Foundations of Nursing - Unit 6 Exam

Describe the nursing process and nursing care for a client with anxiety and depression LO 5 - 4 questions

-Anxiety tool: GAD-7 "How difficult have those problems made if for you to do your work, take care of things at home, or get along with other people?" -Depression Assessment Continuum: Mild: -Mood: Sadness -Behavior: Crying -Thoughts: Distractedness -Physical manifestations: low energy Severe: -Mood: Emptiness, total despair -Behavior: Psychomotor retardation -Thoughts: Delusions, confusion, self-blame -Physical manifestations: Anorexia, insomnia, poor hygiene -Depression tool: PHQ-9 -Suicide screening -AsQ suicide screening questions

A nurse manager is reviewing self-concept assessment findings with their staff. List at least six expected findings.

-Cultural background -Quality of relationships -Feelings related to recent body image changes, self-concept, and issues of sexuality -Coping mechanisms used in the past -Expectations -Posture -Appearance -Demeanor -Eye contact -Grooming -Unusual behavior

Discuss the factors that affect nutrition LO 4 - 2 questions

-Educational level -Eating for health: focus on the caveman, 'paleo' eating -Medications: potassium supplementation, stimulants decrease appetite -Knowledge of nutrition: includes access to educational materials -Lifestyle choice: dietary patterns, work environment, cooking methods, oral contraceptive use, using food to relieve stress, tobacco use, alcohol, caffeine intake -Vegetarianism: semi-vegetarians, ovo-lacto vegetarians, lacto vegetarians, vegans, fruitarians, complete proteins, supplementation -Eating for weight loss -Ethnic, cultural, and religious practices -Disease processes and functional limitations -Special diets

Discuss the concept of energy balance and the impact on health LO 3 - 0 questions

-Energy in nutrients measure in calories -Calories "in" must equal calories burned -too few calories/nutrients = undernourished -Too many calories = obesity Carbs= 4 calories per gram Protein= 4 calories per gram Fats= 9 calories per gram BMR: Basal metabolic rate -Amount of energy required at rest *Factors affecting includes: -Environment, body temp -Shivering -Illness, infections -Growth periods -Physical exertion, strenuous exercise Total energy needs: -Replacing calories used for BMR+physical activity

Describe nursing interventions designed to achieve identified goals for the client with altered self-concept LO 2 - 2 questions

-Impaired adjustment -Complicated grieving -Deficient knowledge -Hopelessness -Impaired social interaction -Sexual dysfunction -Ineffective coping -Powerlessness -Social isolation -Chronic low self-esteem -Disturbed personal identity -Disturbed body image These interventions assist with: -Anger control -Anxiety reduction -Coping enhancement -Decision-making -Socialization -Family involvement support Psychosocial diagnoses: must determine cause and effect -Interrupted family processes -Family coping -Parental role conflict -Ineffective individual coping -Post-trauma syndrome

Discuss factors that influence the bowel elimination process LO 1 - 2 questions

-Ingestion: to get something into the body, eating -Digestion: Breakdown of nutrients to be absorbed into the bloodstream -Along the way: peristalsis, flatus, bile -Water reabsorption: stool is 75% water, 25% solids 1. Fecal material reaches rectum 2. Stretch receptors initiate contraction of sigmoid colon/rectal muscles 3. Internal anal sphincter relaxes 4. Sensory impulses cause voluntary "bearing down", valsalva maneuver 5. External sphincter relaxes

Discuss ways economic factors influence nursing practice, family care and access to services especially in the older adult LO 3 - 2 questions

-Poverty -Unemployment -Inadequate or lack of health insurance -Teenage pregnancy -Overall economic climate -Infectious diseases -Chronic illness and disability -Homelessness -Violence and neglect within families

Determine current nutritional guidelines from reliable sources LO 1 - 1 question

1. Follow on a healthy eating pattern across the lifespan 2. Focus on variety, nutrient density, and amount 3. Limit calories from added sugars and saturated fats and reduce sodium intake 4. Shift to healthier food and beverage choices 5. Support healthy eating patterns for all Other sources: -ChooseMyPlate.org -Daily references intakes -Nutritional facts label

Which statement by a dying client reflects Kübler-Ross's stage of depression in the grief process? A. "I am upset that I will not be here for my daughters wedding." B. "I wrote a letter to be read by my daughter on the day of her wedding." C. "I just need to get a little stronger so I can go to my daughter's wedding." D. "I don't care if I die as long as I live long enough to see my daughter married."

A. "I am upset that I will not be here for my daughters wedding."

A 70 year old client tells the nurse about experiencing problems with sleep and requests sleeping medication. Which concept associated with drug therapy and quality of sleep is important for the nurse to explain when providing nursing care for this client? A. "Sedatives are not well tolerated by older adults" B. "Antianxiety drugs are the least helpful to support sleep" C. "Effectiveness of hypnotics increases with prolonged use" D. "Melatonin is the drug of choice for long term use in sleep disorders"

A. "Sedatives are not well tolerated by older adults"

A nurse utilizing the HOPE approach to spiritual assessment would ask which questions when addressing the "H" part of the method? (Select all that apply) A. "What are your sources of internal support?" B. "Do you belong to a religious or spiritual community?" C. "Do you believe in God?" D. "What do you hold on to to get through your difficult times?" E. "Has your illness affected your relationship with God?"

A. "What are your sources of internal support?" D. "What do you hold on to to get through your difficult times?"

A dying client says to the nurse, "I know I am dying, and what scare me the most is I don't know what is going to happen on the other side. Do you believe that there is a heaven and a hell?" Which is an appropriate response by the nurse? (Select all that apply) A. "What do you think about heaven and hell?" B. "I really don't know, I have not thought about it." C. "Does your religion have theories about heaven and hell?" D. "This is a topic you should explore with your spiritual advisor." E. "I practice a religion that supports concepts about heaven and hell."

A. "What do you think about heaven and hell?"

A hospice nurse is providing emotional support for eight young children of a dying mother. At which age do children first recognize that death is irreversible, universal, and natural? A. 9 years of age B. 6 years of age C. 15 years of age D. 12 years of age

A. 9 years of age

Which factors are beyond the control of the client in relation to self-concept? (Select all that apply) A. Age B. Sex C. Lifestyle D. Body image E. Developmental level

A. Age B. Sex E. Developmental level

In which ways can surgery or procedures contribute to sluggish bowel elimination? (Select all that apply) A. Anesthesia B. Increased IV fluids C. Stress D. Decreased mobility E. Manipulation of the bowel

A. Anesthesia C. Stress D. Decreased mobility E. Manipulation of the bowel

When the nurse assesses an adults client, which client behavior may indicate an unresolved developmental task of infancy? A. Avoiding assistance from others B. Rationalizing unacceptable behaviors C. Being overly concerned about cleanliness D. Apologizing constantly for small mistakes

A. Avoiding assistance from others

What are the parts of a comprehensive nutritional assessment? (Select all that apply) A. Body composition B. Dietary history C. Laboratory findings D. Body surface area E. Physical assessment

A. Body composition B. Dietary history C. Laboratory findings E. Physical assessment

A nurse is discussing essential nutrients for normal functioning of the nervous system with a client. Which of the following should the nurse include in the teaching? (Select all that apply) A. Calcium B. Thiamin C. Vitamin B8 D. Sodium E. Phosphorus

A. Calcium B. Thiamin C. Vitamin B8 D. Sodium

Which is a person referring to when during an interview the person says, "I am a member of the sandwich generation"? A. Cares for children and aging parents at the same time B. Has reversed roles between parents and self C. Assists own parents and spouse's parents D. Has both older and younger siblings

A. Cares for children and aging parents at the same time

What is the consequence when the nurse denies a client the use of a defense mechanism? A. Causes more anxiety B. Precipitates withdrawal C. Facilitates effective coping D. Encourages emotional growth

A. Causes more anxiety

A nurse is conducting a family health assessment and wants to use a genogram. The genogram, constructed with a diagram that evaluates each family member's health risks, includes what information? (Select all that apply) A. Causes of death B. Important health problems C. Infections D. Neighborhood lived in E. Occupations F. Finances

A. Causes of death B. Important health problems C. Infections E. Occupations

The nurse is reviewing the medical record of a client who has not had a bowel movement for 3 days. What factors are concerning? (Select all that apply) A. Client is on bedrest B. Client is in a semi-private room C. Client took a laxative prior to hospitalization D. Client is receiving an iron supplement E. Client has not eaten for 48 hours

A. Client is on bedrest B. Client is in a semi-private room C. Client took a laxative prior to hospitalization D. Client is receiving an iron supplement E. Client has not eaten for 48 hours

A client has been hospitalized for 4 weeks with aggressive therapy for lung cancer. She has become very withdrawn, refuses visitors, and does not participate in personal grooming. Which activity should be encouraged? A. Contacting a support group and psychological consultation B. Getting washed and dressed independently C. Becoming more physically independent and returning to prior activities D. Thinking positively about the treatments

A. Contacting a support group and psychological consultation

A nurse is caring for a client who is experiencing diarrhea. Which physiological response to diarrhea should the nurse be most concerned about? A. Dehydration B. Malnutrition C. Excoriated skin D. Urinary incontinence

A. Dehydration

A man with a heart condition continues to perform strenuous sports against medical advice. Which defense mechanism does the nurse identify the client is using? A. Denial B. Repression C. Introjection D. Dissociation

A. Denial

What does the nurse know is true about depression? (Select all that apply) A. Depression is more common in women B. Once depression is cured, it does not return C. Depression is associated with low socioeconomic status D. Medication is the answer for those with depression E. Spiritual anguish has been noted in clients with depression

A. Depression is more common in women C. Depression is associated with low socioeconomic status E. Spiritual anguish has been noted in clients with depression

A nurse is caring for a client for the first time. Which is the initial intervention that should be performed by the nurse before planning to meet the hygiene needs of this client? A. Determine the client's preferences about hygiene practices B. Assess the client's ability to assist with hygiene activities C. Collect the client's toiletries needed for the bath D. Ensure the client's bathroom will be available

A. Determine the client's preferences about hygiene practices

A nurse discourages a client from straining excessively when attempting to have a bowel movement. Which undesirable physiological response is the primary reason why straining on defecation should be avoided? A. Dysrhythmia B. Incontinence C. Fecal impaction D. Rectal hemorrhoid

A. Dysrhythmia

A school nurse is preparing a health class about vitamins. Which information about vitamins that is based on a scientific principle should the nurse include? A. Eating a variety of foods prevents the need for supplements B. Megadoses of vitamins have proved to be most effective in preventing illness C. Taking a prescribed vitamin supplement is the best way to ensure adequate intake D. Vitamins that are more expensive are purer than those that are less expensive

A. Eating a variety of foods prevents the need for supplements

A client is admitted to the hospital with a history of liver dysfunction associated with hepatitis. Which metabolic problem does the nurse anticipate that this client may have a problem? A. Emulsifying fats B. Digesting carbohydrates C. Manufacturing red blood cells D. Reabsorbing water in the intestines

A. Emulsifying fats

A nurse overhears two health-care personnel having a conversation. One person says to the other, "I think that turning that Muslim woman's bed toward mecca is bizarre." Which specific barrier to culturally competent care is demonstrated by the statement? A. Ethnocentrism B. Chauvinism C. Racism D. Sexism

A. Ethnocentrism

A new nurse is learning about the three perspectives of family nursing. What do these perspectives include? (Select all that apply) A. Family as the context of care B. Family as an interactional unit C. Family as the unit of care D. Family as a system E. Family as a developmental process F. Family with maladaptive coping mechanisms

A. Family as the context of care C. Family as the unit of care D. Family as a system

Which are common disorders that are primary causes of bowel function? (Select all that apply) A. Food allergies B. Diverticulosis C. Pneumonia D. Seasonal allergies E. Food intolerance

A. Food allergies B. Diverticulosis E. Food intolerance

Which objective measures can a nurse use to assess a person's dietary history. (Select all that apply) A. Food questionnaire B. 3-day food record diary C. 24-hour memory recall D. Ask about diet E. Measure body composition

A. Food questionnaire B. 3-day food record diary C. 24-hour memory recall

Which are included as part of the USDA dietary guidelines? (Select all that apply) A. Food safety B. Adequate exercise C. Immunization schedules D. BMI chart E. Choosing a nutritious diet

A. Food safety B. Adequate exercise E. Choosing a nutritious diet

A client is given the instructions to avoid eating before bedtime, keep the head of the bed elevated at 30 to 40 degrees, and to avoid fatty foods, chocolate, and smoking. Which impaired digestive function is most likely for this client? A. Gastroesophageal reflux B. Decreased gastric secretions C. Glucose intolerance D. Decreased intestinal peristalsis

A. Gastroesophageal reflux

Which outcome of the options presented is most appropriate for a client with perceived constipation? A. Have a bowel movement without the use of a laxative B. Explain the rationale for the use of laxatives C. Drink 8 glasses of water per day D. Defecate every day

A. Have a bowel movement without the use of a laxative

The nurse is teaching a client with newly diagnosed diabetes about dietary changes. The client says she is a strict vegetarian for religious reasons. The client may be a follower of which religion? (Select all that apply) A. Hinduism B. Mormonism C. Islam D. Buddhism E. Seventh Day Adventism

A. Hinduism D. Buddhism E. Seventh Day Adventism

A school nurse is teaching a high school health class about the possible causes of a negative nitrogen balance. Which of the following causes should the nurse include in the teaching? (Select all that apply) A. Illness B. Malnutrition C. Adolescence D. Trauma E. Pregnancy

A. Illness B. Malnutrition D. Trauma

A nurse is teaching a group of female clients about risk factors for developing osteoporosis. Which of the following risk factors should the nurse include? (Select all that apply) A. Inactivity B. Family history C. Obesity D. Hyperlipidemia E. Cigarette smoking

A. Inactivity B. Family history E. Cigarette smoking .

A client without any identified current health problems is having a yearly physical examination. The laboratory results indicate the presence of ketosis. Which rational explains the presence of ketosis in this otherwise healthy adult? A. Inadequate intake of carbohydrates B. Increased intake of protein C. Excessive intake of starch D. Decreased intake of fiber

A. Inadequate intake of carbohydrates

Which should be included in client teaching to support normal bowel elimination? (Select all that apply) A. Increase fluid intake B. Limit fiber intake C. Increase caffeine intake D. Increase physical activity E. Do not ignore the urge to defecate

A. Increase fluid intake D. Increase physical activity E. Do not ignore the urge to defecate

Which action is most appropriate for a client experiencing constipation? (Select all that apply) A. Increase intake of beans and legumes B. Increase intake of lean meats C. Increase intake of fruits and vegetables D. Increase intake of bread and pasta E. Increase intake of milk and cheese

A. Increase intake of beans and legumes C. Increase intake of fruits and vegetables

Which defense mechanism is being used when the client who has just been diagnosed with terminal cancer calmly says to the nurse, "I'll have to get on the internet to assess my options"? A. Intellectualization B. Introjection C. Depression D. Denial

A. Intellectualization

A charge nurse is conducting a nutritional class for a group of newly licensed nurses regarding basal metabolic rate (BMR). The charge nurse should inform the class that which of the following factors increases BMR? (Select all that apply) A. Lactation B. Prolonged stress C. Malnutrition D. Puberty E. Age older than 60 years

A. Lactation B. Prolonged stress D. Puberty

Which disorders place the client at a higher risk for abusing substances? (Select all that apply) A. Mood disorders B. Conduct disorders C. Anxiety disorders D. Neurological disorders E. Gastrointestinal disorders

A. Mood disorders B. Conduct disorders C. Anxiety disorders

A nurse identifies that a client's colostomy stoma is pale. Which should the nurse do? A. Notify the surgeon B. Listen for bowel sounds C. Wash the area with warm water D. Gently massage around the soma

A. Notify the surgeon

A nurse is performing a nutrition assessment on a client. Which of the following clinical findings are suggestive of malnutrition? (Select all that apply) A. Poor wound healing B. Dry hair C. Blood pressure 130/80 mm Hg D. Weak hand grips E. Impaired coordination

A. Poor wound healing B. Dry hair D. Weak hand grips E. Impaired coordination

A nurse is caring for several clients who state that they faithfully practice the religion of either Orthodox Judaism or Islam. Which food custom common to both Islam and Orthodox Judaism should the nurse consider when meeting these clients' nutritional needs? A. Pork is prohibited in the diet B. Meat cannot be eaten on Fridays C. Special cookware is used for different meals D. Meat and dairy products are served at different times -

A. Pork is prohibited in the diet

A patient tells the nurse in the well child clinic that their 2 year old is trying to eat with a spoon and is making a mess. Which should the nurse encourage the parent to do? A. Praise and encourage the child while eating B. Provide finger foods until the child is older C. Feed the child along with the child's attempts at eating D. Take the spoon and feed the child until the child is more capable

A. Praise and encourage the child while eating

A nurse is conducting a nutrition class at a local community center Which of the following information should the nurse include in the teaching? A. Progress toward limiting saturated fat to 7% of total daily intake B. Good bowel function requires 35 g/day of fiber for females C. Limit cholesterol consumption to 400 mg/day D. Normal functioning cardiac systems depends on B-complex vitamins

A. Progress toward limiting saturated fat to 7% of total daily intake

Which are functions of body fat? (Select all that apply) A. Protection of vital organs B. Produces blood cells C. Essential to cell metabolism D. Enables nerve-impulse transmission E. Helps eliminate wastes

A. Protection of vital organs C. Essential to cell metabolism D. Enables nerve-impulse transmission

Which nutrients are needed to repair and maintain cells? A. Proteins B. Carbohydrates C. Lipids D. Vitamins

A. Proteins

Which are ways the nurse can promote regular defecation for clients? (Select all that apply) A. Provide privacy B. Remind the client that constipation could occur if he or she does not defecate regularly C. Take a matter of fact straightforward approach D. Control odors to prevent embarrassment E. Accompany the client and provide encouragement while he or she is attempting defecation

A. Provide privacy C. Take a matter of fact straightforward approach D. Control odors to prevent embarrassment

A woman with diabetes does not follow her prescribed diet and states, "Everyone with diabetes cheats on their diet." Which defense mechanism does the nurse identify this client is using? A. Rationalization B. Sublimation C. Undoing D. Denial

A. Rationalization

To promote wound healing, the nurse is teaching a patient about choosing foods containing protein. Which foods are incomplete proteins that should be consumed with a complementary protein? (Select all that apply) A. Refried beans B. Peanut butter C. Cheese D. Whole grain bread E. Turkey

A. Refried beans B. Peanut butter D. Whole grain bread

A client expresses a sense of hopelessness. Which concern identified by the nurse is the priority? A. Risk for self-harm B. Inability to cope C. Powerlessness D. Fatigue

A. Risk for self-harm

A 35-year-old patient diagnosed with Hodgkin's lymphoma is undergoing chemotherapy, which leaves her unable to help care for her three young children. As a result, her husband has missed work often to care for her and the children. This leaves her feeling that she is not doing her part for the family. Which best describes this situation? A. Role performance B. Personal identity C. Anxiety D. Body image

A. Role performance

A newly divorced parent of two children reports working full-time and returning to school to obtain a higher degree. He or she says it is difficult to meet the demands of life. Which role performance difficulty is this client experiencing? A. Role strain B. Interrole conflict C. Role expectations D. Interpersonal role conflict

A. Role strain

Which examples define a family? (Select all that apply) A. Single parents B. Blended stepfamilies C. A married couple with children D. A married couple without children E. A lesbian couple without children

A. Single parents B. Blended stepfamilies C. A married couple with children D. A married couple without children E. A lesbian couple without children

A nurse has started a new job working in family health and understands that the overall economic climate can be a major challenge. What family unit is most at risk for this challenge? A. Single-parent families B. A pregnant teenager who lives at home with her parents C. Families who have adequate health insurance D. A family member who is living with HIV

A. Single-parent families

The school nurse is preparing a presentation to a group of teenagers about how cognitive understanding affects body image. Which norms influence cognitive understanding? (Select all that apply) A. Social B. Family C. Cultural D. Genetic E. Gender

A. Social B. Family C. Cultural

Which are functions of water in the body? (Select all that apply) A. Solvent B. Nutrient C. Lubricant D. Carries oxygen E. Body structure and form

A. Solvent C. Lubricant E. Body structure and form

A nurse is teaching a client how to irrigate a colostomy. The client asks, "Why is it necessary to use the cone attachment to the irrigation catheter?" What information should the nurse include in a response to this question? A. Stops enema solution from flowing out of the bowel during the procedure B. Prevents prolapse of the bowel during evacuation of the solution C. Dilates the stoma so that the enema tube can be inserted D. Facilitates the elimination of drainage from the colon

A. Stops enema solution from flowing out of the bowel during the procedure

A home-care nurse working in a rural community determines that there is an underutilization of services by members of the community. Which does the nurse conclude is the most common cause for the underutilization of services? A. The culture of independence B. The varieties of ethnicity C. A decreased intelligence D. A disinterest in health

A. The culture of independence

A school nurse is teaching a group of students how to read food labels. Which of the following is a required component of food labels that the nurse should include in the teaching? (Select all that apply) A. Total carbohydrates B. Total fat C. Calories D. Magnesium E. Dietary fiber

A. Total carbohydrates B. Total fat C. Calories E. Dietary fiber

A primary health-care provider informs a client that the diagnosis is inoperable cancer and the prognosis is poor. After the primary health-care provider leaves the room, the client begins to cry. Which should the nurse do? A. Touch the clients hand to provide support B. Leave the room to give the client privacy to cry C. Telephone the client's family to inform them of the diagnosis D. Ask the client questions to encourage an expression of feelings

A. Touch the clients hand to provide support

Which chronic diseases or conditions can have a direct impact on nutritional needs? (Select all that apply) A. Traumatic injury B. Alcoholism C. Degenerative joint disease D. Viral illness E. Cognitive function

A. Traumatic injury B. Alcoholism E. Cognitive function

A nurse is conducting a nutritional class on minerals and electrolytes. The nurse should include which of the following foods is a major source of magnesium? A. Tuna B. Tomatoes C. Eggs D. Oranges

A. Tuna

A nurse identifies that a client has tarry stools. Which problem should the nurse conclude that the client is experiencing? A. Upper gastrointestinal bleeding B. Pancreatic dysfunction C. Lactulose intolerance D. Inadequate bile salts

A. Upper gastrointestinal bleeding

Which vitamin that does not require fat in the diet to be absorbed should a nurse teach a client about? A. Vitamin C B. Vitamin A C. Vitamin E D. Vitamin D

A. Vitamin C

A nurse is providing teaching to a client who follows vegan dietary practices. The nurse should instruct the client that there is a risk of having a deficit in which of the following nutrients? (Select all that apply) A. Vitamin D B. Fiber C. Calcium D. Vitamin B12 E. Whole grains

A. Vitamin D C. Calcium D. Vitamin B12

A nurse is preparing to administer a cleansing enema to an adult client in preparation for a diagnostic procedure. Which of the following steps should the nurse take? (Select all that apply) A. Warm the enema solution prior to installation B. Position the client on the left side with the right leg flexed forward C. Lubricate the rectal tube or nozzle D. Slowly insert the rectal tube about 5 cm (2 in) E. Hang the enema container 61 cm (24 in) about the client's anus

A. Warm the enema solution prior to installation B. Position the client on the left side with the right leg flexed forward C. Lubricate the rectal tube or nozzle

A nurse is teaching a client with a history of constipation about the excessive use of laxatives. Which effect of laxatives should the nurse include as the primary reason why their use should be avoided? A. Weakens the natural response to defecation B. Results in distention of the intestines C. Causes abdominal discomfort D. Precipitates incontinence

A. Weakens the natural response to defecation

Differentiate between anxiety and depression LO 4 - 2 questions

Anxiety: -Common emotional response to a (usually known) stressor -Results from psychological conflicts -Accompanied by physical symptoms -Can be mild, moderate, severe, disabling Depression: -Causes sadness or "the blues" -Occurs in all age groups -Be alert for risk factors -Is a psychiatric diagnosis -Consider suicide prevention strategies

A nurse is caring for a client who recently immigrated to the United States and who is not completely fluent in English. The nurse is discussing options for continuity of care after the client is discharged from the hospital. Which is the most appropriate response by the nurse after presenting various options? A. "Which seems to be the option that best meets your needs as you seem them?" B. "Do you have any questions regarding any of the options that we discussed?" C. "In light of your values and beliefs, I believe that home care might be the best option" D. "I think that you should take some time to discuss these options with your family members"

B. "Do you have any questions regarding any of the options that we discussed?"

Which client statement supports the nurse's conclusion that a client understand the need to reestablish bowel flora after a week of diarrhea? A. "I must wean myself off of the antibiotics one day after my temperature is normal." B. "I should eat a container of yogurt every day for a few days." C. "I have to add rice to my diet in one meal each day." D. "I ought to drink eight glasses of water a day."

B. "I should eat a container of yogurt every day for a few days."

A nurse is discussing the plan of care for a client who reports following Islamic practices. Which of the following statements by the nurse indicates culturally responsive care to the client? A. "I will make sure the menu includes kosher options." B. "I will ask the client if they want to schedule some times to pray during the day." C. "I will avoid discussing care when the client's family is around." D. "I will make sure daily communion is available for this client."

B. "I will ask the client if they want to schedule some times to pray during the day."

A nurse is teaching a group of clients how to care for their colostomies. Which of the following statements indicates an issue with self-concept? A. "I was having difficulty with attaching the appliance at first, but my partner was able to help." B. "I'll never be able to care for this at home. Can't you just send a nurse to the house?" C. "I met a neighbor who also has a colostomy, and they taught me a few things." D. "It can take me awhile to get the hang of this. I have to admit, I am pretty nervous."

B. "I'll never be able to care for this at home. Can't you just send a nurse to the house?"

A nurse in an ambulatory care clinic is caring for a client who had a mastectomy 6 months ago. The client tells the nurse that there has been a decreased desire for sexual relations since the surgery, stating, "My body is so different now." Which of the following responses should the nurse make? A. "Really you look just fine to me. There's no need to feel undesirable." B. "I'm interested in finding out more about how your body feels to you." C. "Consider an afternoon at the spa. A facial will make you feel more attractive." D. " It's still too soon to expect to feel normal. Give it a little more time."

B. "I'm interested in finding out more about how your body feels to you."

A nurse is caring for a client who is recovering from a myocardial infarction and a cardiac catheterization. The client states, "I am concerned that things might be a little, you know, 'different' with my partner when I get home." Which of the following statements should the nurse make? A. "Sounds like something you should discuss with them when you get home." B. "It sounds like you are concerned about sexual functioning. Let's discuss your concerns." C. "Oh, I wouldn't be too concerned. Things will be fine as soon as we get you home." D. "Just make sure you take your medication as directed, and you should be fine."

B. "It sounds like you are concerned about sexual functioning. Let's discuss your concerns."

A nurse is teaching a client about the positive effects of exercise to reduce anxiety. Which client comment about how exercise reduces anxiety indicates that the client understands the nurse's teaching? A. "It interferes with the ability to concentrate." B. "It stimulates the production of endorphins." C. "It reduces the metabolism of epinephrine." D. "It decreases the acidity of blood."

B. "It stimulates the production of endorphins."

A nurse is reviewing dietary recommendations with a group of clients at a health fair. Which of the following information should the nurse include? A. "Fats should be 5% to 15% of daily calorie intake." B. "Make protein 10% to 35% of total calories each day." C. "Consume 1,500 mL of water from liquids and solids daily." D. "The body needs 40 mg of iron each day."

B. "Make protein 10% to 35% of total calories each day."

A nurse caring for a woman who on admission stated that she belongs to a church that traditionally prohibits blood transfusions. However, the woman agreed to receive packed red blood cells as part of her medical regimen. The husband says to the nurse in the hall, "I can't believe that she is having packed red blood cells. We both have attended our church our whole lives, and now she is going against the convictions that we have had faith in for over 30 years." What is the best response by the nurse? A. "Do you think you could be as supportive as you can possibly need?" B. "This is a difficult topic. However, let's sit down and talk about it." C. "How do you feel about your wife's willingness to have a transfusion?" D. "Men don't always understand what women are going through. Ask her about how she feels."

B. "This is a difficult topic. However, let's sit down and talk about it."

A client who is withdrawn says, "When I have the opportunity, I am going to commit suicide." Which is the best response by the nurse? A. "You have a lovely family. They need you." B. "You must feel overwhelmed to want to kill yourself." C. "Let's explore the reasons you have for wanting to live." D. "Suicide does not solve problems. Tell me what is wrong."

B. "You must feel overwhelmed to want to kill yourself."

A nurse is caring for a group of clients on a medical-surgical unit. Which of the following clients are at increased risk for body-image disturbance? (Select all that apply) A. A client who had a laparoscopic appendectomy B. A client who had a mastectomy C. A client who had a left above-the-knee amputation D. A client who had a cardiac catheterization E. A client who had a stroke with right-sided hemiplegia

B. A client who had a mastectomy C. A client who had a left above-the-knee amputation E. A client who had a stroke with right-sided hemiplegia

A nurse is caring for several children on a pediatric unit. Children in which age group should the nurse expect will be most unstable and challenging with regard to the development of a personal identity? A. Toddlerhood B. Adolescence C. Childhood D. Infancy

B. Adolescence

A nurse is screening clients who are in various age groups for clinical manifestation of eating disorders. In which age group should the nurse expect more problems to become evident? A. Toddlerhood B. Adolescence C. Senescence D. Infancy

B. Adolescence

Which client behavior demonstrates an external locus of control? A. Taking responsibility for mistakes B. Blaming a corporation for getting the client fired C. Understanding drinking while driving can result in jail time D. Listening to his or her own intuition before making decisions

B. Blaming a corporation for getting the client fired

Undigested food first enters the large intestine through which structure? A. Duodenum B. Cecum C. Rectum D. Sigmoid colon

B. Cecum

While a nurse is administering a cleansing enema, the client reports abdominal cramping. Which of the following actions should the nurse take? A. Have the client hold their breath briefly and bear down B. Clamp the enema tubing C. Remind the client that cramping is common at this time D. Raise the level of the enema fluid container

B. Clamp the enema tubing

One of the participants attending a parenting seminar asks the nurse teaching the class, "What is the leading cause of death during the first year of life?" Besides exploring the person's concerns, what should the nurse respond? A. Sudden infant death syndrome B. Congenital malformations C. Unintentional injuries D. Short gestation

B. Congenital malformations

Which is the result of the passage of stool through the colon being slowed? A. Diarrhea B. Constipation C. Distention D. Ileus

B. Constipation

A nurse is using an interpreter to communicate with a client. Which of the following actions should the nurse use when communicating with a client and family members? (Select all that apply) A. Talk to the interpreter about the family while the family is in the room B. Determine client understanding several times during the conversation C. Look at the interpreter when asking the family questions D. Use lay terms if possible E. Do not interrupt the interpreter and the family as they talk

B. Determine client understanding several times during the conversation D. Use lay terms if possible E. Do not interrupt the interpreter and the family as they talk

A nurse is caring for clients with a variety of nutrition-related problems. Which problem should the nurse anticipate eventually may require a client to have a feeding tube inserted? A. Malabsorption syndrome B. Difficulty swallowing C. Stomatitis D. Vomiting

B. Difficulty swallowing

A nurse is educating a client who has anemia about dietary intake of iron. Which of the following is a non-heme source of iron? A. Ground beef B. Dried beans C. Salmon D. Turkey

B. Dried beans

Which action is important for the nurse to teach clients about the intake of bran to facilitate defecation? A. Ingest 3 tablespoons of bran each morning B. Drink at least 8 glasses of fluids daily when taking bran C. Attempt a bowel movement right after ingesting the bran D. Take a cathartic daily that will supplement the action of bran

B. Drink at least 8 glasses of fluids daily when taking bran

Which of the following statements are true? (Select all that apply) A. Cultural universals are unique beliefs of individuals within a culture B. Ethnicity is passed down through generations C. Cultural stereotypes are based on facts D. Race is groupings based on biological similarities E. Culture changes over time

B. Ethnicity is passed down through generations D. Race is groupings based on biological similarities E. Culture changes over time

The nurse is caring for a mother with three small children who has been admitted with a newly diagnosed chronic illness. The nurse would like to encourage communication between the parents about sharing household responsibilities and child care. What is the intention of this strategy for the client? A. Decreasing anxiety B. Facilitate role enhancement C. Prevent depersonalization D. Promote self-esteem

B. Facilitate role enhancement

A nurse determines that the teaching about a guaiac test of stool is understood when the client states that it identifies the presence of which of the following? A. Ova and parasites B. Hidden blood C. Bacteria D. Bile

B. Hidden blood

A nurse is assessing a client who has had diarrhea for 4 days. Which of the following findings should the nurse expect? (Select all that apply) A. Bradycardia B. Hypotension C. Elevated temperature D. Poor skin turgor E. Peripheral edema

B. Hypotension C. Elevated temperature D. Poor skin turgor

The nurse is interviewing a client who has lost his or her job and has increased his or her alcohol consumption to at least four to six drinks a day. Which nursing diagnosis is most appropriate for this client? A. Social isolation B. Ineffective coping C. Parental role conflict D. Posttraumatic stress disorder (PTSD)

B. Ineffective coping

The nurse is caring for an elderly client who is suddenly confused and disoriented. The client is usually alert and oriented to time, place, person, and situation. Which factors should the nurse assess for in the client's health record that could cause this change in mental status? (Select all that apply) A. Age B. Infections C. Dehydration D. Medications E. Recent loss of a spouse

B. Infections C. Dehydration D. Medications

A nurse is reviewing prescribed medications for a newly admitted client. Which of the following medications increases the body's rate of metabolism? A. Morphine B. Levothyroxine C. Phenobarbital D. Dilaudid

B. Levothyroxine

The nurse is preparing to interview a 25-year-old client who reports having problems at work. Which skills should the nurse incorporate into the interview to promote open communication with the client? (Select all that apply) A. Allowing emotions to show B. Maintaining the focus on the client C. Incorporating open-ended questions D. Being respectful of cultural details E. Being cognizant of self-imposed biases F. Permitting the client to control the interview direction

B. Maintaining the focus on the client C. Incorporating open-ended questions D. Being respectful of cultural details E. Being cognizant of self-imposed biases

Due to the growth of various populations, the United States is expected to become what type of nation by 2044? A. Mostly non-Hispanic Whites B. Majority-minority C. Mostly asians D. Mostly from the MENA region

B. Majority-minority

An older adult is admitted to the hospital for multiple health problems. Assessment reveals that the client has no teeth and is having difficulty eating. Which diet should the nurse encourage the primary health-care provider to prescribe for this client? A. Liquid supplements B. Mechanical soft C. Pureed D. Soft

B. Mechanical soft

Which are nutrients that are inorganic elements found in nature? A. Vitamins B. Minerals C. Proteins D. Carbohydrates

B. Minerals

A client is told that surgery is necessary. The client begins to experience elevations in pulse, respirations, and blood pressure. Which stage of anxiety is indicated by these nursing assessments? A. Mild B. Moderate C. Severe D. Panic

B. Moderate

A nurse on an orthopedic unit is reviewing data for a client who sustained trauma in a motor-vehicle crash. Which of the following values indicates the client is in a catabolic state (using protein faster than protein is being synthesized)? A. Blood albumin 3.5 g/dL B. Negative nitrogen balance C. BMI of 18.5 D. Blood prealbumin 15 mg/dL

B. Negative nitrogen balance

In caring for families with older adults, there are common health risk factors that a nurse must be aware of. What is the most important health risk for this family? A. Social isolation and loneliness B. Nutrition and hydration C. Falls and safety D. Forgetfulness and confusion

B. Nutrition and hydration

When researching the correlation between depression and health-related issues in older adults, what will the nurse find? (Select all that apply) A. Older adults with depression have increased longevity B. Older adults with depression report higher rates of physical ailments C. Older adults with depression present with greater functional impairments D. Older adults with depression have lower suicide rates than younger adults E. Older adults with depression tend to use health-care services more frequently

B. Older adults with depression report higher rates of physical ailments C. Older adults with depression present with greater functional impairments E. Older adults with depression tend to use health-care services more frequently

To provide appropriate nursing care, which concept about anxiety is important to consider? A. Panic attacks related to anxiety, which generally have a slow onset, can be prevented if identified early B. One can conceptualize anxiety as being similar to the health-illness continuum C. People who lead healthy lifestyles rarely experience anxiety D. Anxiety is an abnormal reaction to realistic danger

B. One can conceptualize anxiety as being similar to the health-illness continuum

A nurse is providing dietary teaching for a client who reports constipation. Which of the following foods should the nurse recommend? A. Macaroni and cheese B. One medium apple with skin C. One cup of plain yogurt D. Roast chicken and white rice

B. One medium apple with skin

The nurse is teaching a patient about the importance of reducing saturated fats in a cardiac diet. Which oils should the nurse recommend as options? (Select all that apply) A. Palm oil B. Peanut oil C. Cottonseed oil D. Coconut oil E. Olive oil

B. Peanut oil C. Cottonseed oil E. Olive oil

Which client should the nurse identify is at the highest risk when taking a drug that has a high teratogenic potential? A. Older adult man B. Pregnant woman C. Four year old child D. One month old infant

B. Pregnant woman

A school nurse is planning a health class about bodily functions. Which information should be included regarding the purpose of mucus in the gastrointestinal tract? A. Activates digestive enzymes B. Protects the gastric mucosa C. Enhances gastric acidity D. Emulsifies fats

B. Protects the gastric mucosa

A client is diagnosed with a vitamin A deficiency. The client loves pie for dessert. Which type of pie should the nurse encourage the client to ingest? A. Blueberry B. Pumpkin C. Cherry D. Pecan

B. Pumpkin

Which are common gastrointestinal symptoms suggestive of food allergy? (Select all that apply) A. Nausea B. Rash around the anus C. Excessive gas D. Intestinal bleeding E. Severe vomiting

B. Rash around the anus C. Excessive gas D. Intestinal bleeding

Which describes the updated revision of vitamins, minerals, proteins, and total calories that are thought to meet the needs of about 98% of a particular group? A. Daily reference intake B. Recommended daily allowance C. Adequate intakes D. Standards

B. Recommended daily allowance

A nurse is discussing health problems associated with nutrient deficiencies with a group of clients. Which of the following conditions is associated with a deficiency of vitamin C? (Select all that apply) A. Dysrhythmias B. Scurvy C. Pernicious anemia D. Megaloblastic anemia E. Bleeding gums

B. Scurvy E. Bleeding gums

A nurse is teaching an older adult who immigrated to the United States 10 years ago about foods that are low in sodium. Which is most important when teaching this client? A. Encourage the asking of questions B. Seek feedback that is measurable C. Use humor when appropriate D. Observe family interactions

B. Seek feedback that is measurable

A male client refuses to have a male nurse as a caregiver. The client tells the nurse in charge, "I don't want a man for a nurse. Nursing is a woman's job; they are great." Which of the following can be attributed to the client based on his statement? A. Racism B. Sexism C. Chauvinism D. Misogynism

B. Sexism

A client with a terminal illness, tells the nurse, "I have lived a long life. I am ready to go." Which is the nurse's best response? A. Offer the client a back rub B. Sit quietly by the client's bedside C. Tell the family about the client's statement D. Discuss with the client how dying is part of the life cycle

B. Sit quietly by the client's bedside

Which behaviors would the nurse expect to find in a client with dementia? (Select all that apply) A. Inability to concentrate B. Sleeping a lot during the day C. Difficulty finding correct words D. Slow to respond to verbal stimuli E. Answers questions inappropriately

B. Sleeping a lot during the day C. Difficulty finding correct words E. Answers questions inappropriately

A nurse educator is planning a program for new graduate nurses regarding various religions. Which aspects of Judaism does the nurse educator include? (Select all that apply) A. Sacred writings of scripture are from the bible B. The Sabbath is celebrated from sunset on Friday to sunset on Saturday C. Passover is celebrated in either March or April D. A rabbi is consulted for spiritual or dietary advice E. Foods must be kosher for some members of the Jewish fate F. Blood transfusions are never allowed

B. The Sabbath is celebrated from sunset on Friday to sunset on Saturday C. Passover is celebrated in either March or April D. A rabbi is consulted for spiritual or dietary advice E. Foods must be kosher for some members of the Jewish fate

A nurse is discussing how the body processes food with a client during a routine provider's visit. Which of the following statements should the nurse include? A. Glycerol can be broken down into glucose for use by the body B. The liver converts unused glucose into glycogen C. Excess fatty acids are stored in the muscle tissue D. The body uses glycogen for fat before using available ATP

B. The liver converts unused glucose into glycogen

What did Purnell define culture as? A. A unique way we view the world by what luggage we carry around in life B. The totality of socially transmitted behaviors, arts, beliefs, values, customs, and other characteristics of a population of people that guides their worldview and decision making C. The learned, shared, and transmitted knowledge of values and beliefs of a specific group that are transmitted from generation to generation D. The integrated pattern of thoughts, communications, actions, customs, beliefs, values, and institutions associated with racial, ethnic, religious, spiritual, biological, geographical, and sociological qualities

B. The totality of socially transmitted behaviors, arts, beliefs, values, customs, and other characteristics of a population of people that guides their worldview and decision making

A nurse in a clinic is caring for clients in a variety of age groups. Which age group should the nurse anticipate will have the highest potential to demonstrate regression when ill? A. Infants B. Toddlers C. Adolescents D. Young adults

B. Toddlers

Which are interventions used to manage and minimize the symptoms of dry mouth? (Select all that apply) A. Increase salt intake B. Use hard candy or gum C. Take frequent sips of water D. Use lip moisturizer E. Eat acidic foods

B. Use hard candy or gum C. Take frequent sips of water D. Use lip moisturizer

A nurse is caring for four clients who each engage in one of the following behaviors. Which of the following is based on a religious belief? A. Drinks lemon juice to treat hypertension B. Wears an amulet to chase away bad spirits C. Massages a foot to relieve migraine headache pain D. Brushes the teeth after every meal to prevent tooth decay

B. Wears an amulet to chase away bad spirits

A client is diagnosed with an intestinal infection after traveling to a developing country. The nurse should encourage the intake of which food to optimize the gut's normal flora, creating a healthier environment? A. Milk B. Yogurt C. Oatmeal D. Bread

B. Yogurt

A nurse identifies that according to Erikson, establishing relationships based on commitment mainly occurs in which stage of psychosocial development? A. Middle age adulthood B. Young adulthood C. Adolescence D. Infancy

B. Young adulthood

Water soluble vitamins: Vitamin C B-Complex (B vitamins as a whole ones like B6 & B12) Vitamin B 9-Folic Acid (Folate)-What is the recommended dose for this one? What is their primary action (function) and food sources effects of deficiency?

B12: -Metabolic reactions -Maintain myelin sheath -Hemoglobin synthesis Food sources: Dairy products, meat, poultry, fish, liver, milk, cheese, eggs Deficiency: Classic triad of glossitis, weakness, and ascending paresthesia, pernicious anemia, irreversible nerve damage, memory loss, dementia Folic acid: -Cellular metabolism -Neurotransmitter synthesis -Cell division -DNA synthesis -Hemoglobin formation Food sources: Green leafy vegetables, asparagus, liver, yeast, eggs, beans, fruits, enriched cereals Deficiency: Megaloblastic anemia, neural tube defects

Discuss nursing diagnoses, outcomes, and interventions utilized in managing bowel disorders LO 5 - 2 questions

Bowel incontinence: -External collection -Internal drainage devices -Bowel training program Bowel training program: -Plan program with the client -Increase fiber in diet gradually -Increase fluid intake to eight glasses of water per day -Establish a designated time for defecation -Privacy should be provided for the client -The treatment should be staged -The treatment may include a stool softener -The plan should be modified based on client results

Which statement by a client with an ileostomy alerts the nurse to the need for further education? A. "I don't expect to have much of a problem with fecal odor from the stoma." B. "I will have to take special precautions to protect my skin around the stoma." C. "I am going to have a bowel movement every morning when I irrigate the stoma." D. "I should avoid gas-forming foods like beans to limit funny noises from the stoma."

C. "I am going to have a bowel movement every morning when I irrigate the stoma."

The nurse is applying cultural concepts to community outreach work. Which statement by the nurse demonstrates correct understanding of cultural concepts? A. "Assimilation is the process of learning to become a member of a society or group." B. "I will provide care based on my cultural beliefs because they are more acceptable." C. "I believe new members in the community from Thailand are experiencing the acculturation process." D. "I can care for minority groups the same if they live in the same neighborhood."

C. "I believe new members in the community from Thailand are experiencing the acculturation process."

The nurse is caring for a client diagnosed with severe depression. Which statement made by the client should alert the nurse of an increased risk for suicide? A. "I don't understand why my spouse wants a divorce." B. "I am going to cancel my plans this weekend." C. "I have outlived my friends and spouse. There is nothing left for me in life." D. "I am so unhappy in my life. I have lost my job and my family due to gambling."

C. "I have outlived my friends and spouse. There is nothing left for me in life."

A young adult who is receiving chemotherapy for cancer says to the nurse, "I was brought up as a Christian by my parents, but since I have been on my own I have not practiced my religion. I guess I should get more involved again." Which is the best response by the nurse? A. "Which religion do you belong to?" B. "How long has it been since you went to church?" C. "What can I do to support your religious endeavors?" D. "When do you want me to call your spiritual advisor to come visit you?"

C. "What can I do to support your religious endeavors?"

A client who has a sorrowful and dejected facial expression says to the nurse, "I am very sorry for some of the things that I did in my early life." Which is the best response by the nurse A. "That was a long time ago, and it seems as though you have done many good things in your later life." B. "God is total love and forgives your past transgressions." C. "You seemed very sad as you shared that with me." D. "I want to do something to make you feel better.

C. "You seemed very sad as you shared that with me."

A nurse in a nutrition clinic is calculating body mass index (BMI) for several clients. The nurse should identify which of the following client BMIs as overweight? A. 24 B. 30 C. 27 D. 32

C. 27

Which age group should the nurse identify as being reflected in the following statement? "More time spent in bed, but less time is spent asleep." A. 2 year olds B. 40 year olds C. 70 year olds D. 14 year olds

C. 70 year olds

Which client is most likely to have the lowest self-concept and body image? A. A client of lower socioeconomic status B. A client who has just graduated college C. A client born with cerebral palsy who uses a walker D. A teenage client who excels in athletics in high school

C. A client born with cerebral palsy who uses a walker

Which concept is reflective of Erik Erikson's Theory of Personality Development? A. Defense mechanisms help people to cope with anxiety B. Moral maturity is a central theme in all stages of development C. Achievement of developmental goals is affected by the social environment D. Two continual processes, assimilation and accommodation, stimulate intellectual growth

C. Achievement of developmental goals is affected by the social environment

A pediatric nurse is caring for children of a variety of ages. Which group should the nurse anticipate will have the most problems sleeping as a result of multiple complex developmental factors? A. Infants B. Toddlers C. Adolescents D. Preschoolers

C. Adolescents

A nurse is assisting a client with morning care. Which is most important for the nurse to do when assisting the client with care of the hair? A. Use rubbing alcohol to remove tangles B. Ensure that the client's hair is left dry, not wet C. Ask the client what should be done with the hair D. Comb hair from the proximal to distal end of the hair shaft

C. Ask the client what should be done with the hair

Which describes the measure of energy used while at rest in a neutral temperature environment that is required for the heart, lungs, and brain to function optimally? A. Body mass index B. Calorie C. Basal metabolic rate D. Body composition analysis

C. Basal metabolic rate

Which metabolic process breaks larger particles into smaller ones and releases energy? A. Micronutrients B. Anabolism C. Catabolism D. Glycogenolysis

C. Catabolism

Parents with young children are concerned with safety, development, education, and nutrition. What is the most important risk to family health? A. Childcare services B. Marital relationships C. Communicable diseases D. Chronic illnesses

C. Communicable diseases

A nurse is counseling a client with the diagnosis of osteoporosis. In addition to calcium, which vitamin supplement should the nurse anticipate that the primary health-care provider will prescribe for this client? A. B B. K C. D D. E

C. D

A nurse is assessing a client who is admitted to the hospital with withdrawal from alcohol. Which effect of alcohol on the body will influence the client's plan of care? A. Interferes with the absorption of glucose B. Accelerates the absorption of medications C. Decreases the absorption of many important nutrients D. Lengthens passage time of stool through the intestinal tract

C. Decreases the absorption of many important nutrients

A nurse is caring for a group of clients. Which client factor should the nurse identify as placing a client at risk for bowel incontinence? A. Being ninety years old B. Taking a sedative for sleep C. Disoriented to time, place, and person D. Receiving multiple antibiotic medications

C. Disoriented to time, place, and person

Which word reflects the ability of a nurse to perceive a client's emotions accurately? A. Autonomy B. Sympathy C. Empathy D. Trust

C. Empathy

A nurse enters the room of a client who is crying while reading from a religious book and asks to be left alone. Which of the following actions should the nurse take? A. Contact the hospital's spiritual services B. Ask what is making the client cry C. Ensure no visitors or staff enter the room for a short time period D. Turn on the television for a distraction

C. Ensure no visitors or staff enter the room for a short time period

A client says to the nurse, "I'm the same age as my father when he died. Am I going to die of my cancer?" Which is the appropriate inference about what the client is experiencing? A. Grieving associated with the potential for death B. Powerlessness associated with feelings of being out of control C. Fear associated with the perceived threat to biological integrity D. Impaired coping associated with inadequate psychological resources

C. Fear associated with the perceived threat to biological integrity

A nurse is caring for a client who is confused and disoriented. Which type of food containing chicken is most appropriate for this client? A. Soup B. Salad C. Fingers D. Casserole

C. Fingers

Which procedure produces a surgical opening in the abdomen and bypasses the large intestine entirely? A. Sigmoid colostomy B. Kock pouch C. Ileostomy D. Loop colostomy

C. Ileostomy

What is the effect of physical activity on normal defecation? A. Increased physical activity can increase constipation B. Decreased physical activity can result in diarrhea C. Increased physical activity promotes normal defecation patterns D. Physical activity has no effect on defecation patterns

C. Increased physical activity promotes normal defecation patterns

A client is anorexic because of stomatitis related to chemotherapy. Which should the nurse be most concerned about when planning care for this client? A. Aspiration B. Dehydration C. Malnutrition D. constipation

C. Malnutrition

Which describes the body breaking down nutrients into chemical energy and then into usable energy? A. Intake B. Conversion C. Metabolism D. Synthesis

C. Metabolism

A nurse in the emergency department is assessing clients of various ages. Which age group should the nurse anticipate will have the most individual differences in appearance and behavior? A. Adolescents B. Older adults C. Middle age adults D. School age children

C. Middle age adults

Which individual does the nurse anticipate has the highest risk for problems with regulating body temperature? A. Toddler B. Teenager C. Older adult D. School age child

C. Older adult

A nurse must collect a specimen for the presence of pinworms. Which action is essential to ensure accuracy of the specimen? A. Press the sticky side of non-frosted cellophane tape across the anus before the client goes to bed at night B. Insert a swab beyond the internal anal sphincter and rotate it gently while removing it from the anus C. Perform the procedure the first thing in the morning before the first bowel movement D. Wash the rectal area gently with soap and water before performing the procedure

C. Perform the procedure the first thing in the morning before the first bowel movement

A client is scheduled for an elective abortion. Which is the best way for the nurse to reinforce this client's self-esteem needs? A. Supporting the use of defense mechanisms B. Encouraging social interaction with others C. Providing a nonjudgemental environment D. Employing a positive mental attitude

C. Providing a nonjudgemental environment

A nurse concludes that a woman is remembering only the good times after the death of her husband. Which defense mechanism is the woman using? A. Compensation B. Minimization C. Repression D. Regression

C. Repression

Which factors work together to form a client's self-concept? (Select all that apply) A. Phobias B. Beliefs and values C. Sexual performance D. Physical appearance E. Intellectual abilities F. Problem-solving abilities

C. Sexual performance D. Physical appearance E. Intellectual abilities F. Problem-solving abilities

Which assessment provides an estimate of a person's body fat content? A. Weight B. Percussion C. Skinfold measurements D. Basal metabolic rate

C. Skinfold measurements

Which mineral can contribute to heart disease, hypertension, and stroke if consumed in large amounts? A. Iron B. Magnesium C. Sodium D. Calcium

C. Sodium

A confused client becomes extremely upset. Which is the best action by the nurse? A. Speak louder with a lower-pitched voice B. Use touch to communicate caring and concern C. Talk to the client in a way that is simple and direct D. Administer medication to minimize the client's anxiety

C. Talk to the client in a way that is simple and direct

A 4 year old boy is admitted to the emergency department and diagnosed with leukemia. The parents are informed that their child has an excellent prognosis if treated with chemotherapy. The parents adamantly refuse drug therapy because it is not consistent with their religious beliefs. They believe that prayer can cure everything. Which should the nurse do? A. Encourage the parents to see the prayers of one of their churches clergy B. Explain to the parents how the chemotherapeutic regimen will cure the leukemia C. Talk with the nursing supervisor about referring this situation to the ethics committee D. Accept the decision based on the First Amendment of the Constitution of the United States

C. Talk with the nursing supervisor about referring this situation to the ethics committee

A client strongly states the desire to go to the hospital coffee shop for lunch regardless of hospital policy. Which does the nurse conclude that his behavior most likely reflects? A. Anger with the policies of the hospital B. Dissatisfaction with hospital meals C. The need to regain a little control D. A desire for a change of scenery

C. The need to regain a little control

Which of the following best describes an individual's self-concept? A. An understanding of how one is perceived by others B. A person's perception of his or her physical appearance C. The overall view a person has of oneself D. A perspective of one's role in society

C. The overall view a person has of oneself

A nurse is caring for two clients who report following the same religion. Which of the following information should the nurse consider when planning care for these clients? A. Members of the same religion share similar feelings about their religion B. A shared religious background generates mutual regard for one another C. The same religious beliefs can influence individuals differently D. The nurse and client should discuss the differences and commonalities in their beliefs

C. The same religious beliefs can influence individuals differently

A nurse is learning about family structures. What does the nurse understand a holistic definition of a family to be? A. Two or more related people living in the same household B. A group of people consisting of a wife, husband, and children C. Two or more individuals who provide physical, emotional, economic, or spiritual support to each other and may or may not be related by blood D. A group of grandparents, aunts, uncles, and cousins living in a single dwelling

C. Two or more individuals who provide physical, emotional, economic, or spiritual support to each other and may or may not be related by blood

Minerals: Sodium (Na) Potassium (K) Phosphorus (P) Magnesium (Mg) Calcium (Ca) What is their primary action (function) and food sources effects of deficiency or excess?

Calcium: -Bone and teeth formation -Blood clotting -Nerve conduction -Muscle contraction -Cellular metabolism -Heart action Food sources: Dairy products, sardines, green leafy vegetables, broccoli, whole grains, egg yolks, legumes, nuts, fortified products Deficiency: Bone loss, tetany, rickets, osteoporosis Excess: Kidney stones, constipation, intestinal pain

Energy Nutrients: Carbohydrates and fiber Protein Fats Do you know what nitrogen balance is (positive vs negative?) *Know primary action (function) and considerations, food sources labs considerations for each

Carbohydrates: primary energy source -Simple carbohydrates=sugars -Supply energy for muscle and organ function -Spare protein -Play a role in nutrition and metabolism -Food sources: corn syrup, honey, milk, table sugar, molasses, white flour, sugar cane, fruits, vegetables, grains, potatoes, beans, brown rice, legumes, whole grains, oats, fresh greens, fiber-rich cereals Proteins: tissue building, nitrogen balance, amino acids -Positive nitrogen balance: intake exceeds output, growth, pregnancy, tissue maintenance -Negative nitrogen balance: intake is less than output, illness, injury, malnutrition -Metabolism -Immune system function; lymphocytes -Fluid and acid-base balance -Secondary energy source Food sources: animal sources; meat, poultry, fish, eggs, and milk products, grains, nuts, legumes, seeds, vegetables

Identify family risk factors in five different stages of the family life span, especially the older adult LO 2 - 3 questions

Childless and childbearing couples: -Adapting to new roles creates stress -This can lead to maladaptive coping Families with young children: -Experience financial difficulties -Illness and injuries create risks to family health Families with adolescents and young adults: -Risk taking behaviors -Dealing with aging grandparents -Life transitions between dependence and independence

Discuss nursing diagnoses, outcomes, and interventions utilized in managing bowel disorders LO 5 - 2 questions

Common alterations in defecation: -Diarrhea -Constipation -Fecal impaction -Bowel diversions Managing diarrhea: -Monitor stools to quantify diarrhea -Assess and monitor for fluid imbalance -Monitor for alterations in perineal skin integrity -Proper dietary teaching: clear liquid, BRAT (Bananas, rice, applesauce, toast), foods to avoid = dairy, caffeine -Antidiarrheal medications *not recommended for acute diarrhea, lomotil imodium, teach clients about over-the-counter aids

Relate diagnostic lab values with nutritional status LO 5 - 3 questions

Complete physical examination: -General survey -Alterations in vital signs -Poor skin turgor, wound healing -Concave abdomen/ascites -Change in muscle mass Lab results: -Blood glucose: blood sugars, A1C, fuel available for cellular energy -Serum albumin: synthesized in the liver and constitutes 60% of total body protein -Prealbumin: better marker for acute change in the albumin -Transferrin: protein that binds with iron -Globulin: serum protein -BUN: end product of protein metabolism -Creatinine: end product of protein metabolism, loss of muscle mass indicates increased levels -Hemoglobin: iron

Identify the characteristics of culture, including their relationship to acculturation LO 2 - 3 questions

Concepts related to culture: -Socialization -Acculturation -Assimilation -Dominant culture -Subcultures -Minority groups Vulnerable populations as subcultures: -Homeless -Poor -Mentally ill -People with physical disabilities -Young -Elderly adults -Some ethnic and racial minority groups Acculturation is defined as a concurrent process of cultural and psychological change occurring when individuals or groups from one culture are placed into contact with another culture and acquire some of those new elements.

Identify types of health practices that may influence care of clients from various cultural backgrounds LO 3 - 2 questions

Culture of healthcare: -Indigenous healthcare system -Professional healthcare system Health and illness beliefs: -Scientific/biomedical -Magico-religious -Holistic Traditional and alternative healing: -Folk medicine: reservation life/healers/spiritual -Complementary medicine: professional/accepted practice -Alternative medicine: "instead of" ie. aromatherapy Possible effects: -When the practice is efficacious -When the practice is neutral -When the effects of a practice are unknown -When the practice is dysfunctional

A nurse is caring for a client who is 3 days postoperative following a below-the-knee amputation as a result of a motor-vehicle crash. Which of the following statements indicates that the client has a distorted body image? A. "I'll be able to function exactly as I did before the accident." B. "I just can't stop crying." C. "I am so mad at the guy who hit us. I wish he lost a leg." D. "I don't even want to look at my leg. You can check the dressing."

D. "I don't even want to look at my leg. You can check the dressing."

A nurse is caring for a client who tells the nurse that based on religious values and mandates, a blood transfusion is not an acceptable treatment option. Which of the following responses should the nurse make? A. "I believe in this case you should really make an exception and accept the blood transfusion." B. "I know your family would approve of your decision to have a blood transfusion." C. "Why does your religion mandate that you cannot receive any blood transfusions?" D. "Let's discuss the necessity for a blood transfusion with your religious and spiritual leaders and come to a reasonable solution."

D. "Let's discuss the necessity for a blood transfusion with your religious and spiritual leaders and come to a reasonable solution."

A nurse is caring for a client who recently was diagnosed with a terminal illness. The client says to the nurse, "I was told this morning that I have 3 to 6 months to live. I have to just keep the faith." Which response by the nurse is appropriate when considering the needs of this client? A. "You have a few months left. It's important that you make the most of the days you do have." B. "I am sorry to hear about your terminal illness. Let's talk about what the future holds for you." C. "You should get a second opinion. There may be additional medical interventions that can help you." D. "Some people express spiritual needs. Let me know if there is some way that I can help you meet similar needs."

D. "Some people express spiritual needs. Let me know if there is some way that I can help you meet similar needs."

The nurse is caring for a client scheduled for cancer surgery. In a discussion, the client reminds the nurse that he is a Jehovah's Witness. What should the nurse ask next? A. "Would you like a religious leader present during surgery?" B. "Do you want any religious symbols kept with you during surgery?" C. "Would you like to receive Holy Communion before surgery?" D. "Would you be opposed to blood transfusions?"

D. "Would you be opposed to blood transfusions?"

A nurse is discussing foods that are high in vitamin D with a client who is unable to be out in the sunlight. Which of the following should be included in the teaching? A. 1 cup steamed long-grain brown rice B. 6 medium raw strawberries C. 1/2 cup boiled brussel sprouts D. 2 large, poached eggs

D. 2 large, poached eggs

A nurse is teaching wellness to a church group. How many daily 8-ounce servings of water should be encouraged for normal bowel health? A. 10 to 12 servings B. 4 to 6 servings C. 8 to 10 servings D. 6 to 8 servings

D. 6 to 8 servings

A nurse identifies that a client is mildly anxious. Which assessment of the client supports this conclusion? A. Preoccupied B. Forgetful C. Fearful D. Alert

D. Alert

Which situation identified by the nurse reflects the defense mechanism of displacement? A. A woman is very nice to her mother-in-law, whom she secretly dislikes B. A man says that he is not so bad, so don't believe what they say about him C. An adolescent puts a poor grand on a test out of her mind when at her after-school job D. An older man gets angry with friends after family members attempt to talk with him about his illness

D. An older man gets angry with friends after family members attempt to talk with him about his illness

A client is admitted with lower gastrointestinal tract bleeding. Which characteristic of the client's stool should the nurse assess for that supports this medical diagnosis? A. Tarry stool B. Orange stool C. Green mucoid stool D. Bright red-tinged stool

D. Bright red-tinged stool

Which is an example of abnormal anxiety? A. Being startled by a snake when gardening B. Being scared of driving across a high bridge C. Feeling nervous before meeting new people D. Choosing to drive long distances due to fear of a plane crash

D. Choosing to drive long distances due to fear of a plane crash

The nurse is learning about the differences between spirituality, religion, and spiritual care. Which definition demonstrates that the nurse has a correct understanding of spirituality? A. A map that tells you what to believe and what values are important in life B. Discussions and theories related to God and God's relation to the world C. Doctrines about the human soul as it relates to death, judgment, and eternal life D. Core issues involving divine experiences on a daily basis that include faith, hope, and love

D. Core issues involving divine experiences on a daily basis that include faith, hope, and love

During digital removal of stool, which is the most serious complication the client is at risk of developing? A. Bleeding B. Decreased blood pressure C. Hypertension D. Decreased heart rate

D. Decreased heart rate

An occupational nurse is facilitating a group discussion on weight reduction. Which should the nurse explain is the most common contributing factor to obesity? A. Sedentary lifestyle B. Low metabolic rate C. Hormonal imbalance D. Excessive caloric intake

D. Excessive caloric intake

A nurse is teaching a client with a cardiac condition to avoid the Valsalva maneuver. Which should the nurse teach the client to do? A. Eat rice several times a week B. Take a cathartic on a regular basis C. Attempt to have a bowel movement every day D. Exhale while contracting the abdominal muscles

D. Exhale while contracting the abdominal muscles

An older adult tends to bruise easily, and the primary health-care provider recommends that the client eat foods high in vitamin K. In addition to teaching the client about food sources of vitamin K, the nurse should include nutrients that must be ingested for vitamin K to be absorbed. Which foods that increase the absorption of vitamin K should be included in the teaching plan? A. Carbohydrates B. Starches C. Proteins D. Fats

D. Fats

A school nurse is teaching a class of adolescents about nutrition. Which age group should the nurse identify as having the highest energy expenditure and nutrient requirements? A. End of life cycle B. Middle adult years C. Early adult years D. First year of life

D. First year of life

A culturally competent nurse is planning to teach a client about a new regimen of self-care. Which must the nurse assess first before implementing the teaching plan? A. Religious affiliation B. Support system C. National origin D. Health beliefs

D. Health beliefs

Which word describes the process of growth and development? A. Fast B. Simple C. Limiting D. Individual

D. Individual

A nurse is caring for clients of a variety of ages. Which individual should the nurse anticipate will have the highest risk for complications during the perioperative period? A. Middle age adult B. Pregnant woman C. Adolescent D. Infant

D. Infant

A nurse in the clinic is monitoring clients for iron-deficiency anemia. Which group of individuals should the nurse anticipate to be at the highest risk? A. Postmenopausal women B. Older adults C. Teenagers D. Infants

D. Infants

When assessing a client for anxiety, which characteristic about anxiety should the nurse consider? A. It is triggered by a known stressor B. It occurs simultaneously with fear C. It is a response that is avoidable D. It is a universal experience

D. It is a universal experience

An obese client of a nursing home who is receiving a 1,500-calorie weight reduction diet has not lost weight in the past 2 weeks. Which should the nurse do first? A. Inform the primary health-care provider of the client's lack of progress B. Instruct the client to limit intake to 1,000 calories per day C. Schedule a multidisciplinary team conference D. Keep a log of the oral intake for 3 days

D. Keep a log of the oral intake for 3 days

A primary health-care provider prescribes a return-flow enema (Harris flush/Harris drip) for an adult client with flatulence. When preparing to administer this enema, the nurse compares the steps of a return-flow enema with those for cleansing enemas. Which nursing intervention is unique to a return-flow enema? A. Lubricate the last 2 inches of the rectal tube B. Insert the rectal tube about 4 inches into the anus C. Raise the solution container about 12 inches about the anus D. Lower the solution container after instilling about 150 mL of solution

D. Lower the solution container after instilling about 150 mL of solution

A nurse is planning care in the spiritual realm for clients with a variety of ages. Which age group should the nurse identify generally is more involved with expanding and refining spiritual beliefs? A. Adolescents B. Older adults C. Young adults D. Middle age adults

D. Middle age adults

Which group of individuals should the nurse anticipate is at the highest risk for constipation? A. Inactive school age children B. Middle age adults C. Bottle fed infants D. Older age adults

D. Older age adults

A nurse is caring for a client who is scheduled for IV chemotherapy for cancer. Which defense mechanism is being used when the client says to the daughter, "Be brave"? A. Rationalization B. Minimization C. Substitution D. Projection

D. Projection

The nurse is caring for a client admitted with a bleeding duodenal ulcer. He states that he has difficulty concentrating, is often "short of breath," and "awakes at night thinking and cannot get back to sleep." He has been unable to work or care for his family for the past 3 months. What should be the nurse's next action? A. Ask more questions about his shortness of breath. B. Do nothing; people with duodenal ulcers typically cannot work. C. Notify the primary care provider and ask for a referral to a mental health professional. D. Provide emotional support for the patient using reflective listening technique.

D. Provide emotional support for the patient using reflective listening technique.

Which is the most accurate method of verifying correct feeding tube placement when a tube is initially placed? A. Auscultation B. Visualization C. Aspiration D. Radiography

D. Radiography

A nurse is teaching a parenting class at a local community health center. Which common stressor associated with the developmental stage of early childhood (1 to 3 years) should the nurse include? A. Accepting limited dietary choices B. Adjusting to a change in physique C. Responding to a life-threatening illness D. Resolving conflicts concerning independence

D. Resolving conflicts concerning independence

A new school health nurse is working in a diverse school district. The nurse is interested in learning how to become a more culturally competent nurse for spiritual care needs of students and staff. What is one of the most important actions the nurse can do? A. Learn about all the religions and cultures in the school by taking a college course B. Make sure all students and staff follow the school lunch policy C. Treat all students and staff the same, regardless of various cultures or religions D. Self-reflect on spiritual needs of self and be sensitive in communicating about spiritual issues of others

D. Self-reflect on spiritual needs of self and be sensitive in communicating about spiritual issues of others

With which type of bowel diversion is the client most likely to have control over bowel elimination and not need to wear an appliance? A. Ileostomy B. Ascending colon colostomy C. Transverse colon colostomy D. Sigmoid colostomy

D. Sigmoid colostomy

A client has a tendency to develop frequent constipation. Which dietary consideration should the nurse recommend? A. The client should increase iron intake B. The client should decrease fiber intake C. The client should increase intake of fats D. The client should increase fiber intake

D. The client should increase fiber intake

A nurse is caring for a client who will perform fecal occult blood testing at home. Which of the following information should be included when explaining the procedure to the client? A. Eating more protein is optimal prior to testing B. One stool specimen is sufficient for testing C. A red color change indicates a positive test D. The specimen cannot be contaminated with urine

D. The specimen cannot be contaminated with urine

A home-care nurse is assessing a client and family members from a cultural perspective. Which is most important for the nurse to do? A. Recall experiences of caring for clients with a similar background B. Recognize beliefs common to the client's ethnic group C. Interview the members of the client's family D. Use the client as the main source of data

D. Use the client as the main source of data

Which is the correct formula for calculating body mass index? A. Weight in pounds ÷ (height in meters)2 B. Weight in kg ÷ (height in inches)2 C. Weight in pounds ÷ (height in inches)2 D. Weight in kg ÷ (height in meters)2

D. Weight in kg ÷ (height in meters)2

Create a plan of care for a client with inadequate nutrition as well as obesity LO 6 - 2 questions

Determine what is the cause for the patient's nutritional status/weight? *THEN treat Promotes health and reduction of chronic disease associated with diet and weight Client/family teaching related to: vitamin and mineral supplements, obtaining nutritious foods on a limited budget Supporting special clients' nutritional needs -Clients who are NPO -Older clients -Nausea -Impaired swallowing -Impaired digestive function Assisting clients with meals: -Inpatient: delegating feeding -Home care: refer to agency for help obtaining food

Discuss the factors that affect nutrition LO 4 - 2 questions

Developmental stage: -Infants: eat what family feeds them -Adolescence: they decide what they want to eat -Pregnant/Childbearing age: Folic acid intake -Elders: lost interest in eating, decreased calorie demand, poor dental hygiene, lack of teeth

Discuss the factors that affect nutrition LO 4 - 2 questions

Diets available: Special diets: -Regular -Low sodium -Diabetic -Calorie-push -Fat-restricted -Protein-restricted -Low residue/low fiber -Renal diet Modified by consistency: -Clear -Full -Mechanical soft: SOFT smaller pieces cut up -Pureed -NPO

Review the energy and micronutrients required for health LO 2 - 4 questions

Energy nutrients: -Carbohydrates: primary energy source, sugars, quickly digested -Proteins: tissue building, nitrogen balance, amino acids -Fats/Lipids: key component of lipoproteins, back-up energy source, organ insulation/protection, helps us to "feel full" Micronutrients: -Needed only in small amounts, don't provide energy -Regulate body functions; vitamins, minerals Water: -Makes up large percentage of body weight -Solvent for chemical processes -Transports substances -Form for tissues -Maintains body temperature

Discuss factors that influence the bowel elimination process LO 1 - 2 questions

Factors affecting: -Developmental stage -Personal and sociocultural factors -Nutrition, hydration, activity -Medications -Surgery and procedures -Pregnancy -Pathological conditions

Identify family risk factors in five different stages of the family life span, especially the older adult LO 2 - 3 questions

Families with middle-aged adults: -Role fulfillment -Midlife crisis -Onset of health problems Families with older adults: -Ralls and trauma risks -Risk for social isolation, depression, and malnutrition -Risk for alteration in mental status ie. confusion, forgetfulness Challenges to family health: -Poverty and unemployment -Infection diseases -Chronic illness and disability -Homelessness -Family violence and neglect

Identify family risk factors in five different stages of the family life span, especially the older adult LO 2 - 3 questions

Family health assessment: -Identify data -Family composition -Family history and developmental stage -Environmental data -Family structure -Family functions -Health beliefs, values, behaviors -Family stressors and coping -Family strengths -Abuse and violence within the family -Family communication patterns -Caregiver role strain

Describe approaches to working with various types of families to provide optimal care to both well and ill clients LO 1 - 6 questions

Family structures include: -Traditional families -Grandparent families -Dual-earner families -Single-parent families -Blended and stepfamilies -Extended families -Sandwich families -Same-sex families -Military families -Others include: cohabitating adults, single individuals sharing a household, individuals or couples who adopt children *Nursing care holistically directed toward the whole family as well as to individual members *Three perspectives include: 1. Family as context 2. Family as unit of care 3. Family as system *Interventions when a family member is ill

What is the difference between fat-soluble and water-soluble vitamins?

Fat soluble vitamins are A, D, E, and K. They are stored primarily in the liver and adipose tissues, although vitamin E is deposited in all body tissue. Water Soluble vitamins include vitamin C and the B-complex vitamins. Because they are soluble in water, excess amounts are regularly exceeded in the urine.

Trace Minerals: Iron Zinc Fluoride Iodine What is their primary action (function) and food sources effects of deficiency?

Fluoride: -Increases resistance to dental caries Food sources: fluoridated water, toothpaste, dental treatment, seaweed, fish, tea Deficiency: Dental caries Iodine: -Synthesis of the thyroid hormone thyroxine Food sources: Iodized salt, salt water fish, dairy products, enriched white bread Deficiency: Goiter, poor infancy growth, cretinism, hypothyroidism

Describe the contents of a nursing assessment and physical examination focused on bowel elimination LO 2 - 3 questions

Focused nursing history: **MUST ASK** "Describe your normal bowel pattern, when was the last BM?" "What is a normal BM for you? Focused physical assessment: -Normal bowel sounds: 5-15 gurgles a min -Hyperactive: high pitched, could indicated small bowel obstruction or inflammatory disorders -Hypoactive: low pitched, infrequent

Compare and contrast the four components of self-concept: identify, body image, self-esteem, and roles LO 1 - 2 questions

Identity: -View of self -Constant -Learned through socialization -Illness impairs Body Image: -Mental image of physical self -Involves cognition and sensory input -Ideal versus perceived body image -Gradual vs. sudden body changes -Illness influences Self-Esteem: -How I like myself -Expectations of myself versus true abilities -Ideal versus actual self -Illness precipitates a crisis in Role Performance: -Actions taken, behavior demonstrated -Role strain -Role conflict -Illness affects

Compare the location and anticipated function of bowel diversion procedures and related nursing care LO 4 - 2 questions

Ileostomy: ileum, zero water reabsorption, all liquid, zero control Colostomy: colon, anywhere in the colon, the further along in the colon the more firm the stool What characteristics will the stool have depending on where the ostomy is placed? Stoma assessment and care: -Pay strict attention to skin care/peristomal skin assessment -Monitor the amount and type of effluent -Be attentive to client's psychosocial needs -Client teaching for home care

Trace Minerals: Iron Zinc Fluoride Iodine What is their primary action (function) and food sources effects of deficiency?

Iron: -Synthesis of hemoglobin -General metabolism -Antibody production -Drug detoxification in the liver Food sources: Meats, eggs, spinach, seafood, broccoli, peas, bran, enriched breads, fortified cereals Deficiency: small pale red blood cells, anemia Zinc: -Cofactor for many enzymes involved in growth -Insulin storage immunity -Alcohol metabolism -Sexual development and reproduction Food sources: Primarily meats and seafood, legumes, peas, and whole grains Deficiency: Skin rash, diarrhea, decreased appetite, hair loss, poor growth and development, poor wound healing

Energy Nutrients: Carbohydrates and fiber Protein Lipids Do you know what nitrogen balance is (positive vs negative?) *Know primary action (function) and considerations, food sources labs considerations for each

Lipids: Fats and oils, key component of lipoproteins, backup energy source, organ insulation/protection -Glycerides -Sterols -Phospholipids -Lipoproteins (Cholesterol, LDL=BAD, HDL=GOOD) -Supply essential nutrients -Flavor and satiety -Cholesterol functions Food Sources: -Pork, beef, poultry, egg yolk, dairy, coconut oil, palm oil, olive oil, vegetable oils, nuts, avocados, fatty fish, margarine, packaged baked goods, and processed foods

Discuss nursing diagnoses, outcomes, and interventions utilized in managing bowel disorders LO 5 - 2 questions

Managing constipation: -Increase intake of high fiber foods -Increase fluid intake -Increase activity/exercise -Provide privacy -Help client to position that facilitates defecation -Allow uninterrupted time -Offer laxatives when lifestyle changes are ineffective Enemas: -Cleansing Retention -Return flow: for flatulence Digital removal of stool: -Manual/digital removal = disimpacting -Establish a bowel program to prevent recurrence

Discuss nursing diagnoses, outcomes, and interventions utilized in managing bowel disorders LO 5 2 questions

Nursing diagnosis: -Bowel incontinence -Constipation -Chronic constipation -Risk for constipation -Perceived constipation -Diarrhea -Gastrointestinal motility alteration -Toileting self-care Outcomes: -Soft, formed, regular bowel movement Promoting regular defecation: -Privacy -Correct position: seated upright -Timing: often occurs after meals, some clients may need assistance -Fluid intake -Proper diet: fresh fruits, vegetables, whole grains, fiber -Exercise: 3-5 times a week, ROM for clients on bedrest

Minerals: Sodium (Na) Potassium (K) Phosphorus (P) Magnesium (Mg) Calcium (Ca) What is their primary action (function) and food sources effects of deficiency or excess?

Phosphorus: -Bone and took strength -Overall metabolism -Formation of enzymes -Acid base balance -Food sources: Dairy products, beef, pork, beans, sardines, eggs, chicken, wheat bran, chocolate Deficiency: Bone loss, poor growth Excess: Tetany, convulsions Magnesium: -Aids thyroid hormone secretion -Maintains normal BMR -Activates enzymes for car and protein metabolism -Nerve and muscle function -Cardiac function Food sources: Whole grains, nuts, legumes, green leafy vegetables, lima beans, broccoli, squash, potatoes Deficiency: Tremor, spasm, convulsions, weakness, muscle pain, poor cardiac function Excess: Weakness, nausea, malaise

Identify types of health practices that may influence care of clients from various cultural backgrounds LO 3 - 2 questions

Possible effects: -When the practice is efficacious -When the practice is neutral -When the effects of a practice are unknown -When the practice is dysfunctional Responding to a client's cultural health practices: -Negotiation -Repatterning/restructuring

Describe ways to overcome cultural barriers to healthcare LO 4 - 3 questions

Purnell Model for Cultural Competence: -Unconscious incompetence -Conscious incompetence -Conscious competence -Unconscious competence Barriers include: -Bias -Ethnocentrism -Prejudice -Discrimination -Racism -Sexism -Language barriers -Lack of knowledge -Self-knowledge Developing strategies: -Reflect and know yourself -Keep learning -Accommodate and negotiate -Collaborate -Respect -Take a trip to BALI *"Be aware, Appreciate, Learn, Incorporate,"

Describe and understand the purpose of common diagnostic tests used to identify bowel elimination problems LO 3 - 3 questions

Radiographic view: flat plate of the abdomen **To detect gallstones, fecal impaction, and distended bowel Colonoscopy: direct visualization of the rectum, colon, entire large intestine, and distal small bowel. **To detect lower GI disease Sigmoidoscopy: direct visualization of the canal canal, rectum, and sigmoid colon. **Done to perform a biopsy, remove polyps, or coagulate sources of bleeding in the area. Also used as a screen for cancer Hemoccult (Guaiac test): Testing stool for occult blood or hidden blood

Create a plan of care for a client with inadequate nutrition as well as obesity LO 6 - 2 questions

Screening for nutritional problems -Obtain a diet history, 24 hr recall, food frequency questionnaire, food record -Subjective global assessment -Mini-nutritional assessment -Nutrition screening initiative -Body composition Overweight/Obesity: -Consuming nutrients in excess of metabolic demands, more than needed for activity, gender, height, and weight Underweight: Below 18.5 Normal: 18.5 to 24.9 Overweight: 25.0-29.9 Class I obesity: 30.0-34.9 Class II obesity: 35.0-39.9 Class III obesity: 40.0 or higher Alterations in nutrition: Underweight/undernutrition: -Insufficient intake of protein, fat, vitamins, minerals -Consuming fewer calories than needed according to activity, gender, height, and weight

Compare and contrast the four components of self-concept: identify, body image, self-esteem, and roles LO 1 - 2 questions

Self Concept: forms out of a person's evaluation of her/his; physical appearance, sexual performance, intellectual abilities, success in the workplace, friendships, problem-solving and coping abilities, unique talents Factors that affect self-concept: -Gender -Developmental level -Socioeconomic status -Family -Peer relationships -Locus of control

Identify common stressors affecting self-concept and means for assessment LO 3 - 1 question

Self concept is influenced by: -Body image, ideal vs. perceived and actual body image -Appearance and function of body -Gradual vs. sudden body changes -Role performance -Personal identity Psychosocial assessment: -Biological, psychological, and social details -Functional abilities -Self-efficacy -Family relationships -Relationships with the wider social environment -Interpersonal communication -Social resources and networks -Understanding current illness -Usual coping mechanisms -Health priorities

Minerals: Sodium (Na) Potassium (K) Phosphorus (P) Magnesium (Mg) Calcium (Ca) What is their primary action (function) and food sources effects of deficiency or excess?

Sodium: -Water balance -Acid base balance -Muscle action -Nerve transmission -Convulsions Food sources: Table salt, milk, eggs, baking soda, baking powder, celery, spinach, carrots, beets Deficiency: Dizziness, abdominal cramping, nausea, vomiting, diarrhea, tachycardia, convulsions, coma Excess: Thirst, fever, dry and sticky tongue and mucous membranes, restlessness, irritability, convulsions Potassium: -Intracellular fluid control -Acid base balance -Nerve transmission -Muscle contraction -Glycogen formation -Protein synthesis -Energy metabolism -Blood pressure regulation Food sources: Unprocessed foods, especially fruits, and vegetables, meats, potatoes, avocados, legumes, milk, molasses, shellfish, dates, figs Deficiency: Muscle weakness, weak pulse, fatigue, abdominal distention Excess: Cardiac dysrhythmias, cardiac arrest, weakness, abdominal cramps, diarrhea, anxiety, paresthesia

Create a plan of care for a client with inadequate nutrition as well as obesity LO 6 - 2 questions

Some interventions for obesity: -Assist with calorie calculations and meal planning -Encourage exercise/lifestyle changes -Weigh weekly; suggest food diary Some interventions for undernutrition: -Encourage client to seek counseling for eating disorder management -Devise strategies to improve client's appetite -Enteral nutrition -Parenteral nutrition

Identify types of health practices that may influence care of clients from various cultural backgrounds LO 3 - 2 questions

Specifics that affect health: -Communication -Space -Time organization -Social organization -Environmental control -Biological variations -Religion and philosophy -Education -Technology -Politics, law -Economy

Maslow's Hierarchy of Needs

Tier 1: Self-Actualization -Morality -Creativity -Spontaneity -Problem solving -Lack of prejudice -Acceptance of facts Tier 2: Esteem -Self-esteem -Confidence -Achievement -Respect of others -Respect by others Tier 3: Love/Belonging -Friendship -Family -Sexual intimacy Tier 4: Safety -Security of body -Of employment -Of resources -Of morality -Of the family -Of health -Of property Tier 5: Physiological -Breathing -Food -Water -Sex -Sleep -Homeostasis -Excretion

Describe the communication difficulties that arise when caring for clients and families from multicultural backgrounds LO 1 - 4 questions

Tips for communication include: -Interpreter -Internet and computer translator software -Translator

Fat soluble vitamins: Vitamin A Vitamin D Vitamin E Vitamin K What is their primary action (function) and food sources effects of deficiency?

Vitamin A: -Night and color vision -Cellular growth and maturity -Maintaining healthy skin and mucous membranes -Growth of skeletal and soft tissues -Reproduction Food sources: Fish liver oil, liver, butter, cream, egg yolk, yellow fruit, green leafy vegetables, fortified milk Deficiency: Night blindness, xerosis, xerophthalmia, keratomalacia, skin lesions Vitamin D: -Regulates blood calcium levels -Regulates rate of deposit and resorption of calcium in bone Food sources: Fish liver oil, fish, fortified milk, sunlight exposure Deficiency: Bone and muscle pain, weakness, softening of bone, fractures, rickets

Water soluble vitamins: Vitamin C B-Complex (B vitamins as a whole ones like B6 & B12) Vitamin B 9-Folic Acid (Folate)-What is the recommended dose for this one? What is their primary action (function) and food sources effects of deficiency?

Vitamin C: -Collagen synthesis -"Cementing" substance for capillary walls -Antioxidant -Iron absorption -Immune function Food sources: Citrus fruits, tomatoes, potatoes, green vegetables, cauliflower Deficiency: Anemia, tissue bleeding, easy bone fracture, gingivitis, petechiae, poor wound healing, joint pain, scurvy B-Complex (B6 & B12) B6: -Protein metabolism -Red blood cell production -Neurotransmitter synthesis Food sources: Meats, poultry, fish, beans, nuts, seeds, dairy products, enriched cereals Deficiency: Rash, stomatitis, seizure, peripheral neuritis, depression

Fat soluble vitamins: Vitamin A Vitamin D Vitamin E Vitamin K What is their primary action (function) and food sources effects of deficiency?

Vitamin E: -Antioxidant -Protects red blood cells and muscle tissue cells Food sources: Vegetable oils, nuts, milk, eggs, muscle meats, fish, wheat and rice germ, green leafy vegetables Deficiency: Hyporeflexia, ataxia, hemolytic anemia, myopathy Vitamin K: -Synthesis of clotting factors -Bone development Food sources: Green leafy vegetables, liver Deficiency: Increased bleeding