Nursing Test 1

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What are the 3 disruptive behavior commonly reported by nurses

incivility, lateral violence, and bullying

simplicity

includes the use of commonly understood word, brevity, and completeness

Assault

intentional threat to bring about harm or offensive contact

battery

intentional touching without consent

Encoding

involves the selection of specific signs or symbols

bioethics

is ethics as applied to human life or health such as decisions about abortion or euthanasia

development

language, psychosocial and intellectual development move through stages across the lifespan

Standards of care

legal guidelines for nursing practice that provides the minimum acceptable nursing care

boundaries

limits of individuals, objects or relationship

utilitarianism

one form of consequentialist theory:views a good act as one that is the most useful-that is, one that brings the most good and the least harm to the greatest number of people

environment

people usually communicate most effectively in a comfortable enviornment

Sender

person or group that wishes to communicate a message to another

perception

personal view of an event

Criminal Laws

prevent harm to society and provide punishment for crimes

deontological

principle-based theories. They involve logical and formal processes and emphasize individual rights

assertive communication

provides client safety by minimizing miscommunication with collegues

Briefly explain the IOM 2004 report Keeping Patients Safe- Transforming the Work Environment of Nurses

provides new information for nurses about the workplace enviornments with their patients

Autonomy

refers to the right to make ones own decision

Regulatory law

reflects decision made by administrative bodies such as State board of Nursing when they pass rules and regulations

Decoding

relate the message perceived to the recievers storehouse of knowledge and experience and to sort out the meaning of the message

termination phase

relationship is often expected to be difficult and ambivalent

Caring theory

relationship-based theories. Stress courage, generosity, commitment and the need to maintain relationships

The nurse has applied wrist restraints to a disoriented client to keep the client from removing a feeding tube. Which intervention is now​ required? Ensure that the order is renewed every 48 hours. Change the client​'s position once each shift. Assess the client​'s feeding tube hourly. Remove the restraints every 2 hours for 5 minutes.

remove the restraints every 2 hours for 5 minutes

Roles and relationships

roles and relationships between sender and receiver affect the communication process

preinteraction phase

similar to the planning stage before an interview

SBAR

situation, background, assessment, recoomendation

elderspeak

speech style similar to baby talk that gives the message of dependence and incompetence

micro-aggressions

stereotyping someone

risk management

system of ensuring appropriate nursing care that attempts to identify potential hazards and eliminate them before harm occurs

Veracity

telling the truth

timing

the _____ needs to be appropriate to ensure that words are heard.

What does cognitive awareness mean?

the ability to perceive environmental stimuli and body reactions and to respond appropriately through throughout and action

Reciever

the decoder who must perceive what the sender intended

personal space

the distance that people prefer in interaction with others

pace and intonation

the manner of speech, as in the rate or rhythm of tone, will modify the feeling and impact of a message

Response

the message that the receiver returns to the sender and is also called feedback

working phase

the nurse and client begin to view each other as unique individuals

adaptability

the nurse needs to alter spoken messages in accordance with behavioral cues from the client

values

the standards that influence behavior

humor

the use of humor can be a positive and powerful tool in the nurse-client relationship

congruence

the verbal and nonverbal aspect of a message math

Fidelity

to be faithful to agreements and promises.

false imprisionment

unjustified restraining of a person without a legal warrant

nonverbal communication

uses other forms such as gestures or facial expressions and touch

verbal communication

uses the spoken or written word

morals

usually refer to private, personal standards or what is right and wrong in conduct, character, and attitude

The message

what is actually said or written

credibility

worthiness of belief, trustworthiness, and reliability

The nurse is preparing to discharge a client diagnosed with anosmia. Which statement by the client would indicate to the nurse that a potential safety hazard exists in the client​'s ​home? ​"My wife said that the neighbor finished building the ramp for​ us, so I won​'t have to climb any stairs when I get​ home." ​"We had a new shower put in so that I can sit down when I bathe. It also has grab bars so that I won​'t be so​ unsteady." ​"This hospital food is​ okay, but I can​'t wait to get home and grill out a steak on my gas​ grill." ​"My son is going to go over to the house and change the batteries in our smoke​ detectors."

"This hospital food is​ okay, but I can​'t wait to get home and grill out a steak on my gas​ grill."

The school nurse has been asked to make suggestions regarding educational programs that would be appropriate to promote safety among​ high-school students. What would be the most appropriate response by the​ nurse? ​"I believe an​ in-service on the dangers of engaging in conversations with strangers would be​ well-received." ​"Maybe we should focus on fire safety this​ year." ​"We would have great success with a program provided by the local police department on the dangers of drinking and​ driving." ​"Given our target​ population, I believe a session on depression would be​ appropriate."

"We would have great success with a program provided by the local police department on the dangers of drinking and​ driving."

The nurse is completing a health history on a client​'s cardiac history. Which question by the nurse is an example of the technique known as​ focusing? ​"Describe how you take your blood pressure at​ home." ​"Sounds like you are monitoring your blood pressure every​ day, is that​ right?" ​"What did you mean when you said you don​'t understand why you have to take your blood​ pressure?" ​"How do you feel about your overall​ health?"

"describe how you take your blood pressure at home"

ethics

1) a method of inquiry that helps people to understand the morality of human behavior 2) the practices or beliefs of a certain group 3) the expected standards of moral behavior of a particular group as described in the groups formal code of professional ethics

List the 5 criteria a nurse should use when selecting a restraint.

1. it restricts the clients movement as little as possible. If the client needs to have one arm restrained, do not restrain the entire body 2. It is safe for the particular client. Choose a restraint with with he client cannot self-inflict injury. 3. It does not interfere with the clients treatment or health problem. 4. It is readily changeable. Restraints need to be changed frequently especially if they become soiled. 5. It is a discreet as possible.

moral distress

A conflict between what is in the client's best interest and the nurses personal belief system. This is considered a serious issue in the workplace.

State a Nursing Diagnosis for clients at risk of injury.

A nursing diagnosis is when you appropriately identify the patients problems, so for a risk of injury it could be seeing that the patient is quite disorientated and dizzy.

Name four factors affecting safety

Age and Development, Cognitive awareness, emotional and environmental factors

Which information would the nurse include when assessing the family history of a client to be documented as a​ genogram? As many generations as possible Two generations of relatives The client​'s siblings and children only The client​'s nuclear family only

As many generations as possible

Name three alternatives to restraints.

Assess for pain and treat appropriately, place a picture or personal item on the door to the clients room to identify their room, allow restless clients to walk after determining the safety of the environment

The nurse is caring for an increasingly agitated postoperative client who is trying to remove the intravenous​ (IV) catheter. What is the best initial response by the​ nurse? Restrain the client​'s hands to avoid removal of the IV catheter. Attempt to reorient the client to the hospital environment and the need for the IV catheter. Notify the health care provider and ask for an order for a physical restraint. Move the client to a room at the end of the hall so she does not disturb other clients.

Attempt to reorient the client to the hospital environment and the need for the IV catheter.

Values clarification is a process in which people​ identify, examine, and develop their own values and how they relate to care decisions. How do nurses help clients clarify ​values? Select all that apply. By identifying alternative actions possible in a given situation . By asking the client how​ he/she feels about the decision By asking the client if the decision​ he/she is making corresponds to​ his/her normal behavior By asking the client to make the decision without input from friends or family By ensuring the client understands the health care provider​'s plan of care

By identifying alternative actions possible in a given situation By asking the client how he/she feels about the decision By asking the client if the decision he/she is making corresponds to his/her normal behavior

What is the role of criminal law in the practice of nursing​ care? Criminal law relates to​ contracts, ownership of​ property, and the right to practice as a nurse. Nurses are subject to criminal prosecution for any breach of the Nurse Practice Act. Criminal law defines actions such as theft and illegal drug​ possession, even in the hospital setting. . Nurses are immune from state and federal criminal statutes while caring for clients.

Criminal law defines actions such as theft and illegal drug possession, even in the hospital setting

Nurse Practice Acts

Defined as the legal boundaries of nursing practice within each state

nonmalefience

Do no harm. Not intentionally harming

The nurse is completing a health history on a client who is being seen in the clinic for the first time. Which information would the nurse obtain during the psychosocial ​assessment? Select all that apply. Medication history Educational level Past hospitalizations Occupation Social supports Review Only

Educational Level Occupation Social Supports

How often must a restraint order be renewed?

Every 12 hours

The nurse at the primary care clinic is clarifying a new client​'s complaint of foot pain. Which type of assessment is the nurse​ completing? Preinteraction chart review Initial assessment interview ​Cross-examination Focused interview

Focused Interview

The nurse is completing a health history for a client in the hospital. Which action by the nurse indicates a need for the nurse​'s further​ teaching? Listens attentively to the client during the interview Frequently takes notes and writes down all the client​'s answers Conducts the interview in the client​'s room Asks the client to turn TV off during the interview

Frequently takes notes and writes down all the client​'s answers

Florence Nightingale is considered a pioneering nursing theorist. What is the best description of how her theories contribute to nursing care​ today? Individuals choose and bear responsibility for patterns of personal health. Nurses interact with clients when recovery may not be feasible. Caring is a personal response and promotes health more than curing. Fresh​ air, pure​ water, cleanliness, and light allow the client to recover from illness.

Fresh​ air, pure​ water, cleanliness, and light allow the client to recover from illness.

The nurse is preparing an education session to promote safety in​ middle-aged adults. Which topics would be appropriate for this age ​group? Select all that apply. Installing grasp bars and​ non-skid bath mats Maintaining eye health and visual acuity Testing carbon monoxide detectors and knowing when to change batteries Organizing home environment and reducing clutter Making and keeping appointments for an annual physical examination

Installing grasp bars and non-skid bath mats Testing carbon monoxide detectors and knowing when to change batteries Organizing home environment and reducing clutter

Misdemeanor

Less serious crime that has a penally of a fine or imprisionment for less than a year

List 3 steps you might take in preparing a room for a patient with seizure precautions.

Pad the bed for any client who might have a seizure, secure blankets and other linens around the head, foot, and side rails of the bed. Perform adequate hand hygiene Provide client privacy

What does PASS mean?

Pull out the extinguishers safety pin Aim the hose at the base of the fire Squeeze or press the handle to discharge the material onto the fire Sweep the hose from side to side across the base of the fire to until the fire appears to be out

National patient safety goal #2 states: Improve communication among caregivers. What is one way the nurse can help to achieve this goal?

Read back verbal orders, for example, when a doctor tells you to do something, say it back so that you are getting the order right

The role of the nurse as an advocate is an important part of nursing care. How is this role demonstrated in the client care​ setting? The nurse ensures the client​'s blood test is run as a stat order as requested by the health care provider. The nurse calls the dietary office for the client​'s lunch that was not brought to the floor. The nurse refuses to provide care for a teenager who is receiving stem cells from her younger sister. The nurse postpones the client​'s surgery when the client signed the consent without understanding.

The nurse postpones the client​'s surgery when the client signed the consent without understanding.

What does RACE mean?

Rescue, Alarm, Confine, Extinguish

Felony

Serious crime with a penalty of imprisionment of greater than a year or even death

Nurses often face ethical dilemmas related to the care they give clients. These include issues such as client​ privacy, organ and tissue​ transplant, and allocation of resources. What is the best way to deal with an ethical issue encountered in the health care​ setting? The nurse should be familiar with the Nursing Code of Ethics. The nurse should trust​ his/her feelings or emotions on the subject. The nurse should discuss the ethical dilemma with​ his/her personal​ priest, pastor, or rabbi. The nurse should follow the policies and procedures of the hospital.

The nurse should be familiar with the Nursing Code of Ethics

List 4 safety measures you might teach to a group of adolescents.

Teach safety measures for the use of power tools Teach dangers of sunbathing and tanning beds Restrict number of passengers in car during first year of driving Set a good example of behavior that the adolescent can follow

What does QSEN stand for?

The quality and safety education for nurses

Describe the reason the use of a bed or chair safety device.

To alert the nurse that the client is attempting to get out of bed, to decrease the risk of client falls

The nurse is teaching a​ 16-year-old female measures to ensure a safe environment for her​ 3-month-old infant. Which actions by the mother indicate an understanding of​ age-appropriate safety ​measures? Select all that apply. Putting hot pots on the back burner of the stove with handles turned inwards Using the microwave to heat the infant​'s formula Using electrical socket covers in the home Placing the infant​'s car seat in the front of the car facing backwards Providing the infant with a soft toy with no small parts

Using electrical socket covers in the home Providing the infant with soft toy with no small parts

Which statement best describes the application of nursing theory to clinical​ practice? Using theory to define the interactions between nurses and health care providers in a hospital Using theory to support knowledge and improve the graduation rates of nursing schools Using theory to expand the types of procedures nurses are allowed to perform Using theory to​ reflect, question, and support the unique role of nurses in client care

Using theory to​ reflect, question, and support the unique role of nurses in client care

Which statement best describes the development of values used in the practice of nursing​ care? Personal​ values, nursing​ values, and professional values are best kept separated. Values are influenced by​ experiences, observing​ others, and a person​'s environment. Values are taught in nursing school and are defined in the Nursing Code of Ethics. Clients​' values do not influence the care given by nurses or other health care providers.

Values are influenced by experiences, observing others, and a person's environment

The nurse is planning an educational session for a group of teenagers to discuss common causes of injury among this age group. Which topic would be a priority to include in the​ session? Drowning Vehicular crashes Falls Suffocation

Vehicular crashes

Negligence is an unintentional wrong committed against a person or a person​'s property and usually occurs when nurses are not careful enough when caring for clients. What is the standard that is used to determine what is careful​ enough? What an actively practicing nurse in that state would do What the protocols and procedures of the hospital say to do What an​ ordinary, reasonable, and prudent person would do What the nurses in the hospital unit commonly do

What an​ ordinary, reasonable, and prudent person would do

emotional intelligence

ability to form work relationships with colleagues, display, maturity in a variety of situations

relevance

asking more than one question at a time

For the older adult list 4 ways to prevent falls in the home

attach side rails to the bed, keep rails in place when the bed is in its lowest position

Explain how to promote safety across the lifespan

becoming advocates for patients

Tort

civil wrong made against a person property

The nurse is planning to obtain biographical information for a health history. Which person should the nurse interview as the primary source for this​ information? Client Friend Health care professional Family member

client

Electronic communication

communication with technology

territoriality

concept of space and things that an individual considers belonging to the self

incident report

database used in an attempt to determine deviations from standard of care and corrective measures needed to prevent recurrence and to alert risk management to a potential claim situation

beneficence

doing good. Nurses are obligated to do this

Justice

frequently referred to as fairness

gender

girls use language to seek confirmation, minimize differences, and establish intimacy. Boys use language to establish independence and negotiate status within a group

agressive communication

honest, direct, and appropriate while being open to ideas and respecting the rights of others

introductory phase

important because it sets the tone for the rest of the realtionship

The nurse is reviewing the health care provider​'s orders for a newly admitted client. Which medication order would place the client at the highest risk for​ injury? ​"Give bacitracin​ (AK-Tracin) optic solution 2 gtts in right eye every 2​ hours." ​"Give codeine sulfate 15 mg PO every 6 hours for cough​ relief." ​"Give cephalexin​ (Keflex) PO 500 mg​ bid." ​"Give ibuprofen​ (Motrin) 800 mg PO four times a day for arthritic​ pain."

​"Give codeine sulfate 15 mg PO every 6 hours for cough​ relief."


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