Foundations Exam 1

A nurse assessing children in a pediatrician's office would expect a child to achieve self-recognition at what age?

18 months

Which is an emerging trend in health care delivery?

Active involvement of consumers

A hospice nurse is caring for a client with terminal cancer. The family would like the client to continue aggressive therapy to treat the cancer, but the client has voiced to the nurse that no further pursuit of treatment is desired. The nurse speaks to the family about the client's wishes, condition, and terminal state. This action is most likely derived from which nursing obligation?

Ethical principals

Using the nursing process to make ethical decisions involves following several steps. Which step is the nurse implementing when reflecting on the decision-making process and the role it will play in making future decisions?

Evaluating

A community health nurse is providing care to several farming families in a rural community. Which concept would be most important for the nurse to integrate into the plans of care for these families?

Family structures may change over time.

A female client is brought to the emergency room with matted hair, bruising, and malnutrition. The nurse suspects physical abuse and neglect. The nurse states, "This happens to many women." Which type of ethical approach is the nurse exhibiting?

Femenist

Alarm Stage

Fight or Flight response. Everything in body increases (heart rate, blood pressure, glucose....) as the threat approaches

Physical Dimension (Human Dimension)

Genetic Inheritances, age, development level, race and sex assigned at birth. EX- Toddlers are at a greater risk for drowning. Young males are increased risk for car accidents.

During the orientation to the hospital, the staff development educator discusses unit and institutional-based policies. What is the source of the practice rules that result in unit and institutional-based policies?

Health care institution

Environmental Dimension (Human Dimension)

Housing, sanitation, climate, and pollution of air, food and water EX- Death in older adults from inadequate heating and cooling

Emotional Dimension (Human Dimension)

How the mind affects body functions and responds to body conditions also influences health. EX- A student always having diarrhea before exams.

The nurse researcher is aware that the type of variable that can be manipulated in a study is which type of variable?

Independent

The nurse beginning practice would like to access the standards for ethical practice. Which organization should the nurse research for these standards?

International Council for Nurses

Fidelity

Keep promises. EX- Never abandon a patient entrusted to your care without first providing for the patients needs.

A nurse is reviewing nursing theory for usefulness in a home healthcare setting. Which is the appropriate application of Dorothea Orem's Self-Care Model in a home healthcare setting?

Match the client's self-care needs with appropriate supportive interventions.

The nurse has identified an ethical dilemma that has the potential to interfere with a client receiving optimal care. The nurse discussed this issue with the charge nurse on the unit. What action should the nurse choose next?

Monitor for a resolution to the problem

Clara Barton

Nurse during the Civil War; founder of the American Red Cross

The home care nurse is providing care and education to a client who is pregnant for the first time. The client states, "I have no money or food. I don't know what I should do. I want to provide for my unborn child." The nurse refers the woman to the WIC program and a local food bank. This is an example of what aspect of community-based nursing?

Planning

The nurse enters the client's room in the acute care unit immediately after the client experiences a generalized tonic-clonic type seizure in bed. What is the first action the nurse should take?

Position the client in a side-laying position

A client was admitted to the hospital 2 weeks ago following an ischemic stroke. Since the early introduction of stroke rehabilitation, the client has seen significant improvements in both medical status and activities of daily living (ADLs). This morning, however, the nurse notes that the client has been coughing since eating a minced and pureed breakfast. Auscultation of the client's chest reveals the presence of coarse crackles. Which practitioner should the nurse consult with to obtain a swallowing assessment?

Speech Therapist

Which nursing intervention reflects culturally appropriate care when addressing a client?

"Good morning, Mr. Smith. I am your nurse, John."

Which nursing actions best describe the use of the professional value of human dignity? Select all that apply. The nurses the client in developing the plan of care. A nurse provides honest information to a client about the client's illness. A nurse provides privacy for an older adult client. A nurse reports an error made by an incompetent coworker. A nurse plans individualized nursing care for clients. A nurse refuses to discuss a client with a curious friend.

The nurses the client in developing the plan of care. A nurse provides privacy for an older adult client. A nurse plans individualized nursing care for clients. A nurse refuses to discuss a client with a curious friend.

A family assessment of a father, mother, and four children has suggested the presence of several risk factors. Which aspect of the family's structure and function would be considered a psychosocial risk factor?

The parents have a tumultuous relationship, with frequent separations in the past

Which of the following is objective data related to self-concept?

The person refuses to make eye contact

Which aspect of the nursing research process addresses a client's understanding of the potential risks and benefits of the study?

Undergoing the informed consent process with the client.

The nurse is providing discharge teaching for a client who is from a different culture. The nurse notes that the client will look away from the nurse and does not maintain eye contact. What would be the most appropriate action by the nurse, with regard to culturally competent care?

Utilize a key informant and continue with the teaching, verifying the client's understanding through open-ended questions.

What are standards for decision-making that endure for a significant time in one's life?

Values

Cultural Imposition

Values, Beliefs, or Practices forced upon a person or group of people

Resistance Stage

Vital signs, hormone levels, and energy production return to normal. Coping and defense mechanisms

Autonomy

(self-determination) respect the rights of patients or their surrogates to make health care decisions. EX- Providing information and support to patients and families need to making the decision that is right for them

The client being admitted to the oncology unit conveys wishes regarding resuscitation in the event of cardiopulmonary arrest. The nurse advises the client that it would be in the client's best interest to obtain which document?

A living will

Dorethea Dix

Educated the public about the poor conditions for prisoners and the mentally ill.

A home health care nurse develops a client's individualized plan of care during the:

Entry Phase

Which best defines value clarification?

A process by which people come to understand their own values and value systems

While assessing an older adult client's upper back, the nurse notes round, raised red spots along the client's back. The client's daughter says, "Oh, that is just cupping." What action should the nurse take?

Ask about the practice of cupping

The nurse is assessing a young child in the clinic by asking simple questions. Which concept will the nurse predict this toddler to verify as per Sullivan's theory?

Begins integrating good me and bad me into self-concept

Which ethical principle refers to the obligation to do good?

Beneficence

Stages of Change Model

-Precontemplation: no intention on changing behavior -Contemplation: Know problems exist, no commitment to action -Preparation: Intent on taking action to address the problem -Action: Action modification/behavior -Maintenance: Sustained change-- New behavior replaces old -Relapse: Fall back to old patterns

Beneficence

Benefit the patient, and balance benefits against risks and harms. EX- Commit yourself to actively promoting the patient's benefit

A client is discussing stressors with the nurse and is describing how she feels better when she takes a brisk walk. The client's action is an example of

adaptation

Family conflict around the care of a recently hospitalized woman has escalated to the point that crisis intervention may be required. This process should begin with:

clear identification of the relevant problem

Continuity of care is an important concept for quality nursing practice. The responsible nurse understands the best description of the process of continuity of care is to:

coordinate uninterrupted care and facilitate transfer between units and levels of care.

A client who immigrated from another country informs the nurse of dietary requests. The nurse responds to the special dietary needs by stating, "You are now living here, and you should try to start eating those foods common to our diet." This inappropriate response is an example of:

cultural imposition

A client with diabetes mellitus is experiencing acute stress. The nurse identifies that the client will be secreting excess levels of cortisol. What should the nurse monitor the client for related to the increased levels of cortisol?

elevated glucose levels

The nurse is caring for a client who is a doctor in a general hospital. He complains about the stressful condition of his job. Lately, he has become increasingly susceptible to colds, headaches, muscular tension, excessive tiredness, and many other symptoms. At what stage of stress is the client?

exhaustion stage

Florence Nightingale

founder of modern nursing and a reformer of hospital sanitation methods, separated medicine and nursing, established nursing education

A nurse is assisting a neurologist, who is assessing the norepinephrine (noradrenaline) level of a client who is reporting stress. Which function does norepinephrine (noradrenaline) perform?

heightens arousal and increases energy

When the client's primary care health care provider does not have hospital privileges, a service is available to provide the client's care and communicate with the client's health care provider. This service is provided by health care providers called:

hospitalists

A client is experiencing a stress response each time the family visits the room. What nursing intervention is most appropriate?

limit the family visits to once a day

An occupational health nurse at an oil refinery on the Gulf Coast of Texas performs client education with an adult client. The client is being seen after having suffering a chemical burn in an accident at the refinery. Which type of stressor has this client been exposed to?

physiologic

The spouse of a client asks the nurse whether the spouse may bring in a cream from home to apply to the client's skin. The spouse says, "Whenever anyone gets sick, we always use this cream." The nurse interprets this as:

ritual

Which data is most appropriate for the nurse to include when assessing an older adult client's capacity to adapt to current stressors?

social losses, network of social factors, and advanced age

The nurse determines that a client understands instruction regarding progressive relaxation when the client states that the technique requires:

tensing and relaxing various muscle groups

Which type of quantitative research will examine cause-and-effect relationships between selected variables?

Quasi-experimental

Exhaustion Stage

Adaptive mechanisms can no longer provide defense. Panic, crisis

Linda Richards

America's first trained nurse Practice of keeping records and writing orders

Which statement accurately reflects the findings of the 1999 Institute of Medicine report, "To Err Is Human"?

Anywhere from 44,000 to 98,000 people are estimated to die in U.S. hospitals each year as a result of preventable medical errors. pg 276

A nurse researcher is involved in an experimental research study. Which component would the nurse researcher manipulate?

Independent Variable

The nurse discussing the importance of professional nursing organizations setting standards should include which statement?

It identifies nursing as a profession

Which teaching statement best exemplifies cultural competence in relation to time for the American culture?

It is important to be on time to your health care appointments

What was one barrier to the development of the nursing profession in the United States after the Civil War?

Lack of educational standards.

Which action most clearly demonstrates a nurse's commitment to social justice?

Lobbying for an expansion of healthcare resources and benefits to those in poverty

A nurse is working as part of a group to address factors within the community affecting the health of the families in that community. Which area would the nurse identify as playing a role in contributing to altered health status? Select all that apply. Limited number of institutions providing health care Small number of recreational opportunities for adults and children Low incidence of violent crimes in the community Overlapping of industrial zones with residential zones Absence of air pollution

Low incidence of violent crimes in the community Absence of air pollution

Which is a characteristic of nursing practiced from early civilization to the 16th century?

Most early civilizations believed that illness had supernatural causes.

Sociocultural Dimension (Human Dimension)

Person's economic level, lifestyle, family and culture EX-An adolescence who sees nothing wrong with smoking or drinking because their parents smoke and drink

The nurse on the elective surgery floor receives a report that describes the client's abdominal wound dressing as having a moderate amount of yellowish and bloody drainage on it and a very foul smell. In planning for a dressing change, it is most important for the nurse to perform which action?

Wash the nurses hands before changing the dressing

A nursing student administers an overdose of an opioid to a client and the client arrests. When discussing the incident with nursing faculty, which statements made by the student indicate the need for further teaching? Select all that apply. "I realize that I am held to the same standards as a registered nurse." "I have also put the nursing faculty at risk with my action." "I am glad I am a student because nursing faculty will be blamed, not me." "I should have informed you that I felt unprepared for my assignment." "I cannot be held liable because this is only my second time at this facility."

"I am glad I am a student because nursing faculty will be blamed, not me." "I cannot be held liable because this is only my second time at this facility."

At the last hospital unit meeting, the policy for the insertion of Foley catheters was revised based on current evidence. The new nurse on the unit just learned "the old way" and is frustrated to now have to learn a new methodology. Several other nurses comment that the change is "all about money." The charge nurse must educate the staff about the importance of this new policy. Which explanation by the charge nurse is most appropriate?

"Incorporating evidenced-based practice into our care routines links our interventions to valued outcomes, thereby increasing quality care. When we provide quality care, we can decrease cost."

A client is admitted to the health care facility with hypoglycemia. After the client is stable, the nurse discovers that the client has not taken the prescribed medicines. The client believes that eating saffron will keep blood sugar under control. What is the most appropriate response by the nurse?

"What would you think about taking the medicines, too, and benefitting from both?"

Upon arrival to the emergency room, the mother of a client involved in a motor vehicle accident becomes upset when she learns her son is unconscious and unstable. The mother begins to yell at the emergency room staff in unintelligible words, and she is trembling. She becomes short of breath and yells she can't breathe. What is the mother likely experiencing?

A panic attack

When completing a transcultural assessment of communication, which assessment by the nurse is most appropriate?

Assessment of eye contact, personal space and social taboos

An older adult client has been recently diagnosed with vascular dementia. Because the client lives alone and has poorly controlled hypertension, the client has begun to receive home healthcare. This new aspect of the client's care is characteristic of which stage of illness?

Assuming the dependent role

Nonmaleficence

Avoiding causing harm. EX- Seek to not inflict/prevent harm.

Tertiary Health Promotion

Begins after and illness is diagnosed and treated with the goal of reducing disability and helping rehabilitate the patients to a maximum level of functioning EX- Teaching a patient with diabetes how to recognize and prevent complications, using physical therapy to prevent contractures in a patient who has had a stroke or spinal cord injury

Qualitative Research

Concepts are fairly well-developed An existing body of literature is available Statistical processes are used to interrupt the data Dynamic or subjective (open to interpretation) Gathered through observations Answer the questions "Why" and "How" 4 types: Phenomenology, Grounded Theory, Ethnography, and Historical

Quantitative Research

Countable or measurable Tells us "How many" "How Much" "How Often" Gathered by measuring and counting things 4 types: Descriptive, Correlational, Quasi-experimental, and Experimental

The process of considering an idea as a whole and then dividing it into smaller, more specific ideas is which?

Deductive reasoning

Primary Health Promotion

Directed towards promoting health and preventing the development of disease processes or injury EX- immunization clinics, family planning centers, providing poison control information and and accident prevention education class

A nurse is named as a defendant in a malpractice lawsuit. Which action would be recommended for this nurse?

Do not volunteer any information on the witness stand

Intellectual Dimension (Human Dimension)

Encompasses cognitive abilities, educational background and past experiences EX- Young college student with diabetes who follows a diabetic diet but drink beer and eats pizza with friends several times a week

Secondary Health Promotion

Focus on screening for early detection of disease with prompt diagnosis and treatment of any found .EX- assessing children for normal growth and development and encouraging regular medical, dental, and vision exams.

How is culture learned by each new generation?

Formal and informal experiences

Justice

Give each their due; act fairly. EX- Always seek to distribute the benefits, risk and costs nursing care justly

A client who recently underwent a coronary artery bypass graft is taking furosemide and metoprolol following the procedure. While developing a plan for a heart-healthy diet with the nurse, the client states that diet did not contribute to the heart disease and that the client should be fine just continuing to take the medications. According to the Stages of Change Model, which stage of change is the client in related to diet?

Precontemplation

Cultural Assimilation

Process by which a minority culture comes to resemble a societies majority group and they start to assume the values and beliefs. EX-Spanish Inquisition-Jews and Muslims assumed Roman Catholic practices to "fit in"

Good Samaritan Law

Protect healthcare workers when they are giving aid to people in emergency situations. EX- A nurse at the scene of an car crash may give emergency care without fear of a legal suit if such care appears necessary, unless care is given in a grossly negligent manor

inductive reasoning

Specific Observation->Pattern Recognition->General Conclusion Cheap meds A and B cause major side effects-> All observed cheap meds cause major side effects->ALL cheap meds cause major side effects.

deducative reasoning

Specific conclusion, follows a general theory. All students eat pizza. John is a Penn State student. Therefore, John eats pizza.

Spiritual Dimension (Human Dimension)

Spiritual beliefs and values. Nurses must respect these values and understand their importance for the individual patient. EX- the Roman Catholic requirement of baptism for both live and stillborn births

What is the best definition of ethics?

The formal, systematic study of moral beliefs.

The American Nurses Association (ANA) Standards of Professional Nursing Practice provides standard of care for all nurses. Which statement on the assessment of the nursing process is accurate?

The nurse collects comprehensive data pertaining to the patients health or situation

A nurse is caring for a client with a complete spinal cord injury that has caused paraplegia. The client is very distraught and asks the nurse, "Are they sure, even with therapy, I will never walk again?" Which statement made by the nurse demonstrates veracity?

"You have a complete injury, which results in a total loss of movement and sensation below the level of injury."

Steps in Making an Ethical Decision

1. Gather Data- recognize and describe ethical problem 2. Identify- Who is conflict? Why is conflict? 3. Plan- Identify and weigh options 4. Implement Decision- Do it and compare outcome to what you hoped for in advance. 5. Evaluate- What did you learn and how can it help you in the future?

What is the priority nursing responsibility when transferring a client from one unit in the hospital to another?

Provide a verbal report of the client's status to the admitting nurse.

Which scenario is the best example of a nurse implementing care according to the ANA standards of practice?

Providing nutrition classes to a person with diabetes

SBARQ

Situation, Background, Assessment, Recommendation, Questions a framework of communication between members of the healthcare team about a patients condition.

A nurse is assessing a client with stress-related problems. Which factor influences responses to stressors?

Social Support

A nurse is using the quantitative research process to study the cause of healthcare-associated infections (HAI) and how to prevent them. Which actions are examples of the components of this process? Select all that apply. The nurse collects data from subjects in the study. The nurse defines the purpose of the study after conclusions have been made. The nurse formulates a hypothesis and variables in the study. The nurse uses instruments to determine the variables in the study. The nurse uses grounded theory to discover the beliefs of the subjects. The nurse formulates an abstract to state the relationship between the variables.

The nurse collects data from subjects in the study. The nurse formulates a hypothesis and variables in the study.

The nurse obtains a health history interview on a client with lung cancer. The client states, "I became too focused at work; I did not have time to rest. I usually work 8 hours per day but, for the past few months, I have been spending at least 12 hours per day at the office. That is probably the reason why I was diagnosed with cancer. Maybe when I try to go back to my usual schedule, the cancer will go away. I did not want to be here but my wife is insistent. I do not think medications work. My brother-in-law died of cancer. He took a lot of medicines and prayed really hard, but he died just the same."

The nurse determines that the client believes in the holistic cause of illness as manifested by believing one can be cured of cancer by limiting work hours