Exam 3 practice questions

Which characteristics exemplify an effective team? Select all that apply. Effective communication O Trust Effective conflict management

A good team is important to effective nursing care. The team should be able to communicate properly and avoid miscommunication. The team members should be able to trust each other. Conflicts may arise among team members; the team should be able to manage it amicably. All the team members should have a common purpose so that their efforts are focused. Providing feedback to each other helps improve patient care. Test-Taking Tip: Trust your training! Your nursing judgment and "common sense" both are valuable when answering this question. You can eliminate the incorrect choices by thinking "Does that make sense?" as you read a choice. Clearly a team needs to have a united purpose and team members need to be able to give each feedback. The other choices will seem right to you because of your training and good judgment. p. 162

A patient has abnormally shallow respirations followed by irregular periods of apnea. Which term does the nurse use to record this breathing pattern? Apnea O Bradypnea OO Biot respiration X O Kussmaul respiration

Biot respiration is the presence of abnormally shallow breaths followed by irregular periods of apnea. The cessation of respiration for several seconds is called apnea. Bradypnea is a regular, slow respiration of less than 10 breaths per minute. Kussmaul respiration is an abnormally deep, regular, and increased rate of respiration. Test-Taking Tip: If you are unsure of a response, start by eliminating the choices you know are incorrect. Apnea (a- + -pnea) means no breathing, so you quickly bypass it. Bradypnea (brady-, slow) means slow breathing, or less than the normal respiratory rate, so that's not correct. Then you just need to distinguish between Biot and Kussmaul. Here's a way to remember one of their differences: Kussmaul is a longer word and has deeper depth of respiration; Biot is a shorter word and has a shallower depth of respiration. p. 287

Which assessment finding is a symbolic aspect of culture for a patient? O Language O Occupation O Infrastructure O Gender roles

Rationale However, it is not symbolic, but a concept shared by the people in that culture. integrated culture; it is not symbolic. Culture assigns different roles to people according their gender. not culture specific. An infrastructure provides the basic necessities of life and is a required aspect of an Language is a system of verbal symbols that is used to communicate cultural beliefs and ideas. Occupation is

How can nurses perform effective hand-off reporting? Ensure that the hand-off report is performed quickly Hand-off reporting should be thorough and not rushed. Include the minimal amount of information necessary Hand-off reporting should be thorough and include all information about the patient necessary for care. Ensure all pertinent information is conveyed Effective hand-off reporting is achieved by ensuring all pertinent information necessary for patient care is exchanged. Include all information about the patient's past hospitalizations and treatments All information about the patient's past hospitalizations and treatments would not be included in the hand-off report.

Ensure all pertinent information is conveyed Effective hand-off reporting is achieved by ensuring all pertinent information necessary for patient care is exchanged.

Which information should be included in an ANTICipate hand-off report? V Previous patient hospitalizations Previous patient hospitalizations are not included in the ANTICipate model. Details about the patient's intubation procedure The ANTICipate model should include information about tasks performed by the provide V Planned treatment if the patient's condition worsens The ANTICipate model should include information about contingency plans. V Change in the patient's status from "critical" to "serious" The ANTICipate model should include information about changes in the patient's clinical s Information about the patient's next of kin Information about the patient's next of kin is not included in the ANTICipate model.

Details about the patient's intubation procedure The ANTICipate model should include information about tasks performed by the provide V Planned treatment if the patient's condition worsens The ANTICipate model should include information about contingency plans. V Change in the patient's status from "critical" to "serious" The ANTICipate model should include information about changes in the patient's clinical s

When a nurse uses information and technology to communicate, locate and use knowledge, reduce and eliminate errors, and help make decisions, the nurse is working in which area? O Integrated delivery system Health care patient system OO Nursing informatics OO Computerized nursing network

Nursing informatics is the use of information, data, and technology to communicate, manage knowledge. mitigate errors, and support decision making. It requires knowledge, skills, and attitudes from the nurse to be able to effectively use information and technology. Nursing informatics is focused on the organization, analysis, and dissemination of information. Integrated delivery systems, health care patient systems, and computerized nursing networks do not use information and technology to communicate, locate and use knowledge, or reduce and eliminate errors. p. 200

Which diet does the nurse provide for a pregnant patient whose subjective assessment findings are described on the table? Faith Spiritual Obsenvance Ritual • Abrahamic faith • Friday night to Seturday • ifa male child is born, the night chid will be circumcised on the eghthday in a ritual caled a bris.

O Kosher diet Rationale The assessment findings indicate that the patient practices Judaism; therefore the nurse ensures that the patient is given a kosher diet. Dietary restrictions in Judaism do not allow the patient to eat pork. The nurse must ensure that a patient practicing Hinduism is served a vegetarian diet. A kosher diet does not allow mixing of meat and dairy products; therefore the nurse ensures that the patient does not receive meat and dairy products in the same tray.

The nurse is assessing the relationship between the weight and age in a group of children. Which type of quantitative research is the nurse performing? Descriptive O Correlational Experimental Quasiexperimental

Quantitative research consists of four main types: descriptive, correlational, experimental, and quasiexperimental. Correlational research helps explore a relationship and age. Descriptive research involves the identification of data and the characteristics of a population or phenomenon. Experimental research explores the causal relationship between two variables. between two variables such as weight Quasiexperimental research examines causal relationships between variables but may not meet the strict guidelines of experimental research. Test-Taking Tip: Correlational research relates two factors. Do you see the letters "relat" in each word? If asked about a relationship between two variables, you know to choose correlational research. Be careful, though; experimental research looks for a causal relationship between two variables. Correlational research is not looking for cause-and-effect. p. 173

Which system assists the nurse in determining an accurate diagnosis as well as selecting appropriate interventions? O Electronic health record (EHR) Computerized provider order entry (CPOE) Bar-code medication administration (BCMA) Computerized decision support system (CDSS)

Rationale A CDSS is an application designed to assist all health care professionals with decision-making tasks. The CDSS helps the nurse write a correct nursing diagnosis and choose an appropriate nursing intervention based on evidence-based practice. It also sends safety alerts and reminders to ensure the patient's safety. Nurses use the EHR for storing, sending, and accessing a patient's health data. Health care providers use CPOE to facilitate communication among various departments in the hospital, such as the pharmacy, laboratory, and dietary departments per requirements. The BCMA system is a part of the process of medication administration. With BCMA, the nurse's and patient's identity cards, the medication administration record (MAR), and the drug are scanned to determine whether the medication received is appropriate and on schedule.

prefer to have at the bedside to help in the healing process? Which person would a patient who is Native American and practices a traditional faith O Shaman O

Rationale A Native American who practices a traditional faith would prefer to have a shaman or medicine man or woman available during times of illness. A traditional Native American belief is that the shaman helps restore the making for a patient who practices Sikhism. An imam is a Muslim religious leader who may be involved with balance between the person and natural forces. A guru is a Sikh teacher who may participate in decision the family in decision making. A chaplain is a minister or member of the clergy who attends to the spiritual needs of a patient. Traditionally chaplains are the primary providers of spiritual care. STUDY TIP: For this chapter, because you are expected to remember specifics of different faiths, a great tool American traditional faith," the spiritual leader row would list "shaman." You could later use this grid as a study aspect, such as "spiritual leader," "dietary habits," "rituals in sickness," etc. For the column titled "Native would be for you to construct a grid with each column titled a different faith. Each row would be a different tool, but it is the actual construction of the grid that will be of the most benefit. p. 402

A nurse is planning a teaching session about healthy nutrition with a group of first-graders. The nurse determines that after the teaching session, the children will be able to name three examples of foods that are fruits. Which phrase is this an example of? O A teaching plan O A learning objective O Reinforcement of content Enhancing self-efficacy

Rationale A learning objective describes what the learner will do after the teaching session. A teaching plan is an educational tool that a nurse may use to teach a patient. Nurses may need to reinforce content that was previously taught. This is done by determining what the patient learned or understood from the last educational session. Self-efficacy is an individual's belief in his or her innate ability to achieve goals. p. 189

A patient states, "My religion does not permit me to bathe today." Which nursing action would be appropriate? O Request a clarification of the patient's beliefs and adapt a plan for bathing accordingly.

Rationale A patient's religious and cultural preferences should be considered when providing hygiene. Facility schedules should not take priority over the patient's religious beliefs, nor should the health care provider's instructions. Verifying the patient's beliefs with clergy is inappropriate. Telling the patient the provider has ordered the bath and insisting that the patient take a bath is not providing spiritually competent care. The nurse should not call a clergyperson to learn if the patient is telling the truth. Test-Taking Tip: Make certain that the answer you select is reasonable and obtainable under ordinary circumstances and that the action can be carried out in the given situation.

In level 1 of Lawrence Kohlberg's theory of moral development, which statement would a child perceive as the reason for contracting an illness? O illness is a punishment for fighting with parents.

Rationale According to Kohlberg's theory of moral development, there are six stages of moral development under three levels. In level I, children have preconventional and limited cognitive thinking, and they believe that their illness is a punishment for fighting with parents or siblings. In level 1, children do not have rational thinking, so they will not know the exact reason for their illness. It is unlikely that children in level I moral development would believe their illnesses are a result of going to school or a blessing and opportunity to miss school. p. 233

Which phrase describes an electronic medical record (EMR)? Can create work lists to ensure patient care Is used to document a single episode of care Ensures timely administration of medications Can assess long term responses to interventions

Rationale An EMR is the documentation of a single EMR becomes part of an electronic health record (EHR), which is a longitudinal record of care. The EHR episode of care such as an outpatient visit or inpatient stay. The maintains the patient's health records over long periods. The EHR and not the EMR creates work lists on the basis of information in the database. The work list ensures timely administration of medication and respons to specific interventions over the long term. p. 202

e A newborn with a respiratory infection has a heart rate of 150 beats per minute. Which term or phrase does the nurse use to record this finding? Bradycardia OO Heart rate within normal limits O Primary tachycardia O Tachycardia secondary to infection

Rationale An acceptable pulse in newborns is between 80 and 160 beats per minute. Therefore a newborn pulse rate of 150 beats per minute would be normal. Bradycardia in a newborn would be a heart rate below 80 beats per minute. Tachycardia in a newborn would be a heart rate above 160 beats per minute. The newborn does have an infection; however, the heart rate is within normal limits. Test-Taking Tip: Read carefully and answer the question asked; pay attention to specific details in the question. p. 285

75 Which understanding would the nurse have about a patient's agnostic spiritual belief? O The existence of a God is not known.

Rationale An agnostic believes that the nature or existence of God cannot be known. An agnostic neither believes nor claims to disbelieve in God. Individuals who practice Hinduism believe in the concept of many gods, who are different aspects of one God. An atheist does not believe that any higher power exists. Individuals who practice Judaism believe that God established a covenant with the Jews. STUDY TIP: Recall medical terminology word parts and word origins to understand a-gnos-tic. Gnosis is the Greek word for knowledge. A- is a prefix of negation, meaning not. The suffix -tic means pertaining to. So the literal interpretation of the term agnostic is pertaining to not knowing. p. 402

A nurse is teaching patient how to administer an epinephrine injection in case of a severe allergic reaction. The nurse instructs the patient to hold the injection like a dart. Which instructional method did the nurse use? O Telling O Analogy O Demonstration Simulation

Rationale Analogies use familiar images when teaching to help explain complex information. The nurse used the analogy of holding a dart to explain proper technique when handling the syringe. Telling is used when the nurse is explaining or lecturing content. Demonstration occurs when the nurse actually performs a skill while the patient observes. Simulation occurs when the nurse and patient "carry out" a certain scenario. Test-Taking Tip:Be sure to read all the choices before making your final selection. Yes, the nurse did tell the patient, but the better answer was that s/he used an analogy. If you had picked "telling" and moved to the next question without reading all the choices, you would have missed this one. p. 195

A 46-year-old woman from Bosnia came to the United States 6 years ago. Although she did now. This woman has experienced assimilation into the culture of the United States because not celebrate Christmas when she lived in Bosnia, she celebrates Christmas with her family she took which action? O Chose to be bicultural O Adapted to and adopted the American culture Had an extremely negative experience with the American culture Gave up part of her ethnic identity in favor of the American culture

Rationale Assimilation results when an individual gradually adopts and incorporates the characteristics of the dominant culture. There is not enough information within the question to determine whether the is bicultural. There is nothing within the question that would signify that the patient possesses any negative connotations regarding the American culture. Partial assimilation occurs when a person gives up part of their ethnic identities in favor of another culture. p. 383

A nurse plans to discuss the treatment options with a cancer patient. Which factors would ensure a conducive learning environment? Select all that apply. Some correct answers were not selected O The patient does not have any pain. The patient is not watching TV.

Rationale Before initiation of any educational discussion, of pain or physical discomfort. The patient as watching TV. A hungry or anxious decisions. Distractions such as friends or visitors may also prevent learning from occurring. patient will lack the level of concentration required to make informed should be focused and should not be doing any other activity such the nurse should make sure that the patient is not in any kind 190

A nurse uses a Doppler ultrasound to assess a patient's blood pressure. Which rationale justifies the nurse's action? O The patient is in shock. The patient has prehypertension. The patient's age is less than 10 years. The patient has stage 1 hypertension.

Rationale Doppler ultrasound is used to measure blood flow through the blood vessels when the patient's pulse is too feeble to be heard by a stethoscope. Shock is a life-threatening condition in which there is an excessive drop in blood pressure, which results in a feeble pulse. The blood pressure in patients with prehypertension, children younger than 10 years, and patients with stage 1 hypertension can easily be measured using a stethoscope and sphygmomanometer. p. 284

According to the World Health Organization (WHO), which statement accurately defines health? The state of being free from illness or injury The state of complete physical, mental, and social well-being O The state of absence of symptoms and signs with normal lab reports The state of total absence of all diseases, disorders, and syndromes

Rationale The WHO defines health as a "state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity." Health is not only the state of being free from illness or injury, or the absence of signs and symptoms. Health does not refer to the state of total absence of all diseases, disorders, and syndromes. Health includes the mental health and spiritual health components as well.

The nurse is conducting evidence-based research (EBR) on communication techniques used with pediatric patients. In which order should the nurse perform the EBR? 1. Assess the need for change in communication techniques with pediatric patients. 2. Search for reliable evidence relevant to the research question. Design a communication practice change based on the evidence found in the literature. 4. Develop a research question related to communication with pediatric patients. 5. Implement the communication practice change. 6. Evaluate the effectiveness of the communication practice change.

Rationale EBR requires a specific process. The first step of EBR is to assess the need for change. The second step is developing a research question for an effective literature review. The third step involves searching the databases for relevant existing evidence. The fourth step is designing a plan for changes in practice. The fifth step is implementation of the practice change. The last step of EBR is to evaluate the effectiveness of the practice change to determine whether it is successful. Test-Taking Tip: When asked to order the choices, begin by choosing the first and last steps. Then you will only need to order the middle steps, which is an easier task when there are two fewer choices! For this question, assessing the problem is first, and evaluating the effectiveness of the plan is the last step. So you just need to order the four middle steps, and you're done. p. 177

O The student nurse places the covered probe snugly in the ear canal. Which action of the student nurse needs correction? A student nurse is recording the tympanic temperature of a 2-year-old child with a fever. O The student nurse cleans the lens of the thermometer using an alcohol wipe. O The student nurse angles the probe toward the jaw line before activating the sensor. O The student nurse pulls the child's ear pinna gently in the upward and backward direction.

Rationale Ear temperature is measured near the tympanic membrane. In children, the external auditory canal is slightly curved; therefore to straighten the canal, the pinna is pulled down and back. Placing the probe snugly in the ear canal and angling it toward the jaw line before activating the sensor provides an accurate reading. The lens of the thermometer should be cleaned properly with an alcohol wipe because an unclean lens may result in an inaccurate reading. Test-Taking Tip: Be sure to check if you are looking for the correct or incorrect action! If you are coming up with more than one correct choice in a single-response (multiple-choice) question such as this one, reread the question in case you should be looking for an incorrect action as the correct answer instead. p. 280

Elasticity of the skin is assessed using which technique? Lightly palpating intact skin anywhere on the body Deeply palpating edematous areas on the extremities Inspecting reddened, pink, or pale areas of the skin Grasping a fold of skin on the forearm and releasing

Rationale Elasticity of the skin ( turgor) refers to the ability of the skin to reassume the normal contour or shape once pinched and released. Elasticity can be checked by grasping a fold of the skin on the back of the forearm or over the sternum with the fingertips and then releasing it. If the patient is adequately hydrated, the skin wil return swiftly to its original position. If the patient is moderately or severely dehydrated, the skin will remain in the pinched position (tenting). Lightly palpating intact skin aids in assessing superficial structures for tenderness, but does not reveal information about skin elasticity. Deeply palpating edematous areas on the extremities may be used to assess pitting edema, not elasticity of skin. Caution should be used when deeply palpating edematous areas, as deep palpation may be painful and/or potentially damaging to delicate tissues. Inspecting reddened, pink, or pale areas of the skin is useful for assessing the blood supply (vascularity) of the skin, but not for checking elasticity.

Experimental research seeks to establish which defining characteristics of variables? O Narrative documentations O Detailed descriptions Correlational relationships Causal relationships

Rationale Experimental research investigates causal relationships between variables. Experimental research uses strict guidelines to establish causation and not simply correlation between variables. Narrative documentations are the outcome of particular types of qualitative research. Detailed descriptions of variables are the outcome of descriptive research. Correlational relationships between variables are established through quasiexperimental research methods. p. 173

The nurse is planning an educational program for an immigrant population. Which nursing action will enhance the effectiveness of the program? O Developing cross-cultural linguistic competencies O Asking colleagues to assist in teaching the class O Encouraging people to rely on Western therapies O Including only English-speaking people in the class

Rationale Experts have noted that in addition to cultural competence, linguistic competence is needed to offer appropriate care and responses to culturally diverse patients. The use of certain words may be specific to a culture, and the nurse needs linguistic competence to prevent any misunderstanding. Asking colleagues to assist in the teaching is ineffective if those colleagues lack linguistic competence. Encouraging people to rely on Western therapies indicates an ethnocentric view. Including only English-speaking people in the program demonstrates the nurse's bias, which is not good nursing practice.

To what angle should the nurse elevate the head of the examination table for patient comfort at the beginning of a standard physical examination? Record your answer using a whole number. 30 degrees

Rationale For optimal patient comfort on an examination table, the head of the table should be raised to 30 degrees and a small pillow (or towel) offered for support under the patient's head. Examination tables are often very firm and unsupportive when the patient lies supine. Elevation to 30 degrees promotes relaxation and is generally tolerated by patients with shortness of breath. p. 320 Next

15 Which research topics are most appropriate for grounded theory research methods? Select all that apply. Some correct answers were not selected Postpartum depression O Communication processes O Patient self-management of chronic illness O Best treatment protocol for pressure ulcers O Effect of cooling pad use on core body temperature

Rationale Grounded theory focuses on deriving a theory from the collected data of the research. The grounded theory method is useful in investigating and creating theories about complex human processes such as postpartum depression, communication processes, and patient self-management of chronic illness. Best treatment protocols for pressure ulcers would be appropriately investigated through quantitative studies using experimental or quasiexperimental research methods. Effect of cooling pad use on core body temperature would be an appropriate experimental or quasiexperimental study. p. 173

An older Chinese woman is admitted to the hospital after a hip fracture. The nurse encourages the patient to walk about the room; however, the patient refuses to walk without her son. Which action by the nurse is culturally congruent? Leave the patient alone but understand that the patient has no self-confidence. O Respect the patient's wish and ask her to walk when her son is present. Explain to the patient calmly that she can't be dependent on her son. Tell the patient that needs to walk now.

Rationale In some cultures, families make decisions together. This patient may only be comfortable when her son is present; therefore the nurse should respect the patient's wishes and come back when the son is there. This patient is not lacking confidence. The patient is not comfortable without her son present. It is not therapeutic to speak sternly with the patient and tell her that she is dependent on others. The patient has the right to refuse care; therefore the nurse should not demand that the patient walk now.

A patient has regular but abnormally rapid respirations of more than 24 breaths per minute. Which term does the nurse use to record this breathing pattern? O Tachypnea

Rationale In tachypnea, patients exhibit regular but rapid breathing of more than 20 breaths per minute. Hyperpnea is labored respiration associated with increased rate and depth. Hyperventilation is an increase in the rate and depth of respiration. Cheyne-Stokes respiration is characterized by alternating periods of apnea and hyperventilation. Test-Taking Tip:Tachy- means fast or rapid, just like when the tachometer of your car shows you are going too fast! p. 287

Which body areas should the nurse inspect for jaundice? Select all that apply. Some correct answers were not selected O I Sclera O Hard palate Ankles OOO Tip of the nose O Feet Rationale Jaundice is a yellow hue to the skin, mucous membranes, or eyes. The yellow pigment results from excess bilirubin, a by-product of red blood cell destruction or liver failure. The best place to evaluate a patient for jaundice is the sclera or, on darker-skinned individuals, the hard palate. The tip of the nose and the ankles and feet may not show the yellow hue of excess bilirubin deposition.

Rationale Jaundice is a yellow hue to the skin, mucous membranes, or eyes. The yellow pigment results from excess bilirubin, a by-product of red blood cell destruction individuals, the hard palate. The tip of the nose and the ankles and or liver failure. The best place to evaluate a patient for jaundice is the sclera or, on darker-skinned feet may not show the yellow hue of excess bilirubin deposition. Test-Taking Tip: Be sure to note whether a question is a single-answer, multiple-choice question versus a multiple-response "select-all-that-apply" question! If you think there is just one answer, but it is really a multiple-response question, you may submit just the first answer you know to be true and miss the additional correct responses. p. 329 Next

The nurse documents that a hospitalized patient is alert and that the patient can identify which facts about themselves? Select all that apply. oriented x 4. This indicates O Current location O Current situation I Full name I Current time Rationale of orientation and mental status

Rationale Level of orientation and mental status are place, time, and situation. Appropriate identification assessed by determining the patient's ability to identify person, of all four facts is documented as "oriented x 4."A patient's ability to identify his or her current diagnosis is not an element considered in testing for orientation. p. 367

A Catholic patient receives a meal tray on the Friday before Easter. Which food item would the nurse offer to substitute? Applesauce Cheese and crackers O Spaghetti with meat sauce Tossed salad with ranch dressing

Rationale Most Catholics do not eat meat on Good Friday. cheese, crackers, and a tossed salad with ranch dressing, provided that the salad does not contain any meat. Patients who practice Catholicism are able to eat applesauce, p. 400

The nurse is caring for an older adult patient with cancer. When the nurse asks about the patient's educational background, the patient states, "I was a farm kid and never really went to school." Which mode of teaching would be best for this patient? Books O Simulations O O Verbal teachings O O Written instructions

Rationale Nursing instructions should always be given ability to understand. For patients who lack formal with hearing loss and may not be necessary or helpful for this patient. read books and may not be able to read the written instructions. Simulations are generally used for patients Because the patient lacks education, he or she will not be able to education, the nurse should teach verbally and to a patient in a way that is tailored to the patient's individual communicate in simple and easy language.

What are advantages of formulating a good clinical research question in PICO format? Yields a tightly focused question O Isolates effective keywords for use in literature search Identifies gaps in the study's design or goals

Rationale PICO is a method of research question formulation which identifies the elements of: (P) patient, population, or problem; (1) intervention of interest; (C) comparison intervention (not always used); and (0) outcome. The PICO format helps refine the focus of the research by isolating and defining each element in a tightly focused question. Each element of PICO identifies a key word or concept in the study question that may be used as keywords in literature searches. By going through the process of formulating a good research question by using PICO, the researcher may uncover gaps in the study's design or goals, such as an ill-defined population or unmeasurable outcomes. The PICO format does not outline the six phases of evidence-based research. The PICO format aids the researcher in defining core elements of the study but does not specifically aid in relating a study to a nursing theory. Test-Taking Tip: Recall what each letter of PICO represents before choosing your answer/s. p. 178

A nurse is caring for a Hispanic male who has tattoos all over his body. The nurse tells her coworker, "I guarantee you this patient is a drug dealer." This statement can be described as which term or phrase? O Discrimination Delivery of culturally congruent care O Effective intercultural communication Sufficient comparative knowledge of diverse groups

Rationale Prejudices associate negative permanent characteristics with people who are different from the valued group. When a person acts on these prejudices, discrimination occurs. If the nurse applies a stereotype and assumes that all people with a group will act in a predetermined manner, he or she has committed discrimination, The nurse did not deliver culturally congruent care, nor did she develop effective intercultural communication. The nurse used stereotyping and discrimination based on the patient's ethnicity and appearance. The nurse did not compare knowledge of diverse groups before making the discriminating statement.

Which age group of children has imaginary playmates? Infant Toddler O Preschooler Adolescent

Rationale Preschoolers usually have imaginary playmates. These playmates play with the child when he is lonely, or accomplish what the child is still trying to do. Having imaginary playmates is a healthy sign. Infants engage in exploratory play and use their senses for observation and examination. Toddlers engage in parallel play. They do not have imaginary playmates. Adolescents usually have organized play. STUDY TIP: To help you remember the characteristics of various stages of growth, recall individuals you know or have known who have those characteristics. Do you have a sibling, niece, or nephew who had an imaginary playmate? How old were they at that time? Relating general characteristics to individuals in your life will you remember the stage of each characteristic. p. 240

As part of an evidence-based disinfectants on nursing care units. The nurse analyzes outcome measures and finds that practice research study, a hospital introduces the use of hand infection rates in patients have been reduced. Which type of research method does this study employ? Ethnography Historical Descriptive O Quasiexperimental

Rationale Quasiexperimental research explores the causal disinfectant and infection rates, but without the strict through field observation of a sociocultural phenomenon; this study is guidelines of experimental research. Ethnography relationship between two variables, in this case use of hand focuses on the sociology of meaning characteristics about a population or phenomenon investigates a past event or time period, not a not focused on sociocultural meaning. Historical research current situation. Descriptive research identifies data and comparing data before and after the implementation of an intervention such as hand disinfectant. at a certain time, but does not encompass p. 173

Which part of the brain controls the patient's respiratory functions? O O Medulla oblongata

Rationale Respiratory centers in the medulla and pons are stimulated by impulses from chemoreceptors located throughout the body. Broca's area is present in the frontal lobe and is associated with the production of speech. The cerebellum is located at the base of the brain above the brain stem. It coordinates the voluntary functions of the body, such as posture, balance, and coordination. The hypothalamus is the part of brain below the thalamus that regulates body temperature.

The nurse is teaching the parents of toddlers about the use of seat belts and vehicle safety. Which nursing goal is behind this teaching? O Specific protection

Rationale Specific protection activities help prevent a specific disease or a potential injury. Teaching safety measures to parents helps prevent injury and accidents in toddlers. Rehabilitation or restoration of health refers to help in rehabilitation. Diagnostic tests are performed to detect a disease at an early stage; however, teaching attaining the highest possible level of recovery from the illness. Use of seat belts and safety measures do not to prevent illness and promote health. They include activities such as lifestyle modifications, nutritional safety measures does not help in detection of diseases. Health promotion activities include general measures counseling, and modification of the environment.

Which condition characterizes strabismus? Difficulty maintaining alignment in one or both eyes

Rationale Strabismus is a condition in which one or both eyes deviate out of alignment when focusing on an object. In this condition, the patient's eyes appear crossed. Blurred vision may be caused by a variety of eye conditions, but is not a hallmark characteristic of strabismus, which is mostly likely to result in diplopia, or double images. Impairment of near vision due to aging is a sign of presbyopia. Clouding of the lens characterizes cataracts. STUDY TIP: Identify your problem areas that need attention for studying. Do not waste time restudying information you know. p. 338

A nurse wants to determine the effectiveness of a behavioral therapy intervention in adolescents with conduct disorder. Which type of research should the nurse conduct order to compile the most reliable evidence? Randomized controlled trial

Rationale Systematic reviews or metaanalyses of randomized controlled trials are the highest level of evidence, and a single well-designed randomized controlled trial is the next highest; these studies provide the strongest evidence. A descriptive study, correlational study, or controlled trial without randomization is lower in the hierarchy of evidence. p. 180

The nurse uses the back of the hand when palpating an extremity for which characteristic? Edema Texture O Turgor O Temperature

Rationale Temperature is assessed by palpating with the back of the hand. This is because skin on the back of the hand is thinner and more sensitive to temperature than skin on other areas of the hand. Edema (swelling) is assessed by pressing the thumb or forefinger over the edematous area for 2 to 3 seconds and evaluating for indentation. Texture is assessed using fingertips. Turgor is assessed by grasping a fold of skin, gently pinching, and then releasing. pp. 323-333

The nurse identifies a patient whose health status is affected by attitudes, values, and cultural practices. Which health model would be the best to identify the relationship between the patient's cultural practices and health status? O Health Belief Model (HBM)

Rationale The HBM identifies the impact of patient's attitudes and beliefs on the patient's susceptibility to illness, the severity of the illness, barriers to adopting a healthy lifestyle, and self-care during an illness. The nurse provides culturally competent and congruent care to the patient based on the HBM. The HHM deals with promotion of natural healing methods and collaborative care. The HPM deals with providing preventive care. The nurse follows the BHNM to categorize the areas of patient need. pp. 213-214

Which three A's of the National Action Plan to Improve Health Literacy should the nurse consider when planning patient education? Select all that apply. Some correct answers were not selected OD Accurate O Accessible Actionable Assessment Affective

Rationale The National Action Plan to Improve Health Literacy was designed in order to improve patients' quality of health. The three A's of this plan include Accurate, Accessible, and Actionable. The health information provided to the patient should be accurate. The health information provided should be accessible, so that even a patient with a disability is able to access it. The health information provided should be actionable and have practical value. Assessment and affective are not terms included in this plan to promote health literacy. Assessment is the first step in the nursing process. Affective is one of the three domains of learning. p. 194

A patient is scheduled for a chemotherapy treatment and asks the nurse to pray. Which intervention would be appropriate for a nurse who is not accustomed to praying? Arrange for the chaplain to pray with the patient since the nurse is busy. Ask the family members to pray with the patient instead of the nurse. Ask if there is anything else that can be done for the patient at this time. Maintain a respectful silence and allow the patient to lead all the prayers.

Rationale The best intervention in this situation would be to maintain respectful silence and allow the patient to lead the prayer. This provides comfort for the patient and fosters trust in the nurse. The nurse may arrange for the chaplain or family members to join in the prayer; however, the nurse's presence is required. The nurse should not evade the situation by making an excuse or asking if something else can be done. p. 406

Arrange the assessment techniques in the correct order for an abdominal examination. 1. Inspection 2. Auscultation 3. Percussion Palpation

Rationale The correct order of abdominal assessment is inspection, auscultation, palpation, and finally percussion. Unlike in other body areas, auscultation is performed before palpation in an abdominal assessment because pressure on the abdomen disturbs the gastrointestinal tract, altering the frequency and characteristics of abdominal sounds. Test-Taking Tip: The order of examination techniques moves from least invasive to most invasive as the examination progresses. p. 367

A committee of hospital nurses is evaluating the results 1 year after implementing an evidence-based nursing practice change. Which question addresses this evaluation? O Is the application of the evidence in clinical practice feasible? O Is the staff supportive of using the evidence as a practice change? V O How effective was the nursing practice change in the clinical setting? O Does the literature provide evidence to support a practice change?

Rationale The evaluation addresses the effectiveness of the practice change in the clinical setting. Determining whether the application of the evidence in clinical practice is feasible does not happen during the evaluation stage of research, but rather when formulating the research question. The question of whether the staff supports the use of evidence as a practice change is not part of the evaluation process. Finding out whether the literature provides sufficient evidence to support a practice change is done toward the beginning of the research process, during the literature review.

Which diastolic blood pressure finding is considered normal in a newborn? 53 mm Hg

Rationale The normal diastolic blood pressure for a newborn is between 20 and 60 mm Hg. Diastolic pressure of 53 mm Hg falls within this normal range. Diastolic pressure of 15 mm Hg falls below the normal level and thus indicates low blood pressure. A diastolic pressure of 80 mm Hg or 74 mm Hg is above the normal range and thus indicates high blood pressure. STUDY TIP: For information that needs to be memorized exactly, such as "The diastolic blood pressure of a newborn is 20 to 60 mm Hg." use the best method you have found for YOU to recall facts. Is it listening? Then say the facts aloud, record them, and replay them. Is it seeing them? Then write the facts on notecards and review them. Does motion help? Then bob up and down while looking at the numbers or saying them aloud, or both. Find the techniques that work for you and use them! p. 276

Portal | e Login | Evolve Pageburstls: Library A patient is scheduled for surgery on a fractured foot. After the nurse explains the surgery and its potential outcomes, the nurse demonstrates postoperative exercises and asks the patient for a return demonstration. Which outcome does this nursing action determine? It improves the patient's self-efficacy.

Rationale The nurse improves the patient's motivation. It also does not improve the attentiveness of the patient. Teaching the patient postoperative exercises does not determine the learning needs of the patient or increas self-efficacy with the methods of demonstration and return demonstration

Which action would be an appropriate intervention by the nurse to help a mother bond with her dying infant? Allow the mother to hold the infant and pray.

Rationale The nurse must remove environmental the mother as a means of providing spiritual care. However, these are not nurse may pray with the mother, read passages from a spiritual book, or arrange for the chaplain to pray with barriers and allow the mother to hold the infant while praying. The nursing interventions that promote mother-infant bonding. p. 406

Assessment Cue 1 Assessment Cue 2 AssessmentCue 3 • The patient talks about the • The patient asksfrequent • The patientexpresses purpose of life and death. questions aboutthe concerns aboutthe family. diagnosis.

Rationale The nurse recognizes verbal cues during conversations with the patient. The patient may talk about life and death, ask questions about the diagnosis, or express concerns for the family. The nurse recognizes facial expressions or tone of voice as nonverbal cues during assessment. The patient may exhibit situational cues when a life-threatening diagnosis is made or when the patient is facing death. Environmental cues are the presence of religious articles, symbols, or prayer objects near the patient. p. 405

A Muslim patient is scheduled for transplant surgery. The patient asks the nurse to postpone the operation for an hour so that the evening prayers can be completed before the operation. How would the nurse respond to such a request? OAsk the patient to finish his prayers early. Offer to pray on his behalf so the operation is on time. O Ask the family to persuade the patient to be on time for surgery. O Agree to the patient's request and postpone surgery.

Rationale The nurse should allow time for the patient's religious rituals, prayers, spiritual visitations, and attendance in religious services. These are integral parts of the patient's spiritual well-being. Followers of Islam have specific timing for prayers and should not be asked to pray early. The nurse may offer to pray with the patient but not on his behalf, as the nurse may not know the prayer ceremonies the patient prefers. The nurse should not ask the family to persuade the patient to be on time for the operation if that means he misses his prayer time. Test-Taking Tip: Look for patient-centered choices that support the patient's cultural and spiritual well-being. With that in mind, the answer to this question is clear. p. 401

options. Which patient teaching would be best for the nurse to include in the discharge A patient newly diagnosed with cervical cancer refuses to discuss her illness and treatment planning? O Teach the patient's spouse. Focus on knowledge the patient will need in a few weeks. O Provide pertinent information needed. O Convince the patient that learning about her health is necessary.

Rationale The nurse should examine the patient's situation and comfort level before beginning teaching. This patient assimilate more information after the just learned that she has cervical cancer and is not patient has had time to acclimate herself to her diagnosis. Therefore the ready to listen and learn. This patient will learn and and more education can be provided at that time. presence may only complicate the situation. The needed for discharge only. The patient is not ready to physician can follow up with the patient after discharge, learn; therefore educating the patient's nurse should provide the most pertinent information spouse in her inspire you. If they can do it, so can you! decades who have had the same goal you have. Their STUDY TIP: To avoid becoming discouraged about your training, think learning and dedication are the light that can lead and of all the nurses throughout the p. 190

The nurse is participating in an immunization awareness program in the community. Which government website should the nurse recommend as the best source of immunization information for parents? National Institutes of Health (NIH) Centers for Disease Control (CDC) Health Maintenance Organization (HMO) U.S Department of Health and Human Services (DHHS)

Rationale The nurse should instruct parents about age-appropriate health checkups, screening examinations, and régular immunizations as per the schedule. The CDC recommends an immunization schedule that parents can use to access accurate information. This brings awareness and promotes parental motivation. The NIH promotes biomedical research under the U.S. DHHS. These organizations are primarily responsible for biomedical and human-related search. An HMO provides guidance for the management of health care, insurance, and self-health care benefit plans. It acts as a liaison with health care providers (hospitals, health care settings, individual practices). The U.S. DHHS provides links to health screening and disease prevention sites. STUDY TIP: Locate vaccination schedules on the CDC website: www.cdc.gov/vaccines. To check whether you are up to date on your vaccines, take the CDC's quiz about what vaccines are recommended for you. p. 219

A patient presents in the clinic with dizziness and fatigue. The nursing assistant reports a very slow radial pulse of 44. Which nursing intervention is priority? Request that the nursing assistant repeat the pulse check. Call for a stat electrocardiogram (ECG). Assess the patient's apical pulse and evidence of a pulse deficit. Prepare to administer cardiac-stimulating medications. That's

Rationale The nurse's priority intervention is to assess the patient, determine the patient's apical heart rate, and determine if a pulse deficit exists. The nurse cannot delegate vital signs to an unstable patient. Calling for an ECG and administering cardiac-stimulating medications are interventions that require notification of the health care provider and occur after you assess the patient. Test-Taking Tip: If the question asks for an immediate action or response, more than one answer may be correct, so base your selection on identified priorities for action.

The nurse is teaching a patient who has been newly diagnosed with diabetes mellitus. Which possible patient outcome indicates effective learning in the cognitive domain? O The patient accurately administers the insulin using a syringe. O The patient correctly verbalizes the prescribed medication regimen. The patient is able to find the appropriate resources on the Internet. The patient actively takes part in the teaching session with the nurse.

Rationale The patient is able to understand and recall the information about the drug regimen given by the nurse. Learning about the medication regimen and integrating it into real life indicates that the patient has effective learning in the cognitive domain. If the patient accurately administers the insulin, effective learning has occurred in the psychomotor domain. It is good that the patient is able to find appropriate Internet resources, but this does not demonstrate effective learning in the cognitive domain. A patient who understands the importance of attending the teaching session given by the nurse would actively participate in the teaching sessions. This outcome indicates that the patient has effective learning in the affective domain. р. 189

The nurse is teaching a patient who has been newly diagnosed with diabetes mellitus. Which possible patient outcome indicates effective learning in the cognitive domain? O The patient accurately administers the insulin using a syringe. O The patient correctly verbalizes the prescribed medication regimen. O The patient is able to find the appropriate resources on the Internet. O The patient actively takes part in the teaching session with the nurse.

Rationale The patient is able to understand and recall the information about the drug regimen given by the nurse. Learning about the medication regimen and integrating it into real life indicates that the patient has effective sessions. This outcome indicates that the patient has effective learning in the affective domain. importance of attending the teaching session given by the nurse would actively participate in the teaching but this does not demonstrate effective learning in the cognitive domain. A patient who understands the occurred in the psychomotor domain. It is good that the patient is able to find appropriate Internet resources, learning in the cognitive domain. If the patient accurately administers the insulin, effective learning has D. 189

Which statement spiritual distress? made by an elderly patient whose spouse died a week ago indicates O "All my prayers and good deeds were in vain."

Rationale The patient is going through a phase of disturbed faith and lacks confidence in his or her prayers and good deeds. This indicates that the If the patient seeks a meeting The patient expresses sadness, not spiritual moving to an assisted-living facility, the patient is trying patient is experiencing spiritual distress. When the patient is thinking about to find practical solutions to meet health care needs. with the chaplain, the patient is trying to reconcile with self and overcome grief. distress, at being unable to spend more time with the spouse.

According to the institutional review board, which principle requires equitable selection of subjects in a research study? Justice

Rationale The principle of justice directs researchers to select subjects equitably, treat them fairly, and avoid using vulnerable subjects. The principle of autonomy involves ensuring that the subjects have the mental capacity and freedom to make independent decisions about their participation. The principle of beneficence guides researchers to minimize potential harm to subjects and maximize benefits. The principle of respect for persons requires researchers to treat all subjects as autonomous human beings with free will and the right to privacy.

Which PICO elements are included in the research question "How do patients with cervical cancer rate their quality of life?" Select all that apply. Some correct answers were not elected Patient population of interest IIntervention of interest Comparison of interest I Outcomne

Rationale Using the PICO format helps ask a focused clinical question. P stands for population of interest. I stands for intervention of interest. C stands for comparison of interest. O stands for outcome. Patients with cervical cancer represent the patient population of interest, and rating the quality of life represents the outcome. The question does not contain the other 2 elements: intervention of interest and comparison of interest. Test-Taking Tip: Recall what each letter of PICO represents before choosing your answer/s. р. 178

patient complains of pain in the knee joint. Which action would the nurse perform? A nurse is discussing treatment goals with a patient who has osteoarthritis. Suddenly, the Ask the patient to relax and go to sleep. O Stop the discussion and focus on patient comfort. O Continue the discussion of treatment goals. O Persuade the patient to listen carefully.

Rationale alleviate the patient's pain if possible. patient is experiencing pain; therefore the timing is not conducive continue the discussion. In order for teaching to be effective, the timing must be conducive to learning. This The first priority by the nurse is to address the patient's complaint of pain; therefore the nurse would not The nurse should attempt to identify the cause of the patient's pain and discussion and focus on the patient's comfort. The nurse should not ask the patient to relax and go to sleep. patient's situation and comfort level before beginning teaching. Therefore the nurse should stop the With any physical discomfort like pain, the ability to learn is greatly affected. The nurse should examine the to learning. The nurse should not persuade the patient to listen carefully.

A nurse is measuring a patient's blood pressure. Which pulse site location is used to auscultate blood pressure? O Groove between biceps and triceps muscles at antecubital fossa

Rationale and triceps muscles at the antecubital fossa. The radial pulse is located at the thumb side of the forearm at the The brachial pulse is used when measuring blood pressure. It can be located in the groove between the biceps wrist. This pulse is used to assess the circulation to the hand. The ulnar pulse is located at the ulnar side of the forearm at the wrist. This pulse is used to assess the circulatory status to the hand and also used to perform the Allen's test. The apical pulse can be palpated at the fourth to fifth intercostal space at the left midclavicular line. pp. 283, 290

Which action should the nurse take when teaching an older adult about a new antihypertensive medication? O Speak loudly. O Present the information once. O Expect the patient to understand the information quickly. Allow the patient time to ask questions.

Rationale ask questions. Older adults are may need to repeat the information and allow the patient time to fully understand what is being conveyed. hearing impaired, therefore there is no need to speak loudly. Due to cognitive and sensory decline, the nurse and the teaching materials should be adjusted accordingly. There is nothing to suggest that this patient is Although each patient must be assessed individually, cognitive and sensory alterations often occur with aging, vulnerable to low health literacy due to educational level or cognitive decline. When teaching older adults, it is important to establish rapport, involve them in their care, and allow them to STUDY TIP: Remember that being smart involves more than just intelligence. Being practical and applying common sense are also part of the learning experience.

. e Login | Evolve Karma is defined by which phrase? O The result of past behaviors The cycle of birth and rebirth O The individual's moral conduct O The path of liberation to harmony

Rationale birth and rebirth. Dharma is the moral conduct of an individual. Moksha is the path of liberation toward According to Hinduism, karma is a consequence of past behaviors. Samara is reincarnation, or the cycle harmony, which occurs through reincarnation. p. 401

A patient was diagnosed with cervical cancer and underwent a hysterectomy. During recovery, the patient states, "I don't believe in God anymore. I can't believe I can never have a child. Why me? I can never be the same person again." Which reality does this reaction suggest? O Atheism due to illness O Spiritual distress due to loss of purpose in life Awareness about loss of uterus O Risk of spiritual distress due to surgery

Rationale distress. The patient is not at risk of spiritual patient has lost her uterus and is upset supreme being exists, is a lifelong self, and God as a result of a health connectedness with self and with Spiritual distress results when the patient loses the purpose and principle and does not result from complication. Atheism, wherein a person God. A patient suffering from spiritual distress shows loss of belief in life, meaning of life, loses hope, and loses does not believe God or another about it. However, the reaction is more suggestive of a spiritual surgery or a health condition. The distress but is actually experiencing spiritual distress. Do not submit your answer until you have reread the question stem along with your chosen Test-Taking Tip: After correctly? If not, reconsider the choices. choosing an answer, go back and answer. Does it fit performed this simple check. p. 404

While studying about the cognitive domain of learning, the nurse learns that discussion is the most appropriate teaching method based on cognitive learning. Which characteristics are found within the discussion method? Select all that apply. Some correct answers were not selected It allows peer support. O It involves both the nurse and the patients. O It involves presentation of procedures or skills by the nurse. O It helps the patient learn from others' experiences. It allows patients to assume responsibility for completing learning activities at their own pace.

Rationale does not allow the patient to assume which involves presentation of procedures or skills involvement and also helps the patient learn from others' The discussion method involves interaction between both the nurse and the patients. This method allows peer responsibility for completing learning activities at his or her own pace. by the nurse. Unlike the role play method, this method experiences. Demonstration is the teaching method p. 189

Which technology can the nurse use to deliver emergency interventions when the primary health care provider is not available in the emergency room? O Listserv O Telemedicine Social networking site Electronic health record

Rationale health care products and share health-care-related information. Electronic health send health care e-mails to a large group of patients. Social networking sites help health care experts promote interventions to save a patient. A listserv is a computer program that is used to clinicians via high-quality video links. In an emergency, the nurse can enlist the help of a health care expert or Telehealth, also known as telemedicine, helps health care professionals connect to health care experts or clinician to provide emergency records are documents on the medical status of the patient that communicate the patient's past and current medical status for health care providers. p. 201

Which information about a nursing research study is required to be communicated to a patient in the process of obtaining informed consent? Select all that apply. O The tasks involved A list of other participants I The confidentiality measures used by researchers O The study's purpose Expected overall study results

Rationale information which is required to be It is the right of the patient to receive an explanation of a study in which he or she is a participant. Specific communicated includes the subject-related tasks involved in the study, participants is not required to be the confidentiality and anonymity measures used by researchers, and the purpose of the study. A list of communicated to a patient during a study, and would likely violate the for the study. Potential harm and/or benefit from añonymity and/or confidentiality measures established participation in a study must be communicated, but communicating results is not required and could introduce bias into subjects in the study. the researcher's expected overall study Test-Taking Tip: If you cannot recall the you would want to be treated if you were a participant requirements of informed consent during the test, just imagine how in the study, You would want to understand the tasks involved, how your confidentiality is maintained, and the purpose of the study. You would not expect to be provided a list of other participants, as that would compromise confidentiality, and you can reasonably deduce that being told expected overall study results might cause introducing bias and jeopardizing the validity of the study. participants to manipulate outcomes, thereby p. 175

| Evolve Pageburstis Libiary sugar results. This is an example of which type of learning? A nurse is teaching a young adult patient how to adjust insulin dosages based on the blood O Cognitive O Affective O Adaptation Psychomotor

Rationale making comparisons with previous Adaptation occurs once the patient new knowledge. This domain knowledge resulting in a conclusion. learning then recalling the information. Cognitive learning requires thinking. Learners in the cognitive domain integrate knowledge through first takes the patient's feelings, values, motivations, and attitudes into account. Affective learning recognizes the emotional They then categorize and evaluate, component of integrating them into everyday life. The psychomotor domain incorporates physical movement and the accepts the changes made and incorporates use of motor skills in learning. 189 search

A patient shows the nurse a website that recommends weight-loss medications. Which question would the nurse ask in order to evaluate the authority of the website? O "What is the cost of the recommended product?" O "When did the website recommend the product?" O "How reputable are any links to source information?" "Who are the authors, sponsors, and publisher?"

Rationale of the recommendation helps in evaluating the currency of the information, but not the authority of the site website. Determining the cost of the product would not help in evaluating the website for authority. The date The nurse asks for the names of the authors, sponsors, and publisher to determine the authority of the creators. Links to external sources help in cross-checking the content provided in the website and determining the validity of that content. p. 206

A nurse is preparing to teach a young woman diagnosed with asthma how to manage her disease. Which topic would the nurse teach first? VO How to use an inhaler during an asthma attack O The need to avoid people who smoke to prevent asthma attacks O Where to purchase a medical alert bracelet for asthma The importance of maintaining a healthy diet and exercising regularly

Rationale people who smoke to prevent asthma purchase a medical alert bracelet; however, it would attacks, but it would not be the first thing a nurse would what you tell them first. The nurse should include the need to avoid It is important to start with essential life-saving information when teaching because people usually remember teach. A patient with a history of asthma should with asthma should maintain a healthy diet and exercise regularly; however, this would not be taught first. not be the first thing the nurse would teach. A person p. 190

Which aspect of nursing informatics involves the use of experience to manage and solve problems? Wisdom

Rationale processed and organized helps in the analysis of a patient's past medical history and present health condition but is not sufficient on its information that helps in critical thinking and clinical decision making. Information patient assessment data and then evaluate patient priorities in the plan of care. Medical knowledge is cannot solve or manage problems by simply observing the data. The nurse uses critical thinking to interpret The nurse uses wisdom to manage and solve problems by applying knowledge and experience. The nurse own to manage and solve problems. Test-Taking Tip: Remember to eliminate choices when you are uncertain of an answer. For this question, experience is not needed to access need to decide between wisdom and knowledge. Which one involves the use of experience? You have the data or information, so those two choices can be eliminated. Then you only answer: wisdom! p. 200

A nurse administers a polio vaccine to an infant. Which level of prevention is being utilized? Rehabilitation Tertiary prevention O Primary prevention O Secondary prevention

Rationale taken by people who are experiencing taken to minimize the harmful effects of disease or disability. diseases and are at risk for developing complications. Tertiary Giving a vaccination to the infant is an example of primary Primary prevention aims at health promotion and taking preventive steps before the disease or problem starts, prevention. Secondary prevention measures are prevention includes measures

A Muslim patient refuses to eat the pork that was served on his dinner tray. Which statement offers an explanation for this? The nurse lacks appropriate communication skills. The nurse has failed to plan culturally congruent care. The nurse is prejudiced against the patient's culture. O The nurse has exhibited racist behavior during the interaction.

Rationale the patient's diet. The patient is not offended because of the nurse's communication skills, but due to the Therefore the nurse needs to consider such patient preferences and find alternative foods to incorporate into The nurse shows a lack of cultural competence, as Middle Eastern patients are likely to consider pork as taboo. nurse's lack of cultural sensitivity. Prejudicial thinking refers to the process of devaluing an entire cultural group due to assumed attributes. Racism refers to the act of considering a patient or a group superior based on race. tremendous source of comfort and security. gathering) so they understand what you are studying! Or let your mind rest You can review note cards with a family member at a holiday STUDY TIP: Maintain your own cultural traditions as much as possible while you are a student. They are a gathering (instead of skipping the while you participate in a comforting ritual; rejuvenation and connectedness are essential to keep your balance as a nurse as well as while you are a student. pp. 384-385, 390

The nurse is applying ice packs to a patient with hyperthermia. Which mechanism of heat transfer is being used? Radiation O Convection O Conduction O Evaporation

Rationale the process by which a liquid is changed to a vapor through heat. Sweating is a type of evaporative heat loss. energy. Convection is a process by which heat is transferred by the movement of fluid or air. Evaporation is form of heat waves, and there is no contact between the source of heat and the object receiving the heat comes in contact with a cooler object, sueh as an ice pack or cool cloth. In radiation, heat is transferred in the Conduction is the transfer of and reaction to heat through a direct contact. Heat from the body is lost when it p. 278

A nurse researcher is developing a research proposal and is in the instrument to measure anxiety. In which part of the research process is this nurse? process of selecting an OAnalyzing the data Designing the study Conducting the study Identifying the problem

Rationale tools) to measure variables. and data analysis can begin. Instruments must be During study design the researcher selects instruments (data collection Instruments must already be selected before data collection selected before the study is conducted. The first part of the research this initial part the researcher is focused on identifying the population, intervention, comparison (if needed), after the research question has been formulated and study process is to identify the problem; during and outcomes. Instrument selection happens design begins. p. 172

A nurse is evaluating the assessment skills of students by asking them to perform an assessment of vital signs. The nurse finds that a student is assessing the pulse in an improper way. Which assessment of the student leads the nurse to conclude this? O The student is assessing the radial pulses individually. O The student is assessing the temporal pulses individually. OO The student is assessing the carotid pulses simultaneously. O The student is assessing the brachial pulses simultaneously.

Rationale without causing any harm to the patient. Simultaneous assessment of brachial pulses also has no adverse occlude blood supply to the brain. Radial and temporal pulses may be assessed simultaneously or individually Carotid pulses should not be assessed simultaneously because excessive pressure on both the carotids may effects. STUDY TIP: To remember which pulses that one should not assess right and left simultaneously, consider that you would not plan to strangle or choke a patient! Thus you need to assess the carotid pulses individually. p. 283

What is the intervention of interest in the PICO research question "Effectiveness of hot fomentation compared to NSAID medications in dysmenorrheal pain management"? O NSAID medications Hot fomentation O Dysmenorrheal pain Women with dysmenorrhea

STUDY TIP: Be sure you can recall what each letter of PICO front and the meanings on the back. Then practice writing PICO research questions stands for. Make a note card with "PICO" on the included. with all of the elements р. 178

The visual acuity of a patient is a 20/40. This means that what an average person can see at 40 feet away, this patient can see at how many feet away? Record your answer using a whole number. 20

Snellen chart. The larger the denominator, the poorer the patient's visual acuity. The Snellen chart is used in Normal visual acuity is 20/20. The denominator indicates the distance from which a patient can read a line in the assessment of distance vision in a well-lighted room. The patient sits or stands 6.1 m (20 feet) away from the chart and tries to read all the letters beginning at any line with both eyes open. Then the patient reads the line with each eye separately. p. 341

A nurse researcher decides to conduct a study to examine ways in which Florence Nightingale improved patient outcomes in the Crimean War. This is an example of what type of research? O Quasiexperimental Grounded theory Historical Experimental

So close! Rationale Historical research examines historical documents and reports to create an accurate record of a past time period. Quasiexperimental research examines causal relationships between variables and involves control of variables, but not as strictly as experimental research requires; regardless, a study of a past event would be unable to control variables to meet the requirements of quasiexperimental research methods. Grounded theory research derives theories from the data collected in studies; the goal of a study of ways in which Florence Nightingale improved patient outcomes in the Crimean War is not to derive theory. Experimental research uses strict research methods, including controlling variables to investigate causal relationships between variables; a study examining pāst event would be unable to control variables to establish causation. p. 173

Question At which stage of a study does the nurse need to obtain permission from a subject? Enrolling subjects in a study Submitting a research article to a nursing journal O Applying the study results to clinical nursing practice Presenting the research findings at a public forum

So close! Rationale Permission and informed consent must be obtained from subjects enrolling them in tudy. Subjects are entitled to a full explanation of details such as research procedures, purpose, potential harm, possible benefits, and confidentiality measures. The nurse does not need to obtain permission from subjects when submitting a research article to a journal. Permission does not need to be obtained when applying study results to clinical practice. Permission does not need to be obtained from subjects when presenting the research findings at a public forum. p. 175

Which action by the nurse demonstrates unbiased and culturally sensitive care to a patient? O Asking the dietitian to remove pork from the diet of a Muslim patient

That's right! Rationale Middle Eastern patients do not include pork in their diet; competent care. Teaching an Asian patient to discontinue the art of coining is disrespectful and culturally removing it from the menu demonstrates culturally them about the disadvantages of folk medicine insensitive. Many African-American patients believe in the efficacy of folk medicines; therefore informing indicates a lack of cultural sensitivity. Describing the nurse is culturally insensitive to the belief that importance of Western medicine demonstrates that the traditional healing practices may be preferred due to a mistrust of the medical establishment in the Latino culture. Test-Taking Tip: Look for answers that focus on the patient or that are directed toward the patient's feelings. Taking into account the patient's religious dietary preferences is a patient-focused answer.

Which resource would the nurse provide to educate a patient with nearsightedness? Booklet in Braille script O Professional interpreter O Booklet with enlarged fonts Amplified headphones

The nurse should make the health information more accessible to the patient. The patient is nearsighted; educate the patients who are blind. A professional interpreter is needed for patients who do not speak or therefore the patient should be provided with the information in magnified fonts. Braille boards are used to understand the language of the nurse. The patient has a vision problem, not a hearing problem; thus using amplified headphones is unnecessary. p. 191

Which aspect(s) of an unexpected event involving administration of the wrong medication should the nurse document in the incident report? Correct V Dosage of the medication that the patient was administered The dosage of medication that the patient was administered would be recorded in the report. V Nurse's suspicion that the patient lied to obtain a different medication Suspicions should not be included in the incident report, only verifiable facts. V Date and time of the incident The date and time of the incident would be included in the incident report. Name of the nurse who administered the medication The names of all parties present at the time of the incident would be included in the incident report. Action taken in response to the incident The action taken in response to the incident or to remedy the situation would be included in the incident rеpot

V Dosage of the medication that the patient was administered The dosage of medication that the patient was administered would be recorded in the report. V Date and time of the incident The date and time of the incident would be included in the incident report. Name of the nurse who administered the medication The names of all parties present at the time of the incident would be included in the incident report. Action taken in response to the incident The action taken in response to the incident or to remedy the situation would be included in the incident rеpot

How should an incident report be used to provide constructive analysis? To punish the responsible party analysis. Punishment of the responsible party is not a way an incident report can be used to provide constructive To document the incident for the patient's record Documentation of the incident for the patient's record is not a way an incident report can be used to provide constructive analysis. V To provide a framework for implementing change An incident report can allow for constructive analysis by providing a framework for implementing change. V To provide information to guide solutions An incident report can allow for constructive analysis by informing the development of solutions. disseminate information regarding the incident An incident report can allow for constructive analysis by disseminating information regarding the incident.

V To provide a framework for implementing change An incident report can allow for constructive analysis by providing a framework for implementing change. Corect V To provide information to guide solutions An incident report can allow for constructive analysis by informing the development of solutions. To disseminate information regarding the incident An incident report can allow for constructive analysis by disseminating information regarding the incident.

How should an incident report be used to provide constructive analysis? To punish the responsible party analysis. Punishment of the responsible party is not a way an incident report can be used to provide constructive To document the incident for the patient's record Documentation of the incident for the patient's record is not a way an incident report can be used to provide constructive analysis. V To provide a framework for implementing change An incident report can allow for constructive analysis by providing a framework for implementing change. V To provide information to guide solutions An incident report can allow for constructive analysis by informing the development of solutions. To disseminate information regarding the incident An incident report can allow for constructive analysis by disseminating information regarding the incident.

V To provide a framework for implementing change An incident report can allow for constructive analysis by providing a framework for implementing change. V To provide information to guide solutions An incident report can allow for constructive analysis by informing the development of solutions. To disseminate information regarding the incident An incident report can allow for constructive analysis by disseminating information regarding the incident.

Rationale Computer literacy is a basic technological competency. At minimum, it is the knowledge of computers and the ability to use them efficiently. A computer-literate nurse needs minimum assistance to learn and use new computer programs. Web literacy indicates the ability information and to locate, evaluate, and use the information effectively. information given to them by their caregivers. Information literacy is the ability to recognize the need for consumers to understand the medical to look up medications and other health information on reputable Internet reference sites. Health literacy is the ability of the p. 205

Web

Which statement lists steps of the research process in the correct order? Discuss the research results, address ethical procedures, and analyze research results. Review the literature, state the research problem, and address ethical procedures. O Collect data, analyze data, and review the literature. O Collect data, address ethical procedures, and state the research problem.

addressing ethical procedures, conducting the study, collecting data, analyzing data, and discussing the The first step of the research process is to state the research problem, after which follows the literature review, research results. p. 173

A nurse is teaching a group of young women about the importance of using sunscreen. Which type of teaching is the nurse providing? Simulation Restoring health Coping with impaired function Health promotion and illness prevention Rationale Health promotion and illness prevention improve their health and avoid illness. The nurse is not using simulation. Sunscreen are the focus when nurses provide information to help patients would not restore health that an impaired function has occurred. because sunscreen is a preventative measure against skin damage. The information provided does not imply p. 188

hospitalized patient

An older adult is admitted to a hospital for management of depression. The patient asks nurse for permission to do meditation and breathing exercises for 15 minutes in the evening. The nurse has given the permission to do so. Which health model is reflected in these beliefs? Health Promotion Model Holistic Health Model

individual characteristics and experiences, behavior-specific knowledge and affect, and behavioral outcomes. approach used in this case comes under the Holistic Health Model. The Health Promotion Model focuses on including emotional and spiritual well-being dimensions, for the total wellness of an individual. Therefore the The Holistic Health Model emphasizes that all the dimensions of an individual should be considered, The Health Belief Model addresses the relationship between a person's beliefs and behavior. Restoration and rehabilitation fall under tertiary prevention. Next

STUDY TIP: A helpful method decreasing test stress is to practice self-affirmation. After you have adequately studied and really know the material, start looking in the mirror each time you pass one and say to yourself-preferably out loud-"I know this material, and I will do well on the test." After several times of watching and hearing yourself reaffirm your knowledge, you will gain inner confidence and be able to perform much better during the test period. This technique really works for students who are adventurous enough to use it. It may feel silly at first, but if it works, who cares? It will work for performing skills in clinical as well, as long as you have practiced the skill sufficiently. p. 174

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Rationale PICO is a method of research question formulation which identifies the elements of: (P) patient, population, or problem; (1) intervention of interest; (C) comparison intervention (not always used); and (O) outcome. The PICO format helps refine the focus of the research by isolating and defining each element in a tightly focused question. Each element of PICO identifies a key word or concept in the study question that may be used as keywords in literature searches. By going through the process of formulating a good research question by using PICO, the researcher may uncover gaps in the study's design or goals, such as an ill-defined population or unmeasurable outcomes. The PICO format does not outline the six phases of evidence-based research. The PICO format aids the researcher in defining core elements of the study but does not specifically aid in relating a study to a nursing theory. Test-Taking Tip: Recall what each letter of PICO represents before choosing your answer/s. p. 178

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The nurse is teaching a medication regimen to the mother of a toddler who has a throat infection. Which method is best to evaluate effective learning? O Request that the mother read the prescription aloud O Properly assess the child during the next follow-up visit O Ask the mother to repeat the directions given by the nurse Ask the mother to write the drug's name in the prescription

starts taking the medication or administers it to a child. The nurse should always evaluate the parent's understanding of the medication regimen before the patient The best way to evaluate whether the parent has mother to repeat or summarize the instructions. what it means. Improper administration of already been given before the next follow-up visit. medication and how it is to be administered is vital prior to the drug may result in serious complications for the toddler; prescription aloud doesn't guarantee the parent will understand The prescription may contain complex medical terms understood the instructions given by the nurse is to ask the such as po. Requesting that the mother read the therefore proper understanding of the parent can demonstrate a clear understanding of the regimen even if their the drugs in the child's medication regimen, it may not be necessary for her to be able to write them. The While it is important for the mother to know the names of administration. The medication would have reading or writing skills are poor. STUDY TIP: When you want to ensure your study mates understand a concept, have them repeat it back to you understanding. Notice that with patients, it does not require them to be in their own words. The "repeat back" technique is useful for your learning as well as to confirm patient able to read-just to verbalize instructions. Pp. 188, 195