Exam 3 Theory EAQ

The nurse is teaching a group of nursing students about acupuncture. Which statement by a nursing student indicates effective learning?

"Acupuncture is contraindicated in persons who have bleeding disorders." Acupuncture is contraindicated in persons who have bleeding disorders. Acupuncture therapy is used for various disease conditions, not only for chronic disease conditions. Electroacupuncture is contraindicated for pregnant women. Semipermanent needles should not be used with patients who have valvular heart disease, because this may increase the risk of infection.

The nurse has taught imagery therapy to a patient. Which patient response indicates the need for further teaching?

"All images can be used for all patients." Imagery therapy involves eliciting a relaxation response through images. Individualized images are used for each patient; all images are not appropriate for all patients. Patients can respond to their environment according to the way they perceive it and by their own visualizations and expectancies. Images used in imagery therapy should not evoke negative memories or feelings in the patient. Therefore individualized images are required for the patient. Imagery therapy improves sleep and decreases the frequency of nightmares. During imagery therapy the patient does experience smell and sounds. Test-Taking Tip: Be aware of absolute terms in choices, such as all, every, none, and never. For this question, because you were looking for an incorrect statement, the double use of all provides a clue that the statement is incorrect, so that choice is the right one. To help you answer the question correctly, be sure you read the phrase, "the need for further teaching" as "Which statement is false."

While measuring the vital signs of a Muslim patient, the nurse observes that the patient is anxious. Which statement by the nurse indicates a good understanding of transcultural nursing?

"I know modesty is very important for you. Is there any way I can make you comfortable?" Muslim patients often highly value modesty and may be uncomfortable with certain procedures, particularly if the health care worker is of the opposite sex. Therefore, the nurse should make the patient comfortable by showing an attitude of helpfulness and asking what can be done to make the patient more comfortable. The nurse should demonstrate flexibility and should not instruct the patient to adjust, because it may violate the patient's core values. The nurse should provide culturally congruent assessment to the patient. The nurse should not force the patient to adhere to the hospital rules; instead, the nurse should provide patient-centered care.

A registered nurse is evaluating the statements of the student nurse regarding reproductive changes that occur in both sexes due to aging. Which statement made by the student nurse indicates a need for further teaching?

"Production of sperm in men decreases during the third decade of life." Production of sperm declines during the fourth decade of a man's life; that is, it declines at 40 years of age, not at 30 years of age. With increasing age, sexual desire also decreases. A characteristic feature of reproductive change in women is decreased production of estrogen and progesterone. Decreased estrogen and progesterone may cause decreased lubrication of the vaginal mucosa, leading to irritation. Vaginal irritation, which occurs due to lack of lubrication, may result in pain during sexual activity. Test-Taking Tip: The production of sex hormones decreases with increasing age. Relate the effects of sex hormones on reproductive system in geriatrics. This may help you in answering the question.

The nurse is carrying out an assessment of a Chinese patient with pain in the abdomen. Which question by the nurse is open-ended?

"What do you think of your problem?" Open-ended questions allow the patient to express feelings or to elaborate more on the situation. Open-ended questions do not limit the patient's response to either "yes" or "no" or a short answer. In this scenario, asking what the patient thinks about the problem is an open-ended question. Asking about the location, severity, or duration of the pain are closed-ended questions.

A nurse who is caring for an older adult patient observes that the patient lacks confidence and is unwilling to take medications. Which statement by the nurse would promote positive perception in the patient?

"You should try to be happy and spend some time talking with your friends." Older adults respond to therapeutic medication promptly if there is a positive perception. They may feel happy and respond if spoken to nicely and respectfully. Therefore, suggesting that the older adult try to be happy and spend time talking to friends can help to promote positive perception. Using phrases such as "old man," "older people," and "aged people" may make the patient feel discriminated against because of age. Therefore, the nurse should not make statements such as "you need to take medications on time" and "you should accept that aging is a universal truth." Statements such as "talk with other people who are your age" demonstrate ageism and will demotivate the older adult.

The nurse is explaining the benefits of exercise to older adults. Which statements by the older adults indicate effective learning? Select all that apply.

- "Exercise reduces stress." - "Exercise increases muscle tone." - "Exercise improves joint flexibility." Exercise helps to maintain physical activity. The main benefits of exercise are to maintain and strengthen functional ability and promote a sense of enhanced well-being. Exercise promotes the production of chemicals that reduce stress. It also increases circulation of blood to the muscles and increases muscle tone. Exercise promotes the use of joints and improves joint flexibility. Exercise promotes mineralization of bones, thereby strengthening bones. Exercise helps in conditioning the muscles, promotes stamina, and reduces limitations. Test-Taking Tip: Even though the question asks about statements made by older adults, the question is really asking if you know which statements are true. Because the question asks for indications of effective learning, assign "true" or "false" to each statement as you consider them one at a time. Then recheck that the choices you marked as "true" answer the question.

The nurse is teaching a group of older adults. Which principles are helpful in promoting learning in older adults? Select all that apply.

- Ask for feedback from the patient - Present one idea or concept at a time - Use audio and visual cues while teaching In old age, some sensory changes occur in the body, so the teaching should be adjusted accordingly. By using appropriate teaching techniques, the nurse should be able to help the patient compensate for sensory changes and perform activities independently. The nurse should ask for feedback from the patient to ensure that the patient understands the information. Presenting one idea or concept at a time helps to avoid confusion. Audio and visual cues should be used while teaching, because they help the patient to remember and retain information. These principles help to promote learning in the older adult. The nurse should sit facing the patient so that the patient is able to watch lip movements and facial expressions, because this helps the patient to understand the subject. The nurse should speak slowly and in a normal tone of voice for the patient to understand properly. Test-Taking Tip: When you are unsure of the material in a multiple-response question, use your good judgment and common sense to evaluate each response individually. For this question, you can eliminate two of the choices right away. You know you have learned that facing the patient is best. Because older adults may have hearing problems, it would not be advisable to speak fast. Now, to confirm your answers, reread the question and see if the choices you have not eliminated seem reasonable.

Which factor in Watson's carative theory could the nurse utilize in any setting? Select all that apply.

- Cultivating sensitivity to others - Instilling faith and hope - Providing for a supportive and spiritual environment - Developing a trusting relationship between the nurse and patient Watson's theory of caring comprises 10 carative factors: 1) expressing all positive and negative feelings, 2) instilling faith and hope, 3) developing a trusting relationship between the nurse and the patient, 4) forming a human value system, 5) cultivating sensitivity to others, 6) using creative problem-solving processes, 7) promoting transpersonal teaching-learning, 8) providing for a supportive and spiritual environment, 9) meeting human needs, and 10) allowing for existential spiritual forces. Withholding expression of negative emotions is not a carative factor.

The nurse decides to use Swanson's theory of caring in clinical practice. Which caring processes are included in this theory? Select all that apply.

- Knowing - Doing for - Being with The caring processes of Swanson's theory of caring include knowing, doing for, and being with. Knowing helps to understand an event and adds meaning to life. Doing for a patient is comforting to the patient. Being with a patient provides emotional support to the patient. Bias and randomization are not part of Swanson's theory. Test-Taking Tip: Practicing a few relaxation techniques may prove helpful on the day of an examination. Relaxation techniques such as deep breathing, imagery, head rolling, shoulder shrugging, rotating and stretching of the neck, leg lifts, and heel lifts with feet flat on the floor can effectively reduce tension while causing little or no distraction to those around you. Practice one or two of these techniques intermittently to avoid becoming tense.

A 60-year-old patient is undergoing treatment for a brain tumor. The patient is depressed due to the diagnosis. The nurse enters the room and finds that the patient is weeping. On inquiring, the patient starts speaking about the disease and the related problems. To be a good listener, what should the nurse do? Select all that apply.

- Maintain good eye contact - Give complete attention to the patient - Be silent and listen to the patient carefully When communicating with any patient the nurse should be a patient listener. The patient should feel that the nurse is genuinely interested in knowing the complaints. The nurse should make good eye contact and give complete attention to the patient. It is important that the nurse listens to the patient with an open mind. The nurse should keep mind and mouth silent and let the patient speak. The nurse should not interrupt or give opinions. It is easy for the nurse to get distracted by tasks on hand and workload, but the nurse should listen to the patient first and then complete the tasks. Test-Taking Tip: Put yourself in the position of the patient to answer questions like these. How would you want the nurse to respond to your emotional concerns?

When communicating with a patient who has a visual impairment, which techniques should the nurse use? Select all that apply.

- Sit at eye level in front of the patient - Provide diffuse, bright light without glare - Encourage the use of eyeglasses or magnifying glasses Sitting at eye level helps the patient to see the nurse and understand the words better. Help the patient have a better view of the nurse by providing diffuse and bright light, with no glare. Encourage the patient to wear eyeglasses or use magnifying glasses to improve vision. Covering the mouth when talking may muffle the spoken words, which may make them difficult to understand. Standing at eye level with the patient facilitates effective communication.

The nurse is teaching a group of older adults the importance of daily exercise. Which instructions should the nurse include in the teaching? Select all that apply.

- Stop exercising if there is chest pain or tightness. - Walking and swimming exercises protect the musculoskeletal system. - Wear good support shoes and clothing appropriate to the exercise The nurse should instruct older adults to stop exercising if there is chest pain or tightness, because this indicates exertion. Walking and swimming exercises are good for protecting the musculoskeletal system, because they condition the muscles and strengthen the bones. Good support shoes should be worn to prevent soft-tissue injuries. Clothing should be appropriate for exercise to promote comfort. Older adults should avoid outdoor exercises in extreme cold or warm weather to prevent temperature-related complications. Older adults should drink water before and after exercising to prevent dehydration. STUDY TIP: Regular exercise for you—not just for patients—even if only a 10-minute brisk walk each day, aids in reducing stress. Although you may have been able to enjoy regular sessions at the health club or at an exercise class several times a week, you may have to cut down on that time without giving up a set schedule for an exercise routine. Using an exercise bicycle that has a book rack on it can help you accomplish two goals at once. You can exercise while beginning a reading assignment or while studying notes for an exam. Listening to lecture recordings while doing floor exercises is another option. At least a couple of times a week, however, the exercise routine should be done without the mental connection to school; time for the mind to unwind is necessary, too.

Arrange the steps of the research process in correct order

1. Identify areas of interest or a clinical problem. 2. Design the study protocol. 3. Obtain necessary approvals. 4. Analyze the results of the study. 5. Formulate recommendations for further research The research process is an orderly series of steps that allow a researcher to move from asking a research question to finding the answer. The initial step in the research process is identifying areas of interest or a clinical problem. The next step is designing a study protocol. Then the researcher should obtain necessary approvals to conduct the study. Finally, the researcher analyzes the results of the study and formulates recommendations for further research.

The nurse helps a researcher conduct a randomized controlled trial (RCT). Which is the correct sequence when conducting an RCT?

1. Subjects are randomly assigned to either the control or treatment group. 2. The treatment group receives the experimental intervention, and the control group receives the usual standard of care. 3. The researchers measure both groups for the same outcomes to see if there is a difference. 4. The researcher determines if the intervention leads to better outcomes than the standard of care A randomized controlled trial (RCT) is performed to test an intervention against the standard of care. The subjects are randomized to the treatment or the control group. The treatment group receives the experimental intervention, and the control group receives the usual standard of care. The researcher observes both groups to determine the outcome. On completion, the researcher will determine if the experimental intervention leads to better outcomes when compared to the standard of care. Test-Taking Tip: In this question type, you are asked to put in order—or sequence—the options presented. For example, you might be asked to put the steps of performing a nursing action or skill such as those involved in medication administration in the correct order. Be sure to read the question completely and follow the directions.

A patient is disabled due to cancer-related pain. Which non-pharmacological intervention can help enhance the patient's comfort, dignity, and peace?

A clean and pleasant environment Providing a clean and pleasant environment soothes the mind, body, and spirit. The nurse should ensure that the patient's room is clean and uncluttered. The effects of hypnotism are short-lived, and hypnotism is not a medically acceptable measure to relieve body pains. Behavioral therapy and psychiatric counseling are not helpful for relieving physical pain due to cancer. They are used when the illness has a psychological cause. STUDY TIP: Read a book or visit a website about feng shui or clearing clutter and see what the experts have to say about the influence of a clean and pleasant environment. Understanding their viewpoint will help you correctly value this intervention.

Which best describes presence?

A person-to-person encounter that conveys closeness and a sense of caring Providing presence is a person-to-person encounter conveying closeness and a sense of caring. It involves being there and being with. Being there is not only a physical presence but also includes communication and understanding. Presence is an interpersonal process that is characterized by sensitivity, holism, intimacy, vulnerability, and adaptation to unique circumstances.

Which type of elder mistreatment involves desertion of a vulnerable elder at a hospital?

Abandonment Abandonment may involve desertion by a caregiver of older adults who are unable to protect themselves at a hospital or other public location. Physical abuse refers to the infliction of physical pain such as hitting, beating or slapping. Caregiver neglect refers to failure of providing caregiving activities such as refusal to provide food, water, or clothing. Psychosocial abuse refers to an act that inflicts mental pain or distress such as humiliation and social isolation.

Which complementary and alternative therapy involves the application of digital pressure on designated points on the body?

Acupressure Acupressure therapy [1] [2] involves the application of digital pressure in specified ways on designated points on the body. It helps to relieve pain and regulate body functions. Simple touch involves touching the patient in appropriate and gentle ways to make connection. Massage therapy involves manipulating soft tissue through stroking, rubbing, or kneading. Chiropractic medicine involves manipulating the spinal column. It includes physiotherapy and diet therapy. Test-Taking Tip: The key phrase in the question is "on designated points." The other choices also involve touch, but pressure is not just on designated points. Be sure to read the question carefully!

Complementary and alternative therapies are helpful to treat different disease conditions. Which therapy involves the insertion of thin needles in a specific body region?

Acupuncture Acupuncture therapy involves the insertion of thin needles in specific body regions. This traditional Chinese treatment method is used to realign the flow of vital energy ( qi) in the body into specific channels that form a system of pathways called meridians. Reiki therapy, acupressure, and chiropractic medicine do not involve the insertion of thin needles into a specific body region. Test-Taking Tip: The distinguishing feature between acupuncture and acupressure is that acu puncture uses needles. Think of the word puncture to help you remember that.

A patient is admitted to an acute care area. The patient is a businessman who is worried about getting back to work. He has had severe diarrhea and vomiting for the last week. He is weak, and his breathing is labored. Using Maslow's hierarchy of needs, what is this patient's immediate priority?

Air, water, and nutrition The immediate priority is air, water, and nutrition. The patient needs to have sufficient air exchange, which might require oxygen administration. In addition, the patient needs to have appropriate fluid balance and some nutritional supplement. Test-Taking Tip: For questions concerning Maslow's hierarchy of needs, recall the needs in order of highest priority first. First, is there any indication that basic physiological needs are not being met? Ah-ha! The question states that his breathing is labored, he is weak, and so you have the answer. If basic physiological needs were being met, then you would proceed in order of the hierarchy until you found the highest priority that was not being met.

Sexuality is maintained throughout our lives. Which answer below best explains sexuality in an older adult?

All older adults, whether healthy or frail, need to express sexual feelings Sexuality is normal throughout the life span, and older adults need to be able to express their sexual feelings.

When meditation therapy is used, nurses should monitor patients' medications carefully. The effects of which drugs may be augmented by meditation?

Antihypertensive and thyroid-regulating medications Mind-body techniques, including meditation, create physiological responses in the cardiovascular and respiratory systems. These responses may include decreased blood pressure, reduced heart rate, and slowed respirations, which can decrease the need for antihypertensive and other cardiac regulators and thyroid-regulating medications. Prednisone, antibiotics, insulin, vitamins, cough syrups, and aspirin are not adversely affected by meditation.

Which example of caring behavior is considered important to the patients' well-being by families of acutely ill patients?

Asking permission before performing a procedure on a patient Caring for the family takes into consideration the context of the patient's illness and the stress it imposes on all family members. Making health care decisions for patients, having family members provide hygiene for the patient, and injecting the nurse's perceptions about the level of care provided are inappropriate behaviors.

The nurse is using an interpreter to communicate with a patient who does not speak English. Which action by the nurse may hamper the communication between the nurse and the patient?

Asking the patient's family members to serve as interpreters Interpreters are used to communicate effectively with a patient of a different culture. The family members of the patient should not be asked to serve as interpreters, because the patient may not be comfortable sharing certain information with them. The interpreter should be introduced to the patient for better understanding. The interpreter's qualifications should be determined for effective outcomes. While communicating with the patient, the nurse should look at the patient and not the interpreter to encourage the patient and to gain his or her trust and confidence.

A patient is talking to the nurse about being upset after receiving a cancer diagnosis. The nurse attentively listens and touches the patient gently. Which component of Swanson's theory does this action fulfill?

Being with Touch signifies that the nurse understands the patient's concerns. It means being with the patient and listening to the patient whenever needed. Enabling is facilitating the patient's passage through life stages. Doing for is performing for the patient as the patient would do for him-or herself if possible. Maintaining belief is sustaining faith.

What may be the reason for decreased mobility of the ribs?

Calcification of the costal cartilage Decreased mobility of the ribs is due to calcification of the costal cartilage. This occurs with aging. The curvature of the thoracic spine is known as dorsal kyphosis and is due to vertebral change. Decrease in the respiratory muscle strength and increase in the anteroposterior diameter of the thorax are age-related problems due to configurational changes in the thorax.

The nurse gently touches the shoulder of a patient lying with eyes closed. When the patient opens his eyes, the nurse smiles and asks how he is feeling. Which kind of touch is this?

Caring In this scenario, the nurse practices caring touch. Caring touch is a form of nonverbal communication. It helps to improve a patient's comfort and security, enhances self-esteem, increases confidence in the caregivers, and improves mental well-being. Protective touch is used to protect the patient from any harm. Task-oriented touch occurs when the nurse is performing nursing duties. Healing touch is a type of energy therapy used for healing certain diseases.

The hospice nurse sits at the bedside of a male patient in the final stages of cancer. He and his parents made the decision that he would move home and they would help him in the final stages of his disease. The family participates in his care, but lately the nurse has increased the amount of time she spends with the family. Whenever she enters the room or approaches the patient to give care, she touches his shoulder and tells him that she is present. Which type of touch is this?

Caring touch Caring touch is a form of nonverbal communication used to connect with the patient physically and emotionally to enhance a patient's comfort and security, self-esteem, confidence in the caregivers, and mental well-being. Protective touch protects the nurse and/or the patient to prevent physical or emotional harm. Nurses use task-oriented touch when performing a task or procedure. Touch can enhance interpersonal relationships, but there is no category of touch called interpersonal touch.

An elderly patient reports that he is unable to see bright lights, far objects appear blurred, and he is unable to read the newspaper as before. After examining the eyes, the nurse finds the patient's lens to be opaque. What does the nurse suspect in the patient?

Cataract Sensitivity towards bright lights is called glare. Opacity of the lens indicates loss of transparency of the lens. Loss of transparency of the lens, blurred vision, increased sensitivity to glare, and gradual loss of vision are the clinical manifestations of cataract. Presbyopia is a condition, wherein the eye is unable to focus on near objects; though presbyopia is manifested by discoloration of the lens, it is not associated with blurred vision. Diabetic retinopathy has no early signs and symptoms. Macular degeneration is manifested by accumulation of extracellular material on the retina.

A patient reports sleep disturbance. Which herbal medicine should the nurse suggest to promote sleep?

Chamomile Chamomile is helpful to promote sleep. It also helps in relaxation and treatment of mild gastrointestinal disturbances and premenstrual symptoms. Aloe is used to treat skin disorders, inflammation and acute injuries, gastrointestinal ulcerations, and ulcerative colitis. Echinacea is used to treat upper respiratory tract infections. Cranberry juice is used to treat urinary tract infections.

Which type of research explores the interrelationships among variables of interest without any active intervention by the researcher?

Correlational research Correlational research explores the interrelationships among variables of interest without any active intervention by the researcher. Historical research is designed to establish facts and relationships concerning past events. Evaluation research tests how well a program, practice, or policy is working. In experimental research, an investigator controls the study variable and randomly assigns subjects to different conditions to test the variable.

Which is a strategy for creating work environments that enable nurses to demonstrate more caring behaviors?

Creating a setting that allows flexibility and autonomy for staff Encouraging flexibility and autonomy increases nursing satisfaction. When nurses' job satisfaction is high, they have a greater connectedness with their patients and believe that caring practices are part of the nursing culture. Increasing the working hours of staff usually decreases nursing satisfaction. Encouraging increased input concerning nursing functions from physicians decreases nursing autonomy and thus decreases nursing satisfaction. Decreasing salary benefits usually decreases job satisfaction.

Which type of cultural competency recognizes biases, prejudices, and assumptions about other people?

Cultural awareness Cultural awareness refers to recognizing biases, prejudices, and assumptions about other people. Cultural skills assess social, cultural, and biophysical factors that influence patient treatment and care. Cultural desire describes the motivation to learn from the others, accept the learner, be open to and accepting of cultural differences. Cultural knowledge includes sufficient comparative knowledge of diverse groups, including the values, health beliefs, care practices, and worldview.

During their clinical post-conference meeting, several nursing students were discussing their patients with their instructor. One student from a middle-class family shared that a patient was homeless. Which difference is being described?

Culture Culture is the context in which groups of people interpret and define their experiences relevant to life transitions. These include events such as birth, illness, and dying. Culture refers to the system of meanings by which people make sense of their experiences.

A patient has presbyopia. Which visual manifestation would most likely be present upon examination of the patient?

Decline in the ability of the eyes to accommodate from near to far vision Visual activity declines with age. The decline in the ability of the eyes to accommodate from near to far vision is called presbyopia. Aging may also result in changes in color vision and discoloration of the lens, making it difficult to distinguish between blues and greens or between dark colors such as blue and black. However, these are not caused by presbyopia. As one ages, the ability to adapt to abrupt changes from dark to light areas is reduced, thus causing difficulty in vision when moving from bright to dark environments.

The nurse has conducted an assessment of a new patient who has come to the medical clinic. The 82-year-old patient has had osteoarthritis for 10 years and diabetes mellitus for 20 years. The patient is alert but becomes easily distracted during the nursing history. The patient recently moved to a new apartment, and the patient's pet beagle died just 2 months ago. Which is this patient most likely experiencing?

Depression Factors that often lead to depression include presence of a chronic disease or a recent change or life event (such as loss). Patients are alert but easily distracted in conversation. The symptoms presented by this patient do not indicate dementia, delirium, or disengagement.

Upon interacting with an older adult patient with preoccupied thoughts and poor hygiene and self-care, the nurse finds the patient feels lost after losing a family member in an accident. Which condition would the nurse suspect in the patient?

Depression Older adults may experience late-life depression, but it is not a normal part of aging. Depression may occur with major life changes such as losing family in an accident; this is assessed easily by preoccupied thoughts, and poor hygiene and self-care. Delirium may be manifested by variable affective changes and exaggeration of personality type. It is also associated with acute physical illness. Lewy body disease and Alzheimer's disease are the generalized impairment of intellectual functioning that interferes with social and occupational functioning as aging progresses. Test-Taking Tip: Once you have decided on an answer, look at the stem again. Does your choice answer the question that was asked? If the question stem asks "why," be sure the response you have chosen is a reason. If the question stem is singular, then be sure the option is singular, and the same for plural stems and plural responses. Many times, checking to make sure that the choice makes sense in relation to the stem will reveal the correct answer.

When an older adult suffers a major life event such as the death of a loved one, a move to a nursing home, or a cancer diagnosis, for what should the nurse be alert?

Depression The onset of depression could be abrupt or gradual, but the usual cause is a major life-altering event in the life of the person experiencing the depression. Delirium is rapid onset and usually has a physiological cause; dementia's onset is slow; and a stroke presents with neurological changes.

When the nurse has a prejudice against a particular culture, which type of behavior is likely to result?

Discrimination Prejudices associate negative characteristics with people who are different from the valued group. When a person acts on these prejudices, discrimination occurs. Prejudices are not compatible with culturally congruent care, effective intercultural communication, or sufficient knowledge of diverse groups.

The nurse is assessing a patient who has gynecomastia. Which is a sign of gynecomastia?

Enlarged breasts in males Enlargement of breasts in males is called gynecomastia. It occurs due to medication side effects, hormonal changes, or obesity. Atrophy of glandular tissue; replacement of milk ducts by fat; and decreased muscle mass, tone, and elasticity of the breast are not signs of gynecomastia. They are normal aging effects.

Older adults experience a change in sexual activity. Which best explains this change?

Frequency and opportunities for sexual activity may decline. Opportunities for sexual activity may decline due to the loss of a loved one or a chronic illness in the older adult or partner. Physical changes may also alter sexual functioning. However, the need to be touched remains. The sexual preference of an older adult does not factor into frequency. Test-Taking Tip: Key words or phrases in the stem of the question such as first, primary, early, or best are important. More than one choice may be correct, but you are asked to choose the best explanation in this question.

Which system is affected in periodontal disease, which occurs as a result of common physiological change with aging?

Gastrointestinal system Periodontal disease may occur as a physiological change in the gastrointestinal system with aging. The respiratory system is characterized by increased cough reflex, decreased cilia, and fewer alveoli. Physiological changes in the neurological system include degeneration of nerve cells and degeneration of neurons. Physiological changes in the genitourinary system include decreased nephrons and decreased bladder capacity.

The nurse researcher decides to complete a study to evaluate how Florence Nightingale improved patient outcomes in the Crimean War. This is an example of which type of research?

Historical Historical studies establish facts concerning past events. Evaluation research tests how well a program, practice, or policy is working. Exploratory research is designed to develop or refine the dimensions of phenomena or to develop or refine a hypothesis about the relationship among phenomena. Experimental research involves studies in which the researcher controls the study variable and randomly assigns subjects to different conditions to test the variable.

Which nursing intervention indicates a protective touch for a patient with a major injury after an accident?

Holding the patient while assisting with walking The risk of falls is high in patients with injuries from an accident. Therefore, the nurse holds the patient while walking and protects the patient from falling. This indicates that the nurse is using a protective touch. The nurse touches the patient's shoulder while talking to provide comfort or to convey presence to the patient. Shaking the patient's hand when being introduced or while greeting indicates a professional touch. Holding the patient's hand while completing a procedure indicates a task-oriented touch.

A patient is depressed due to chronic illness and disability and reports being unable to sleep. The nurse uses caring touch. Which is an example of caring touch?

Holding the patient's hand Caring touch is an extremely important aspect of nursing. Because the patient is depressed, the nurse should hold the patient's hand and talk to him or her. The nurse should participate in the conversation and help the patient to feel better. Touching the forehead to assess temperature does not indicate caring touch. Holding the arm to start an intravenous (IV) line does not indicate caring touch. Holding the patient to avoid a fall does not indicate caring touch.

When recruiting subjects to participate in a study about the effects of an exercise program on balance, the researcher provides full and complete information about the purpose of the study and gives the subjects the choice to participate or not participate in the study. Of what is this an example?

Informed consent The process of informed consent includes providing research subjects full disclosure about the study and the opportunity to participate or not to participate in the study. Bias is opinion by a researcher that will influence the results of research. Confidentiality guarantees that any information a subject provides will not be reported in any manner that identifies the subject and will not be accessible to people outside the research team. Anonymity guarantees that any information a subject provides will not be reported in any manner than identifies the subject and will not be accessible by anyone, including the research team.

Listening is multifaceted. Besides taking in what a patient says, what else does listening include?

Interpreting and understanding what the patient means Listening is powerful. It conveys the nurse's full attention and interest. A true caring presence involves listening. Listen to what is important to another person and the meaning of a situation to that person. Listening includes "taking in" what a patient says, interpreting and understanding what the patient is saying, and then giving back that understanding to the patient. It does not include incorporating the views of the physician, correcting the errors in the patient's understanding, or injecting the nurse's personal views and statements.

Aging may cause impairment of urinary function. Which is an effect of weakening of the perineal and bladder muscles on the urinary system?

Involuntary release of urine Weakening of the perineal and bladder muscles leads to involuntary release of urine. Urinary tract infection, burning with urination, and pain on one side of the back do not occur because of the weakening of the perineal and bladder muscles.

The nurse holds the hands of a patient when talking to the patient during rounds. Which is a likely impact of the nurse's behavior?

It enhances the self-esteem and mental health of the patient. It is very important for the nurse to have a therapeutic relationship with the patient. By holding the patient's hands, the nurse extends caring touch to the patient, which in turn enhances the self-esteem and mental health of the patient. The patient is likely to feel more connected to the nurse rather than isolated. Caring touch increases comfort and security in the patient. The patient and the patient's caregivers may or may not feel embarrassed by holding hands. STUDY TIP: Role-play with a classmate (as nurse and patient), choosing a scenario where caring touch is not required to perform a task, such as moving a table closer or checking a urine output bag. Make up dialogue to fit the scene. Play the scenario two ways: one with caring touch and one without. Next, switch roles so you and your classmate both get to play both roles. Then discuss how the caring touch made you feel when you were the patient and when you were the nurse.

What is input?

It is data entering the system. A system functions on its content, input, output, and feedback. The components are interrelated and share a common purpose to form a whole; there is a continuous process of input, output, and feedback data. Input for the nursing process is the data or information that comes from a patient's assessment (i.e., how the patient interacts with the environment and the patient's physiological function).

Which description is applicable to therapeutic communication?

It provides care by meeting a patient's expressed or unexpressed needs. Meeting a patient's expressed or unexpressed need is a characteristic of therapeutic communication. Sensory stimulation may be provided through touch therapy. A focus on recalling the past of an older adult is characteristic of reminiscence. The acceptance of time descriptions stated by an older adult is part of validation therapy.

The nurse has long conversations with a patient about the patient's health, family, religious, and cultural practices. What impact will such a conversation likely have on the healing relationship?

It will help to assist the patient in using social resources. Having long conversations helps the nurse provide the patient with social, emotional, and spiritual resources. Such conversations will not necessarily distract the nurse from important tasks because conversation can be held while the nurse performs routine care tasks. These conversations extend the healing relationship so that the patient's recovery will be faster, and it may build the patient's confidence in the nurse. Usually patients are happy to reveal personal information to professionals involved in providing health care.

Which is a barrier for health care providers to health promotion and disease control for older adults?

Lack of consistent guidelines Lack of consistent guidelines is a barrier that health care providers must overcome for health promotion and disease control in older adults. Health literacy, personal motivation, and previous health care experiences are the barriers that older adults themselves must overcome.

An older adult is unable to distinguish between the colors blue and black. Which is the most likely cause for this condition?

Lens discoloration Changes in color vision may occur due to aging. The lens in the eye can become discolored, making it difficult to distinguish between dark colors such as blue and black. It is neither a hereditary syndrome nor a mental problem, and it is not due to the effect of malnourishment. It is due to aging.

Which statement about the older adult is true?

Most older adults are tolerant toward others. Specialists in the field of gerontology consider older adults to have an optimistic outlook on life, tolerance for others, and good memory recall. The United States census bureau states that only 9.5 percent of older adults are poor and most of them are well-cared for, protected, and financially happy. It is a myth that most older adults are mentally instable. Most older adults have an intact memory even up until the end of life. Some stereotypes consider older adults as worthless after leaving the workforce, but they are actually the ones with more knowledge and experience.

A group of nurses on the research council of a local hospital are measuring nursing-sensitive outcomes. Which is a nursing-sensitive outcome that the nurses should consider measuring?

Number of patients who fall and experience subsequent injury on the evening shift Nursing-sensitive outcomes are outcomes that are directly related to nursing care. The number of patients who fall and experience injury on the evening shift can be directly correlated to nursing care, and can be measured in accordance to the measures taken by nursing staff. The incidence of asthma among children of parents who smoke, frequency of low blood sugar in children at a local school, and number of sexually active adolescent girls who attend the community clinic for birth control are not directly related to nursing care.

The nurse plans to teach a diabetic patient about self-administration of insulin injections so that the patient is able to administer his own insulin. Which nursing theory most aptly describes this scenario?

Orem's theory The nurse is promoting patient self-care by teaching self-administration of insulin. This aids the patient in becoming more independent in caring for himself. Orem's theory emphasizes promotion of self-care. Henderson's theory focuses on health, wellness, and illness prevention. Peplau's theory focuses on developing a therapeutic relationship between the patient and the nurse. Leininger's theory focuses on providing culturally competent care.

An older patient is diagnosed with dorsal kyphosis. What is a contributing factor for developing this disorder?

Osteoporosis Osteoporosis is a condition that results in loss of bone mass by crushing bones and leaving the bones brittle and prone to fractures. This causes curvature of thoracic spine, which is known as dorsal kyphosis. Impacted cerumen causes diminished hearing acuity in older adults. Subdural hematomas cause delirium in older adults. Calcification of coastal cartilage causes decreased mobility of the ribs in older adults. Test-Taking Tip: Dorsal kyphosis is curvature of thoracic spine in older adults. Use this information to answer the question.

While assessing the health of four patients, the nurse discovers one of the patient's findings to be age-related. Which patient supports the nurse's conclusion?

Patient B has yellowing of the lens With aging, the crystalline fibers present in the lens stop regenerating and undergo many post-translational changes. These changes make the lens appear opaque and yellowish. Therefore, patient B's finding supports the nurse's conclusion. White sclera is a normal finding, not an age-related change. In older adults, there will be increased sensitivity to glare as an effect of aging. Therefore, the finding of patient C is not a physiological change related to aging. Pupils dilate upon exposure to light. Therefore, patient D's finding is normal.

A patient who is bedridden after an accident has become very quiet and is not interacting with her family or hospital staff. The nurse is focusing on efforts to develop effective nurse-patient communication. Which theory is useful for developing interpersonal relationships?

Peplau's theory Peplau's theory focuses on developing interpersonal relationships among the nurse, the patient, and the patient's family. Following this theory, the nurse acts as a counselor, a resource person, and a surrogate. Thus, the nurse helps the patient reduce the anxiety related to health care problems. Leininger's theory focuses on cultural diversity and providing culturally specific health care. Roy's theory deals with helping the patient to adapt to changes, and Nightingale's theory focuses on environmental factors influencing the patient's health status.STUDY TIP: Have each member of a study group write what they think is the focus of Orem's, Leininger's, Peplau's, and other theories. Compare your responses and summarize each theory on a notecard for review.

The nurse is caring for a patient who has electively terminated a pregnancy. During the caring process, the patient shares her feelings and emotions with the nurse, which results in the nurse developing a bond with the patient. Which nursing theory would be most appropriate to help develop an interpersonal relationship?

Peplau's theory Peplau's theory is to develop interactions between the nurse and the patient. This theory mainly focuses on the nurse developing a therapeutic relationship with the patient to help promote health and prevent sickness. Although Nightingale's theory does promote a relationship between the patient and the nurse, its primary focus is to facilitate the reparative processes of the body by doing manipulations in the environment. Neuman's theory also promotes a therapeutic relationship between the nurse and the patient, but its primary focus is attaining total wellness by much needed interventions. Henderson's theory mainly focuses on working independently with other health care providers and helping the patient to gain independence. A secondary area of concern may be to promote a patient-nurse relationship.

The caregiver of an older adult patient reports, "My father, in spite of turning up the volume on the radio and television, complains that he is unable to hear." Which condition should the nurse suspect in the patient?

Presbycusis Auditory changes are often subtle in older adults, and are often unidentified and untreated. A 68-year-old patient with presbycusis may have impacted cerumen, which is a common cause of diminished hearing acuity. Kyphosis occurs in the older adults due to osteoporosis, which leads to curvature of the thoracic spine. Keratoses are irregular, round or oval, brown, and watery lesions usually found on an older adult's skin due to aging. Presbyopia is a visual acuity defect in older adults that occurs due to retinal damage, reduced pupil size, development of opacities in the lens, or loss of lens elasticity.

A patient loses balance, and the nurse holds the patient to avoid a fall. Which kind of touch is this?

Protective Holding a patient to avoid a fall is an example of protective touch. The use of touch is often a comforting approach while dealing with patients. Touch is classified into different categories based on the type of touch. Protective touch is used to protect the patient or the nurse. Caring touch helps to comfort the patient and establish a personal connection between the nurse and the patient. Noncontact touch mainly involves eye contact, not physical touch. Task-oriented touch is the touch that takes place while the nurse is performing a nursing task or procedure.

Which type of research design would be helpful to determine the percentage of women who are diagnosed with an acute myocardial infarction between the ages of 40 and 60 years?

Quantitative research Quantitative research involves analysis of numbers, such as the percentage of women diagnosed with acute myocardial infarction and what age groups the women belong to. The survey design examines opinions, attributes, behaviors, or characteristics of a population. Qualitative research describes information in a nonnumeric form. Evaluation research determines how well a program, practice, or policy is working.

The nurse researcher conducts a study that randomly assigns 100 patients who smoke and attend a wellness clinic into two groups. One group receives the standard smoking cessation handouts; the other group takes part in a new educational program that includes a smoking cessation support group. The nurse plans to compare the effectiveness of the standard treatment with the educational program. Which type of research study is this?

Randomized controlled trial This is a randomized controlled trial because patients are randomly assigned into the control or treatment group. The researcher will measure the effectiveness of the standard treatment with the educational program, which is a quantitative measure, not qualitative. This research is also not descriptive, which measures people, situations, or groups and the frequency with which certain events or characteristics occur. Correlational research explores the interrelationships among variables of interest without any active intervention by the researcher.

The nurse is working with an older adult after an acute hospitalization. The nurse's goal is to help this person be more in touch with time, place, and person. Which technique should the nurse try?

Reality orientation Reality orientation is a communication technique that can help restore a sense of reality, improve level of awareness, promote socialization, elevate independent functioning, and minimize confusion. Reminiscence recalls the past to bring meaning to the present. Validation is used with confused patients. Body image intervention is not indicated in this case.

Which activity regarding the research process should the nurse conduct to determine what has already been studied about the research problem of interest?

Review the literature A literature review provides a logical but abstract structure that suggests the relationship among the variables in a research study, allowing for the organization and explanation of all the information in the study. All available literature related to the nurse's research problem should be reviewed to provide a theoretical framework as a foundation for the research study. Variables are concepts in the study that are expected to change or differ from one person or time to another. A hypothesis is a prediction that should be based on previous research, so it is developed after conducting a review of the literature.

A group of researchers is conducting research on diabetic patients based on Orem's theory. What is the most probable topic of research?

Self-administration of insulin Orem's theory focuses on the patient's self-care needs. Evidence gained by the research based on insulin self-administration would help in facilitating self-care in patients with diabetes. Research based on effective strategies to improve nurse-patient communication would be based on Peplau's theory. Studies based on pathological processes in diabetes would help to improve the descriptive theories based on diabetes. Research focused on medications for diabetes is useful for improving prescriptive theories.

Which condition can be inferred in a patient who complains of involuntary release of urine while laughing, sneezing, and coughing?

Stress incontinence Involuntary release of urine while laughing, sneezing, coughing, and lifting things is a sign of stress incontinence. In diabetes mellitus, a patient may show symptoms such as increased frequency of urinating. Prostate hypertrophy can lead to difficulty in initiation of voiding and maintenance of the urinary stream. Patients may have pain while urinating when experiencing a urinary tract infection.

A patient asks the nurse about therapeutic touch (TT). Which should the nurse include when providing patient education about TT?

TT intentionally mobilizes energy to balance, harmonize, and repattern the recipient's biofield. Therapeutic touch (TT) focuses on healing the whole person and providing energy to the body, supporting innate healing responses that balance, harmonize, and repattern the patient's biofield. The research literature is questionable; systematic analyses claim that the research designs are too weak to identify any conclusive evidence with confidence, so there is little evidence that TT intentionally heals specific diseases or corrects certain symptoms or is overwhelmingly effective in many conditions. Although TT is relatively safe and there have been very few negative events associated with its use, all therapies (complementary or conventional) should be used with caution in certain populations.

A patient is experiencing paraplegia after a motorcycle accident. How can the nurse involve the family members in patient care?

Teach the family members about caregiving techniques and have them participate in the care. The nurse should involve the family in the patient's care. This helps in the emotional well-being of the patient. The nurse should teach family members some techniques that can help them participate in caregiving. Excluding the family is not advised. The nurse should involve the family but should not make them perform all the caregiving interventions. The use of humor and giving information about respite care may be effective in relieving tension, building relationships and protecting the caregiver's health, but it does not help in the patient's care.

The nurse is caring for a patient with a urinary tract infection. According to systems theory, which statement should be considered as an input from the patient?

The patient reports difficulty with urination Input is the data that is obtained after examining the patient. The statement that the patient has difficulty urinating is input data. Output is the result, and hence, an increase in urinary output can be considered as an output. The outcome for a patient who has difficulty urinating is an ability to urinate without difficulty. Thus, urination without difficulty is output data. The patient thanking the nurse because of improvement in the condition is the feedback, and the information that a diuretic should be given is content.

Theory-based nursing practice uses a theoretical approach for nursing care. This approach moves nursing forward as a science. What does this suggest?

Theories will be tested to describe or predict patient outcomes There are multiple theories for the practice of nursing; these theories are tested to develop the evidence to describe or predict patient outcomes

Which statement is true regarding the goal of core measures?

They help reduce mortality, complications, and inpatient readmissions. Core measures help to reduce mortality, complications, and inpatient readmissions. Cultural awareness helps the nurse to recognize prejudices and assumptions about other people. Culturally congruent care helps to provide care that fits with patients' own values, beliefs, and traditions. Cultural skills help to assess social, cultural, and biophysical factors that influence patient treatment and care.

Reminiscence strategies are used to evaluate an older adult patient's memory. What do these strategies do?

They stimulate memory chains through associations. Reminiscence strategies can be used to stimulate memory chains by attempting to recall patterns of association that will improve the patient's recollection. These strategies may help the patient to recollect a coping strategy but do not produce a positive mood or reduce the patient's anxiety. Reminiscence strategies are not necessarily helpful in evaluating the patient's judgment and general knowledge.Test-Taking Tip: Identifying content and what is being asked about that content is critical to your choosing the correct response. Be alert for words in the question that are the same or similar in nature to one or two of the answer choices . This item states that reminiscence strategies evaluate memory; the only correct answer also focuses on memory.

The nurse hears a colleague tell a nursing student that she never touches a patient unless performing a procedure or doing an assessment. Which response by the nurse focuses on a caring perspective?

Touch forms a connection between nurse and patient Touch is relational and leads to a connection between nurse and patient. It involves contact and non-contact touch. Contact touch involves obvious skin-to-skin contact, whereas non-contact touch refers to eye contact. Before implementing touch, the nurse should be aware of the patient's cultural practices and past experiences. While comforting to some, for others touch may be perceived as invasive or threatening.

The nurse provides care for a diverse group of patients, including many immigrants. To better understand various types of healthcare, the nurse learns the traditional Chinese medicine (TCM) system. Which are primary interventions in TCM?

Uses many modalities that are based on the individual and include herbal therapies, moxibustion, and acupuncture Traditional Chinese medicine (TCM) practitioners use a variety of interventions that are based on individual patient assessment findings and needs. Modalities include herbal therapies, acupuncture, moxibustion, cupping, prescribed exercise such as tai chi or qi gong, and lifestyle changes. Although acupuncture is often confused with traditional Chinese medicine system (TCM) when used alone, acupuncture is not a whole system of medicine. Rather, the National Institute of Health/National Center for Complementary and Alternative Medicine (NIH/NCCAM) considers acupuncture to be a mind-body technique that is often referred to as medical acupuncture. Although herbal therapies and exercise are considered to be part of the treatment repertoire of the TCM provider, these modalities are not considered to be primary interventions.

While caring for an older patient with anxiety, the nurse finds that the patient insists that the date is different from the actual date. The nurse refrains from correcting the patient. Which supporting intervention is the nurse implementing?

Validation therapy Validation therapy involves the nurse refraining from challenging incorrect assertions by an older patient. Reminiscence involves sharing the joyful past experiences of an older adult. Touch therapy provides sensory stimulation and inducing relaxation. It provides physical and emotional comfort and conveys warmth. Therapeutic communication enables perceiving and respecting the older adult's uniqueness and health care expectations.

The nurse is caring for an elderly patient diagnosed with Alzheimer's disease. Which intervention would help reduce the patient's confusion?

Validation therapy Validation therapy is beneficial for older adults who are in a confused state, as is common with Alzheimer's disease. It involves accepting and not arguing with patient statements, even if they are incorrect. Reminiscence as therapy involves recollection of the past to help the patient understand the present situation and resolve current conflicts. Touch is a therapeutic tool that is beneficial in older adults to provide physical and emotional comfort when performing any type of procedure. Reality orientation is a communication technique that helps in restore the sense of reality in an older adult.