Foundations Final prep

A patient with terminal cancer says to the nurse, "I just don't know if I should allow CPR in the event I quit breathing. What do you think?" Which statement by the nurse would be most beneficial to the patient? "If it were me, I would want to live no matter what." "Don't worry. You have plenty of time to decide that later on." "It's totally up to you. Have you discussed this with your family?" "Let's talk about what CPR means to you."

"Let's talk about what CPR means to you." The use of the value clarification process is helpful when assisting patients in making health care decisions regarding end-of-life care. Giving advice or telling patients what to do is unethical and not recommended. Ignoring a patient concern or changing the subject is inappropriate. Patients should be given factual information in order for them to make their own decisions.

The nurse is caring for a patient scheduled for heart surgery. Which statement made by the patient requires further discussion? "My friend died on the operating table several months ago." "The surgeon has a great reputation in the community." "I believe that this surgery is going to make me better." "Yesterday I asked my pastor to visit me after the procedure."

"My friend died on the operating table several months ago." Personal beliefs are one of the most important factors in determining how a person responds to a health problem and its treatment. The patient has a concern about the possibility of dying during the surgery based on prior experiences. The nurse should further explore the concern and determine the patient's true meaning of the statement. Failure to consider the patient's belief systems may result in ineffective implementation of the plan of care. Belief in the surgeon's reputation, the success of the surgery, and the patient's ability to visit after the surgery indicate a positive belief.

A student asks the instructor about health care economics. The instructor knows the student understands when the student makes which statement? "The elderly population uses most of the health care services." "Everyone should have health insurance to obtain services." "Health care dollars should be partitioned by the government." "Resources will be needed to serve health care issues."

"Resources will be needed to serve health care issues." Every health care issue needs resources to bring it to fruition. Without the resources, the health care issue would not be served. The elderly are a large part of the population, but that does not change the economics of health care. Everyone does not have health insurance, so that statement would not enter into health care economics. Last, all health care dollars are not partitioned by the government; third party payers exist.

Environmental Racism :

"any policy, practice or directive that differentially affects or disadvantages (whether intended or unintended) individuals, groups, or communities based on race or color." (Bullard, 1994) Segregation, Settler-Colonialism, Capitalism

Incivility definition

"one or more rude, discourteous, or disrespectful actions that may or may not have a negative intent behind them".

Bullying definition

"repeated, unwanted, harmful actions intended to humiliate, offend, and cause distress in the recipient."

Environmental Injustice/Racism Examples

-Black Americans are exposed to 56% more pollution than they produce -Latinx Americans are exposed to 63% more pollution than they produce -White Americans are exposed to 17% less pollution than they produce

The nurse recognizes that after several years of work in the emergency room, compassion fatigue has developed. What symptoms associated with this condition would the nurse be experiencing? (Select all that apply.) Chronic depression Sleeping all the time Anorexia Poor concentration Feeling detached from patients Euphoria

-Chronic depression -Poor concentration -Feeling detached from patients Global Rationale: Compassion fatigue is an extreme state of distress experienced as the progressive and cumulative result of exposure to stress in the therapeutic use of self in caring for others. Compassion fatigue involves the nurse experiencing a feeling of being unable to meet the needs of patients arising from the inability to alleviate suffering. Compassion fatigue may result in feelings of vulnerability, anxiety, depression, and anger. Left unrecognized, compassion fatigue can produce physical and mental exhaustion manifested by difficulty sleeping, poor concentration, and low morale; and it can lead to compulsive behaviors, such as substance abuse. Nurses experiencing compassion fatigue often detach themselves from patients, have a higher risk of making errors, exercise poor judgment, and experience difficulty in maintaining interprofessional relationships.

Workplace stress can lead to?

-Depression -Compassion fatigue -Burnout -Decreased job satisfaction

How are Low-Income Communities Impacted by Disasters?

-Developing countries are more vulnerable to climate change -Poorer countries are highly dependent on natural resources -Underserved communities are least able to prepare for, and recover from, heat waves, poor air quality, flooding, and other impacts -The most vulnerable groups include children, the elderly, people with preexisting health conditions, outdoor workers, people of color and those with low income

The nurse recognizes which of the following to be a benefit of regular physical exercise? (Select all that apply.) Enhances the immune system Decreases bone density Limits joint mobility Improves mental health Helps to prevent type 2 diabetes

-Enhances the immune system -Improves mental health -Helps to prevent type 2 diabetes Global Rationale: Exercise is essential for the prevention of illness and promotion of wellness. Physical exercise is any bodily activity or movement that enhances or maintains physical fitness levels and overall health. Exercise strengthens muscles, improves cardiovascular performance, hones athletic skills and endurance, and reduces or maintains weight, and it is performed for enjoyment (CDC, 2020). Regular physical exercise enhances the immune system, builds and maintains healthy bone density, increases joint mobility, and helps to prevent cardiovascular disease, type 2 diabetes, and obesity. Exercise also improves mental health and helps to prevent depression through the release of endorphins and other neurotransmitters that are responsible for exercise-induced euphoria (CDC, 2020).

The student nurse learns the ANA's Scope and Standards of Practice for public health nursing include components? (Select all that apply.) Team membership Developing research Ethical behavior Responsible resource use Advocacy

-Ethical behavior -Responsible resource use -Advocacy Global Rationale: The ANA's Scope and Standards of Practice for public health nursing outlines duties related to assessment, coordination of care, responsible resource utilization, ethical behavior, leadership, advocacy, and research similar to the standards of practice for all nurses. Team membership and developing one's own research are not included.

Environmental Injustice

-Human-caused changes to global fisheries affect diet, nutrition, and thus human health around the planet, especially in low-income nations near the equator -Estimated 845 million people (11% of the global population) at risk for becoming undernourished if they lose access to seafood as a result of declines in fisheries ( Seltenrich, 2018)

An accountable care organization (ACO) seeks to deliver which of the following aspects of health care? (Select all that apply.) Lessen Medicare payments Integrate care Enhance evidence-based practices Manage acute conditions Support hospice charges

-Integrate care -Enhance evidence-based practices ACOs work to integrate care, manage chronic conditions, and enhance the use of evidence-based practices. They do not have any involvement with Medicare payments, the management of acute conditions, or hospice care.

When dealing with patient who has a values conflict in which substance abuse or an addiction is involved, the nurse should conduct an assessment interview and use which techniques that will make the interview most effective? (Select all that apply.) Listen for subtle signs of denial. Directly confront the patient about his drug abuse. Use a matter-of-fact approach to inform the patient. Provide straightforward information. Avoid direct confrontation.

-Listen for subtle signs of denial. -Use a matter-of-fact approach to inform the patient. -Provide straightforward information. -Avoid direct confrontation. The most effective approach for dealing with a values conflict in which substance abuse or an addiction is involved is to begin with an assessment interview, during which the nurse should: listen for the subtle signs of denial, avoid direct confrontation, use a matter-of-fact approach to inform the patient of the reality of the consequences of the harmful behavior, and provide straightforward information about the effects of the substance abuse.

A student nurse is discussing Medicare coverage with the clinical instructor. The instructor knows the student understands Medicare when the student makes this which statement(s)? (Select all that apply.) - Medicare covers all patients while they are in the hospital. - Medicare is funded by the federal government. - Medicare is for persons 65 years old and older. - Medicare is partially funded by private third-party payers. - Medicare is for patients who are disabled and/or have end-stage renal disease.

-Medicare is funded by the federal government. -Medicare is for persons 65 years old and older. -Medicare is for patients who are disabled and/or have end-stage renal disease. Medicare is funded by the federal government. It covers people who are 65 years old and older, disabled people, and patients who have end-stage renal disease. It does not cover all patients in the hospital, because some patients do not qualify for Medicare. It is not funded by third-party payers.

Nurses role in climate change?

-Mitigation: working at individual, community, institutional, and governmental level to ensure energy-conserving policies and practices -Response: public health nurses must be prepared for increased fire- and storm-related disasters

Social Determinants of Health

-Non-medical factors that influence health outcomes -The conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life.

The nurse manager of a busy oncology unit is concerned about compassion fatigue among the nursing staff. Which signs and symptoms would alert the nurse to this problem? (Select all that apply.) Nurses become very emotionally upset without an apparent cause. Nurses start to avoid caring for certain patients. Nurses start to call in sick more often. Nurses begin working more overtime. Nurses have difficulty showing empathy for patients.

-Nurses become very emotionally upset without an apparent cause. -Nurses start to avoid caring for certain patients. -Nurses start to call in sick more often. -Nurses have difficulty showing empathy for patients. Global Rationale: Compassion fatigue occurs when deeply caring and empathetic nurses become overwhelmed by the constant needs of patients and families. Symptoms include mood swings, avoidance of working with some patients, frequent sick days, irritability, reduced memory, poor concentration, and a decreased ability to show empathy.

Moral Distress in Nursing

-Phenomenon in which one knows the right action to take, but is constrained from taking it. -Moral distress is different from the classical ethical dilemma in which one recognizes that a problem exists, and that two or more ethically justifiable but mutually opposing actions can be taken

Florence Nightingale Major Concepts

-Put the patient in the best condition for nature to act -(fresh air, light, warmth, cleanliness, quiet, proper selection/administration of diet) -Human beings are defined in relation to their environment and the impact of environment upon them

The nurse manager of the unit is implementing a program to assist the nursing staff in managing compassion fatigue. Which interventions will be the most successful? (Select all that apply.) Support group that nurses can participate in that meets on the unit. Exercise competitions to encourage nurse to exercise and log their time. Organized break times so nurses can get off the unit for breaks and lunches. Quiet area on the unit where the nurses can go during break. Activities that emphasize workplace aggression.

-Support group that nurses can participate in that meets on the unit. -Exercise competitions to encourage nurse to exercise and log their time. -Organized break times so nurses can get off the unit for breaks and lunches. -Quiet area on the unit where the nurses can go during break. Global Rationale: To care most effectively for others, nurses must first take time to care for themselves. Many of the stress reduction interventions incorporated into patient care plans can be effective in addressing the stressors faced by nurses. Exercise, balanced nutrition, and mindfulness therapy have been shown to help health care professionals in coping with the demands of patient care. Interventions designed specifically to prevent nurse burnout and address compassion fatigue include mentoring programs, workplace appreciation, availability of quiet areas on the nursing unit for relaxation, Yoga, meditation, mindfulness, availability of pastoral care, the sharing of feelings with trusted colleagues, and promotion of work-life balance.

Florence Nightingale Environmental Theory

-Understood the significance of unsanitary conditions -Defined nursing as "the act of utilizing the patient's environment to assist him in his recovery"

A nurse is assessing social determinants of health. Which does the nurse include in the assessment? (Select all that apply.) Vaccination compliance Family structure Communication patterns Roles for women Education

-Vaccination compliance -Family structure -Roles for women -Education Global Rationale: Income, education, health literacy, where people live or work, early childhood development, social exclusion, family structure, the status and role of women, and vaccination adherence are just some of the social determinants of health recognized worldwide. Communication patterns often are important to assess in culturally diverse individuals, families, and communities, but this is not considered a social determinant of health care.

Nursing turnover rate

60% of nurses leave/first 6 months of employment because of LV

A nurse is overly friendly with a patient, treating them as if they were a close personal friend or family member. According to the NCSBN, what behavior does this nurse exhibit that may be a professional boundary violation? Keeping secrets with the patient Failing to protect the patient from inappropriate sexual involvement Excessive self-disclosure Acting as if the patient is a family member or close personal friend

Acting as if the patient is a family member or close personal friend Global Rationale: The NCSBN identifies acting as if a patient is a family member or close personal friend as a behavior indicating a risk for professional boundary violations.

A patient is diagnosed with pneumonia after an abrupt onset of fever, cough, and malaise. The patient is started on antibiotic therapy and is expected to improve in 2 to 3 weeks. Which statement by the nurse correctly identifies this illness? Acute Chronic Remission Exacerbation

Acute Global Rationale: Acute illness is typically characterized by an abrupt onset and short duration (<6 months). Clinical manifestations of acute illness appear quickly. They may be severe or lethal, or they may soon resolve because they respond to treatment or are self-limiting. Chronic illness is characterized by a loss or abnormality of body function that lasts longer than 6 months and requires ongoing long-term care. Chronic health conditions may be controlled with lifestyle management or drug therapy, but they are considered to be irreversible. Chronic illness may be characterized by periods of wellness (i.e., remission) and exacerbation (worsening) of clinical manifestations, which can be life threatening. Individuals learn to adjust their lifestyles accordingly.

A nurse is orienting to a new job in a home health care agency and is told that most of her clients need tertiary prevention. What activity does the nurse plan to include in the daily routine? Household safety checks Well-baby checkups Antibiotic administration Monthly blood pressure assessments

Antibiotic administration Global Rationale: Tertiary care is aimed at people who are already experiencing a health alteration, such as those with an infection who need antibiotics. The other options are secondary prevention.

Workplace Violence definition

Any act or threat of physical violence, harassment, intimidation or other threatening, disruptive behavior from patients, patient's family members, external individuals, and hospital personnel. It includes physical, sexual, and psychological assaults.

The nurse knows the World Health Organization defines health in which of the following terms? The absence of disease The lack of infirmity Complete well-being Being independent of fiscal responsibility

Complete well-being Global Rationale: The World Health Organization offers a definition for health: "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity." Nurses are responsible for helping patients reach their optimal levels of physiologic and mental health, but they also must provide health care in a system that requires cost containment and fiscal responsibility.

A nurse is providing care to a patient experiencing heat-related illness during a heatwave. What immediate nursing action is most appropriate? Administering a bronchodilator Administering a diuretic Cooling the patient with a fan and cold compresses Administering an antipyretic

Cooling the patient with a fan and cold compresses Rationale 7: Heat-related illnesses require rapid cooling to prevent further harm. Administering a bronchodilator, diuretic, or antipyretic is not appropriate in this situation.

C.O.D.E

Courage to be moral requires: Obligations to honor - (What is the right thing to do?) Danger management - (What do I need to handle my fear?) Expression and action - (What action do I need to take to maintain my integrity?)

The public health nurse volunteers for a missionary group caring for Ebola clients in Africa. The nurse is reviewing the data using analytic epidemiology methods. What information does the nurse collect as the priority? Cultural norms in burial practices Genetic variables in disease acquisition Statistics related to incidence and prevalence Autopsy data on direct cause of death

Cultural norms in burial practices Global Rationale: Analytic epidemiology hypothesizes why a disease is occurring in a community and looks at cultural practices, nutrition, and extrinsic factors such as the environment for links. Genetic variables and direct cause of death data are more related to epidemiology.

A pediatric nurse is educating parents on the risks of vector-borne diseases like Lyme disease and West Nile virus. What is a key environmental factor contributing to the spread of these diseases? Air pollution Water pollution Deforestation Noise pollution

Deforestation Rationale 4: Deforestation disrupts ecosystems and can lead to increased contact between humans and disease-carrying vectors, contributing to the spread of vector-borne diseases.

A community health nurse is working in a region with frequent heatwaves. Which population should the nurse prioritize for health education and outreach during these events? Young adults Elderly individuals School-age children Middle-aged adults

Elderly individuals Rationale 2: Elderly individuals are more vulnerable to extreme heat due to physiological changes that come with aging. They are at higher risk of heat-related illnesses during heatwaves.

What do the economics of health care include? Medicare and Medicaid dollars Patients' rights Equal distribution of health care holder Nurse salaries

Equal distribution of health care holder The economics of health care include the equal distribution of health care services so everyone may be served when services are needed. Medicare and Medicaid, patients' rights, and nurse salaries do not factor into the economics of health care; they are only parts of the health care system.

A nurse is working in a healthcare facility that adopts sustainable practices to reduce waste and energy consumption. What principle of environmental justice is the facility promoting? Equity Respect for diversity Precaution Sustainability

Equity Rationale 6: By adopting sustainable practices, the facility is promoting equity in environmental decision-making, ensuring that environmental benefits and burdens are distributed fairly.

The nurse has implemented a community-wide immunization program for seasonal influenza. Once the program has ended, what action by the nurse is best? Begin planning for next year's program. Send mail surveys to participants. Determine financial gains or losses. Evaluate the program and outcomes.

Evaluate the program and outcomes. Global Rationale: The last step of the nursing process is evaluation. Evaluation evaluates progress toward the attainment of outcomes. The nurse should evaluate the program to see if interventions had the desired effect. Evaluation could include surveys or looking at financial outcomes, but those are only limited aspects of the process. Planning for next year's event should not occur until after evaluation has been completed.

A nurse shares personal information about their life, experiences, and feelings without prompting from the patient. What behavior is the nurse engaging in that the NCSBN identifies as a potential boundary violation? Keeping secrets with the patient Failing to protect the patient from inappropriate sexual involvement Excessive self-disclosure Acting as if the patient is a family member or close personal friend

Excessive self-disclosure Global Rationale: The NCSBN recognizes engaging in excessive self-disclosure as a potential behavior indicating a risk for professional boundary violations.

When a patient expresses romantic feelings toward a nurse, the nurse fails to establish appropriate professional boundaries, leading to inappropriate sexual involvement. What behavior is the nurse engaging in that the NCSBN recognizes as a potential violation? Excessive self-disclosure Keeping secrets with the patient Spending excessive amounts of time with one patient Failing to protect the patient from inappropriate sexual involvement

Failing to protect the patient from inappropriate sexual involvement Global Rationale: The NCSBN identifies failing to protect the patient from inappropriate sexual involvement as a potential behavior indicating a risk for professional boundary violations.

A home health care nurse is working with the family of a client who has Alzheimer disease and requires 24-hour care. What assessment by the nurse indicates the family is meeting an important goal for caregiver stress? Family eats dinner together every night. Family uses respite care one night a week. Family investigates research trials for client. Family verbalizes exhaustion from caregiving.

Family uses respite care one night a week. Global Rationale: Caregiver stress is from round the clock caregiving responsibilities, fatigue and insufficient time to meet personal needs. Using a respite caregiver once a week gives the family a little time off to accomplish needed tasks. The other observations are not tied to this diagnosis.

Metaparadigm

Global concepts that identify and describe central phenomena and explain the relationship between concepts.

The nurse is preparing a patient teaching plan and is seeking a way to determine the patient's readiness and motivation to act regarding lifestyle changes to best manage diabetes mellitus. Which model would be useful for this nurse? Maslow's hierarchy of needs Holistic Health Model Health Promotion Model Health Belief Model

Health Belief Model Global Rationale: The Health Belief Model was developed by psychologists Hochbaum, Rosenstock, and Kegels. It explores how patients' attitudes and beliefs predict health behavior. Maslow's hierarchy of needs describes the relationships between the basic requirements for survival and the desires that drive personal growth and development. The model is most often presented as a pyramid consisting of five levels. The lowest level is related to physiologic needs, and the uppermost level is associated with self-actualization needs, specifically those related to purpose and identity. Holistic Health Models in nursing care are based on the philosophy that a synergistic relationship exists between the body and the environment. Holistic care is an approach to applying healing therapies. Holistic models focus on the interrelatedness of body and mind. The Health Promotion Model, developed by Pender and colleagues, defines health as a positive, dynamic state of well-being rather than the absence of disease in the physiologic state.

Two nurses are discussing health care in the past and the present. The two nurses know which to be true about health care in the present? Health care in the present is mostly provided by nurses. Health care in the present is controlled by third party payers. Health care in the present is controlled by physicians. Health care in the present is dictated by the patient.

Health care in the present is controlled by third party payers. Health care in the past was controlled by physicians, because they provided the care. Health care in the present is controlled by third party payers, because they finance the care. Health care is provided by nurses, but patient care requires a team of health care workers to assist the patient. The patient is part of the team, but they do not dictate the health care. The patient works with the physician to bring about a good outcome.

The nurse caring for a patient with chronic pain uses guided imagery, therapeutic touch, and relaxation techniques as interventions for pain. The nurse is using what type of approach? Holistic Eastern holistic Risk factor reduction Health protection

Holistic Global Rationale: Nurses participate in holistic care through the use of natural healing remedies and complementary interventions. These include the use of art and guided imagery, therapeutic touch, music therapy, relaxation techniques, and reminiscence. Eastern holistic therapists have been using techniques such as acupuncture, yoga, and tai chi for thousands of years as methods of healing and, more recently, in conjunction with modern allopathic medical therapies. Risk factor reduction is step-by-step improvement of individual health factors. These combined improvements lower the likelihood of developing a disease. Health protection includes intentional behaviors aimed at circumventing illness, detecting it early, and maintaining the best possible level of mental and physiologic function within the boundaries of illness.

A nurse working in a low-income neighborhood observes that residents have limited access to green spaces and healthy food options. Which social determinant of health is the nurse witnessing? Education Income Occupation Gender

Income Rationale 3: Limited access to green spaces and healthy food options is often associated with lower income levels, illustrating how income disparities impact health outcomes.

When planning interventions for a community, what action by the nurse is best? Involve community leaders in planning. Create a plan of action addressing priorities. Determine what resources are available. Attempt to find funding for the plan.

Involve community leaders in planning. Global Rationale: Determining goals for community health must include key stakeholders (individuals or groups with an investment or significant interest in a topic). Stakeholders need to be involved in planning to ensure buy-in from the community. The nurse would collaborate with representatives to establish a goal that is acceptable to all parties. This approach would help ensure adherence with agreed-on procedures, thus increasing the likelihood that the best possible outcome would be achieved. The other actions are important, but if the community leaders are not committed to the plan, the plan is unlikely to work.

A value system is a set of somewhat consistent values and measures that are organized hierarchically into a belief system on a continuum of relative importance. The nurse knows that a value system is also identified by which concept? It is culturally based. It is unique to each individual. It is a poor basis for making decisions. It is rigid and uniform within a culture.

It is culturally based. Anthropologists and social scientists have noted that in every culture, a particular value system prevails and consists of culturally defined moral and ethical principles and rules that are learned in childhood. Everyone possesses a relatively small number of values and may share the same values with others, but to different degrees. A value system helps the person choose between alternatives, resolve values conflicts, and make decisions. Within every culture, however, values vary widely among subcultural groups and even between individuals on the basis of the person's gender, personal experiences, personality, education, and many other variables.

A nurse is assessing a patient from an underserved community with limited access to healthcare services. What ethical principle underlies the provision of care in this context? Autonomy Non-maleficence Beneficence Justice

Justice Rationale 8: The principle of justice underscores the importance of providing equitable access to healthcare services, particularly to underserved communities.

When a patient tries to discuss their medical condition with a nurse, the nurse consistently avoids the conversation and refuses to share information. What behavior does this nurse exhibit that is identified by the NCSBN as a potential professional boundary violation? Excessive self-disclosure Keeping secrets with the patient Spending excessive amounts of time with one patient Failing to protect the patient from inappropriate sexual involvement

Keeping secrets with the patient Global Rationale: The NCSBN recognizes keeping secrets with a patient and limiting others from conversation and patient information as potential behaviors indicating a risk for professional boundary violations.

Collaborating effectively with patients to find treatment methods that are congruent with the patients' belief systems and that promote healthy outcomes is an approach that requires the nurse to include which activity? Focus on patient values only and disregard family desires in setting goals. Rely more and more on their scientific background. Listen carefully to how the patient's beliefs impact their health beliefs. Understand that the nurse's beliefs are the most important.

Listen carefully to how the patient's beliefs impact their health beliefs. Nurses must collaborate effectively with patients to find treatment methods that are congruent with the patients' belief systems and that promote healthy outcomes. This approach requires excellent assessment skills and a willingness to listen carefully to determine how patients' personal beliefs impact their health beliefs. Failure to consider the patient's belief systems may result in ineffective implementation of the plan of care.

A nurse is working in a community exposed to high levels of air pollution from nearby industrial facilities. What health issue is a significant concern in this community? Skin cancer Lung disease Malnutrition Osteoporosis

Lung disease Rationale 5: High levels of air pollution are associated with respiratory problems, making lung disease a significant concern for individuals in such communities.

The nurse has been involved sexually with a patient. The nurse manager becomes aware of this situation and tells the nurse this behavior is which type of crime? Malpractice Libel Slander Battery

Malpractice Global Rationale: Malpractice is negligence committed by a person functioning in a professional role. Malpractice may occur when a professional such as nurse acts unethically, demonstrates deficient skills, or fails to meet standards of care required for safe practice. Examples of these types of malpractice include engaging in sexual activity with a patient; calculating medication dosages inaccurately, resulting in a patient's drug overdose; and administering penicillin to a patient with a documented penicillin allergy, resulting in the patient's death from a severe allergic (anaphylactic) reaction. Written forms of defamation of character are considered libel. Broadcasting or reading statements aloud that have the potential to hurt the reputation of another person is considered libel. Oral defamation of character is slander. Actual physical harm caused to another person is battery.

Several models exist that describe the relationship between health and wellness. Which model is used to understand the interrelationship between elements of basic requirements for survival and the desires that drive personal growth and development and is represented as a pyramid? Maslow's hierarchy of needs Health Belief Model Health Promotion Model Holistic Health Model

Maslow's hierarchy of needs Global Rationale: Maslow's hierarchy of needs describes the relationships between the basic requirements for survival and the desires that drive personal growth and development. The model is most often presented as a pyramid consisting of five levels. The lowest level is related to physiologic needs, and the uppermost level is associated with self-actualization needs, specifically those related to purpose and identity. The Health Belief Model was developed by psychologists Hochbaum, Rosenstock, and Kegels. It explores how patients' attitudes and beliefs predict health behavior. The Health Promotion Model, developed by Pender and colleagues, defines health as a positive, dynamic state of well-being rather than the absence of disease in the physiologic state. Holistic health models in nursing care are based on the philosophy that a synergistic relationship exists between the body and the environment. Holistic care is an approach to applying healing therapies. Holistic models focus on the interrelatedness of body and mind.

Lateral Violence Overt Behaviors:

Name calling Fault finding Backstabbing Sabotage Verbal and physical intimidation Bullying Gossiping Shouting Blaming Bickering Using put downs Tampering with personal items

While helping patients with values clarification and care decisions, the nurse should complete which action? Convince the patient to do what the nurse believes is best. Give advice about what the nurse would do. Tell the patient what the right thing to do is. Provide information so the patient can make informed decisions.

Provide information so the patient can make informed decisions. While helping patients with values clarification and care decisions, nurses must be aware of the potential influence of their professional nursing role on patient decision-making. Nurses should be careful to assist patients to clarify their own values in reaching informed decisions. Providing information to patients so that they can make informed decisions is a critical nursing role. Giving advice, trying to convince the patient that the nurse knows best, or telling patients what to do in difficult circumstances are approaches that are unethical and ill-advised.

When discussing immunizations for infants and children with new parents, the nurse should focus on which approach? Providing scientific evidence to parents Stressing that nonimmunization is a crime Acknowledging that immunizations are not needed Informing the parents that they have no choice

Providing scientific evidence to parents Global Rationale: Parents need to have scientific, evidence-based information about immunizations and their consequences before choosing to accept or reject immunizations for their children. The parent's ability to make an informed decision is the primary goal for nurses educating people about childhood immunizations.

ANA Code of Ethics Provision

Provision 1: The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person. Provision 2: The nurse's primary commitment is to the patient, whether an individual, family, group, community, or population. Provision 3: The nurse promotes, advocates for, and protects the rights, health, and safety of the patient. Provision 4: The nurse has authority, accountability, and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to promote health and provide optimal care. Provision 5: The nurse owes the same duties to self as to others, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence and continue personal and professional growth. Provision 6: The nurse, through individual and collective effort, establishes, maintains, and improves the ethical environment of the work setting and conditions of employment that are conducive to safe, quality health care. Provision 7: The nurse, in all roles and settings, advances the profession through research and scholarly inquiry, professional standards development, and the generation of both nursing and health policy. Provision 8: The nurse collaborates with other health professionals and the public to protect human rights, promote health diplomacy, and reduce health disparities. Provision 9: The profession of nursing, collectively through its professional organizations, must articulate nursing values, maintain the integrity of the profession, and integrate principles of social justice into nursing and health policy.

A nurse is working in a region with an increased prevalence of vector-borne diseases due to climate change. What preventive measure should the nurse recommend to the community? Reduce greenhouse gas emissions Increase deforestation Use more fossil fuels Increase waste generation

Reduce greenhouse gas emissions Rationale 10: Reducing greenhouse gas emissions is a primary prevention strategy to mitigate climate change, which can help reduce the prevalence of vector-borne diseases. The other options contribute to environmental issues.

An overweight, sedentary middle-aged smoker with a family history of cardiac disease has noticed a steady rise in resting blood pressure over a 3- to 4-year period. The patient is concerned about his slightly elevated blood pressure and begins walking 20 to 30 minutes in the evenings with his wife and reduces his pack-a-day cigarette habit to ten cigarettes a day. The nurse identifies these actions are the initial step of which behavior? Risk factor reduction Self-actualization Self-transcendence Health promotion

Risk factor reduction Global Rationale: Risk factor reduction is step-by-step improvement of individual health factors. These combined improvements lower the likelihood of developing a disease. Maslow considered self-actualization the highest level of optimal functioning and involves the integration of cognitive ability, compassion, acceptance of self, and autonomy. In later years, Maslow described a level above self-actualization called self-transcendence. He refers to self-transcendence as a peak experience, in which analysis of reality or thought changes a person's view of the world and his/her position in the greater structure of life. Health promotion is behavior motivated by the desire to increase well-being (as opposed to preventing illness) and optimize health status.

A nurse is planning primary prevention activities. Which activity would the nurse include in this plan? Safer sex education for teens Blood pressure screening Cardiac rehabilitation programs Asking about exposure to partner violence

Safer sex education for teens Global Rationale: Primary prevention includes activities designed to prevent a disease or condition from occurring in the first place. Examples of primary prevention activities include immunization programs, wellness programs, good nutrition for health, and fitness classes. Blood pressure screening and asking the client about exposure to intimate partner violence are secondary prevention measures. Cardiac rehabilitation programs would be tertiary prevention.

Self-concept refers to the way in which individuals perceive unchanging aspects of themselves, such as social character, cognitive abilities, physical appearance, and body image. Which additional point does the nurse the nurse recognize as part of the definition of self-concept? If negative, self-concept will allow the patient to compensate for weaknesses. If positive, self-concept will cause the patient to see challenges as devastating. Self-concept is a concept that is derived from the patient internally. Self-concept depends on relationships with family and friends.

Self-concept depends on relationships with family and friends. Global Rationale: Self-concept refers to the way in which individuals perceive unchanging aspects of themselves, such as social character, cognitive abilities, physical appearance, and body image. It is a mental image of self in relation to others and the surroundings. If the image is positive, the person will develop strengths, compensate for weaknesses, and experience life in a healthy way. If the image is negative (e.g., frail), the person will find life's challenges devastating and sometimes insurmountable. The impact of illness on the self-concept of a patient and the patient's family members depends on how secure the parties' relationships are with one another.

The following questions focus on the specific nurse behaviors that indicate a potential for professional boundary violations. Found in chapter 11, LO 11.8 A nurse is consistently spending excessive amounts of time with a particular patient, often extending beyond the assigned shift. What behavior might this nurse be at risk of according to the NCSBN? Excessive self-disclosure Keeping secrets with the patient Spending excessive amounts of time with one patient Acting as if the patient is a family member or close personal friend

Spending excessive amounts of time with one patient Global Rationale: The NCSBN recognizes spending excessive time with a single patient as a potential behavior that indicates a risk for professional boundary violations.

A group of nursing students are discussing the history of nursing to a staff nurse. When a student states, "Yeah, nurses used to be called the doctors' handmaidens." the staff nurse recognizes that this comment is identified by which term? Prejudice Generalization Stereotype Belief

Stereotype A stereotype is a belief about a person, a group, or an event that is thought to be typical of all others in that category. A prejudice is a preformed opinion, usually an unfavorable one, about an entire group of people that is based on insufficient knowledge, irrational feelings, or inaccurate stereotypes. In the process of learning, people form generalizations (general statements or ideas about people or things) to relate new information to what is already known and to categorize the new information, making it easier to remember or understand. A belief is a mental representation of reality or a person's perceptions about what is right (correct), true, or real, or what the person expects to happen in a given situation.

The US health care system is different from that of other countries in which way? The US charges money from the private sector only. US health care is funded from private organizations. The US health care system is not entirely government funded. The US health care treats the older person first.

The US health care system is not entirely government funded. Other countries fund the health care system so that every citizen may have health care. In addition they provide the option that citizens may purchase private health care too. The US has a combination of private companies and government agencies funding health care, so money is not coming from just the private sector. The older person in the population receives care according to the insurance coverage they have, but the care is not before anyone else.

Which of the following statements is true about health care in the US? The US spends more money on health care than any other nation. The US provides health care to every citizen. The US relies on government funding to treat most citizens. The US spends less money on pediatric care than other nations.

The US spends more money on health care than any other nation. The US spends more money on health care than any other country. The US does not provide health care to every citizen, nor does it rely entirely on government funding. The US does not spend less money on pediatric care but usually more than other countries.

Moral Courage Definition

The commitment to act on ethical beliefs in the face of adversity and potential consequences

Which nurse has committed a serious documentation error? The nurse who documents all medications for assigned patients prior to administration. The nurse who documents medication administration as the medications are given. The nurse who documents assessments as soon as they are completed. The nurse who documents meal intake as meal trays are picked up.

The nurse who documents all medications for assigned patients prior to administration. Global Rationale: Documentation must be accurate to provide a realistic view of a patient's condition. Serious documentation errors include: (1) omitting documentation from patient records, (2) recording assessment findings obtained by another nurse or unlicensed assistive personnel (UAP), and (3) recording care not yet provided. Nurses sometimes document that a patient has received medication before its administration; this is a serious violation of the law and becomes a medication error of omission if the nurse is distracted before administering the patient's medication.

The patient is asking about using the Internet for resources regarding lifestyle behaviors and benefits of modification. What is the best response that the nurse should provide the patient? Information on lifestyle behaviors is not available on the Internet. The patient should use websites that are easy to understand. Most websites are designed for health care providers only. Only negative outcomes are evaluated on the Internet.

The patient should use websites that are easy to understand. Global Rationale: Information on lifestyle behaviors that lead to disease is available at disease advocacy and research-sponsored websites that have peer-reviewed material and expert analyses. Website content should be easy to read and understandable for the general population. Most sites that discuss the latest information about health risks, lifestyle behaviors, and outcomes have separate information specifically for health care providers. Examples of risky lifestyle behaviors that can lead to poor outcomes include excessive alcohol intake, which can cause liver damage and gastrointestinal distress, and poor dietary choices and lack of exercise, which can lead to overweight or obesity in adults and children. Most sites that discuss the latest information about health risks, lifestyle behaviors, and outcomes have separate information specifically for health care providers. Research that evaluates positive and negative lifestyle-behavior outcomes is constantly evolving as discoveries are made about the physiologic changes bodies experience with disease and illness.

60-80% of harm to patients due to breakdown in communication T/F

True

After reading the case study about Raymond Wiley in the book, please answer the following questions. Mr. Wiley's care might have been different if a pay for performance rather than a fee for service plan was in place. True or False. A pay for performance hospital is reimbursed based on the quality and efficiency of care delievered.

True

After reading the case study about Raymond Wiley in the book, please answer the following questions. Mr. Wiley experienced a lot of issues during his trip to the hospital and during his stay. The different models of care offered in healthcare organizations can impact patient care in various ways. The fee for service model has benefits and drawbacks for patients. True or false. The fee for service hospital pays its healthcare providers for each individual service or procedure.

True

Most LV happens in the healthcare setting T/F

True

Lateral Violence Covert Behaviors:

Unfair assignments Sarcasm Eye rolling Ignoring Refusing to help Whining Refusing to work with someone Isolation Exclusion Fabrication Social Media

The nurse identifies the concept of enduring ideas about what a person considers desirable or has worth in life is known by which term? Values First-order belief Higher order belief Stereotype

Values Values are enduring ideas about what a person considers is the good, the best, and the "right" thing to do and their opposites—the bad, worst, and wrong things to do—and about what is desirable or has worth in life. First-order beliefs serve as the foundation or the basis of an individual's belief system. Higher order beliefs are ideas derived from a person's first-order beliefs through inductive or deductive reasoning. A stereotype is a belief about a person, a group, or an event that is thought to be typical of all others in that category.

The nurse is caring for a patient who is under arrest for murder and is attempting to perform nursing care duties while, at the same time, feeling a sense of repugnance toward the patient. The nurse recognizes this situation is identified by which term? Values clarification Values conflict First-order beliefs Higher order beliefs

Values conflict A values conflict occurs when a person's values are inconsistent with his or her behaviors or when the person's values are not consistent with the choices that are available. Providing care for a convicted murderer may elicit troubling feelings for a nurse, resulting in a values conflict between the nurse's commitment to care for all people and a personal repugnance for the act of murder. Values clarification is a therapeutic process that allows individuals to consider, clarify, and prioritize their personal values. First-order beliefs serve as the foundation or the basis of an individual's belief system. Higher order beliefs are ideas derived from a person's first-order beliefs, inductive, or syllogistic reasoning.

A nurse is educating a group of patients about the importance of reducing their carbon footprint. What action by the patients best demonstrates a commitment to environmental sustainability? Walking instead of driving Using disposable plastic products Increasing water consumption Frequent use of single-use plastics

Walking instead of driving Rationale 9: Choosing to walk instead of driving reduces carbon emissions and demonstrates a commitment to environmental sustainability. Using disposable plastics and increasing water consumption have negative environmental impacts.

A nurse is providing care to a patient in a coastal area affected by sea-level rise due to climate change. What potential environmental risk should the nurse consider for this patient? Increased risk of wildfires Water contamination Air pollution Noise pollution

Water contamination Rationale 1: Sea-level rise can lead to the intrusion of saltwater into freshwater sources, increasing the risk of water contamination. This can affect the patient's access to clean drinking water and impact their health.

What Lateral Violence is Not

When someone snaps at you or ignores you because they are under pressure or in a bad mood.......that is not bullying.

The student studying community health nursing learns that vulnerable populations can be best assisted by which activity? Researching their genetic risk for health problems Working with the community to decrease health risks Studying vital statistics to determine their causes of death Making sure the population maintains immunizations

Working with the community to decrease health risks Global Rationale: Vulnerable populations are those who are at particular risk for compromised health as a result of lack of resources, beliefs, life experiences and circumstances, or dependency. The nurse can best assist vulnerable populations by identifying and working with them to decrease their risks. Researching genetic risks, studying vital statistics, and improving immunizations are all part of the solution, but the overarching priority action is to help the community decrease its risks.

The student learns that which is the best definition of a public health nurse? Works with the public Works in public areas Works with the greater community Works with public funding

Works with the greater community Global Rationale: Public health nursing examines the greater community as a whole—the city, county, state, nation, continent, world—and designs collaborative and interdisciplinary strategies to keep the population healthy by preventing or controlling disease and threats to human health. The other options are inaccurate.

When the nurse is dealing with the concept of beliefs and values, the nurse recognizes which type is based in the unconscious? Zero-order beliefs First-order beliefs Higher order beliefs Prejudices

Zero-order beliefs Three types of beliefs are recognized: zero-order beliefs, most of which are unconscious, such as object permanence; first-order beliefs, which are conscious, typically based on direct experiences; and higher order beliefs, which are generalizations or ideas that are derived from first-order beliefs and reasoning. A prejudice is a preformed opinion, usually an unfavorable one, about an entire group of people that is based on insufficient knowledge, irrational feelings, or inaccurate stereotypes.

Healthy coping strategies

exercise, balanced nutrition, mindfulness therapy

Compassion Fatigue

extreme distress experienced as a result of continued exposure to stress in the therapeutic use of self in caring for others.

Self-care includes?

maintenance of good physical and emotional health, yoga, meditation, and mindfulness- based stress reduction activities—is shown to help protect nurses from developing compassion fatigue.