Nursing Workforce Issues and Community-Based Nursing: A Comprehensive Guide, Exams of Nursing

Download Nursing Workforce Issues and Community-Based Nursing: A Comprehensive Guide and more Exams Nursing in PDF only on Docsity! NUR 1025 Miami Dade College questions and answers latest 2024 graded A Nursing workforce issues - correct answer• Nursing students • Staffing and nurse-to-patient ratios • Nursing assignments • Patient abandonment • Nurse delegation Risk management and performance/quality improvement - correct answer• Identifying possible risks • Analyzing risks • Acting to reduce risks • Evaluating the steps take to reduce risks • Quality improvement • Patient safety and improved care are the goals Professional Responsibilities and Roles - correct answer-Autonomy and Accountability: -Educator -Caregiver -Advocate -Communicator -Manager Autonomy and Accountability: - correct answerhave initiation of independent nursing interventions without medical orders. Responsible professionally and legally for the type and quality of nursing care provided. advocate - correct answerprotects patient's human and legal rights and provide assistance in asserting these rights. Secure patient health care rights. Caregiver - correct answerhelp patients maintain and regain health, manage disease and symptoms, and attain a maximal level of function and independence. Restore patients emotional, spiritual a social well-being. educator - correct answerexplain concepts and facts about health, describe reason for routine care activities, demonstrate procedures, reinforce learning or patient behavior, and evaluate progress in learning. communicator - correct answeressential to routinely communicate with patients, to advocate, give emotional support, and make decisions with patients and family. manager - correct answerestablish environment for collaborate patient-center care with positive patient outcome. Coordinate activities of members of nursing staff. Creates a nursing environment that reflects the mission and values of the health care organization. Advanced Practice Registered Nurses - correct answerthe most independently functioning nurse. An APRN has a master's degree or Doctor of Nursing Practice (DNP) NUR 1025 Miami Dade College questions and answers latest 2024 graded A degree in nursing; advanced education in pathophysiology, pharmacology, and physical assessment; and certification and expertise in a specialized area of practice Clinical Nurse Specialist - correct answerAPRN who is an expert clinician in a specialized area of practice. The specialty may be identified by a population (e.g., geriatrics), setting (e.g., critical care), disease specialty (e.g., diabetes), type of care (e.g., rehabilitation), or type of problem (e.g., pain). Clinical nurse specialists provide diagnosis, treatment, and ongoing management of patients in all health care settings. They also provide expertise and support to nurses caring for patients at the bedside, help drive practice changes throughout an organization, and ensure the use of best practices and evidence-based care to achieve the best possible patient Nurse Practitioner - correct answerAPRN who provides comprehensive health care to a group of patients in an inpatient, outpatient, ambulatory care, or community-based setting. This care includes assessment, diagnosis, planning, and treatment; monitoring ongoing health status; evaluation of therapies; and health education. Some NPs provide care to acutely ill patients in hospital settings, including critical care units. Other NPs provide comprehensive care, directly managing the nursing and medical care of patients who are healthy or who have chronic conditions. It is important to review state regulations for advanced practice. Some states require the NP to have a collaborative provider agreement with an agency or physician/physician group to treat a specific group of patients; other states do not. Certified Nurse-Midwife: - correct answerAPRN who is also educated in midwifery and is certified by the American College of Nurse-Midwives (ACNM). The scope of practice of nurse-midwifery has been defined by the ACNM (2011) as encompassing a full range of primary health care services for women from adolescence beyond menopause. These services include primary care; gynecologic and family planning services; preconception care; care during pregnancy, childbirth, and the postpartum period; care of the normal newborn during the first 28 days of life; and treatment of male partners for sexually transmied infections (ACNM, 2011). The nurse-midwife conducts physical examinations; prescribes medications, including controlled substances and contraceptive methods; admits, manages, and discharges patients; orders and interprets laboratory and diagnostic tests; and orders the use of medical devices. Certified Registered Nurse Anesthetist - correct answeradvanced education from a nurse anesthesia-accredited program. Before applying to a nurse anesthesia program, a nurse must have at least 1 year of critical care or emergency experience. Nurse anesthetists' practice both autonomously and in collaboration with a variety of health care providers on the interprofessional team to deliver high-quality, holistic, evidence- based anesthesia and pain care services (American Association of Nurse Anesthetists, 2017). CRNAs practice under the guidance and supervision of an anesthesiologist, a physician with advanced knowledge of surgical anesthesia. NUR 1025 Miami Dade College questions and answers latest 2024 graded A - Assessment of health care needs - Policy - Access to care Vulnerable populations - correct answer- Immigrant populations - homeless people - Patients who are abused - Patients with mental illness - Older adults Competency in Community-Based Nursing - correct answer1. Caregiver: - In the community seeking you manage and care for the health of patients and families in the community. Use a critical thinking approach to apply the nursing process and ensure appropriate, individualized nursing care for your patients and their families. - Must individualize care within the context of a patient's community so that long-term success is more likely. - Together with a patient and family you develop a caring partnership to recognize actual and potential health care needs and identify needed community. 2. Case manager: - Establish an appropriate plan of care based on assessment of patients and families and coordinate needed resources and services for a patient's well- being across a continuum of care. - Assumes responsibility for the case management of multiple patients. The greatest challenge is to coordinate the activities of multiple providers and payers in different settings throughout a patient's continuum of care. - Eventually learns the obstacles, limits, and even the opportunities that exist within the community that influence the ability to find solutions for patients' health care needs. 3. Change agent: - This involves identifying and implementing new and more effective approaches to problems. You act as a change agent within a family system or as a mediator for problems within a patient's community - You identify any number of problems (e.g., quality of community child care services, availability of older-adult day care services, or the status of neighborhood violence). - As a change agent you empower individuals and their families to creatively solve problems or become instrumental in creating change within a health care agency. 4. Patient advocate: · Patient advocacy is important in community-based practice mainly because of the confusion surrounding access to health care ser Community Assessment - correct answer- the systematic data collection on the population, monitoring the health status of the population, and making information available about the health of the community. - The community has three components: structure or locale, the people, and the social systems. NUR 1025 Miami Dade College questions and answers latest 2024 graded A Structure: Name of community or neighborhood Geographical boundaries Emergency services Water and sanitation Housing Economic status Transportation Safety Population • Age distribution • Sex distribution • Growth trends • Density Education level• Predominant ethnic groups• Predominant religious groups Social System • Educational system• Government• Communication system • Welfare system• Volunteer programs• Health system Theory - correct answeris the foundation for the art and science of nursing Theory-based nursing practice - correct answerTheory generates nursing knowledge for use in practice, thus supporting evidence-based practice (EBP). -Is important for implementing nursing interventions. Domain of Nursing - correct answer-Domain: provides the perspective of territory of a profession or discipline. It allows the nurse to identify and treat patients' health care needs at all levels and in all health care settings. Paradigm - correct answeris a pattern of beliefs used to describe the domain of a discipline. It links concepts, theories, beliefs, values and assumptions accepted and applied by the discipline. -it is used to describe the domain of a discipline. Nursing Metaparadigm - correct answerallows nurses to understand and explain what nursing is, does, and why nurses do what they do. Includes the four concepts of person: -Person (human being): recipient of nursing care -Health: clinical setting: and the health care profession -Environment/situation: includes all possible conditions affecting patients and the settings in which health care needs occur Nursing: diagnosis and treatment of human responses or potential health problems. Types of theory - correct answerGrand, Middle-range, practice, Descriptive, Prescriptive grand theory - correct answerAbstract, broad in scope, complex Middle Range Theory - correct answerLimited in scope and less abstract NUR 1025 Miami Dade College questions and answers latest 2024 graded A practice theory - correct answerNarrow in scope and focus descriptive theory - correct answerDescribe phenomena and identify circumstances in which phenomena occur Prescriptive Theory - correct answerAddress nursing interventions for a phenomenon, guide practice change, and predict the consequences Shared Theories - correct answer• Also known as a borrowed or interdisciplinary theory • Explain a phenomenon specific to the discipline that developed the theory • Several nursing theories are based on systems theory. The nursing process is a system. • Input/output • Feedback • Content EBP (evidence based practice) - correct answernursing care provided that is supported by sound scientific rationale What is the purpose of EBP? - correct answer-Looks for the very best scientific and clinical evidence for treating and managing a problem -Improves quality, safety, and patient outcomes. -Increases nurse satisfaction -Reduces costs What are the steps of Evidence Based Practice? - correct answer0. Cultivate a spirit of inquiry. 1. Ask a clinical question in PICOT format. 2. Search for the best evidence. 3. Critically appraise the evidence. 4. Integrate the evidence. 5. Evaluate the outcomes of practice decision or changes. 6. Communicate the outcomes of the evidence-based practice decision. The integration of evidence in nurse practice - correct answer- Apply the research in your plan of care for the patient, use evidence as rationale. - Education about the change must occur. - Large-scale change requires planning. - Pilot study can show if change can be implemented easily. - Incorporate into policies and procedures. - Integrations: teaching tools, clinical practice guidelines, P&Ps, new assessment tools. Sources of Evidence - correct answer-Textbooks -Articles from nursing and health care literature NUR 1025 Miami Dade College questions and answers latest 2024 graded A The nursing process - correct answer- Assessment: Gather information about the patient's condition - Diagnosis: identify the patient's problems - Planning: set goals of care and desired outcomes and identify appropriate nursing actions. - Implementation: perform the nursing actions identified in planning. - Evaluation: determine if goals and expected outcomes are achieved. Types of Data - correct answerSubjective: Patients' verbal descriptions of their health problems Includes patient feelings, perceptions, and self-reported symptoms Objective: Findings resulting from direct observation When you collect objective data, apply critical thinking intellectual standards so that you can correctly interpret your findings. Assessment data sources - correct answer- Patient - Family caregivers and significant others - Health care team - Medical records - Other records and the scientific literature - Nurse's experience The patient-centered interview - correct answer· Motivational interviewing • Interview preparation • Communication skills - Courtesy - Comfort - Connection - Confirmation Phases - Orientation and setting an agenda - Working phase—collecting data Interview techniques Observation Open-ended questions Direct closed-ended questions Leading questions Back channeling Probing Interpret - Termination phase NUR 1025 Miami Dade College questions and answers latest 2024 graded A Types of assessments - correct answer- Patient-centered interview (conducted during a nursing history) - Periodic assessments (conducted during ongoing contact with patients) - Physical examination (conducted during a nursing history and at any time a patient presents a symptoms) Nursing health history - correct answer- Physical and developmental: - intellectual - spiritual - social - emotional The assessment process - correct answeryou collect a comprehensive set of data about a patient and recognize and identify patterns that begin to reflect the meaning of a patient's response to health problems. Types of Nursing Diagnoses - correct answer-Pathophysiological -Treatment-related -Personal -Environmental -Maturational Critical thinking and the nursing diagnostic process - correct answer·Use the nursing diagnostic process to accurately identify a patient's nursing diagnoses. -Critical thinking -Knowledge -Experience -Attitudes -Intellectual standards Clinical Judgement in Nursing Practice - correct answer- Nurses must make accurate and appropriate clinical decisions or judgements. - Clinical judgement o Conclusion about a patient's needs or health problems o Influenced by a nurse's experience and knowledge o Partly relies on knowing the patient o Influenced by the context of clinical situations and the culture of patient care settings o Nurses use a variety of reasoning approaches in combination Sources of diagnostic error - correct answer- data collection: Avoid inaccurate or missing data NUR 1025 Miami Dade College questions and answers latest 2024 graded A - data clustering: occurs when you make a nursing diagnosis before grouping all patient data - interpretation and analysis of data: consider any conflicting data elements and determine whether there are sufficient data to form a diagnosis - labeling the diagnosis/the diagnostic statement - documentation and informatics: Establishing Priorities - correct answerOrdering of nursing diagnoses or patient problems to establish a preferential order for nursing interventions Problem-focused diagnoses and problems take priority over wellness, possible risk, and health promotion problems Helps you anticipate and sequence nursing interventions when a patient has multiple nursing diagnoses and collaborative problems Establish priorities in relation to their ongoing clinical importance • High: Nursing diagnoses that, if untreated, result in harm to a patient or other Maslow's hierarchy of needs • Intermediate: Non-emergent and not life-threatening • Low: Not always directly related to a specific illness or prognosis but affect a patient's future well-being • Review priorities each time you see the patient. critical pathways of care - correct answerMany hospitals are using critical pathways and enhanced recovery after surgery (ERAS) protocols to: - Reduce variations in clinical practice - Standardize evidence-based care - Reduce patient length of stay - Improve patient outcomes o Must individualize patient care** Critical thinking in setting goals - correct answerA broad statement that describes the desired change in a patient's condition, perceptions, or behavior Short-term Long-term Often based on standards of care or clinical guidelines established for minimal safe practice. • Patient and interprofessional team collaboration is needed in goal setting critical thinking in expected outcomes - correct answer- Selecting goals and expected outcomes - Nursing-sensitive patient outcome NUR 1025 Miami Dade College questions and answers latest 2024 graded A These outcomes are the criteria for judging the success in delivering nursing care. - Standards for evaluation Recognize Errors Unmet Outcomes - correct answer- must have an open mind, actively pursue truth, be patient and confident, and engage in self-reflection. - Apply observational skills, critical thinking intellectual standards, knowledge, and reflection to recognize the actual results of care. - Self-reflection and correction of errors. - Systematic use of evaluation - Correction of errors. Revising a Care Plan - correct answer- Discontinuing a care plan Modifying a care plan: - Redefining diagnoses - Revising goals and expected outcome - Revising intervention Federal statutes impacting nursing practice - correct answer- Emergency Medical Treatment and Active Labor Act: when a patient presents to an emergency department, they must be treated - Health Insurance Portability and Accountability Act (HIPAA): Establishes patient rights regarding privacy of their health care information and records - Health Information Technology Act: Nurses must ensure PHI is protected - Americans with Disabilities Act (ADA): Protects rights of people with physical or mental disabilities - Mental Health Parity and Addiction Equity Act: Requires health insurance companies to provide coverage for mental health and substance use disorder (SUD) treatment - Patient Self-Determination Act: Requires health care institutions to provide written information to patients concerning their rights to make decisions about their care, including the right to refuse treatment and to formulate an advance directive - Uniform Anatomical Gift Act - The Omnibus Budget Reconciliation Act (1987) - Older adults - Restraints NUR 1025 Miami Dade College questions and answers latest 2024 graded A State statutes impacting nursing practice - correct answer- Nurse Practice Act: State laws intended to protect citizens, make nurses accountable and assure that care is consistent with best practice within the scope and standards of nursing • Licensure • Enhanced nurse licensure compact • Informed consent and health care acts • An explanation of the procedure or treatment • The names and qualifications of people performing and assisting in the procedure • A description of the serious harm, including death, that may occur as a result of the procedure and anticipated pain and/or discomfort • Knows that he or she has the right to refuse the procedure/treatment • Knows that he or she may refuse the procedure/treatment -Good Samaritan laws: Limit liability and offer legal immunity if a nurse helps at the scene of an accident -Public health laws: Laws affect individuals, populations, and communities that are intended to improve the health of people -The Uniform Determination of Death Act: Determines actual death Legal implications and Issues Associated with Nursing Practice - correct answerTORTS: Intentional -Assault -Battery -False imprisonment Quasi-intentional o Acts in which a person may not intend to cause harm to another but does. - Defamation of character - Slander - Libel Civil and common law issues in nursing practice Unintentional torts -Negligence -Malpractice Beginning -and end-of-life nursing issues -Termination of pregnancy -Death with dignity or physician-assisted suicide. NUR 1025 Miami Dade College questions and answers latest 2024 graded A Nurse experts - correct answer• A nursing expert testifies about the standards of nursing care as applied to the facts of a case • An expert has education and experience related to the alleged complaint of the patient and accurately and concisely describes the pertinent scope and standards of practice required of a nurse under similar circumstances. • The expert nurse must determine that no conflict of interest exists before accepting a case. For example, the expert nurse could not work for either party's employer. • The expert will review all evidence before giving an opinion, including relevant laws and regulations, policies and procedures, patient records, other expert reports, and depositions. Nurse Delegation - correct answerWhen an RN delegates nursing tasks to qualified NACs or NARs Cultural Considerations in Assessment - correct answer- Cultural competence: Involves self-awareness, reflective practice, and knowledge of a patient's core cultural background. - Cultural Humility: Requires you to recognize your own knowledge limitations and cultural perspective and thus be open to new perspectives. - Show your patients respect and understand their individual needs and differences; do not impose your