HESI practice notes - nursings sciences

(1) rely on a combination of dietary, herbal, and other naturalistic therapies to prevent and treat illness (2) use yin treatment (which uses needles to restore balance and flow of qi) and yang treatment (which uses moxibustion or heat with acupuncture to restore the yin/yang balance) (3) use a combo of prayers, herbs, and other rituals to treat traditional illnesses (4) rely on a combo of prayers, chanting, and herbs to treat illnesses caused by supernatural, physiologic, and physical factors

-asian indians -east asians -hispanics -native americans

SOAP?

-includes assessment info or diagnoses based on data -subjective, objective, assessment, plan -originates from medical records

How should a nurse handle a client who blames and directs anger toward the nurse or others? . By listening to the client's concerns By continuing to speak of the reality of the situation By beginning to share information needed for the future By letting the client know that the nurse is available for discussion By reassuring family and significant others of the client's normalcy

1, 5

A registered nurse is teaching a nursing student about evidence-based practice. Which statements should the nurse include in the teaching? "The funding source is usually external, such as a grant." "Evidence-based practice is conducted by practicing nurses and other healthcare team members." "Institutional review board approval is not needed to implement evidence-based practice." "Evidence-based practice uses information drawn from research to determine safe and effective nursing care." "Evidence is generated to find the answers for questions that are unknown about nursing practice."

2, 3, 4

A nursing student is recalling the Stage-Crisis Theory of Robert Havinghurst. Which step listed by the nursing student needs correction according to Havinghurst theory? The number of tasks differs in each age level for individuals. There are six stages and six-to-ten developmental tasks for each stage. Successful resolution of the developmental task is essential to successful progression throughout life. This theory includes four periods that are related to age and demonstrates specific categories of knowing and understanding.

4

________ database is a good source of biomedical and pharmaceutical studies

EMBASE

a standardized survey developed to measure client perceptions of their hospital experience. The survey asks 27 questions about the client's hospital experience. The survey is taken by clients who were discharged from the hospital between 48 hours and six weeks ago.

HCAHPS

______ includes studies in medicine, nursing, dentistry, psychiatry, veterinary medicine, and allied health

MEDLINE

created HEDIS to collect various data to measure the quality of care and services provided by different health plans. It is the database of choice for the Centers for Medicare and Medicaid Services.

NCQA (national committee for quality assurance)

(1) reviews the quality, quantity, and cost of hospital care (2) defined a list of 28 "Never Events" in health care. Death or injury due to medication error is an example of a "Never Event." (3) a group of 28 organizations from a variety of health care disciplines that work together to transform health care on a national level. (4) have utilization review committees to review admissions and identify and eliminate overuse of diagnostic and treatment services for clients on Medicare.

PSROs national quality forum national priorities partnership medicare-qualified hospitals

_______ is a good resource for pschology and psychology-related healthcare disciplines

PsychINFO

_____ is the health science library at the national library of medicine; this database offers free access to many journal articles

PubMed

the tendency of a person to hold his or her own beliefs superior to those of other people; causes biases and prejudices

ethnocentrism

_____ theory: -provides a basis for identifying and testing nurse caring behaviors to determine if caring will improve client health outcomes -provide a foundation of knowledge for nurses to direct and deliver caring nursing practices -defines five components of caring: knowing, being with, doing for, enabling, and maintaining belief -developed by Kristin Swanson by conducting extensive interviews with clients and their professional caregivers

Swanson's theory of caring

health belief model?

The first component is an individual's perception of susceptibility to an illness. The second component is an individual's perception of seriousness of an illness. The third component is the preventive actions taken by a person. The health promotion model focuses on behavioral outcomes, behavior-specific knowledge and affect, and individual characteristics and experience.

(1) used to determine the hours of care and staff required for a given group of clients (2) helps to assess data about a client; data includes vitals and routine repetitive care (3) based on an institution's standards of nursing practice and preprinted and established guidelines used to care for clients who have similar health problems (4) includes meds, diet, community resources, follow-up care, and med contact info in case of emergency or query *discharge documentation, acuity record, flow sheet, standardized care plan*

acuity record flow sheet standardized care plan discharge documentation

a nurse questions the staff about a change in a client's plan of care - what does this demonstrate?

authority

what are the three levels of critical thinking in nursing judgment?

basic critical thinking (nurse has faith that expert has right answer), complex critical thinking (nurse analyzes info from expert), commitment (make decisions without help from others)

(1) _______ research studies are initial studies that are conducted to develop or refine dimensions of phenomena or to develop a hypothesis about the relationships among phenomena. (2) _______ research focuses on determining the effectiveness of a program, practice, or policy. (3) _______ research focuses on measuring the characteristics of people, situations, or groups and the frequency with which certain events or characteristics occur. (4) _______ research aims to explore variables of interest without any active intervention by the researcher.

exploratory evaluation descriptive correlational

a record that contains descriptive and objective info about what a nurse sees, hearas, feels, and smells

factual record

-right task, right circumstances, right person, right direction/communication, right supervision/evaluation

five rights of delegation

what kind of theory is Neuman's system model?

grand theory

______ theory is organized into 14 basic needs of the whole person and includes phenomena from the following domains of the client: physiological, psychological, sociocultural, spiritual, and developmental

henderson's

what focuses on palliative care?

hospice

Which is an example of an actual nursing diagnosis? Risk for acute confusion Impaired social interaction Readiness for enhanced nutrition Readiness for increased family coping

impaired social interaction

theory focuses on stressors perceived by the client or caregiver.

neuman's system theory

internal or external factors: -intellectual background -family practices -cultural background -SES factors

only internal = intellectual

explains the factors within a client's living situation that support or interfere with his or her self-care ability

orem's self-care deficit theory

a record that communicates info in a logical order

organized record

domains of nursing intervention: (a) includes care that supports physical functioning (b) involves care that supports protection against harm (c) incorporates care that supports psychosocial functioning and facilitates lifestyle changes (d) includes electrolyte and acid-base management; physiologic complex, includes care that supports homeostatic regulation

1 4 3 2

A registered nurse is teaching a nursing student about systems theories with a specific reference to Neuman's systems theory. Which statements made by the nursing student post teaching are accurate? Select all that apply. 1. "Factors that change the environment also affect an open system." 2. "The components are interrelated and share a common purpose to form a whole." 3. "A system is composed of separate components and the components can be open or closed." 4. "Neuman's systems theory defines a total-person model of holism and a closed-systems approach." 5. "An open system interacts with the environment, with an exchange of information between the system and the environment."

1, 2, 5

A nursing student is learning about the nursing process, which consists of four components. Which scenarios should the nursing student consider as the 'input' component? "The nurse checks the client's health history for allergy to iodine before inserting a urinary catheter." "The nurse finds that the client's urine has presence of blood after the urinary catheter is removed." "The nurse checks if the client has a history of substance abuse before administering nasal medications." "The nurse finds that the client's skin color has changed to bluish purple after cold therapy is applied to reduce swelling." "The nurse checks the medical records of the client to know if he/she has had a rectal surgery in the past year before placing an internal fecal catheter."

1, 3, 5

Which points about nursing care and nursing practice have been accurately stated? Nursing theories help to describe, explain, predict, and/or prescribe nursing care measures. Expertise in nursing is a result of clinical experience and substantial knowledge is not required. The scientific work used in developing theories expands the scientific knowledge of the profession. Nursing theories offer inadequate rationales for how and why nurses perform specific interventions and for predicting client behaviors and outcomes. The expertise required to interpret clinical situations and make clinical judgments is the essence of nursing care and the basis for advancing nursing practice and nursing science.

1, 3, 5

A registered nurse is teaching a nursing student about nursing research. Which points mentioned by the nursing student post-teaching are accurate? "Research means to search again or to examine carefully." "Research is a theoretical process that only asks questions to generate knowledge." "Nursing research improves professional education and practice but does not lead to the effective use of resources." "Nursing research is a way to identify new knowledge, improve professional education and practice, and use resources effectively." "The knowledge that is generated provides a scientific basis for nursing practice and validates the effectiveness of nursing interventions."

1, 4, 5

A nursing student notes the characteristics of middle-range theories. Which points noted by the nursing student are accurate? Middle-range theories are systematic and broad in scope and complexity. Middle-range theories provide a basis to help nurses understand how clients cope with uncertainty and the illness response. Middle-range theories do not address a specific phenomenon and do not reflect practices such as administration, clinical, or teaching. Middle-range theories include Mishel's theory of uncertainty in illness, which focuses on a client's experiences with cancer while living with continual uncertainty. Middle-range theories tend to focus on a specific field of nursing (such as uncertainty, incontinence, social support, quality of life, and caring) rather than reflect on a wide variety of nursing care situations.

2, 4, 5

What makes a crisis access hospital (CAH) different from an intensive care unit (ICU)? It offers 24-hour emergency care. It offers health care to acutely ill people. It provides temporary care for 96 hours or less. It provides the most expensive health care delivery.

3

Which statement made by a nursing student about Swanson's theory of caring needs correction? 1. The components of Swanson's theory of caring provide a foundation of knowledge for nurses to direct and deliver caring nursing practices. 2. Swanson's theory of caring defines five components of caring: knowing, being with, doing for, enabling, and maintaining belief. 3. Swanson's theory of caring provides a basis to help nurses understand how clients cope with uncertainty and the illness response. 4. Swanson's theory of caring was developed by Kristin Swanson by conducting extensive interviews with clients and their professional caregivers.

3

Which statement about Orem's theory needs to be corrected? 1. It determines self-care needs. 2. It explains the types of nursing care. 3. It aids in the design of nursing interventions. 4. It describes factors supporting the health of the family.

4

The nurse decides to teach deep-breathing exercises to a client recovering from a surgery. Which professional responsibility does the nurse display? Advisory Advocacy Autonomy Caregiving

autonomy

which phase of erikson's includes self-care like feeding/dressing

autonomy vs shame/doubt

"all right" and "go on" are examples of? encourages client to give more details

back channeling

______ theory: the goal of nursing is to focus on a client's need for caring as a means of coping with stressors of illness

benner and wrubel

model of primacy of caring is the basis of _____ - focuses on client's need for caring as a means of coping with stresses of illness

benner and wrubel's theory

In __________, nurses living within a neighborhood provide services to older clients or those unable to leave their homes. Health promotion throughout a school curriculum is provided by school health. Nurse-managed clinics provide nursing services with a focus on health promotion and education, chronic disease assessment management, and support for self-care and caregivers. Community health centers are outpatient clinics that provide primary care to a client population living in a community.

block and parish nursing

_____ has the ability to establish an appropriate care plan based on the assessment of clients and families

case manager

what type of questioning is asking a pt to rate pain on scale of 0 to 10?

close ended

the nurse prepares a _______ record by providing a complete and appropriate record that includes all essential info

complete

occurs when a nurse or health care provider ignores the differences b/w his or her own culture and others and imposes his or her beliefs on people of other cultures

cultural imposition

________ theories describe a phenomenon such as grief or caring

descriptive

(1) refers to analysis of the client's biological and psychosocial data to find out the relevant issues and problems (2) the procedure of assessing the desired outcomes of treatment. (3) done at the very beginning when the nurse collects the data about the client to make an accurate diagnosis. (4) giving a shot

diagnosis evaluation assessment implementation

In which process of Swanson's theory is the nurse engaging when explaining neonatal care to a parent? Enabling Knowing Doing for Being with

enabling

According to Swanson's theory, the nurse is engaging in ______ when explaining the care of a neonate to a parent. ________ includes informing/explaining/supporting/allowing, focusing, generating alternatives, validating, and giving feedback. The process of _______ includes avoiding assumptions, centering on the one being cared for, assessing thoroughly, seeking cues, and engaging the self or both. The process of ______ for includes comforting, anticipating, performing skillfully, protecting, and preserving dignity. The process of ______ with includes being there, conveying ability, sharing feelings, and not burdening.

enabling knowing doing being

(1) comprises 14 basic needs of the whole person and includes phenomena from the following domains of the client: physiological, psychological, sociocultural, spiritual, and developmental (2) focuses on the client's self-care needs (3) based on stress and the client's reaction to the stressor. (4) includes the suggestion that nurses do not need to know all about the disease process differentiated nursing from medicine.

henderson's theory orem's self care deficit theory neuman's systems model nightingale's concept of the environment

In experimental research, the investigator controls the study variable and randomly assigns subjects to different conditions to test the variable. In ______ research, studies are designed to establish facts and relationships concerning past events. In evaluation research, studies test how well a program, practice, or policy is working. _______ research is an initial study designed to develop or refine the dimensions of phenomena or to develop or refine a hypothesis about the relationships among phenomena.

historical, exploratory

content vs feedback vs output? (1) data or info from client's assessment (2) serves to inform a system about how it functions (3) product and info obtained from the system (4) end product of a system

input feedback content output

(1) an inaccurate match b/w clinical cues and the nursing diagnosis, using insufficient number of cues, using unreliable cues (2) failure to validate data (3) includes inaccurate data, missing data, disorganization (4) includes insufficient cluster of cues, premature or early closure, or incorrect clustering

interpreting error labeling error collecting errors errors at clustering level

(1) 0-18 inches is distance, example is changing perineum dressing (2) lecturing students (3) client's bedside taking history or teaching client individually (4) special care needed

intimate zone public zone personal zone vulnerable zone

_____ theory: the goal of nursing is to use communication to help the client reestablish a positive adaptation to his or her environment

king's theory

state-operated program that provides long-term care to low-income families and disabled older clients

medicaid

______ theories provide a basis to help nurses understand how clients cope with uncertainty and the illness response

middle-range

focuses on a client's experiences with cancer while living with continual uncertainty.

mishel's theory of uncertainty in illness

what theory is based on stress ann the client's reaction to the stressor?

neuman's theory

______ theory: the goal of nursing is to facilitate the reparative processes of the body by manipulating

nightingale's

______'s theory focuses on nursing by caring through the environment. Nightingale's theory is oriented toward providing fresh air, light, warmth, cleanliness, quiet, and adequate nutrition. Nightingale's theory focuses on helping the client deal with the symptoms and changes in function related to an illness. Nightingale's theory does not limit nursing to the administration of medications and treatment. Nightingale's theory suggests that nurses do not need to know all about the disease process, which differentiates nursing from medicine.

nightingale's theory of

_______ theory: -explains the factors within a client's living situation -these factors may support or interfere with the client's self-care abilities, but they do not refer to the family's health -this theory interprets data that determine a client's self-care needs, self-care deficits, and self-care abilities -explains, predicts, or describes nursing care that will help the client in bettering his or her health -aids in the design of nursing interventions for the promotion of self-care by the client during times of illness, such as asthma, diabetes mellitus, or arthritis

orem's theory

who benefits from medicare?

people 65 and older

_____ theory: the goal of nursing is to develop and interaction b/w nurse and client; interpersonal relationships b/w nurse, client, and client's family

peplau's theory

maslow's hierarchy of needs

physiological safety belonging/love esteem self-actualization

*helping relationships phases:* (1) when the nurse collects medical data from the client's caregivers (2) when the nurse motivates the client to exercise self-exploration about his or her own health condition (3) when nurse tries to form a healthy relationship with the client (4) when the nurse winds up the conversation and evaluates goal achievements with the client

preinteraction phase working phase orientation phase termination phase

what theory is action-oriented?

prescriptive

(1) ________ theories detail nursing interventions for a specific phenomenon and the expected outcome of the care (2) ________ theories provide the structural framework for broad, abstract ideas about nursing (3) ________ theories identify conditions or factors that predict a phenomenon (4) ________ theories help to explain client assessments.

prescriptive grand predictive descriptive

which theory describes nursing interventions fora specific phenomenon and the expected outcome of care? -grand theories -predictive theories -descriptive theories -prescriptive theories

prescriptive theories

-theory focused on the prescribed medication under particular circumstances -nursing-intervention specific

prescriptive theory

question type? -asking whether anything else is bothering the client

probing

what kind of approach is evidence-based care?

problem solving

evidence-based care = ?

problem-solving approach

Providing short-term relief to the family caregiver aka?

respite care, used with hospice

what model views the client as an adaptive system - the need for care occurs when a client cannot adapt to internal and external environmental demands -goal of nursing is ot help a person adapt

roy adaptation model

a data-driven approach to process improvement that reduces variation in the process

six sigma

*types of children?* (1) adapts slowly with frequent communication and reacts to novelty with mild but passive resistance (2) highly active, irritable, irregular habits (3) regular and predictable habits (4) reacts negatively with mild intensity to new stimuli

slow to warm up difficult easy slow to warm up

any stimuli that can produce tension and cause instability within the system

stressor

provides a basis for identifying and testing nursing care behaviors to determine if caring improves patient health outcomes

swanson's thoery of nursing

focuses on the improvement of processes. It studies each step of a process to determine if that step adds value to that process. It also determines if the process reduces the organization's time, cost, and resources

value stream analysis

theory that involves assisting client sin attaining health, maintaining health, and dying peacefully

watson's theory

what theory defines the outcome of nursing activity in regard to the HUMANISTIC aspects of life and promotes health, restoring the client to health, and preventing illness

watson's theory of transpersonal caring