency in English. • Provide a professional interpreter for the patient and health care providers to communicate with one another. Do not use a family member as an interpreter. • Speak directly to the patient even if an interpreter is present. • Nodding or statements such as "OK" do not necessarily mean that the patient understands. • Provide written information in English and primary language. P a g e 6 | 24 Page 7 • Learn about other cultures, especially those commonly encountered in your work area. • Incorporate the patient's communication methods or need into plan of care. Therapeutic communication - Correct answer Therapeutic communication techniques are specific responses that encourage the expression of feelings and ideas and convey acceptance and respect. These techniques apply in a variety of different situations. Active Listening. Sharing Observations. Sharing Empathy. Sharing Hope. Sharing Humor. Sharing Feelings. Using Touch. Using Silence. Providing Information. Clarifying. Focusing. Paraphrasing. Validation. Asking Relevant Questions. Summarizing. Self-Disclosure. Confrontation. P a g e 7 | 24 Page 10 The Teach Back technique is an ongoing process of asking patients for feedback through explanation or demonstration and presenting information in a new way until you feel confident that you communicated clearly and that your patient has a full understanding of the information presented You also use Teach Back to help you identify explanations and communication strategies that your patients most commonly understand Transcultural nursing - Correct answer focus on providing care within the differences and similarities of the beliefs, values, and patterns of cultures (Leininger) integration of culture into all aspects of nursing care Cultural Competency ASKED - Correct answer Awareness Skill Knowledge Encounter Desire Linguistic Competence - Correct answer the capacity of an organization to communicate effectively and convey information in a manner that is easily understood by diverse audiences including Most health care providers and virtually all health care organizations nationwide are subject to federal civil rights laws. These laws outline requirements for the provision of language access services. They also help ensure meaningful access to health care for people with limited English proficiency and offer effective communication services for those who are deaf or hard-of-hearing Autonomy - Correct answer self choice Nonmaleficence - Correct answer Do no harm P a g e 10 | 24 Page 11 Beneficence - Correct answer doing good Veracity - Correct answer honesty Fidelity - Correct answer faithfulness Health Belief Model - Correct answer Suggests that an individual's decision to adopt healthy behaviors is based upon their perception of susceptibility to an illness & severity of illness role of values and beliefs in predicting adherence and treatment outcomes Social Cognitive Theory - Correct answer Theory that holds that portions of an individual's knowledge acquisition can be directly related to observing others within the context of social interactions, experiences, and outside media influences (Bandura). Transcultural Model of Change - Correct answer where person is in relation to change Primary prevention - Correct answer Primary prevention aims to prevent disease or injury before it ever occurs. This is done by preventing exposures to hazards that cause disease or injury, altering unhealthy or unsafe behaviors that can lead to disease or injury, and increasing resistance to disease or injury should exposure occur. Examples include: legislation and enforcement to ban or control the use of hazardous products (e.g. asbestos) or to mandate safe and healthy practices (e.g. use of seatbelts and bike helmets) education about healthy and safe habits (e.g. eating well, exercising regularly, not smoking) immunization against infectious diseases. P a g e 11 | 24 Page 12 Secondary Prevention - Correct answer Secondary prevention aims to reduce the impact of a disease or injury that has already occurred. This is done by detecting and treating disease or injury as soon as possible to halt or slow its progress, encouraging personal strategies to prevent reinjury or recurrence, and implementing programs to return people to their original health and function to prevent long-term problems. Examples include: regular exams and screening tests to detect disease in its earliest stages (e.g. mammograms to detect breast cancer) daily, low-dose aspirins and/or diet and exercise programs to prevent further heart attacks or strokes suitably modified work so injured or ill workers can return safely to their jobs. Tertiary Prevention - Correct answer Tertiary prevention aims to soften the impact of an ongoing illness or injury that has lasting effects. This is done by helping people manage long-term, often-complex health problems and injuries (e.g. chronic diseases, permanent impairments) in order to improve as much as possible their ability to function, their quality of life and their life expectancy. Examples include: cardiac or stroke rehabilitation programs, chronic disease management programs (e.g. for diabetes, arthritis, depression, etc.) support groups that allow members to share strategies for living well vocational rehabilitation programs to retrain workers for new jobs when they have recovered as much as possible. Penders model - Correct answer a health care provider's responsibility is to : assess,implement and evaluate a screening program and teaching individuals,family and population. everyone has unique personal characteristics that affect their actions multidimensional nature of people as they interact with environment to pursue health Transtheoretical Model - Correct answer precontemplation contemplation P a g e 12 | 24 Page 15 • Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight • Disturbance in the way in which one's body weight, size, or shape is experienced; undue influence of body weight or shape on self-evaluation; or persistent lack of recognition of the seriousness of the current low body weight (e.g., the person claims to "feel fat" even when emaciated, believes that one area of the body is "too fat" even when obviously underweight) Bulimia Nervosa • Recurrent episodes of binge eating (rapid consumption of a large amount of food in a discrete period of time) • A feeling of lack of control over eating behavior during eating binges • Recurrent inappropriate compensatory behaviors to prevent weight gain, such as self-induced vomiting, use of laxatives or diuretics, strict dieting or fasting, or vigorous exercise • Binge eating and inappropriate compensatory behaviors that both occur, on average, at least once a week for 3 months • Self-evaluation unduly influenced by body shape and weight Domains of Learing - Correct answer Cognitive Effective Psychomotor Cognitive teaching methods - Correct answer Cognitive • Discussion (one-on-one or group) • Involves nurse and one patient or a nurse with several patients • Promotes active participation and focuses on topics of interest to patient • Allows peer support • Enhances application and analysis of new information • Lecture P a g e 15 | 24 Page 16 • Is more formal method of instruction because it is educator controlled • Helps learner acquire new knowledge and gain comprehension • Question-and-answer session • Addresses patient's specific concerns • Helps patient apply knowledge • Role play, discovery • Allows patient to actively apply knowledge in controlled situation • Promotes synthesis of information and problem solving • Independent project (computer-assisted instruction), field experience • Allows patient to assume responsibility for completing learning activities at own pace • Promotes analysis, synthesis, and evaluation of new information and skills Effective teaching methods - Correct answer • Role play • Allows expression of values, feelings, and attitudes • Discussion (group) • Allows patient to receive support from others in group • Helps patient learn from others' experiences • Promotes responding, valuing, and organization • Discussion (one-on-one) • Allows discussion of personal, sensitive topics of interest or concern Psychomotor teaching methods - Correct answer • Demonstration • Provides presentation of procedures or skills by nurse P a g e 16 | 24 Page 17 • Permits patient to incorporate modeling of nurse's behavior • Allows nurse to control questioning during demonstration • Practice • Gives patient opportunity to perform skills using equipment in a controlled setting • Provides repetition • Return demonstration • Permits patient to perform skill as nurse observes • Provides excellent source of feedback and reinforcement • Assists in determining patient's ability to correctly perform a skill or technique • Independent projects, games • Requires teaching method that promotes adaptation and origination of psychomotor learning • Permits learner to use new skills DABDA - Correct answer Denial Anger Bargaining Depression Acceptance Assessment Nursing vs Teaching - Correct answer Nursing process: Collect data about patient's physical, psychological, social, cultural, developmental, and spiritual needs from patient, family, diagnostic tests, medical record, nursing history, and literature. Teaching Process: P a g e 17 | 24 Page 20 For example, genes direct the growth rate in height for an individual, but that growth is only maximized if environmental conditions are adequate. Poor nutrition or chronic disease often affects the growth rate and results in smaller stature, regardless of the genetic blueprint. However, adequate nutrition and the absence of disease cannot result in height beyond that determined by heredity. Biophysical Development - Correct answer Biophysical development is how our physical bodies grow and change. Health care providers are able to quantify and compare the changes that occur as a newborn infant grows against established norms. How does the physical body age? What are the triggers that move the body from the physical characteristics of childhood, through adolescence, to the physical changes of adulthood? Ericksons theory Psychosocial - Correct answer Infant (Hope) - Basic Trust vs. Mistrust Toddler (Will) - Autonomy vs. Shame Preschooler (Purpose) - Initiative vs. Guilt School-Age Child (Competence) - Industry vs. Inferiority Adolescent (Fidelity) - Identity vs. Identity Diffusion Young Adult (Love) - Intimacy vs. Isolation Middle-aged Adult (Care) - Generativity vs. Self-absorption Older Adult (Wisdom) - Integrity vs. Despair Freuds Theory Psychosexual - Correct answer Oral Stage (0-1 year) Anal Stage (1-3 years) Phallic Stage (3 to 5 or 6 years) Latency Stage (5 or 6 to puberty) P a g e 20 | 24 Page 21 Genital Stage (puberty to adult) Piagets theory Cognitive - Correct answer Sensorimotor stage (Infancy) Pre-operational stage (Toddler and Early Childhood) Concrete operational stage (Elementary and early adolescence) Formal operational stage (Adolescence and adulthood). development precedes learning Vygotsky Theory - Correct answer Believes that children learn through social and cultural experiences learning precedes development Vygotsky places considerably more emphasis on social factors contributing to cognitive development For Vygotsky, the environment in which children grow up will influence how they think and what they think about. Zone of proximal development Kohlberg Theory Moral Reasoning - Correct answer Level 1 (Pre-Conventional) 1. Obedience and punishment orientation (How can I avoid punishment?) 2. Self-interest orientation (What's in it for me?) P a g e 21 | 24 Page 22 (Paying for a benefit) Level 2 (Conventional) 3. Interpersonal accord and conformity (Social norms) (The good boy/girl attitude) 4. Authority and social-order maintaining orientation (Law and order morality) Level 3 (Post-Conventional) 5. Social contract orientation 6. Universal ethical principles (Principled conscience) Gilligans theory - Correct answer argues that Kolhbergs theory is more applicable to males than females. Her "ethics of care" stage model was based on research with females and emphasized concerns about care, compassion, and responsibility Kohlberg had shown that the average female attained a moral judgment rating of stage three (good boy-nice girl), while adolescent males score at level four (law and order) and are more likely to move on to postconventional levels. Gilligan suggests that these findings reveal a gender bias, not that females are less mature than boys. Men and women follow different voices. Men tend to organize social relationships in a hierarchical order and subscribe to a morality of rights. Females value interpersonal connectedness, care, sensitivity, and responsibility to people. Metacommunication - Correct answer refers to all the factors that influence communication reading between the lines verbal and nonverbal ques together P a g e 22 | 24