PCC1 Exam 1

4.0-11.0 (Units x 10^3/ul)

What is the normal range for WBC count?

4.25-5.25 (mg/dL)

What is the normal range for ionized calcium in an adult?

40-220 (mEq/L/24hrs)

What is the normal range for sodium (urine) in an adult?

8.9-10.3 (mg/dL)

What is the normal range for total calcium in an adult?

10-20 (mg/dl) Elderly could be slightly higher than young adult

What is the normal range of BUN (Blood Urea Nitrogen) in an adult?

39-52%

What is the normal range of Hematocrit (Hct) for an adult?

3.5-5.0 (g/dl) 52-68% total protein

What is the normal range of albumin (serum) for an adult?

70-125 (mg/dl) urine: negative

What is the normal range of blood glucose in an adult?

3.6-5.1 (mEq/L)

What is the normal range of potassium in an adult?

136-145 (mEq/L)

What is the normal range of sodium (serum) in an adult?

10-17 (g/L)

What level of prealbumin (serum) would indicate moderate risk of protein-energy malnutrition?

> 17 (g/L)

What level of prealbumin (serum) would indicate no risk of protein-energy malnutrition?

<10 (g/L)

What level of prealbumin (serum) would indicate severe risk of protein-energy malnutrition?

A

What principle about nurse-patient communication should guide a nurse's fear about "saying the wrong thing" to a patient? a. Patients tend to appreciate a well-meaning person who conveys genuine acceptance, respect, and concern for their situation. b. The patient is more interested in talking to you than listening to what you have to say and so is not likely to be offended. c. Considering the patient's history, there is little chance that the comment will do any actual harm. d. Most people with a mentally illness have by necessity developed a high tolerance of forgiveness.

Family

What the individual believes it to be, includes a set of interacting individuals who are related through biology or enduring commitments

Nontherapeutic Communication Techniques

What type of communication techniques do these examples represent? Excessive questioning Giving approval or disapproval Giving advice Asking "Why" questions

Therapeutic Communication Techniques

What type of communication techniques do these examples represent? Using silence Active listening clarifying techniques asking questions and eliciting patient responses

A

When should a nurse be most alert to the possibility of communication errors resulting in harm to the patient? a. Change of shift report b. Admission interviews c. One-to-one conversations with patients d. Conversations with patient families

Cultural competency

expected component of nursing education and professional nursing practice, requires underlying acceptance of patient's health beliefs, requires adapting care to meet unique needs and perspectives of individual

4

A mother is concerned about her child's flulike symptoms. You learn from the health assessment that the mother practices use of "hot" and "cold" foods to treat ailments. Which of the following foods do you expect the mother to use to treat her child? 1. Chicken 2. Yogurt 3. Fresh fruits 4. Eggs

3

A nurse working in a large occupational health clinic knows that many of the workers at her company are marginalized and at risk for poor health outcomes. Which of the following individuals are most likely to be marginalized? 1. Wives of the employees 2. The head supervisors of the company 3. Workers who have a high school education 4. Workers employed for less than a year at the company

a,b,d,e

. During an admission assessment and interview, which channels of information communication should the nurse be monitoring? Select all that apply. a. Auditory b. Visual c. Written d. Tactile e. Olfactory

Acculturation

Process by acquiring new attitudes, roles, customs, or behaviors Ex: An immigrant from China develops a preference for Western foods and music

Assimilation

Process by which a person gives up his or her original identity and develops a new cultural identity by becoming absorbed into the dominant cultural group

1,4,5

A 35-year-old woman has Medicaid coverage for herself and two young children. She missed an appointment at the local health clinic to get an annual mammogram because she has no transportation. She gets the annual screening because her mother had breast cancer. Which of the following are social determinants of this woman's health? (Select all that apply.) 1. Medicaid insurance 2. Annual screening 3. Mother's history of breast cancer 4. Lack of transportation 5. Woman's age

1,3

6. The patient states, "I don't have confidence in my doctor. She looks so young." The nurse therapeutically responds: (Select all that apply.) 1. Tell me more about your concern. 2. You have nothing to worry about. Your doctor is perfectly competent. 3. You are worried about your care? 4. You can go online and see how others have rated your doctor. I do that. 5. You should ask your doctor to tell you her background.

Enculturation

Process by which a person learns norms, values, and behaviors of another culture Ex: a high school student from the United States spends a summer abroad with a family in Switzerland

2,3

A 44-year-old male patient has just been told that his wife and child were killed in an auto accident while coming to visit him in the hospital. Which of the following statements are assessment findings that support a nursing diagnosis of Spiritual Distress related to loss of family members? (Select all that apply.) 1. "I need to call my sister for support." 2. "I have nothing to live for now." 3. "Why would my God do this to me?" 4. "I need to pray for a miracle." 5. "I want to be more involved in my church."

4

A 7-year-old child was recently diagnosed with asthma. A nurse is providing education to the child and her parents about the treatment and management of asthma and changes they need to make in their home environment to promote her health. Which statement made by the parents requires follow-up by the nurse? 1. "We have made an appointment to talk with the school nurse about the change in our child's health." 2. "We forgot to give our daughter her medications before bedtime, so we made a list of her medications to help us remember." 3. "We have worked out a schedule to check on her before and after school." 4. "We have not been spending time with our parents because we are so busy taking care of our daughter."

3

A client is receiving an enteral feeding at 65 mL/hr. The gastric residual volume in 4 hours was 125 mL. What is the priority nursing intervention? 1. Assess bowel sounds. 2. Raise the head of the bed to at least 45 degrees. 3. Continue the feedings; this is normal gastric residual for this feeding. 4. Hold the feeding until you talk to the primary care provider.

1

A client who is receiving parenteral nutrition (PN) through a central venous catheter (CVC) has an air embolus. What should be the nurse's priority action? 1. Have the patient turn on the left side and perform a Valsalva maneuver. 2. Clamp the intravenous (IV) tubing to prevent more air from entering the line. 3. Have the patient take a deep breath and hold it. 4. Notify the health care provider immediately.

1,2,4

A family consisting of a grandparent, two adults, and three school-age children just immigrated to the United States. They come to a community wellness center to establish health care. Which of the following questions does the nurse ask to assess the family's function? (Select all that apply.) 1. "What does your family do to keep members healthy?" 2. "How does your family usually make decisions?" 3. "What health services are available in your neighborhood?" 4. "Which rituals or celebrations are important for your family?" 5. "Is there a lot of crime in your neighborhood?" 6. "How many parks are there in your community?"

3

A family includes a mother, a stepfather, two teenage biological daughters of the mother, and a biological daughter of the father. The father's daughter just moved home following the loss of her job in another city. The family is converting a study into a bedroom and is in the process of distributing household chores. Nursing assessment reveals all members of the family think that their family can adjust to lifestyle changes. This is an example of family: 1. Diversity. 2. Durability. 3. Resiliency. 4. Configuration.

1,2,4

A family is facing job loss of the father, who is the major wage earner, and relocation to a new city where there is a new job. The children will have to switch schools, and his wife will have to resign from the job she enjoys. Which of the following contribute to this family's hardiness? (Select all that apply.) 1. Family meetings 2. Established family roles 3. New neighborhood 4. Willingness to change in time of stress 5. Passive orientation to life

2

A hospice nurse is caring for a family that is providing end-of-life care for their grandmother, who has terminal breast cancer. The nurse focuses on symptom management for the grandmother and on helping the family with developing coping skills. This approach is an example of which of the following? 1. Family as context 2. Family as patient 3. Family as a system 4. Family as structure

B

A male patient frequently inquires about the female student nurse's boyfriend, social activities, and school experiences. Which is the best initial response by the student? a. The student requests assignment to a patient of the same gender as the student. b. She limits sharing personal information and stresses the patient-centered focus of the conversation. c. The student shares information to make the therapeutic relationship more equal. d. She explains that if he persists in focusing on her, she cannot work with him.

3,4,5

A married couple has three children. The youngest child just graduated from college and is moving to a different city to take a job. The other two children left the home several years ago. Both of their parents are older and are beginning to need help to maintain their home. What assessment questions will help the nurse determine the family's functioning? (Select all that apply). 1. Which transitions or changes in your family are you currently experiencing? 2. Are your children having any problems that are affecting your family right now? 3. Describe a recent family conflict and how your family resolved it. 4. What coping strategies do you typically use as a family? 5. Who is involved in helping care for your parents?

2,4,5

A mother and her two children are homeless and enter a free health care clinic. Which statements most likely describe the effects of homelessness on this family? (Select all that apply.) 1. The children have stability in their education. 2. The family members may have symptoms of malnutrition, such as anemia. 3. The family is at a low risk for experiencing violence. 4. The children are at higher risk for developing ear infections. 5. All family members may have mental health issues.

D

A nurse desires to communicate with a young woman who is Serbian and who has limited experience with being in a hospital. The nurse has 10 years of experience caring for Serbian women. The patient was admitted for a serious pregnancy complication. Apply the LEARN model and match the nurse's behaviors with each step of the model. 1. L __ a. The nurse notes that she has learned that fathers can visit mothers at any time in both Serbia and the United States. b. The nurse shares her perception of the woman's experiences as a patient. c. The nurse asks the patient how she can maintain bed rest when she returns home. d. The nurse attends to the patient and listens to her story about hospitals in Serbia. e. The nurse involves the patient in a discussion of the treatment options for her condition.

B

A nurse desires to communicate with a young woman who is Serbian and who has limited experience with being in a hospital. The nurse has 10 years of experience caring for Serbian women. The patient was admitted for a serious pregnancy complication. Apply the LEARN model and match the nurse's behaviors with each step of the model. 2. E__ a. The nurse notes that she has learned that fathers can visit mothers at any time in both Serbia and the United States. b. The nurse shares her perception of the woman's experiences as a patient. c. The nurse asks the patient how she can maintain bed rest when she returns home. d. The nurse attends to the patient and listens to her story about hospitals in Serbia. e. The nurse involves the patient in a discussion of the treatment options for her condition.

A

A nurse desires to communicate with a young woman who is Serbian and who has limited experience with being in a hospital. The nurse has 10 years of experience caring for Serbian women. The patient was admitted for a serious pregnancy complication. Apply the LEARN model and match the nurse's behaviors with each step of the model. 3. A__ a. The nurse notes that she has learned that fathers can visit mothers at any time in both Serbia and the United States. b. The nurse shares her perception of the woman's experiences as a patient. c. The nurse asks the patient how she can maintain bed rest when she returns home. d. The nurse attends to the patient and listens to her story about hospitals in Serbia. e. The nurse involves the patient in a discussion of the treatment options for her condition.

E

A nurse desires to communicate with a young woman who is Serbian and who has limited experience with being in a hospital. The nurse has 10 years of experience caring for Serbian women. The patient was admitted for a serious pregnancy complication. Apply the LEARN model and match the nurse's behaviors with each step of the model. 4. R__ a. The nurse notes that she has learned that fathers can visit mothers at any time in both Serbia and the United States. b. The nurse shares her perception of the woman's experiences as a patient. c. The nurse asks the patient how she can maintain bed rest when she returns home. d. The nurse attends to the patient and listens to her story about hospitals in Serbia. e. The nurse involves the patient in a discussion of the treatment options for her condition.

C

A nurse desires to communicate with a young woman who is Serbian and who has limited experience with being in a hospital. The nurse has 10 years of experience caring for Serbian women. The patient was admitted for a serious pregnancy complication. Apply the LEARN model and match the nurse's behaviors with each step of the model. 5. N__ a. The nurse notes that she has learned that fathers can visit mothers at any time in both Serbia and the United States. b. The nurse shares her perception of the woman's experiences as a patient. c. The nurse asks the patient how she can maintain bed rest when she returns home. d. The nurse attends to the patient and listens to her story about hospitals in Serbia. e. The nurse involves the patient in a discussion of the treatment options for her condition.

1,3,4

A nurse is caring for a 66-year-old patient who lives alone and is receiving chemotherapy and radiation for a new cancer diagnosis. He is unable to care for himself because of severe pain and fatigue. He moves into his 68-year-old brother's home so his brother can help care for him. Which assessment findings indicate that this family caregiving situation will be successful? (Select all that apply.) 1. Both the patient and his brother attend church together regularly. 2. The brothers are living together and enjoy eating the same foods. 3. Other siblings live in the same city and are willing to help. 4. The patient and his brother have a close network of friends. 5. The patient has obsessive-compulsive disorder and has difficulty throwing away possessions.

3

A nurse is caring for a patient who is Muslim and has diabetes. Which of the following items does the nurse need to remove from the meal tray when it is delivered to the patient? 1. Small container of vanilla ice cream 2. A dozen red grapes 3. Bacon and eggs 4. Garden salad with ranch dressing

2,3,5

A nurse is preparing to teach an older adult who has chronic arthritis how to practice meditation. Which of the following strategies are appropriate? (Select all that apply.) 1. Encourage family members to participate in the exercise. 2. Have patient identify a quiet room in the home that has minimal interruptions. 3. Suggest the use of a quiet fan running in the room. 4. Explain that it is best to meditate about 5 minutes 4 times a day. 5. Show the patient how to sit comfortably with the limitation of his arthritis and focus on a prayer.

4S 1B 2A 3R

A nurse prepares to contact a patient's physician about a change in the patient's condition. Put the following statements in the correct order using SBAR (Situation, Background, Assessment, and Recommendation) communication. 1. "She is a 53-year-old female who was admitted 2 days ago with pneumonia and was started on levofloxacin at 5 PM yesterday. She states she has a poor appetite; her weight has remained stable over the past 2 days." 2. "The patient reported feeling very nauseated after her dose of levofloxacin an hour ago." 3. "Is it possible to make a change in antibiotics, or could we give her a nutritional supplement before her medication?" 4. "The patient started to complain of nausea yesterday evening and has vomited several times during the night."

2

A nurse sees an assistive personnel (AP) perform the following intervention for a patient receiving continuous enteral feedings. Which action would require immediate attention by the nurse? 1. Fastening tube to the gown with new tape 2. Placing client supine while giving a bath 3. Monitoring the client's weight as ordered 4. Ambulating patient with enteral feedings still infusing

3

A nurse used spiritual rituals as an intervention in a patient's care. Which of the following questions is most appropriate to evaluate its efficacy? 1. Do you feel the need to forgive your wife over your loss? 2. What can I do to help you feel more at peace? 3. Did either prayer or meditation prove helpful to you? 4. Should we plan on having your family try to visit you more often in the hospital?

2,4,1,3

A nurse works with a patient using therapeutic communication and the phases of the therapeutic relationship. Place the nurse's statements in order according to these phases. 1. The nurse states, "Let's work on learning injection techniques." 2. The nurse is mindful of his/her own biases and knowledge in working with the patient with B12 deficiency. 3. The nurse summarizes progress made during the nursing relationship. 4. After providing introductions, the nurse defines the scope and purpose of the nurse-patient relationship.

3,4,5

A nursing student is developing a plan of care for a 74-year-old-female patient who has spiritual distress over losing a spouse. As the nurse develops appropriate interventions, which characteristics of older adults should be considered? (Select all that apply.) 1. Older adults do not routinely use complementary medicine to cope with illness. 2. Older adults dislike discussing the afterlife and what might have happened to people who have passed on. 3. Older adults achieve spiritual resilience through frequent expressions of gratitude. 4. Have the patient determine whether her husband left a legacy behind. 5. Offer the patient her choice of rituals or participation in exercise.

2

A patient has just learned she has been diagnosed with a malignant brain tumor. She is alone; her family will not be arriving from out of town for an hour. The nurse has been caring for her for only 2 hours but has a good relationship with her. What is the most appropriate intervention for support of her spiritual well-being at this time? 1. Make a referral to a professional spiritual care adviser. 2. Sit down and talk with the patient; have her discuss her feelings and listen attentively. 3. Move the patient's Bible from her bedside cabinet drawer to the top of the over-bed table. 4. Ask the patient whether she would like to learn more about the implications of having this type of tumor.

4

A patient is receiving both parenteral (PN) and enteral nutrition (EN). When would the nurse collaborate with the health care provider and request a discontinuation of parenteral nutrition? 1. When 25% of the patient's nutritional needs are met by the tube feedings 2. When bowel sounds return 3. When the central line has been in for 10 days 4. When 75% of the patient's nutritional needs are met by the tube feedings

1,3

A patient is receiving total parenteral nutrition (TPN). What are the primary interventions the nurse should follow to prevent a central line infection? (Select all that apply.) 1. Change the dressing using sterile technique. 2. Change TPN containers every 48 hours. 3. Change the TPN tubing every 24 hours. 4. Monitor glucose levels to watch and assess for glucose intolerance. 5. Elevate head of the bed 45 degrees to prevent aspiration.

1

A patient who is newly diagnosed with breast cancer states, "Although I am really scared about what is going to happen to me, I know my family will learn from this experience, and we will be stronger in the end." What term does the nurse use in the patient's 133medical record to describe the characteristic displayed in this statement? 1. Resiliency 2. End-of-life care 3. Family functioning 4. Family's culture

Culture

A pattern of shared attitudes, beliefs, self-definitions, norms, roles, and values that can occur among those who speak a particular language or live in a defined geographic region

Communication

A process of interaction between people in which symbols are used to create, exchange, and interpret messages about ideas, emotions, and mind states

C

A registered nurse is caring for an older male who reports depressive symptoms since his wife of 54 years died suddenly. He cries, maintains closed body posture, and avoids eye contact. Which nursing action describes attending behavior? a. Reminding the patient gently that he will "feel better over time" b. Using a soft tone of voice for questioning c. Sitting with the patient and taking cues for when to talk or when to remain silent d. Offering medication and bereavement services

SBAR

A tool that supports consistent and accurate communication between professionals, provides a framework for communication

10-150 (mg/dL)

Normal range for triglycerides in an adult?

A

Carolina is surprised when her patient does not show for a regularly scheduled appointment. When contacted, the patient states, "I don't need to come see you anymore. I have found a therapy app on my phone that I love." How should Carolina respond to this news? a. "That sounds exciting, would you be willing to visit and show me the app?" b. "At this time, there is no real evidence that the app can replace our therapy." c. "I am not sure that is a good idea right now, we are so close to progress." d. "Why would you think that is a better option than meeting with me?"

Professional Responsibilities and roles

Autonomy and Accountability Caregiver Advocate Educator Communicator Manager

Metacommunication

Context of the message

Self examination of ones's biases toward other cultures and in-depth exploration of one's own culture and professional background

Cultural awareness

B

Cultural competency in Nursing A.) indicates the nurses responsiblity to advise the patient on cultural issues B.) is an expected component of professional nursing C.) is something for the nurse to consider only in special circumstances D.) does not mean the nurse has to accept the patients health belief

1

During a nursing assessment a patient displayed several behaviors. Which behavior suggests the patient may have a health literacy problem? 1. Patient has difficulty completing a registration form at a medical office 2. Patient asks for written information about a health topic 3. Patient speaks Spanish as primary language 4. Patient states unfamiliarity with a newly ordered medicine

2

During a visit to a family clinic, a nurse teaches a mother about immunizations, the use of car seats, and home safety for an infant and toddler. Which type of nursing interventions are these? 1. Restorative 2. Health promotion 3. Acute care 4. Growth and development

Biculturalism

Duel pattern of identification Example: A woman of Christian faith married to a Muslim adopts some Muslim practices and also maintains some traditional Christian practices

C

Emily is a 28-year-old nurse who works on a psychiatric unit. She is assigned to work with Jenna, a 27-year-old who was admitted with major depressive disorder. Emily and Jenna realize that they graduated from the same high school and each has a 2-year-old daughter. Emily and Jenna discuss getting together for a play date with their daughters after Jenna is discharged. This situation reflects: a. Successful termination b. Promoting interdependence c. Boundary blurring d. A strong therapeutic relationship

Family Assessment

Establishes a working relationship with the patient and family

1,2,4,5

Health care organizations must provide which of the following based on federal civil rights laws? (Select all that apply.) 1. Provide language assistance services at all points of contact free of charge. 2. Provide auxiliary aids and services, such as interpreters, note takers, and computer-aided transcription services. 3. Use patients' family members to interpret difficult topics. 4. Ensure that interpreters are competent in medical terminology. 5. Provide language assistance to all patients who speak limited English or are deaf.

AIDET (Acknowledge, introduce, duration, explanation, thank you)

How do you introduce yourself during the orientation phase?

Age, elderly, race/ethnicity, socioeconomic status, genetics, and burn patients

Identify risk factors for nutrition alterations

40-60 (mg/dL)

In most healthy adults without risk factors for heart disease, to have HDL their levels must be greater than....

130 (mg)

In most healthy adults without risk factors for heart disease, to have LDL (low density lipids) cholesterol their levels must be lower than....

C

James is a 42-year-old patient with schizophrenia. He approaches you as you arrive for day shift and anxiously reports, "Last night, demons came to my room and tried to rape me." Which response would be most therapeutic? a. "There are no such things as demons. What you saw were hallucinations." b. "It is not possible for anyone to enter your room at night. You are safe here." c. "You seem very upset. Please tell me more about what you experienced last night." d. "That must have been very frightening, but we'll check on you at night and you'll be safe."

A

Mary is a 39-year-old attending a psychiatric outpatient clinic. Mary believes that her husband, sister, and son cause her problems. Listening to Mary describe the problems the nurse displays therapeutic communication in which response? a. "I understand you are in a difficult situation." b. "Thinking about being wronged repeatedly does more harm than good." c. "I feel bad about your situation, and I am so sorry it is happening to you and your family." d. "It must be so difficult to live with uncaring people."

E

Match the cultural concepts on the left with the correct definitions on the right. Cultural Desire a. Factor that shapes how people perceive others and how they relate to reality b. Insider's perspective in an intercultural encounter c. A policy model that describes factors and power structures that shape and influence life d. An outsider's perspective in an intercultural encounter e. The motivation of a health care professional to "want to" engage in cultural competency

B

Match the cultural concepts on the left with the correct definitions on the right. Emic World View a. Factor that shapes how people perceive others and how they relate to reality b. Insider's perspective in an intercultural encounter c. A policy model that describes factors and power structures that shape and influence life d. An outsider's perspective in an intercultural encounter e. The motivation of a health care professional to "want to" engage in cultural competency

D

Match the cultural concepts on the left with the correct definitions on the right. Etic World View a. Factor that shapes how people perceive others and how they relate to reality b. Insider's perspective in an intercultural encounter c. A policy model that describes factors and power structures that shape and influence life d. An outsider's perspective in an intercultural encounter e. The motivation of a health care professional to "want to" engage in cultural competency

C

Match the cultural concepts on the left with the correct definitions on the right. Intersectionality a. Factor that shapes how people perceive others and how they relate to reality b. Insider's perspective in an intercultural encounter c. A policy model that describes factors and power structures that shape and influence life d. An outsider's perspective in an intercultural encounter e. The motivation of a health care professional to "want to" engage in cultural competency

A

Match the cultural concepts on the left with the correct definitions on the right. World View ______ a. Factor that shapes how people perceive others and how they relate to reality b. Insider's perspective in an intercultural encounter c. A policy model that describes factors and power structures that shape and influence life d. An outsider's perspective in an intercultural encounter e. The motivation of a health care professional to "want to" engage in cultural competency

C

Morgan is a third-year nursing student in her psychiatric clinical rotation. She is assigned to an 80-year-old widow admitted for major depressive disorder. The patient describes many losses and sadness. Morgan becomes teary and says meaningfully, "I am so sorry for you." Morgan's instructor overhears the conversation and says, "I understand that getting tearful is a human response. Yet, sympathy isn't helpful in this field." The instructor urges Morgan to focus on: a. "Adopting the patient's sorrow as your own." b. "Maintaining pure objectivity." c. "Using empathy to demonstrate respect and validation of the patient's feelings." d. "Using touch to let her know that everything is going to be alright."

1,3,5

Motivational interviewing (MI) is a technique that applies understanding a patient's values and goals in helping the patient make behavioral changes. When using motivational interviewing, what outcomes does the nurse expect? (Select all that apply.) 1. Gaining an understanding of the patient's motivations 2. Directing the patient to avoid poor health choices 3. Recognizing the patient's strengths and supporting his or her efforts 4. Providing assessment data that can be shared with families to promote change 5. Identifying differences in patient's health goals and current behaviors

Paralinguistic communication

Nonverbal messages (Ex: gestures, eye contact, facial expressions)

2,3,4

Nurses must communicate effectively with the health care team for which of the following reasons? (Select all that apply.) 1. To improve the nurse's status with the health team members 2. To reduce the risk of errors to the patient 3. To provide an optimum level of patient care 4. To improve patient outcomes 5. To prevent issues that need to be reported to outside agencies

Termination phase

Phase that occurs at the end of the relationship, exchange memories, review situations of the relationship, summarize goals and objectives learned, and going in and saying good bye to the patient,

Orientation phase

Phase when the nurse and the patient meet and get to know each other, establishing rapport and parameters of the relationship (telling them whats going on, how long, and who else will be coming in and helping out)

FICA

Spiritual assessment tool, use it to ask your patient about spirituality

Assessment

Step in the nursing process that involves history, subjective and objective, diagnosis, family dynamics, and environment

Interventions

Step of the nursing process that involves plan of care, education, and rationale

Diagnosis

Step of the nursing process that involves potential and actual factors relating to their situation, as well as defining characteristics

Evaluation

Step of the nursing process that involves seeing if the goal was met, seeing if it was helpful or not helpful, and reflection on the process

1. Self awareness 2. Cultural knowledge 3. Cultural skill

Steps for developing cultural competence/desire

Social determinants of health

The conditions in which people are born, grow, live, work, and age

B

The emphasis on understanding cultural influence on health care is important because of A.) litigious society. B.) increasing global diversity. C.) HIPAA requirements D.) disability entitlements.

4,1,3,2

The nurse applying effective communication skills throughout the nursing process should: (Place the following interventions in the correct order.) 1. Validate health care needs through verbal discussion with the patient. 2. Compare actual and expected patient care outcomes with the patient. 3. Provide support through therapeutic communication techniques. 4. Complete a nursing history using verbal communication techniques.

C

The nurse identifies the family with a child graduating from college as being in which family life cycle? A.) Families with young children B.) Single young adult leaving home C.) Launching children and moving on D.) New couple joins their families through marriage or living together

A

The nurse is assessing a patient's spirituality and observes the patient meditating before any treatments. What is the nurse's best action? A.) Arrange for quiet time for the patient as needed B.) Limit the time patient can meditate before procedures C.) Document that the patient is not religious D.) Offer the patient a copy of the bible to read

Patients who are unresponsive

These are things you can do for a patient with what type of special need? • Call patient by name during interactions. • Communicate both verbally and by touch. • Speak to patient as though he or she can hear. • Explain all procedures and sensations. • Provide orientation to person, place, and time. • Avoid talking about patient to others in his or her presence.

D

What is the greatest trigger for the development of a patient's nurse focused transference? a. The similarity between the nurse and someone the patient already dislikes b. The nature of the patient's diagnosed mental illness c. The history the patient has with their parents d. The degree of authority the nurse has over the patient

1,3

The nurse is caring for a 50-year-old woman visiting the outpatient medicine clinic. The patient has had type 1 diabetes since age 13. She has numerous complications from her disease, including reduced vision, heart disease, and severe numbness and tingling of the extremities. Knowing that spirituality helps patients cope with chronic illness, which of the following principles should the nurse apply in practice? (Select all that apply.) 1. Pay attention to the patient's spiritual identity throughout the course of her illness. 2. Select interventions that you know scientifically support spiritual well-being. 3. Listen to the patient's story each visit to the clinic, and offer a compassionate presence. 4. When the patient questions the reason for her long-time suffering, try to provide answers. 5. Consult with a spiritual care adviser, and have the adviser recommend useful interventions.

4

The nurse is caring for a client with dysphagia and is feeding her a pureed chicken diet when she begins to choke. What is the priority nursing intervention? 1. Suction her mouth and throat. 2. Turn her on her side. 3. Put on oxygen at 2 L nasal cannula. 4. Stop feeding her.

2,3,4

The nurse is caring for a client with pneumonia, who has severe malnutrition. The nurse should assess the patient for which of the following assessment findings? (Select all that apply.) 1. Heart disease 2. Sepsis 3. Hemorrhage 4. Skin breakdown 5. Diarrhea

D

The nurse is caring for a patient that speaks little English. Spanish is his primary language. The nurse took Spanish in high school. Which of the following is an appropriate intervention. A.) the nurse can just have the patient sign the consent as is and explain the procedure after surgery B.) the nurse can interpret for the patient and get consent for his surgery C.) the nurse can ask a family member to explain the surgical procedure to the patient. D.) the nurse requests a professional medical interpreter.

1

The nurse is caring for a patient who has just had a near-death experience (NDE) following a cardiac arrest. Which intervention by the nurse best promotes the spiritual well-being of the patient after the NDE? 1. Allowing the patient to discuss the experience 2. Referring the patient to pastoral care 3. Having the patient talk to another patient who had an NDE 4. Offering to pray for the patient

A

The nurse is caring for a patient who is very depressed and decides to complete a spiritual assessment using the FICA tool. Using the FICA assessment tool, match the criteria on the left with the appropriate assessment question on the right. 1. F-Faith a. Tell me if you have a higher power or authority that helps you act on your beliefs b. Describe which activities give you comfort spiritually c. To whom do you go for support in times of difficulty? d. Your illness has kept you from attending church. Is that a problem for you?

B

The nurse is caring for a patient who is very depressed and decides to complete a spiritual assessment using the FICA tool. Using the FICA assessment tool, match the criteria on the left with the appropriate assessment question on the right. A-Address a. Tell me if you have a higher power or authority that helps you act on your beliefs b. Describe which activities give you comfort spiritually c. To whom do you go for support in times of difficulty? d. Your illness has kept you from attending church. Is that a problem for you?

C

The nurse is caring for a patient who is very depressed and decides to complete a spiritual assessment using the FICA tool. Using the FICA assessment tool, match the criteria on the left with the appropriate assessment question on the right. C-Community a. Tell me if you have a higher power or authority that helps you act on your beliefs b. Describe which activities give you comfort spiritually c. To whom do you go for support in times of difficulty? d. Your illness has kept you from attending church. Is that a problem for you?

D

The nurse is caring for a patient who is very depressed and decides to complete a spiritual assessment using the FICA tool. Using the FICA assessment tool, match the criteria on the left with the appropriate assessment question on the right. I-Importance a. Tell me if you have a higher power or authority that helps you act on your beliefs b. Describe which activities give you comfort spiritually c. To whom do you go for support in times of difficulty? d. Your illness has kept you from attending church. Is that a problem for you?

1,5

The nurse is evaluating the recent lab results for a patient. Which labs are the best indicators for malnutrition? (Select all that apply.) 1. Serum total protein 2. Potassium 3. Lipids 4. Albumin 5 Serum BUN

D

The nurse that responds to a patient's family with genuine interest is demonstrating the professional value of: A.) Truth-telling B.) Humility C.) Human flourishing D.) Compassion

2,3,4

The nurse therapeutically responds to an adult patient who is anxious by: (Select all that apply.) 1. Matching the rate of speech to be the same as that of the patient 2. Providing good eye contact 3. Demonstrating a calm presence 4. Spending time attentively with the patient 5. Assuring the patient that all will be well

2,3

The nurse uses silence as a therapeutic communication technique. What are the purposes of the nurse's silence? (Select all that apply.) 1. Allows the nurse time to focus and avoid saying the wrong thing 2. Prompts the patient to talk when he or she is ready 3. Allows the patient time to think and gain insight 4. Allows time for the patient to drift off to sleep 5. Determines whether the patient would prefer to talk with another staff member

A

The patient expresses sadness at "being all alone with no one to share my life with." Which response by the nurse demonstrates the existence of a therapeutic relationship? a. "Loneliness can be a very painful and difficult emotion." b. "Let's talk and see if you and I have any interests in common." c. "I use Facebook to find people who share my love of cooking." d. "Loneliness is managed by getting involved with people."

D

Therapeutic communication is the foundation of a patient- centered interview. Which of the following techniques is not considered therapeutic? a. Restating b. Encouraging description of perception c. Summarizing d. Asking "why" questions

Patients who have a cognitive impairment

These are things you can do for a patient with what type of special need? Use simple sentences and avoid long explanations. • Ask one question at a time. • Allow time for patient to respond. • Be an attentive listener. • Include family and friends in conversations, especially in subjects known to patient. • Use picture or gestures that mimic the action desired.

Patients who have a hearing impairment

These are things you can do for a patient with what type of special need? • Check for hearing aids and glasses. • Reduce environmental noise. • Get patient's attention before speaking. • Face patient with mouth visible. • Do not chew gum. • Speak at normal volume—do not shout. • Rephrase rather than repeat if misunderstood. • Provide a sign-language interpreter if indicated.

Patients who are visually Impaired

These are things you can do for a patient with what type of special need? • Check for use of glasses or contact lenses. • Identify yourself when you enter the room, and notify the patient when you leave the room. • Speak in a normal tone of voice. • Do not rely on gestures or nonverbal communication. • Use indirect lighting, avoiding glare. • Use at least 14-point print.

Patients Who Cannot Speak Clearly (Aphasia, Dysarthria, Muteness)

These are things you can do for a patient with what type of special need? • Listen attentively, be patient, and do not interrupt. • Ask simple questions that require "yes" or "no" answers. • Allow time for understanding and response. • Use visual cues (e.g., words, pictures, and objects) when possible. • Allow only one person to speak at a time. • Encourage patient to converse. • Let patient know if you have not understood him or her. • Collaborate with speech therapist as needed. • Use communication aids: letter boards, flash cards, computer-generated speech program).

Patients who do not speak english

These are things you can do for patient with what type of special need? • Speak to patient in normal tone of voice. • Establish method for patient to ask for assistance (call light or bell). • Provide a professional interpreter as needed. • Avoid using family members, especially children, as interpreters. • Use communication board, pictures, or cards. • Translate words from native language into English list for patient to make basic requests. • Have dictionary (e.g., English/Spanish) available if patient can read.

Preorientation phase

This phase occurs before meeting the patient, involves nurse self-evaluation/exploration

Therapeutic relationships

Type of relationship that promotes a psychological climate that facilitates positive change and growth

Personal appearance, posture and gait, facial expressions, eye contact, territoriality and personal space

What are some things to consider regarding non-verbal communication?

vocabulary, denotative and connotative meaning, pacing, intonation, clarity and brevity, timing and relevance

What are some things to consider regarding verbal communication?

Preorientation (preinteraction), orientation, working, and termination

What are the four stages of therapeutic nurse client relationship?

-Age within family -History of the people -Culture -Norms -Role of each member -Changes in roles

What are the influences on family dynamics?

Assessment, Diagnosis, Goals, Interventions, Evaluation

What are the steps of the nursing process?

linguistic, paralinguistic, metacommunication

What are the three primary categories of communication?

Assessment (What does the nurse think the problem is)

What does the A mean in SBAR?

Address (Ex: What can I do for you? or What support or guidance can health care provide to support your beliefs?)

What does the A stand for in FICA?

Background (what are the circumstances leading up to the situation)

What does the B mean in SBAR?

Community (Ex: Are you connected with a faith center in the community?)

What does the C stand for in FICA?

Faith or beliefs (Ex: what are your spiritual beliefs)

What does the F in FICA stand for?

Importance and influence (Ex: Is your faith/spirituality important to you?)

What does the I stand for in FICA?

Recommendation (what should we do to correct the problem)

What does the R mean in SBAR?

Situation (What is happening in the current time)

What does the S mean in SBAR

Conflict resolution, determine patient's attitude towards family, cultural aspects, discharge planning

What does the family assessment involve?

Ranges from effective to no communication

What does the scope of communication range from?

B

What interrelated constructs facilitate a nurse to become culturally competent? A.) Cultural desire, self-awareness, cultural knowledge, and cultural identity B.) Cultural desire, self-awareness, cultural knowledge, and cultural skill C.) Cultural desire, self-awareness, cultural knowledge, and cultural diversity D.) Cultural diversity, self-awareness, cultural skill, and cultural knowledge

Breastfeeding

What is the best option for infants up to 6 months of age?

13.3-17.3 (g/dL)

What is the normal range for Hemoglobin (Hg) in an adult?

4.3-5.9 (Units x 10^6/ul)

What is the normal range for RBC for an adult male?

C

When teaching an Asian patient with newly diagnosed diabetes, the nurse notes the patient nodding yes to everything that is being said. With a better understanding of cultural interdependence in self-concept, a nurse should immediately A.) call the recognized elder for this patient. B.) write everything down for the patient to refer to later. C.) prompt further to elicit additional questions or concerns D.) call the oldest male relative for help with decision making

1,3,4

When working with an older adult who is hearing-impaired, the use of which techniques would improve communication? (Select all that apply.) 1. Check for needed adaptive equipment. 2. Exaggerate lip movements to help the patient lip-read. 3. Give the patient time to respond to questions. 4. Keep communication short and to the point. 5. Communicate only through written information.

1

Which action can a nurse delegate to assistive personnel (AP)? 1. Performing glucose monitoring every 6 hours on a patient 2. Teaching the client about the need for enteral feeding 3. Administering enteral feeding bolus after tube placement has been verified 4. Evaluating the client's tolerance of the enteral feeding

1

Which explanation provided by the nurse is the most accurate meaning for "providing culturally congruent care"? 1. It fits the patient's valued life patterns and set of meanings. 2. It is the same set of values as those of the health care team member providing daily care. 3. It holds one's own way of life as superior to those of others. 4. It redirects the patient to a more socially expected set of values.

D

Which nursing statement is an example of reflection? a. "I think this feeling will pass." b. "So you are saying that life has no meaning." c. "I'm not sure I understand what you mean." d. "You look sad."

A,B,C

Which of the following are considered factors that place a family at risk? (Select all that apply) A.) Domestic Violence B.) Poverty C.) Homelessness D. )Non-traditional Family

2,3,5

Which of the following is an example of a patient with a health disparity? (Select all that apply.) 1. A patient who has a homosexual sexual preference 2. A patient unable to access primary care services 3. A patient living with a chronic disease 4. A family who relies on public transportation 5. A patient who has had a history of smoking for 10 years

E

Which of the following roles of the professional nurse are consistent with the American Nurses Association (ANA) definition of nursing? (Select all that apply) A.) Researcher B.) Educator C.) Counselor D.) Advocate E.) All of the above

B

Which patient outcome is directly associated with the goals of a therapeutic nurse-patient relationship? a. Patient will be respectful of other patients on the unit. b. Patient will identify suicidal feelings to staff whenever they occur. c. Patient will engage in at least one social interaction with the unit population daily. d. Patient will consume a daily diet to meet both nutritional and hydration needs.

A

Which patient statement demonstrates a value held regarding children? a. "Nothing is more important to me than the safety of my children." b. "I believe my spouse wants to leave both me and our children." c. "I don't think my child's success depends on going to college." d. "I know my children will help me through my hard times."

1

Which statement made by a new graduate nurse about the teach-back technique requires intervention and further instruction by the nurse's preceptor? 1. "After teaching a patient how to use an inhaler, I need to use the teach-back technique to test my patient's technique." 2. "The teach-back technique is an ongoing process of asking patients for feedback." 3. "Using teach-back will help me identify explanations and communication strategies that my patients will most commonly understand." 4. "Using pictures, drawings, and models can enhance the effectiveness of the teach-back technique."

4

Which statement made by a patient who is recovering after recently experiencing third-degree burns shows connectedness? 1. "My pain medicine helps me feel better." 2. "I know I will get better if I just keep trying." 3. "I see God's grace and become relaxed when I watch the sun set at night." 4. "I feel so much closer to God after I read my Bible and pray."

B

Which statement made by either the nurse or the patient demonstrates an ineffective patient-nurse relationship? a. "I've given a lot of thought about what triggers me to be so angry." b. "Why do you think it's acceptable for you to be so disrespectful to staff?" c. "Will your spouse be available to attend tomorrow's family group session?" d. "I wanted you to know that the medication seems to be helping me fell less anxious."

B

Which statement made by the nurse demonstrates the best understanding of nonverbal communication? a. "The patient's verbal and nonverbal communication is often different." b. "When my patient responds to my question, I check for congruence between verbal and nonverbal communication to help validate the response." c. "If a patient is slumped in the chair, I can be sure he's angry or depressed." d. "It's easier to understand verbal communication that nonverbal communication."

4

Which statement made by the parents of a 2-month-old infant requires further education by the nurse? 1. "I'll continue to use formula for the baby until he is at least a year old." 2. "I'll make sure that I purchase iron-fortified formula." 3. "I'll start feeding the baby cereal at 4 months." 4. "I'm going to alternate formula with whole milk, starting next month."

1,3

Which strategies should a nurse use to facilitate a safe transition of care during a patient's transfer from the hospital to a skilled nursing facility? (Select all that apply.) 1. Collaboration between staff members from sending and receiving departments 2. Requiring that the patient visit the facility before a transfer is arranged 3. Using a standardized transfer policy and transfer tool 4. Arranging all patient transfers during the same time each day 5. Relying on family members to share information with the new facility

B

Which student behavior is consistent with therapeutic communication? a. Offering your opinion when asked to convey support. b. Summarizing the essence of the patient's comments in your own words. c. Interrupting periods of silence before they become awkward for the patient. d. Telling the patient he did well when you approve of his statements or actions.

A,D, E

Which vitamins are fat soluble and stored in adipose tissue of the body?

B

You have been working closely with a patient for the past month. Today he tells you he is looking forward to meeting with his new psychiatrist but frowns and avoids eye contact while reporting this to you. Which of the following responses would most likely be therapeutic? a. "A new psychiatrist is a chance to start fresh; I'm sure it will go well for you." b. "You say you look forward to the meeting, but you appear anxious or unhappy." c. "I notice that you frowned and avoided eye contact just now. Don't you feel well?" d. "I get the impression you don't really want to see your psychiatrist—can you tell me why?"

Oppression

a formal and informal system of advantages and disadvantages tied to our membership in social groups, reinforced by societal norms, biases, interactions, and beliefs

Health Disparity

a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage

less than 200 (mg/dL)

healthy total cholesterol level

undernutrution

impaired nutrient absorption, ineffective nutrient utilization, starvation-related malnutrition; chronic starvation (anorexia)

linguistic competenece

knowing when you need to buy language assistance

cultural knowledge

learning or becoming educated about the beliefs and values of other cultures and diverse ethnic groups

Overnutrution

obesity leads to diabetes and cardiovascular disease via the metabolic syndrome, is one of the most known causes of cancer- insulin becomes resistant when youre obese

Linguistic Communication

spoken words or written symbols

Goals (outcomes)

step of the nursing process that involves making a plan that is specific, measurable, attainable, realistic, and timely

ANA nursing definition

the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations

Working Phase

when the nurse and the patient work together to solve problems and accomplish goals, facilitate behavior change, and redefine problems and goals when necessary