NR 222 Final practice Q's potter/Perry

Place the following stages of Freud's psychosexual development in the proper order by age progression. 1. Oedipal 2. Latency 3. Oral 4. Genital 5. Anal

3,5,2,1,4

A nurse is caring for a patient with end-stage lung disease. The patient wants to go home on oxygen and be comfortable. The family wants the patient to have a new surgical procedure. The nurse explains the risk and benefits of the surgery to the family and discusses the patient's wishes with the family. The nurse is acting as the patient's: 1. Educator 2. Advocate 3. Caregiver 4. Case manager

Advocate

Two single mothers are active professionals and have teenage daughters. They also have busy social lives and date occasionally. Three years ago they decided to share a house and housing costs, living expenses, and child care responsibilities. The children consider one another as their family. What type of family form does this represent? Diverse family relationship Blended family relationships Extended family relationship Alternative family relationship

Alternative family relationship Alternative family relationships include multi-adult households, "skip-generation" families, and communal groups with children; "nonfamilies"; cohabitating partners; and homosexual couples.

When a nurse conducts an assessment, data about a patient often comes from which of the following sources? (Select all that apply.) An observation of how a patient turns and moves in bed The unit policy and procedure manual The care recommendations of a physical therapist The results of a diagnostic x-ray film Your experiences in caring for other patients with similar problems

An observation of how a patient turns and moves in bed The care recommendations of a physical therapist The results of a diagnostic x-ray film There are many sources of data for an assessment, including the patient through interview, observations, and physical examination; family members or significant others, health care team members such as a physical therapist, the medical record (which includes x-ray film results, and the scientific and medical literature.

"Since my mother had breast cancer, I know that I am at increased risk for developing breast cancer."

As part of a faith community nursing program in her church, a nurse is developing a health promotion program on breast self-examination for the women's group. Which statement made by one of the participants is related to the individual's perception of susceptibility to an illness? "I have a door hanging tag in my bathroom to remind me to do my breast self-examination monthly." "Since my mother had breast cancer, I know that I am at increased risk for developing breast cancer." "Since I am only 25 years of age, the risk of breast cancer for me is very low." "I participate every year in our local walk/run to raise money for breast cancer research."

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

Family as patient When the family as patient is the approach, the patient's needs and family processes and relationships (e.g., parenting or family caregiving) are the primary focuses of nursing care.

What is the most common reason for calling on grandparents to raise their grandchildren? Single parenthood Legal interventions Dual-income families Increased divorce rate

Legal interventions This new parenting responsibility is most often a consequence of legal intervention when parents are unfit or renounce their parental obligations. It is usually related to a parent's criminal activity or substance abuse or a parent's unwillingness to assume parenting responsibilities.

A nurse is presenting a program to workers in a factory covering safety topics, including the wearing of hearing protectors when workers are in the factory. Which level of prevention is the nurse practicing? Primary prevention Secondary prevention Tertiary prevention Quaternary prevention

Primary Prevention

A nurse is working with a patient who wants needs to be met and is impatient and demanding when these needs are not met immediately. How should the nurse interpret this finding according to Freud?

The id is functioning

The nurse asks a patient, "Describe for me a typical night's sleep. What do you do to fall asleep? Do you have difficulty falling or staying asleep? This series of questions would likely occur during which phase of a patient-centered interview? Orientation Working phase Data validation Termination

Working phase The gathering of information is the working phase of a patient-centered interview.

confidentiality

You see an open medical record on the computer and close it so no one else can read the record without proper access.

responsibility

You tell your patine that you will return in 30 minutes to give him his next pain medication

A nurse is measuring an infants head circumference and height. Which area is the nurse assessing?

biophysical development

affective learning domain

emotional aspect of learning changing attitudes, values, and feelings

A nurse is using the proximodistal pattern to assess an infants growth and development as normal. Which assessment finding will the nurse determine as normal?

lifts head before grasps

Understanding that an individual needs a break before processing best describes

metacommunication

The point of the ethical practice is an agreement to reassure the public that in all ways the health care team not only works to heal patients but agrees to do this in the least painful and harmful way possible. This principle is commonly called the principle of _____________?

nonmaleficence

You are working in a clinic that provides services for homeless people. The current local regulations prohibit providing a service that you believe is needed by your patients. You adhere to the regulations but at the same time are involved in influencing authorities to change the regulation. This action represents ___________ stage of moral development.

social contract orientation

Which of the following is the third leading cause of death in adolescents between 10 and 24 years of age? · Accidents · Suicide · Cancer · Sport injuries

suicide

What is a closed loop communication technique used to evaluate pt understanding and retention of material?

teach back method

A nurse is assessing the risk of intimate partner violence (IPV) for patients. Which population should the nurse focus on most for IPV? · White males · Pregnant females · Middle-aged adults · Nonsubstance abusers

· Pregnant females

What are some strategies that nurses can use to promote health literacy?

-Speak clearly & distictly -face person when speaking -conclude with summary of key points

What are some ethical standards that nurses can utilize for interpersonal communications?

-communicate information accurately -be sensitive to gender & cultural context -communicate verbal and non verbal messages in a congruent manner

The nurse is preparing an educational activity for adolescents. The primary reason that emphasis is placed on teaching testicular self-examination is because: · adolescents are naturally interested in their developing bodies. · baseline assessment data is necessary for comparison in the future. · rapid anatomical changes are occurring in the testes · testicular cancer is the number one cancer in the adolescent male.

-testicular cancer is the number one cancer in the adolescent male.

In evaluating the gross-motor development of a 5-month-old infant, which of the following would the nurse expect the infant to do? 1 Roll from abdomen to back 2 Move from prone to sitting unassisted 3 Sit upright without support 4 Turn completely over

1 Roll from abdomen to back Pg. 145; Table 12-1

When designing a plan for pain management for a postoperative patient, the nurse assesses the patient's priority is to be as free of pain as possible. The nurse and patient work together to identify a plan to manage the pain. The nurse continually reviews the plan with the patient to ensure that the patient's priority is met. Which principle is used to encourage the nurse to monitor the patient's response to the pain? 1. Fidelity 2. Beneficence 3. Nonmalficence 4. Respect for autonomy

1. Fidelity

A nurse has been gathering physical assessment data on a patient and is now listening to the patient's concerns. The nurse that's a goal of care that incorporates the patient's desire to make treatment decisions. This is an example of the nurse engaged in which phase of the nurse patient relationship? 1. working phase 2. pre-interaction phase 3. termination phase 4. orientation phase

1. working phase

1. With the exception of pregnant or lactating women, the young adult has usually completed physical growth by the age of: 1. 18. 2. 20. 3. 25. 4. 30.

2

A nurse is participating in a health and wellness event at the local community center. A woman approaches and relates that she is worried that her widowed father is becoming more functionally impaired and may need to move in with her. The nurse inquires about his ability to complete activities of daily living (ADLs). ADLs include independence with: (Select all that apply.) 1. Driving. 2. Toileting. 3. Bathing. 4. Daily exercise. 5. Eating.

2,3,5

A patient's family member is considering having her mother placed in a nursing center. The nurse has talked with the family before and knows that this is a difficult decision. Which of the following criteria does the nurse recommend in choosing a nursing center? (Select all that apply.) 1. The center needs to be clean, and rooms should look like a hospital room. 2. Adequate staffing is available on all shifts. 3. Social activities are available for all residents. 4. The center provides three meals daily with a set menu and serving schedule. 5. Staff encourage family involvement in care planning and assisting with physical care.

2,3,5

A child's immunizations may cause discomfort during administration, but the benefits of protection from disease, both for the individual and society, outweigh the temporary discomforts. Which principle is involved in this situation? 1. Fidelity 2. Beneficence 3. Nonmalficence 4. Respect for autonomy

2. Beneficence

A patient is receiving total parenteral nutrition (TPN). What is the primary intervention the nurse should follow to prevent a central line infection? 1. Institute isolation precautions 2. Clean the central line port through which the TPN is infusing with antiseptic 3. Change the TPN tubing every 24 hours 4. Monitor glucose levels to watch and assess for glucose intolerance

2. Clean the central line port through which the TPN is infusing with antiseptic Use either alcohol or an alcoholic solution of chlorhexidine gluconate to clean the injection port or catheter hub 15 seconds before and after each time it is used to reduce the risk of a central line infection.

The nurse sees the nursing assistive personnel (NAP) perform the following intervention for a patient receiving continuous enteral feedings. Which action would require immediate attention? 1. Fastening tube to the gown with new tape 2. Placing patient supine while giving a bath 3. Hanging a new container of enteral feeding 4. Ambulating patient with enteral feeding

2. Placing patient supine while giving a bath A patient receiving continuous enteral feedings should never be placed supine because it increases the risk for pulmonary aspiration. If the nurse needs to lay the patient in the supine position, the feedings should be stopped and restarted when the head of the bed is at 45 degrees.

A patient who is hospitalized has just been diagnosed with diabetes. He is going to need to learn how to give himself injections. Which teaching method does the nurse use? 1. simulation 2. demonstration 3. group instruction 4. one on one discussion

2. demonstration

A patient needs to learn how to administer a subcutaneous injection. Which of the following reflects that the patient is ready to learn? 1. describing difficulties a family member had and taking insulin 2. expressing the importance of learning the skill correctly 3. being able to see and understand the markings on the syringe 4. having the dexterity needed to prepare and inject the medication

2. expressing the importance of learning the skill correctly

3. Which statement best describes the evidence associated with complementary therapies as a whole? 1. Many clinical trials in complementary therapies support their effectiveness in a wide range of clinical problems. 2. It is difficult to find funding for studies about complementary therapies. Therefore we should not expect to find evidence supporting its use. 3. The science supporting the effectiveness of complementary therapies is early in its development. 4. Most of the research examining complementary and alternative therapies has found little evidence, suggesting that, although people like them, they are not effective.

3

4. While planning care for a patient, a nurse understands that providing integrative care includes treating which of the following? 1. Disease, spirit, and family interactions 2. Desires and emotions of the patient 3. Mind-body-spirit of patients and their families 4. Muscles, nerves, and spine disorders

3

A 50-year-old woman has elevated serum cholesterol levels that increase her risk for cardiovascular disease. One method to control this risk factor is to identify current diet trends and 171describe dietary changes to reduce the risk. This nursing activity is a form of: 1. Referral. 2. Counseling. 3. Health education. 4. Stress-management techniques.

3

A nurse is completing an assessment on a male patient, age 24. Following the assessment, the nurse notes that his physical and laboratory findings are within normal limits. Because of these findings, nursing interventions are directed toward activities related to: 1. Instructing him to return in 2 years. 2. Instructing him in secondary prevention. 3. Instructing him in health promotion activities. 4. Implementing primary prevention with vaccines.

3

The nurse is working with an older adult after an acute hospitalization. The goal is to help this person be more in touch with time, place, and person. Which intervention will likely be most effective? 1. Reminiscence 2. Validation therapy 3. Reality orientation 4. Body image interventions

3

The nurse sees a 76-year-old woman in the outpatient clinic. She states that she recently started noticing a glare in the lights at home. Her vision is blurred; and she is unable to play cards with her friends, read, or do her needlework. The nurse suspects that the woman may have: 1. Presbyopia. 2. Presbycusis 3. Cataract(s). 4. Depression.

3

A parent has brought her 6-month-old infant in for a well-child check. Which of her statements indicates a need for further teaching? 1 "I can start giving her whole milk at about 12 months." 2 "I can continue to breastfeed for another 6 months." 3 "I've started giving her plenty of fruit juice as a way to increase her vitamin intake." 4 "I can start giving her solid food now."

3 "I've started giving her plenty of fruit juice as a way to increase her vitamin intake." Pg. 147; The use of fruit juices and nonnutritive drinks such as fruit-flavored drinks or soda should be avoided since these do not provide sufficient and appropriate calories during this period.

You are working in an adolescent health center when a 15-year-old patient shares with you that she thinks she is pregnant and is worried that she may now have a sexually transmitted infection (STI). Her pregnancy test is negative. What is your next priority of care? 1 Contact her parents to alert them of her need for birth control. 2 Refer her to a primary health care provider to obtain a prescription for birth control. 3 Counsel her on safe sex practices. 4 Ask her to have her partner come to the clinic for STI testing.

3 Counsel her on safe sex practices. Pg. 156; Be proactive by using the interview process to identify risk factors in the adolescent and provide education to prevent STI's including (HIV), HPV, and unwanted pregnancies.

The patient's blood glucose level is 330 mg/dL. What is the priority nursing intervention? 1. Recheck by performing another blood glucose test 2. Call the primary health care provider. 3. Check the medial record to see if there is a medication order for abnormal glucose levels. 4. Monitor and recheck in 2 hours.

3. Check the medial record to see if there is a medication order for abnormal glucose levels. Check the medical record to see if there is a medication order for deviations in glucose level; if not, notify the health care provider. As the nurse you want to get the patient's blood sugar as close to normal as possible.

In most ethical dilemmas in healthcare, the solution to the dilemma requires negotiation among members of the health care team. Why is the nurse's point of view valuable? 1. Nurses understand the principle of autonomy to guide respect for a patient's self-worth 2. Nurses have a scope of practice that encourages their presence during ethical decisions 3. Nurses develop a relationship with the patient that is unique among all professional health care providers. 4. The nurse's code of ethics recommends that a nurse be present at any ethical discussion about patient care

3. Nurses develop a relationship with the patient that is unique among all professional health care providers.

A patient is newly diagnosed with cervical cancer and is going home. The patient is avoiding discussion of her illness and post operative orders. What is the nurses best plan in teaching this patient? 1. Teach the patient spouse 2. focus on knowledge the patient will need in a few weeks 3. provide only the information that the patient needs to go home 4. convince the patient that learning about her health is necessary

3. provide only the information that the patient needs to go home

1. When planning patient education, it is important to remember that patients with which of the following illnesses often find relief in complementary therapies? 1. Lupus and diabetes 2. Ulcers and hepatitis 3. Heart disease and pancreatitis 4. Chronic back pain and arthritis

4

8. Meditation may compound the effects of which of these medications? 1. Prednisone and antibiotics 2. Insulin and vitamins 3. Cough syrups and aspirin 4. Antihypertensive and thyroid-regulating medications

4

A patient is admitted to a medical unit. The patient is fearful of hospitals. The nurse carefully assesses the patient to determine the exact fears and then establishes interventions designed to reduce these fears. In this setting, how is the nurse practicing patient advocacy? 1. Seeking out the nursing supervisor to talk with your patient 2. Documenting patient fears in the medical record in timely manner 3. Working to change the hospital environment 4. Assessing the patient's point of view and preparing to articulate it

4. Assessing the patient's point of view and preparing to articulate it

The nurse ovulated which laboratory values to assess a patient's potential for wound healing? 1. Fluid status 2. Potassium 3. Lipids 4. Nitrogen balance

4. Nitrogen balance Nitrogen balance is important to determining serum protein status. A negative nitrogen balance is present when catabolic states exist. When a patient has a decreased protein level, he or she is at risk for delayed wound healing.

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

4. Stop feeding her and place on NPO Stop feeding and place patient on NPO. If choking persists, suction airway. Notify health care provider.

Pay for performance

A nurse is presenting information to a management class of nursing students on the topic of financial reimbursement for achievement of established, measurable patient outcomes. The nurse is presenting information to the class on which topic? Prospective payment system Pay for performance Capitation payment system Managed care systems

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

A. Teach Back is not a test of patient knowledge or ability to use devices but a confirmation of how well the nurse explained concepts to patients

Match the following definitions with the key terms related to intersectionality. Term Definition A. Groups have unequal access to resources, services, and positions. B. A group has been overlooked in research and the design of interventions. C. One's place in society is based on membership in a social group that determines access to resources. Definitions 1. Under inclusion 2. Social inequality 3. Social location

A2 B1 C3

27.) The home care nurse is visiting an older client whose spouse died 6 months ago. Which behaviors by the client indicates effective coping? · A. Neglecting personal grooming · B. Looking as old snapshots of family. · C. Participating in a senior citizens program · D. Visiting spouses grave once a month · E. Decorating a wall with the spouses pictures and awards received.

B, C, D, E

A child who has been in a house fire comes to the emergency department with her parents. The child and parents are upset and tearful. During the nurse's first assessment for stress the nurse says: A. "Tell me who I can call to help you." B. "Tell me what bothers you the most about this experience." C. "I'll contact someone who can help get you temporary housing." D. "I'll sit with you until other family members can come help you get settled."

B. "Tell me what bothers you the most about this experience." The patients' appraisal of the crisis is the most important area to address first.

1.) The nurse is to instruct the client about the long- term consequences of non-compliance to prescribed medication. Which education strategy would be most appropriate for the nurse to use in order to develop the affective learning domain of the client? · A. Lecture followed by a simple written test. · B. Role playing and group discussion · C. Video presentation and handouts · D. Demonstration and practice

B. Role playing and group discussion

4.) Which of the following emphasizes that an individuals belief in being personally capable of preforming the behavior is required to influence one's own health? A. Social Cognitive Theory B. Self-Efficacy Theory C. Health Belief Model D. Theoretical Model

B. Self-Efficacy Theory

17.) Which statement is true regarding secondary prevention? · A. The nurse creates a care plan for the patients outpatient therapy. · B. The nurse identifies individuals in an early detectable state of the disease process. · C. The nurse focuses on increasing the patient's self-care by providing prevention instructions. · D. The nurse is driven by the objective to minimize the effect of the disability through rehabilitation.

B. The nurse identifies individuals in an early detectable state of the disease process.

During an encounter with an elderly patient, the nurse recognizes that a thorough cultural assessment is necessary because the patient has recently come to the United States from Russia and has never been hospitalized before. The nurse wants to discuss cultural similarities between herself and the patient. Which step of the LEARN mnemonic is this? a. Listen b. Explain c. Acknowledge d. Recommend treatment e. Negotiate agreement

C. The nurse's desire to discuss cultural similarities is an example of Acknowledging

18.) One Leading Health Indicator (LHI) of Healthy People 2020 is the availability of medical services to all people. Which topic does this cover · A. Injury and Violence · B. Environmental Quality · C. Access to Health Services · D. Clinical Preventative Services

C. Access to Health Services

A nurse observes that a patient whose home life is chaotic with intermittent homelessness, a child with spina bifida, and an abusive spouse appears to be experiencing an allostatic load. As a result, the nurse expects to detect which of the following while assessing the patient? A. Posttraumatic stress disorder B. Rising hormone levels C. Chronic illness D. Return of vital signs to normal

C. Chronic illness An increased allopathic load can result in long-term physiological problems and chronic illness. Posttraumatic stress disorder results from a single traumatic event. Hormone levels rise in the alarm stage. Vital signs return to normal in the resistance stage.

Contemporary nursing requires that the nurse has knowledge and skills for a variety of professional roles and responsibilities. Which of the following are examples? (Select all that apply.) 1. Caregiver 2. Autonomy and accountability 3. Patient advocate 4. Health promotion 5. Lobbyist

Caregiver, Autonomy and accountability, patient advocate, health promotion (1,2,3,4)

The nurse observes a patient walking down the hall with a shuffling gait. When the patient returns to bed, the nurse checks the strength in both of the patient's legs. The nurse applies the information gained to suspect that the patient has a mobility problem. This conclusion is an example of: Cue. Reflection. Clinical inference. Probing.

Clinical inference. An inference is your judgment or interpretation of cues such as the shuffling gait and reduced leg strength. Any information gathered through your senses is a cue. Probing is a technique used in interviewing. Reflection is an internal process of thinking back about a situation.

A nurse is preparing to perform a cultural assessment of a patient. Which of the following questions is an example of a contrast question? a. Tell me about your ethnic background. b. Have you had this problem in the past? c. Where do other members of your family live? d. How different is this problem from the one you had previously?

D "Tell me about your ethnic background" is an example of an ethnohistory statement. "Have you had this problem in the past?" is an example of a focused question, and "Where do other members of your family live?" is an example of a social organization question

A staff nurse is talking with the nursing supervisor about the stress that she feels on the job. The supervising nurse recognizes that: A. Nurses who feel stress usually pass the stress along to their patients. B. A nurse who feels stress is ineffective as a nurse and should not be working. C. Nurses who talk about feeling stress are unprofessional and should calm down. D. Nurses frequently experience stress with the rapid changes in health care technology and organizational restructuring.

D. Nurses frequently experience stress with the rapid changes in health care technology and organizational restructuring. Nurses frequently experience stress with the rapid changes in health care technology and organizational restructuring and when the situation seems out of their personal control.

Which of the following most greatly affects a family's access to adequate health care, opportunity for education, and sound nutrition? Development Family function Family structure Economic stability

Economic stability Economic resources and stability help the family attain health care, education, and basic needs.

A family has decided to care for their father who is in the last stages of a debilitating neurological illness. Although he is alert, he cannot speak clearly or carry out self-care activities; he indicates that he wants to remain involved in family life as long as possible and loves spending time with his wife and two teenage children. Which best defines family caregiving? (Select all that apply.) Designing a nurturing family to raise children Providing physical and emotional care for a family member Establishing a safe physical environment for a family Monitoring for side effects of illness and treatments Reducing the use of community resources

Providing physical and emotional care for a family member Establishing a safe physical environment for a family Monitoring for side effects of illness and treatments Family caregiving involves routinely providing services and personal care activities for a family member by spouses, siblings, or parents. Caregiving activities include safety, personal care (bathing, feeding, or grooming), monitoring for complications or side effects of medications, providing instrumental activities of daily living (shopping or housekeeping), and the ongoing emotional support and decision making that is necessary. Use of community resources to help with tasks such as family errands, grocery shopping is beneficial for the family caregiver.

A nurse is caring for an older-adult couple in a communitybased assisted living facility. During the family assessment he notes that the couple has many expired medications and multiple medications for their respective chronic illnesses. They note that they go to two different health care providers. The nurse begins to work with the couple to determine what they know about their medications and helps them decide on one care provider rather than two. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency? 1. Patient-centered care 2. Safety 3. Teamwork and collaboration 4. Informatics

Safety

A nurse is a assessing an 18 month toddler. The nurse distinguishes normal from abnormal findings by remembering Gesell's theory of development. Which information will the nurse consider?

The cephalocaudal pattern describes the sequence in which growth is fastest at the top

Based on findings from patients who developed ulcers, implementing an evidence-based skin care protocol.

The nurses on a medical unit have seen an increase in the number of pressure ulcers that develop in their patients. They decide to initiate a quality improvement project using the Plan-Do-Study-Act (PDSA) model. Which of the following is an example of "Do" from that model? Implementing the new skin care protocol on all medicine units. Reviewing the data collected on patients cared for using the protocol. Reviewing the quality improvement reports on the six patients who developed ulcers over the last 3 months. Based on findings from patients who developed ulcers, implementing an evidence-based skin care protocol.

-Lack of interest in exercise -Difficulty falling asleep -Lack of desire to go to work -Anxiety while working

Which of the following are symptoms of secondary traumatic stress and burnout that commonly affect nurses? (Select all that apply.) Regular participation in a book club Lack of interest in exercise Difficulty falling asleep Lack of desire to go to work Anxiety while working

A nurse is teaching a 27-year-old gentleman how to adjust his insulin dosages on the basis of his blood sugar results. This type of activity address is learning in the cognitive domain at the level of ________ ?

application

8.) The following are health concerns and issues of migrant workers (Select All that Apply) · A. Pesticide exposure · B. Iron deficiency anemia · C. Constipation and Dehydration · D. Tuberculosis · E. Chronic Conditions · F. Dental Disease

· A. Pesticide exposure · B. Iron deficiency anemia · D. Tuberculosis · E. Chronic Conditions · F. Dental Disease

13.) Which statement by the nurse best describes values? · A. Values are not constant; they change over time. · B. Values learned in childhood remain the same for a lifetime. · C. It is impossible for people to understand their own values. · D. The clients values are not considered when care is provided.

· A. Values are not constant; they change over time.

A nurse is caring for an older adult. Which goal is priority? · Adjusting to career · Adjusting to divorce · Adjusting to retirement · Adjusting to grandchildren

· Adjusting to retirement

Socialization into one's primary culture as a child is known as enculturation. A 6-month-old child from Guatemala was adopted by an American family in Indiana. The child's socialization into the American midwestern culture is best described as: Assimilation. Acculturation. Biculturalism. Enculturation

Assimilation results when an individual gradually adopts and incorporates the characteristics of the dominant culture.

7.) True statements about the ANA Code of Ethics (Select All That Apply): · A. The nurses primary commitment is to self first; then , if the situation is favorable, commitment to the patients whether the individual, family, group, community, or population. · B. The nurse has authority, accountability and responsibility for nursing practices; make decisions; and takes action consistent with the obligations to provide optimal patient care. · C. The profession of nursing articulates its values through individual nurses without recommendations from professional organizations; maintaining integrity and principles of social justice into nursing and healthy policy is optimal for nurses. · D. The nurse owes the same duties to self as to other, including the responsibility to promote health and safety, preserve wholeness of character and integrity, maintain competence and continue personal and professional duties. · E. It is the nurses responsibility to protect human rights, promote health diplomacy, and reduce health disparities. · F. Nurse advocates for, and protects the rights, health, and safety of the patient.

B, D, E, F

In the United States, there has never been a president of Asian or Hispanic culture. This is an example of: a. Social inequality b. Marginalization c. Under inclusion d. Social location

B. Not having a U.S. president representing an Asian or Hispanic culture is an example of marginalization—when a group is left out from facets of society. Social inequality is when people have unequal access to resources, services, and positions. Under inclusion is when a group has been overlooked in research and the design of interventions. Social location occurs when a person's place in society is based on his or her membership in a social group that determines access to resources.

28.) A nurse is planning to provide personal health care information to several patients. Which patients should the nurse anticipate will be more motivational to learn? · A. 55 y/o F who has a mastectomy and is very anxious about her body image. · B. 56 y/o M who has a heart attack last week and is requesting information about exercise · C. 18 y/o M who smokes two packs per day and is in denial about the dangers or smoking. · D. 47 y/o F who has a long leg cast after sustaining a broken leg and is still experience severe pain.

B. 56 y/o M who has a heart attack last week and is requesting information about exercise

A crisis intervention nurse working with a mother whose Down syndrome child has been hospitalized with pneumonia and who has lost her entitlement check while the child is hospitalized can expect the mother to regain stability after how long? A. After 2 weeks when the child's pneumonia begins to improve B. After 6 weeks when she adjusts to the child's respiratory status and reestablishes the entitlement checks C. After 1 month when the child goes home and the mother gets help from a food pantry D. After 6 months when the child is back in school

B. After 6 weeks when she adjusts to the child's respiratory status and reestablishes the entitlement checks Generally a person resolves the crisis and reaches psychological equilibrium in about 6 weeks.

During the assessment interview of an older woman experiencing a developmental crisis, the nurse asks which of the following questions? A. How is this flood affecting your life? B. Since your husband has died, what have you been doing in the evening when you feel lonely? C. How is having diabetes affecting your life? D. I know this must be hard for you. Let me tell you what might help.

B. Since your husband has died, what have you been doing in the evening when you feel lonely? A developmental crisis occurs as a person moves through life's stages, including widowhood.

When you care for a patient who does not speak English, it is necessary to call on a professional interpreter. Which of the following are proper principles for working with interpreters? (Select all that apply.) Expect the interpreter to interpret your statements word-for-word so there is no misunderstanding by the patient. If you feel an interpretation is not correct, stop and address the situation directly with the interpreter. Pace a conversation so there is time for the patient's response to be interpreted. Direct your questions to the interpreter. Ask the patient for feedback and clarification at regular intervals.

BCE You should not expect the interpreter to interpret your statements word for word. Although the interpreter must ensure that everything that was said is interpreted, he or she may need to use more or fewer words to convey the meaning of your conversation with a patient. Direct your questions to the patient. Look at the patient instead of at the interpreter

"I understand. Can you think of the greatest reason why stopping smoking would be challenging for you?"

Based on the transtheoretical model of change, what is the most appropriate response to a patient who states: "Me, stop smoking? I've been smoking since I was 16!" "That's fine. Some people who smoke live a long life." "OK. I want you to decrease the number of cigarettes you smoke by one each day, and I'll see you in 1 month." "I understand. Can you think of the greatest reason why stopping smoking would be challenging for you?" "I'd like you to attend a smoking cessation class this week and use nicotine replacement patches as directed."

A nurse has worked in a home health agency for a number of years. She goes to visit a patient who has diabetes and who lives in a public housing facility. This is the first time the nurse has cared for the patient. The patient has four other family members who live with her in the one-bedroom apartment. Which of the following, based on Campinha-Bacote's (2002) model of cultural competency, is an example of cultural awareness? a. The nurse begins a discussion with the patient by asking, "Tell me about your family members who live with you?" b. The nurse asks, "What do you believe is needed to make you feel better?" c. The nurse silently reflects about how her biases regarding poverty can influence how she assesses the patient. d. The nurse uses a therapeutic and caring approach to how she interacts with the patient.

C Cultural awareness involves becoming more self-aware of your biases and attitudes about human behavior and considering these factors when you interact with patients

A new nurse is caring for a hospitalized obese patient who is homeless. This is the first time the patient has been admitted to the hospital, and the patient is scheduled for surgery. Which of the following is a universal skill that will help the nurse work effectively with this patient? a. The nurse shifts her focus to understanding the patient by asking her, "Describe for me the course of your illness." b. The nurse tells the patient, "Your choices of foods and unwillingness to exercise are adding to your health problems." c. The nurse asks the patient, "Tell me about the main problems you have had with your health from not having a home." d. The nurse explains, "Because you have obesity, it is important to know the effects it has on wound healing because of reduced tissue perfusion."

C This response enables the nurse to elicit the patient's explanation of her health problems and their causes. The nurse saying "Describe for me the course of your illness"uses a biomedical explanatory model instead of the patient's explanatory model. The nurse saying "Your choices of foods and unwillingness to exercise are adding to your health problems" shows the nurse's disrespect and unwillingness to understand the patient's perceptions and health beliefs.

30.) A nurse is collecting information to prepare a teaching plan for a patient with type 1 diabetes. Which question asked by the nurse is associated with collecting information in the cognitive domain of leaning? · A. " How do you inspect your feet each day?" · B. "Can you measure a serum glucose levels?" · C. " What do you know about diabetes mellitus?" · D. "Are you able to preform a subcutaneous injection?

C. " What do you know about diabetes mellitus?"

A patient with chest pain is being admitted to the ER. When asked about the next of kin the patients states, "Don't bother calling my daughter; she is always too busy." Which is best response by the nurse? · A. "She might be upset if you don't call her." · B. " What does your daughter do that makes her so busy?" · C. "Is there someone else that you would like me to call for you?" · D. "I cant imagine that your daughter wouldn't want to know that you are sick."

C. "Is there someone else that you would like me to call for you?"

After a health care provider has informed a patient that he has colon cancer, the nurse enters the room to find the patient gazing out the window in thought. The nurse's first response is which of the following? A. "Don't be sad. People live with cancer every day." B. "Have you thought about how you are going to tell your family?" C. "Would you like for me to sit down with you for a few minutes so you can talk about this?" D. "I know another patient whose colon cancer was cured by surgery."

C. "Would you like for me to sit down with you for a few minutes so you can talk about this?" Ask the patient if he would like you to sit down for a few minutes so he can talk. Providing an open-ended question and an opportunity for the patient to talk allows the nurse to assess the patient's perception of the situation, which is of utmost importance.

When assessing an older adult who is showing symptoms of anxiety, insomnia, anorexia, and mild confusion, one of the first assessments includes which of the following? A. The amount of family support B. A 3-day diet recall C. A thorough physical assessment D. Threats to safety in her home

C. A thorough physical assessment Physical causes for problems need to be discovered before treatment for psychosocial problems can be initiated.

A grandfather living in Japan worries about his two young grandsons who disappeared after a tsunami. This is an example of: A. A situational crisis. B. A maturational crisis. C. An adventitious crisis. D. A developmental crisis.

C. An adventitious crisis. An adventitious crisis is a type of crisis resulting from a natural disaster such as a tsunami.

16.) An RN is teaching a group of patients about Diabetes Management material from a Diabetes Education Program. Which of the following should an RN prepare prior to each teaching session? · A. Plan handouts on general principles that patients can understand materials at the high school level. · B. Implement changes during class whenever a patient complains the material is too difficult to understand. · C. Assess materials to be relevant plan changes according to the needs of patients, implement teaching according to the patients ability to understand the information. · D. Assess, plan, implement, and evaluate teaching materials only according to the recommendations of the director of nursing.

C. Assess materials to be relevant plan changes according to the needs of patients, implement teaching according to the patients ability to understand the information.

Which of the following family assessments are most important for successful family caregiving? (Select all that apply.) Educational level of family members Cultural food preferences Collaboration between family members Social support Conflict resolution practices

Collaboration between family members Social support Conflict resolution practices For successful family caregiving, members of the family must collaborate and use conflict resolution strategies to divide the workload, make decisions, identify recreational activities, etc. A support system is important to help individual members and the entire family deal with the some of the high demands and challenges of family caregiving.

Which of the following examples are steps of nursing assessment? (Select all that apply.) Collection of information from patient's family members Recognition that further observations are needed to clarify information Comparison of data with another source to determine data accuracy Complete documentation of observational information Determining which medications to administer based on a patient's assessment data

Collection of information from patient's family members Correct Recognition that further observations are needed to clarify information Comparison of data with another source to determine data accuracy Assessment includes collection of data from secondary sources such as the patient's family. Recognizing that more observation is needed is an example of validation of data. Comparing data to determine accuracy is a feature of interpretation. Although complete documentation is an important step in communicating assessment data, it is not an assessment step.

A family has decided to care for a grandparent with terminal cancer in the daughter's home. Family caregiving is new to the family. When helping this family as they begin to plan for their caregiving roles, what are the two top priority assessments to best learn about family functioning? (Select all that apply.) Communication Decision making Development Economic status Family structure

Communication Decision making Understanding how the family communicates and makes decisions are priority assessments. This information will help to establish goals of care, how care will be provided, who provides the care, which resources are needed, and when to ask for additional help. Although the other factors are important, these two have priority and will assist in understanding the impact of other factors on family function and caregiving in this situation.

A new immigrant family consisting of a grandparent, two adults, and three school-age children has decided to receive their health promotion care at the Community Wellness Center. This is their first visit, and a family assessment, a health history, and a physical of each family member are needed. Which of the following are included in a family function assessment? (Select all that apply.) Cultural practices Decision making Neighborhood services Rituals and celebrations Neighborhood crime data Availability of parks

Cultural practices Decision making Rituals and celebrations This information describes what is important to a family and how they share their practices and make decisions. These pieces of information help you gain insight into how the family functions and what they consider important to their health and family functioning.

25.) A patient is extremely upset and mentions something about work-related issues that the nurse cannot understand. Which is the nurses best response? · A. "Its natural to worry about your job." · B. " Your job must be very important to you." · C. "Calm down so I can understand what you are saying." · D. " I'm not quite sure I heard what you were saying about your work."

D. " I'm not quite sure I heard what you were saying about your work."

The nurse is evaluating the coping success of a patient experiencing stress from being newly diagnosed with multiple sclerosis and psychomotor impairment. The nurse realizes that the patient is coping successfully when the patient says: A. "I'm going to learn to drive a car so I can be more independent." B. "My sister says she feels better when she goes shopping, so I'll go shopping." C. "I've always felt better when I go for a long walk. I'll do that when I get home." D. "I' m going to attend a support group to learn more about multiple sclerosis."

D. "I' m going to attend a support group to learn more about multiple sclerosis." Support groups often benefit people experiencing stress.

21.) Which statement best describes Erikson's Theory of Development. · A. The premise of the theory is that individuals are interdependent beings. · B. Developmental stages result in an attempt to make sense of the world. · C. A healthy personality will achieve the pre-conventional stage by 15. · D. An individuals achievements of identity is through sequential psychosocial stages.

D. An individuals achievements of identity is through sequential psychosocial stages.

A patient states, "Do you think I could have cancer?" The nurse responds, "What did the doctor tell you?" Which interviewing approach did the nurse use? · A. Paraphrasing · B. Confrontation · C. Reflective Technique · D. Open-ended question

D. Open-ended question

A nurse manager is teaching a group of nurses about the levels of prevention. Which example of the tertiary level of prevention should be included in the instruction. · A. Surgery to repair a hip dislocation of an older adult client. · B. Teaching breastfeeding to expectant mothers in a prenatal clinic. · C. Chemotherapy treatment to a client newly diagnosed with cancer. · D. Physical therapy to a patient who has a right sided paralysis from a stroke.

D. Physical therapy to a patient who has a right-sided paralysis from a stroke Tertiary prevention seeks to reduce or soften the impact of an ongoing injury, illness or disease that has lasting effects. Tertiary prevention is done to assist individuals to manage long-term, complex problems. Tertiary prevention aims to improve an individual's ability to function, life expectancy and the overall quality of life. Physical therapy is aimed at improving the ability to function after stroke and improve the quality of life. Physical therapy is not a principal treatment for the right-sided paralysis but it is a strategy that is aimed at improving the ability to function

The nurse plans care for a 16-year-old male, taking into consideration that stressors experienced most commonly by adolescents include which of the following? A. Loss of autonomy caused by health problems B. Physical appearance, family, friends, and school C. Self-esteem issues, changing family structure D. Search for identity with peer groups and separating from family

D. Search for identity with peer groups and separating from family Search for identity with peer groups and separating from family are stressors most commonly experienced by adolescents. Loss of autonomy caused by health problems applies to the older adult. Physical appearance, family, friends and school apply to children. Self-esteem issues and a changing family structure apply to preadolescents.

A patient newly diagnosed with type 2 diabetes says, "My blood sugar was just a little high. I don't have diabetes." The nurse responds: A. "Let's talk about something cheerful." B. "Do other members of your family have diabetes?" C. "I can tell that you feel stressed to learn that you have diabetes." D. With silence.

D. With silence. The nurse understands that denial is a defense mechanism that assists in coping with a shock. Therapeutic use of silence gives patients time to process their thoughts.

You are participating in a clinical care coordination conference for a patient with terminal cancer. You talk with your colleagues about using the nursing code of ethics for professional registered nurses to guide care decisions. A nonnursing colleague asks about this code. Which of the following statements best describes this code? 1. Improves self-health care 2. Protects the patient's confidentiality 3. Ensures identical care to all patients 4. Defines the principles of right and wrong to provide patient care

Defines the principles of right and wrong to provide patient care

You are caring for a family that consists of a father and 3-year-old boy who has well-managed asthma but misses care infrequently. They live in state-supported housing. The father is in school studying to be an information technology professional. His income and time are limited, and he admits to going to fast-food restaurants frequently for dinner. However, he and his son spend a lot of time together. The family receives state-supported health care for his son, but he does not have health insurance or a personal physician. He has his son enrolled in a government-assisted day care program. Which of the following are risks to this family's level of health? (Select all that apply.) Economic status Chronic illness Underinsured Government-assisted day care Frequency of fast-food dinners State-supported housing

Economic status Underinsured Frequency of fast-food dinners Although the family is able to meet some basic needs, they depend on supported day care and state-supported insurance for the little boy. The father's lack of insurance affects family health because he does not have the resources to support health promotion and screening activities. Although asthma is a chronic illness, it is well controlled at this time.

An 18-year-old woman is in the emergency department with fever and cough. The nurse obtains her vital signs, auscultates her lung sounds, listens to her heart sounds, determines her level of comfort, and collects blood and sputum samples for analysis. Which standard of practice is performed? 1. Diagnosis 2. Evaluation 3. Assessment 4. Implementation

Evaluation

Which of the following are possible outcomes with clear family communication? (Select all that apply.) Family goals Increased socialization Decision making Methods of discipline Improved education Impaired coping

Family goals Decision making Methods of discipline Clear and direct family communication helps the family establish goals and make decisions, especially those decisions related to method of discipline.

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

Family meetings Established family roles Willingness to change in time of stress Family hardiness is the internal strengths and durability of the family unit. A sense of control over the outcome of life, a view of change as beneficial and growth producing, and an active rather than passive orientation in adapting to stressful events all contribute to family hardiness.

Advanced practice registered nurses generally: 1. Function independently 2. Function as unit directors 3. Work in acute care settings 4. Work in the university setting.

Function independently

A nurse is working with a young childbearing family who has one child with a congenital heart disease. The parents are trying to determine the risks of a second child being born with congenital heart disease. Describe why genomics information is important in assisting the parents in this decision.

Genomics describes the study of all the genes in a person and the interactions of these genes with one another and with that person's environment. Genomic information allows health care providers to determine how genomic changes contribute to patient conditions and influence treatment decisions.

In viewing the family as context, what is the primary focus? Family members within a system Family process and relationships Family relational and transactional concepts Health needs of an individual member

Health needs of an individual member When you view the family as context, the primary focus is on the health and development of an individual member existing within a specific environment (i.e., the patient's family). Although the focus is on the individual's health status, it is also important to assess how much the family provides the individual's basic needs.

A nurse assesses a patient who comes to the pulmonary clinic. "I see that it's been over 6 months since you've been here, but your appointment was for every 2 months. Tell me about that. Also I see from your last visit that the doctor recommended routine exercise. Can you tell me how successful you've been in following his plan?" The nurse's assessment covers which of Gordon's functional health patterns? Value-belief pattern Cognitive-perceptual pattern Coping-stress-tolerance pattern Health perception-health management pattern

Health perception-health management pattern The nurse's assessment covers the health perception- health management pattern, which is a patient's self-report of how he or she manages his or her health and his or her knowledge of preventive health practices. The coping-stress tolerance pattern includes questions focused on how a patient manages stress and sources of support. An assessment covering the value belief pattern leads a patient to describe patterns of values, beliefs, and life goals. An assessment of the cognitive-perceptual pattern includes questions that focus on the patient's language adequacy, memory, and decision-making ability.

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

Health promotion activities Health promotion activities focus on interventions designed to maintain the physical, social, emotional, and spiritual health of the family unit, including information about specific health behaviors and family coping techniques.

A patient in the emergency department has developed wheezing and shortness of breath. The nurse gives the ordered medicated nebulizer treatment now and in 4 hours. Which standard of practice is performed? 1. Planning 2. Evaluation 3. Assessment 4. Implementation

Implementation

Nurses at a community hospital are in an education program to learn how to use a new pressure-relieving device for patients at risk for pressure ulcers. This is which type of education? 1. Continuing education 2. Graduate education 3. In-service education 4. Professional Registered Nurse Education

In-service education

A critical care nurse is using a computerized decision support system to correctly position her ventilated patients to reduce pneumonia caused by accumulated respiratory secretions. This is an example of which Quality and Safety in the Education of Nurses (QSEN)competency? 1. Patient-centered care 2. Safety 3. Teamwork and collaboration 4. Informatics

Informatics

Health care reform will bring changes in the emphasis of care. Which of the following models is expected from health care reform? 1. Moving from an acute illness to a health promotion, illness prevention model 2. Moving from illness prevention to a health promotion model 3. Moving from an acute illness to a disease management model 4. Moving from a chronic care to an illness prevention model

Moving from an acute illness to a health promotion, illness prevention model

The nurses on an acute care medical floor notice an increase in pressure ulcer formation in their patients. A nurse consultant decides to compare two types of treatment. The first is the procedure currently used to assess for pressure ulcer risk. The second uses a new assessment instrument to identify at-risk patients. Given this information, the nurse consultant exemplifies which career? 1. Clinical nurse specialist 2. Nurse administrator 3. Nurse educator 4. Nurse researcher

Nurse Researcher

Which of the following nursing roles may have prescriptive authority in their practice? (Select all that apply.) 1. Critical care nurse 2. Nurse practitioner 3. Certified clinical nurse 4. Charge nurse

Nurse practitioner, Certified clinical nurse

patient safety

Nurses on a nursing unit are discussing the processes that led up to a near-miss error on the clinical unit. They are outlining strategies that will prevent this in the future. This is an example of nurses working on what issue in the health care system? Patient safety Evidence-based practice Patient satisfaction Maintenance of competency

Which type of interview question does the nurse first use when assessing the reason for a patient seeking health care? Probing Open-ended Problem-oriented Confirmation

Open-ended The best interview question for initially determining why a patient is seeking health care is by asking an open-ended question that allows the patient to tell his or her story. This is also a more patient-centered approach. Probing questions are asked after data are gathered to seek more in-depth information. Problem-oriented and confirmation are not types of interview questions.

A nurse is checking a patient's intravenous line and, while doing so, notices how the patient bathes himself and then sits on the side of the bed independently to put on a new gown. This observation is an example of assessing: Patient's level of function. Patient's willingness to perform self-care. Patient's level of consciousness. Patient's health management values.

Patient's level of function Observing a patient perform activities physical, socially, psychologically, and developmentally assesses his or her level of function. In the case of this question the nurse assesses physical functional level. Observation does not measure willingness to perform self-care but the ability to do so. Observing physical performance of self-hygiene is not a measure of level of consciousness nor does it reveal a patient's values.

When doing an assessment of a young woman who was in an automobile accident 6 months before, the nurse learns that the woman has vivid images of the crash whenever she hears a loud, sudden noise. The nurse recognizes this as ____________.

Post Traumatic Stress Disorder (PTSD) "PTSD originates with a person's experiencing or witnessing a traumatic event and responding with intense fear or helplessness. The car accident is the traumatic ev, Posttraumatic stress disorder (PTSD), PTSD originates with a person's experiencing or witnessing a traumatic event and responding with intense fear or helplessness. The car accident is the traumatic ev, Posttraumatic stress disorder (PTSD)"

The examination for registered nurse licensure is exactly the same in every state in the United States. This examination: 1. Guarantees safe nursing care for all patients 2. Ensures standard nursing care for all patients 3. Ensures that honest and ethical care is provided 4. Provides a minimal standard of knowledge for a registered nurse in practice

Provides a minimal standard of knowledge for a registered nurse in practice

The Collins family includes a mother; stepfather, two teenage biological daughters of the mother; and a 25-year-old biological daughter of the father. The father's daughter just moved home following the loss of her job in another city. The family is converting a study into Stacey's bedroom and is in the process of distributing household chores. When you talk to members of the family, they all think that their family can adjust to lifestyle changes. This is an example of family: Diversity. Durability. Resiliency. Configuration.

Resiliency. Resiliency is the ability of the family to cope with the unexpected. In this scenario the family used resources to provide some short-term solutions for the return home of an adult child.

A family is undergoing a major change. Just as twins graduate from college and leave home to begin their careers, the husband loses his executive well-paying job. Because the family had two children in college at the same time, they did not save for retirement. They planned to save aggressively after the children left college. In this situation, which of the following demonstrate family resiliency? (Select all that apply.) Resuming full-time work when spouse loses job Increasing problems among siblings Developing hobbies when children leave home Placing blame on family members Expecting children to help financially Consulting a financial planner

Resuming full-time work when spouse loses job Developing hobbies when children leave home Consulting a financial planner These three strategies show how a family uses problem solving and changes activities when family function and structure change. Resiliency addresses the ability of the family to have healthy responses or changes to family events (in this case loss of income status and children leaving the home).

Which behavior indicates the nurse is using a process recording correctly to enhance communication with patients? · Shows sympathy appropriately · Uses automatic responses fluently · Demonstrates passive remarks accurately · Self-examines personal communication skills

Self-examines personal communication skills

A patient who visits the surgery clinic 4 weeks after a traumatic amputation of his right leg tells the nurse practitioner that he is worried about his ability to continue to support his family. He tells the nurse he feels that he has let his family down after having an auto accident that led to the loss of his left leg. The nurse listens and then asks the patient, "How do you see yourself now?" On the basis of Gordon's functional health patterns, which pattern does the nurse assess? Health perception-health management pattern Value-belief pattern Cognitive-perceptual pattern Self-perception-self-concept pattern

Self-perception-self-concept pattern This is an example of assessment of a patient's feelings about his worth and body image, which is the self-perception- self-concept health pattern.

During a visit to the clinic, a patient tells the nurse that he has been having headaches on and off for a week. The headaches sometimes make him feel nauseated. Which of the following responses by the nurse is an example of probing? So you've had headaches periodically in the last week and sometimes they cause you to feel nauseated—correct? Have you taken anything for your headaches? Tell me what makes your headaches begin. Uh huh, tell me more.

Tell me what makes your headaches begin. An open-ended question that probes such as "Tell me what makes your headaches begin" encourages a fuller description of a situation. The statement "So you've had headaches periodically in the last week, and sometimes they cause you to feel nauseated—correct?" is a summative statement. Asking whether the patient has taken anything for the headaches is a closed-ended question. Saying "Uh huh, tell me more" is an example of back channeling.

Mother died from CAD at age 48 History of hypertension Elevated cholesterol level

The nurse assesses the following risk factors for coronary artery disease (CAD) in a female patient. Which factors are classified as genetic and physiological? (Select all that apply.) Sedentary lifestyle Mother died from CAD at age 48 History of hypertension Eats diet high in sodium Elevated cholesterol level

-Use of physical restraints -Pain assessment, intervention, and reassessment -Registered nurse (RN) education and certification

The nursing staff is developing a quality program. Which of the following are nursing-sensitive indicators from the National Database of Nursing Quality Indicators (NDNQI) that the nurses can use to measure patient safety and quality for the unit? (Select all that apply.) Use of physical restraints Pain assessment, intervention, and reassessment Patient satisfaction with food preparation Registered nurse (RN) education and certification Number of outpatient surgical cases per year

A nurse gathers the following assessment data. Which of the following cues together form(s) a pattern suggesting a problem? (Select all that apply.) The skin around the wound is tender to touch. Fluid intake for 8 hours is 800 mL. Patient has a heart rate of 78 beats/min and regular. Patient has drainage from surgical wound. Body temperature is 38.3° C (101° F). Patient states, "I'm worried that I won't be able to return to work when I planned."

The skin around the wound is tender to touch Patient has drainage from surgical wound. Body temperature is 38.3° C (101° F). Tender skin around the wound, drainage from the surgical wound, and a temperature of 38.3° C (101° F) indicate a wound infection. Fluid intake of 800 mL over 8 hours and a heart rate of 78 beats/min and regular are normal assessment findings. A patient's expressed concern about returning to work is his or her subjective response about a separate issue and is insufficient to form a pattern.

3.The individual becomes angry when the physician tells him that he needs to increase his activity to lose 30 lbs. 1.The individual recognizes that he is out of shape when his daughter asks him to walk with her after school. 5.The individual visits the local running store to purchase walking shoes and obtain advice on a walking plan. 4.The individual walks 2 to 3 miles, 5 nights a week, with his wife. 2.Eight months after beginning walking, the individual participates with his wife in a local 5K race.

Using the Transtheoretical Model of Change, what is the correct order for the steps that a patient goes through to make a lifestyle change related to physical activity? 1.The individual recognizes that he is out of shape when his daughter asks him to walk with her after school. 2.Eight months after beginning walking, the individual participates with his wife in a local 5K race. 3.The individual becomes angry when the physician tells him that he needs to increase his activity to lose 30 lbs. 4.The individual walks 2 to 3 miles, 5 nights a week, with his wife. 5.The individual visits the local running store to purchase walking shoes and obtain advice on a walking plan. 3, 1, 4, 5, 2 3, 1, 4, 2, 5 1, 3, 5, 2, 4 3, 1, 5, 4, 2

Holistic

When taking care of patients, a nurse routinely asks if they take any vitamins or herbal medications, encourages family members to bring in music that the patient likes to help the patient relax, and frequently prays with her patients if that is important to them. The nurse is practicing which model? Holistic Health belief Transtheoretical Health promotion

Attending a review course in preparation for a certification examination

Which activity performed by a nurse is related to maintaining competency in nursing practice? Asking another nurse about how to change the settings on a medication pump Regularly attending unit staff meetings Participating as a member of the professional nursing council Attending a review course in preparation for a certification examination

A school health nurse provides a program to the first-year students on healthy eating.

Which activity shows a nurse engaged in primary prevention? A home health care nurse visits a patient's home to change a wound dressing. A nurse is assessing risk factors of a patient in the emergency department admitted with chest pain. A school health nurse provides a program to the first-year students on healthy eating. A nurse schedules a patient who had a myocardial infarction for cardiac rehabilitation sessions weekly.

- Provider receives a predetermined payment for each patient in the program. - System tries to reduce costs while keeping patients healthy. - Focus of care is on prevention and early intervention.

Which of the following are characteristics of managed care systems? (Select all that apply.) Provider receives a predetermined payment for each patient in the program. Payment is based on a set fee for each service provided. System includes a voluntary prescription drug program for an additional cost. System tries to reduce costs while keeping patients healthy. Focus of care is on prevention and early intervention.

-Providing prenatal teaching on nutrition to a pregnant woman during the first trimester -Assessing the nutritional status of older adults who come to the community center for lunch. -Teaching a class to parents at the local grade school about the importance of immunizations.

Which of the following are examples of the nurse participating in primary care activities? (Select all that apply.) Providing prenatal teaching on nutrition to a pregnant woman during the first trimester Assessing the nutritional status of older adults who come to the community center for lunch. Working with patients in a cardiac rehabilitation program Providing home wound care to a patient Teaching a class to parents at the local grade school about the importance of immunizations.

-Changing the postoperative dressing for a patient on a medical-surgical unit. -Doing endotracheal suctioning for a patient on a ventilator in the medical intensive care unit.

Which of the following nursing activities is provided in a secondary health care environment? (Select all that apply.) Conducting blood pressure screenings for older adults at the Senior Center. Teaching a clinic patient with chronic obstructive pulmonary disease purse-lipped breathing techniques. Changing the postoperative dressing for a patient on a medical-surgical unit. Doing endotracheal suctioning for a patient on a ventilator in the medical intensive care unit.

Magnet is a special designation for hospitals that achieve excellence in nursing practice

Which of the following statements is true regarding Magnet status recognition for a hospital? Nursing is run by a Magnet manager who makes decisions for the nursing units Nurses in Magnet hospitals make all of the decisions on the clinical units Magnet is a term that is used to describe hospitals that are able to hire the nurses they need Magnet is a special designation for hospitals that achieve excellence in nursing practice

"I am enjoying my quilting group that meets each week at my church."

Which statement made by a nurse shows that the nurse is engaging in an activity to help cope with secondary traumatic stress and burnout? "I don't need time for lunch since I am not very hungry." "I am enjoying my quilting group that meets each week at my church." "I am going to drop my gym membership because I don't have time to go." "I don't know any of the other nurses who met today to discuss hospital-wide problems with nurse satisfaction."

accountability

You administer a once-a-day cardiac medication at the wrong time, but nobody sees it. However you contact the primary care provider and your head nurse and follow agency procedure

A nurse is assigned to a 42-year-old mother of 4 who weighs 136.2 kg (300 lbs), has diabetes, and works part time in the kitchen of a restaurant. The patient is facing surgery for gallbladder disease. Which of the following approaches demonstrates the nurse's cultural competence in assessing the patient's health care problems? "I can tell that your eating habits have led to your diabetes. Is that right?" "It's been difficult for people to find jobs. Is that why you work part time?" "You have four children; do you have any concerns about going home and caring for them?" "I wish patients understood how overeating affects their health."

You have four children; do you have any concerns about going home and caring for them?" This is the only assessment approach that is not biased or does not show judgment about the patient's weight or occupational status. With the other options, the nurse is reacting to the patient on the basis of personal stereotypes and biases.

A nurse is choosing an appropriate topic for a young adult health fair. Which topic should the nurse include? a. retirement b. menopause c. climacteric factors d. unplanned pregnancies

d. unplanned pregnancies

The communication of health information in a manner which is clear and understandable to the client is:

health literacy

A patient had surgery for a total knee replacement a week ago and is currently participating in daily physical rehabilitation sessions at the surgeon's office. In what level of prevention is the patient participating? Primary prevention Secondary prevention Tertiary prevention Quaternary prevention

tertiary prevention

Which statement, if made by a parent, will require further instruction from the nurse? · "I should not be surprised that my teenage son has so many friends." · "I get worried because my teenage son thinks he's indestructible." · "I should cover for my 10-year-old son when he makes mistakes until he learns the ropes." · "I usually have nutritious snacks available because my 10-year-old son is always hungry right after school."

· "I should cover for my 10-year-old son when he makes mistakes until he learns the ropes."

11.) What information is about nursing standards of care? · A. Nursing standards of care guidelines for nursing practice. · B. Nursing standards of care are defined in Nurse Practice Acts. · C. Nursing standards of care are used to measure nursing conduct in malpractice suit. · D. Nursing standards of care are specific guidelines only for unlicensed assistive personnel. · E. Nursing standards of care are upheld by law and indicate what standards nurse must follow. · F. Nursing standards of care are used to determine whether the nurse acted as any reasonably prudent nurse under the same or similar conditions.

· A. Nursing standards of care guidelines for nursing practice. · B. Nursing standards of care are defined in Nurse Practice Acts. · C. Nursing standards of care are used to measure nursing conduct in malpractice suit. · E. Nursing standards of care are upheld by law and indicate what standards nurse must follow. · F. Nursing standards of care are used to determine whether the nurse acted as any reasonably prudent nurse under the same or similar conditions.

According to Erikson's developmental theory, the primary developmental task if the middle years is to: · Achieve intimacy · Achieve generativity · Establish a set of personal values · Establish a sense of personal identity

· Achieve generativity

According to Kohlberg, children develop moral reasoning as they mature. Which of the following is most characteristic of a preschooler' stage of moral development? · The rules of correct behavior are obeyed. · Behavior that pleased others is considered good. · Showing respect for authority is important behavior. · Actions are determined as good or bad in terms of their consequences.

· Actions are determined as good or bad in terms of their consequences.

A mother has delivered a healthy newborn. Which action is priority? · Encourage close physical contact as soon as possible after birth. · Isolate the newborn in the nursery during the first hour after delivery. · Never leave the newborn alone with the mother during the first 8 hours after delivery. · Do not allow the newborn to remain with parents until the second hour after delivery. · After immediate physical evaluation and application of identification bracelets, the nurse promotes the parents' and newborn's need for close physical contact.

· After immediate physical evaluation and application of identification bracelets, the nurse promotes the parents' and newborn's need for close physical contact.

A nurse is caring for a young adult after surgery. Which action by the nurse will be priority? · Allow involvement of peers · Allow involvement of partner · Allow involvement of volunteer activities · Allow involvement of consistent schedule

· Allow involvement of partner

A nurse is teaching a group of older-adult patients. Which teaching strategy is best for the nurse to use? · Provide several topics of discussion at once to promote independence and making choices. · Avoid uncomfortable silences after questions by helping patients complete their statements. · Ask patients to recall past experiences that correspond with their interests. · Speak in a high pitch to help patients hear better.

· Ask patients to recall past experiences that correspond with their interests.

A patient has heart failure and kidney failure. The patient needs teaching about dialysis. Which nursing action is most appropriate for assessing this patient's learning needs? · Assess the patient's total health care needs. · Assess the patient's health literacy. · Assess all sources of patient data. · Assess the goals of patient care.

· Assess the patient's health literacy.

A nurse is conducting a community education program about cognition in older adults. Which of the following information should be included? · Some form of mild dementia is a normal part of aging. · All forms of dementia have the same symptoms, but progress at different rates. · Assessment for dementia should be part of routine physical exams. · Elders who score below 27 points on the Mini-Mental State Exam (MMSE) are not likely to have a cognition problem.

· Assessment for dementia should be part of routine physical exams.

Which of the following emphasizes an individuals belief and being personably capable of preforming the behavior is required to influence ones own health. · A. Social cognitive theory · B. Self efficiency theory · C. Health Belief Model · D. Transtheoretical Model

· B. Self efficiency theory

A nurse is establishing health promotion goals for a female client who smokes cigarettes, has hypertension and has a BMI of 26. Which of the following goals should the nurse include? · A. The client will list foods that are high in calcium, which should be avoided. · B. The client will walk for 30 mins a day 5 days a week. · C. The client will increase calorie intake by 200 cal per day. · D. The client will replace cigarettes with smokeless tobacco products.

· B. The client will walk for 30 mins a day 5 days a week.

26.) A nurse must conduct a focused interview to complete an admission history. Which interviewing technique should the nurse use? · A. Probing · B. Clarification · C. Direct questions · D. Paraphrasing statements

· C. Direct questions

14.) Which educational strategy would be most appropriate to use in order to provide affective learning domain of the client? · A. Lecture followed by simple written test · B. Video presentation and handouts · C. Role playing and group discussion · D. Demonstration and practice

· C. Role playing and group discussion

How would the nurse approach this ethical dilemma: Two patients are on the list for kidney transplants and they will both die without one. Which patient would get the one kidney that is immediately available for transplantation. · A. Choose the patients who has the ability to fiancé the hospitalization and treatment. · B. Advocate for the younger of the two clients since that client will live longer. · C. Use ethical principles to guide the decision making process. · D. Select a client who is most productive in society.

· C. Use ethical principles to guide the decision making process.

A nurse is attending a continuing education program about growth and development. Why is it necessary that nurses are well educated about this content? (Select all that apply) · Can deliver anticipatory guidance to families · Have a better understanding of genetics and genomics · Can meet the requirements of Healthy People 2020 · Can provide more effective health education

· Can deliver anticipatory guidance to families · Have a better understanding of genetics and genomics ·· Can provide more effective health education

A nurse determines that a middle-aged patient is a typical example of the "sandwich generation." What did the nurse discover the patient is caught between? · Job responsibilities or family responsibilities · Stopping old habits and starting new ones · Caring for children and aging parents · Advancing in career or retiring

· Caring for children and aging parents

According to Piaget, the school-age child is in the third stage of cognitive development, which is characterized by: · Concrete operations · Conventional thought · Post-conventional thought · Identity versus role diffusion

· Concrete operations

A nurse is teaching a class to students of pediatric nursing on comparing the concepts of growth and development which statement most accurately represents these concepts · Growth patterns are qualitative changes. · Growth is from the head to toe or cephalocaudal. · Development reflects an increase in the number and size of cells. · Development is a gradual change that includes advances in skills.

· Development is a gradual change that includes advances in skills.

A nurse is teaching a patient with a risk for hypertension how to take a blood pressure. Which action by the nurse is the priority? · Assess laboratory results for high cholesterol and other data. · Identify that teaching is the same as the nursing process. · Perform nursing care therapies to address hypertension. · Focus on a patient's learning needs and objectives.

· Focus on a patient's learning needs and objectives.

A nurse is using Jean Piaget's developmental theory to focus on cognitive development. Which area will the nurse assess in this patient? · Latency · Formal operations · Intimacy versus isolation · The postconventional level

· Formal operations

According to Erikson, the developmental task of adolescence is : · Industry vs. inferiority · Identity vs. role confusion · Autonomy vs. shame and doubt · Role acceptance vs. role confusion

· Identity vs. role confusion

Which information from the nurse indicates a correct understanding of emerging adulthood? · It is a type of young adulthood. · It is a type of extended adolescence. · It is a type of independent exploration. · It is a type of marriage and parenthood.

· It is a type of independent exploration.

An older patient with dementia and confusion is admitted to the nursing unit after hip replacement surgery. Which action will the nurse include in the plan of care? · Keep a routine. · Continue to reorient. · Allow several choices. · Socially isolate patient.

· Keep a routine.

The nurse is caring for a 14-year-old patient in the hospital. Which goal will be priority? · Maintain industry · Maintain identity · Maintain intimacy · Maintain initiative

· Maintain identity

The referent in the communication process is: · Information shared by the sender · The means of conveying messages · That which motivates the communication · The person who initiates the communication · Motivates one person to communicate with the other.

· Motivates one person to communicate with the other.

According to Healthy People 2020, the leading causes of death among children and young adults are due to injuries from which of the following? · Homicide · Suicide · Burns · Motor Vehicle Crashes

· Motor Vehicle Crashes

A nurse is developing a plan of care for an older adult. Which information will the nurse consider? · Should be standardized because most geriatric patients have the same needs · Needs to be individualized to the patient's unique needs · Focuses on the disabilities that all aging persons face · Must be based on chronological age alone

· Needs to be individualized to the patient's unique needs

A nurse is working in the delivery room. Which action is priority immediately after birth? · Open the airway. · Determine gestational age. · Monitor infant-parent interactions. · Promote parent-newborn physical contact.

· Open the airway.

A nurse is reviewing car seat safety with the parents of a 1-month-old infant. When reviewing car seat use which of the following instructions should the nurse include? · Use a car seat that has a three point harness system. · Position the car seat so that the infant is rear facing. · Secure the car seat in the front passenger seat of the vehicle · Convert to a booster seat after 12 months.

· Position the car seat so that the infant is rear facing.

Taking into account all of the agents that affect middle-age adults, the nurse plans a health education workshop focused on developing an individualized lifestyle change program for each participant. Which of the following actions should the nurse stress that individuals take first? · Limiting unprotected exposure to sun · Starting a smoking cessation program · Exercising at least three times a week · Scheduling a complete physical and dental exam

· Scheduling a complete physical and dental exam

The nurse works with pediatric patients who have Diabetes. Which is the youngest age group to which the nurse can effectively teach psychomotor skills such as insulin administer? · Toddler · Preschool · School age · Adolescent

· School age

The nurse is caring for an infant. Which activity is most appropriate for the nurse to offer to the infant? · Set of cards to organize and separate into groups · Set of sock puppets with movable eyes · Set of plastic stacking rings · Set of paperback book

· Set of plastic stacking rings

A nurse is giving a presentation about accident prevention to a group of parents of toddlers. Which of the following accident-prevention strategies should the nurse include? (Select all that apply). · Store toxic agents in locked cabinets · Keep toilet seats up · Turn pot handles toward the back of the stove · Place safety gates across stairways · Make sure balloons are fully inflated

· Store toxic agents in locked cabinets · Turn pot handles toward the back of the stove · Place safety gates across stairways

The school nurse is working on a campaign in the school to prevent adolescent pregnancies. Which of the following interventions should the nurse implement? · Talk to teenagers about sex, including abstinence, contraception, and sexually transmitted diseases. · Tell the teenagers they should abstain from sex until they are old enough to cope with the potential consequences such as an unwanted pregnancy. · Encourage parents of all teenage girls to make sure their daughters start oral contraceptives early. · Offer all teenagers free condoms when they come in for physical exams.

· Talk to teenagers about sex, including abstinence, contraception, and sexually transmitted diseases.

Demonstration of the principles of body mechanics used when transferring patients from bed to chair would be classified under which domain of learning? · social · affective · cognitive · psychomotor

· psychomotor

The nurse utilizes strategies associates with client centered communication by doing what?

-Not being "too busy" to talk -developing mutual understanding -using a conversational interviewing style -tuning in to the clients preferences and style

10. Which of the following statements best explains the actions of therapeutic touch (TT)? 1. Intentionally mobilizes energy to balance, harmonize, and repattern the recipient's biofield 2. Intentionally heals specific diseases or corrects certain symptoms 3. Is overwhelmingly effective in many conditions 4. Is completely safe and does not warrant any special precautions

1

A single young adult interacts with a group of close friends from college and work. They celebrate birthdays and holidays together. In addition, they help one another through many stressors. These individuals are viewed as: 1. Family. 2. Siblings. 3. Substitute parents. 4. Alternative family structure.

1

Middle-age adults frequently find themselves trying to balance responsibilities related to employment, family life, care of children, and care of aging parents. People finding themselves in this situation are frequently referred to as being a part of: 1. The sandwich generation. 2. The millennial generation. 3. Generation X. 4. Generation Y.

1

Sexually transmitted infections (STIs) continue to be a major health problem in young adults. Men ages 20 to 24 years have the highest rate of which STI? 1. Chlamydia 2. Syphilis 3. Gonorrhea 4. Herpes zoster

1

The nurse is completing a health history with the daughter of a newly admitted patient who is confused and agitated. The daughter reports that her mother was diagnosed with Alzheimer's disease 1 year ago but became extremely confused last evening and was hallucinating. She was unable to calm her, and her mother thought she was a stranger. On the basis of this history, the nurse suspects that the patient is experiencing: 1. Delirium. 2. Depression. 3. New-onset dementia. 4. Worsening dementia.

1

When nurses are communicating with adolescents, they should: 1 Be alert to clues to their emotional state. 2 Ask closed-ended questions to get straight answers. 3 Avoid looking for meaning behind adolescents' words or actions. 4 Avoid discussing sensitive issues such sex and drugs.

1 Be alert to clues to their emotional state. Pg. 154; Good communication skills are critical for adolescents in overcoming peer pressure and unhealthy behaviors.

A school nurse is counseling an obese 10-year-old child. Which factors would be important to consider when planning an intervention to support the child's health? (select all that apply) 1 Consider both the child and the family when addressing the issue. 2 Consider the use of medications to suppress the appetite. 3 First plan for weight loss through dieting and then add activity as tolerated. 4 Plan food intake to allow for growth 5 Consider consulting a bariatric surgeon if other measures fail.

1 Consider both the child and the family when addressing the issue. 4 Plan food intake to allow for growth. Pg. 153; Children need adequate caloric intake for growth throughout childhood accompanied by activity for continued gross-motor-development.

An 8-year-old child is being admitted to the hospital from the emergency department with an injury from falling off her bicycle. Which of the following will most help her adjust to the hospital? 1 Explain hospital routines such as meal times to her. 2 Use terms such as "honey" and "dear" to show a caring attitude. 3 Explain when her parents can visit and why siblings cannot come to see her. 4 Since she is young, orient her parents to her room and hospital facility.

1 Explain hospital routines such as meal times to her. Pg. 152; The nurse helps the child cope with stress by helping the parents and the child identify potential stressors and designing interventions to minimize stress and the child's stress response.

In an interview with a pregnant patient, the nurse discussed the three risk factors that have been cited as having a possible effect on prenatal development. They are: 1 Nutrition, stress, and mother's age. 2 Prematurity, stress, and mother's age. 3 Nutrition, mother's age, and fetal infections. 4 Fetal infections, prematurity, and placenta previa.

1 Nutrition, stress, and mother's age. Pg. 142; The diet of a women both before and during pregnancy has a significant effect on fetal development as well as stress and anxiety. Fetuses of older mothers are at risk for chromosomal defects.

At a well-child examination, the mother comments that her toddler eats little at mealtime, will only sit briefly at the table, and wants snacks all the time. Which of the following should the nurse recommend? 1 Provide nutritious snacks. 2 Offer rewards for eating at mealtimes. 3 Avoid snacks so she is hungry at mealtime. 4 Explain to her firmly why eating at mealtime is important.

1 Provide nutritious snacks. Pg. 149; Encourage parents to offer a variety of nutritious meals and to provide only nutritious snacks between meals.

Which of the following are examples of the conventional reasoning form of cognitive development? (Select all that apply.) 1. A 35-year-old woman is speaking with you about her recent diagnosis of a chronic illness. She is concerned about her treatment options in relation to her ability to continue to care for her family. As she considers the options and alternatives, she incorporates information, her values, and emotions to decide which plan will be the best fit for her. 2. A young father is considering whether or not to return to school for a graduate degree. He considers the impact the time commitment may have on the needs of his wife and infant son. 3. A teenage girl is encouraged by her peers to engage in shoplifting. She decides not to join her peers in this activity because she is afraid of getting caught in the act. 4. A single mother of two children is unhappy with her employer. She has been unable to secure alternate employment but decides to quit her current job

1, 2

15. The nurse manager of a community clinic arranges for staff in-services about various complementary therapies available in the community. What is the purpose of this training? (Select all that apply.) 1. Nurses have a long history of providing some of these therapies and need to be knowledgeable about their positive outcomes. 2. Nurses are often asked for recommendations and strategies that promote well-being and quality of life. 3. Nurses play an essential role in patient education to provide information about the safe use of these healing strategies. 4. Nurses appreciate the cultural aspects of care and recognize that many of these complementary strategies are part of a patient's life. 5. Nurses play an essential role in the safe use of complementary therapies. 6. Nurses learn how to provide all of the complementary modalities during their basic education.

1, 2, 3, 4, 5

Which of the following properly applies an ethical principle to justify access to health care? (select all that apply) 1. Access to health care reflects the commitment of society to principles of beneficence and justice 2. If low income compromises access to care, respect for autonomy is compromised 3. Access to health care is a privilege in the United Sates, not a right 4. Poor access to affordable health care causes her, that is ethically troubling because nonmalficence is a basic principle of health care ethics. 5. Providers are exempt from fidelity to peo;e with drug addiction because addiction reflect a lack of personal accountability 6. If a new drug is discovered that cures a disease but at great cost per patient, the principle of justice suggests that the drug should be made available to those who can afford it

1, 2, 4

Which of the following activities are examples of the use of activity theory in older adults? (Select all that apply.) 1. Teaching an older adult how to use e-mail to communicate with a grandchild who lives in another state 2. Introducing golf as a new hobby 3. Leading a group walk of older adults each morning 4. Engaging an older adult in a community project with a short-term goal 5. Directing a community play at the local theater

1, 2, 4 1. Teaching an older adult how to use e-mail to communicate with a grandchild who lives in another state 2. Introducing golf as a new hobby 4. Engaging an older adult in a community project with a short-term goal

The ethics of care suggests that ethical dilemmas can best be solved by attention to relationships. How does this differ from other ethical practices? (select all that apply) 1. Ethics of care pays attention to the environment in which caring occurs. 2. Ethics of care pays attention to the stories of the people involved in the ethical issue. 3. Ethics of care is used only in nursing practice 4. Ethics of care focuses only on the code of ethics for nurses 5. Ethics of care focuses only on understanding relationships.

1, 2, 5

The nurse is teaching a program on healthy nutrition at the senior community center. Which points should be included in the program for older adults? (select all that apply) 1. Avoid grapefruit and grapefruit juice, which impair drug absorption. 2. Increase the amount of carbohydrates for energy. 3. Take a multivitamin that includes vitamin D for bone health. 4. Cheese and eggs are good sources of protein. 5. Limit fluids to decrease the risk of edema.

1, 3, 4 1. Avoid grapefruit and grapefruit juice, which impair drug absorption. 3. Take a multivitamin that includes vitamin D for bone health. 4. Cheese and eggs are good sources of protein. Cheese, eggs, and peanut butter are also useful high-protein alternatives. Vitamin D supplements are important for improving strength and balance, strengthening bone health, and preventing bone fractures and falls. Grapefruit and grapefruit juice can interfere with warfarin (Coumadin) (anticoagulant), preventing its breakdown. This would lead to an increased risk of bleeding.

Chronic illness (e.g., diabetes mellitus, hypertension, rheumatoid arthritis) may affect a person's roles and responsibilities during middle adulthood. When assessing the health-related knowledge base of both the middle-age patient with a chronic illness and his family, your assessment includes which of the following? (Select all that apply.) 1. The medical course of the illness 2. The prognosis for the patient 3. Socioeconomic status 4. Coping mechanisms of the patient and family 5. The need for community and social services

1,2,4,5

A 45-year-old woman who is obese tells a nurse that she wants to lose weight. After conducting a thorough assessment, the nurse concludes that which of the following may be contributing factors to the woman's obesity? (Select all that apply.) 1. The woman works in an executive position that is very demanding. 2. The woman works out at the corporate gym at 5 AM two mornings per week. 3. The woman says that she has little time to prepare meals at home and eats out at least four nights a week. 4. The woman says that she tries to eat "low-cholesterol" foods to help lose weight. 5. The woman says that she vacations annually to reduce stress.

1,3,4

The nurse is educating the patient and his family about the parenteral nutrition. Which aspect related to this form of nutrition would be appropriate to include? (select all that apply.) 1. The purpose of the fat emulsion in parenteral nutrition is to prevent a deficiency in essential fatty acids. 2. We can give you a parenteral nutrition through your peripheral intravenous line to prevent further infection. 3. The fat emulsion will help control hyperglycemia during periods of stress. 4. The parenteral nutrition will help your wounds heal. 5. Since we just started the parenteral nutrition, we will only infuse it at 50% of your daily needs of the next 6 hours.

1,3,4 1. The purpose of the fat emulsion in parenteral nutrition is to prevent a deficiency in essential fatty acids. 3. The fat emulsion will help control hyperglycemia during periods of stress. 4. The parenteral nutrition will help your wounds heal. Sometimes adding intravenous fat emulsions to parenteral nutrition supports the patient's need for supplemental kilocalories, prevents essential fatty acid deficiencies, and helps control hyperglycemia during periods of stress. Parenteral nutrition is administered at 50% of the patient's daily needs for the first 24 hours to assess how he or she is tolerating the infusion.

Intimate partner violence (IPV) is linked to which of the following factors? (Select all that apply.) 1. Alcohol abuse 2. Marriage 3. Pregnancy 4. Unemployment 5. Drug use

1,3,4,5

Formation of positive health habits may prevent the development of chronic illness later in life. Which of the following are examples of positive health habits? (Select all that apply.) 1. Routine screening and diagnostic tests 2. Unprotected sexual activity 3. Regular exercise 4. Excess alcohol consumption 5. Consistent seat belt use

1,3,5

1. Motivational interviewing is a technique that applies understanding of patient values and goals in helping the patient make behavior changes. What are other benefits of using MI techniques? Select all that apply 1. Gaining an understanding of patient's motivations 2. focusing on opportunities to avoid poor health choices 3. recognizing patient strength and supporting their efforts 4. providing assessment data that can be shared with families to promote change 5. identifying differences in patient's health goals and current behaviors

1,3,5 1. Gaining an understanding of patient's motivations 3. recognizing patient strength and supporting their efforts 5. identifying differences in patient's health goals and current behaviors

A 63-year-old patient is retiring from his job at an accounting firm where he was in a management role for the past 20 years. He has been with the same company for 42 years and was a dedicated employee. His wife is a homemaker. She raised their five children, babysits for her grandchildren as needed, and belongs to numerous church committees. What are the major concerns for this patient? (Select all that apply.) 1. The loss of his work role 2. The risk of social isolation 3. A determination if the wife will need to start working 4. How the wife expects household tasks to be divided in the home in retirement 5. The age the patient chose to retire

1,4

A 71-year-old patient enters the emergency department after falling down stairs in the home. The nurse is conducting a fall history with the patient and his wife. They live in a one-level ranch home. He has had diabetes for over 15 years and experiences some numbness in his feet. He wears bifocal glasses. His blood pressure is stable at 130/70. The patient does not exercise regularly and states that he experiences weakness in his legs when climbing stairs. He is alert, oriented, and able to answer questions clearly. What are the fall risk factors for this patient? (Select all that apply.) 1. Impaired vision 2. Residence design 3. Blood pressure 4. Leg weakness 5. Exercise history

1,4,5

A patient who is receiving parenteral nutrition (PN) through a central venous catheter (CVC) has a air embolus. What would the nurse do first? 1. Have the patient perform a Valsalva maneuver 2. Clamp the Intravenous (IV) tubing to prevent more air from entering the line. 3. Have the patient take a deep breath and hold it. 4. Notify the healthcare provider immediately

1. Have the patient perform a Valsalva maneuver Turn the patient on his or her left side to prevent air from entering the left side of the heart. Then have the patient perform a Valsalva maneuver (holding the breath and "bearing down").

Allison, age 15 years, calls her best friend Laura and is crying. She has a date with John, someone she has been hoping to date for months, but now she has a pimple on her forehead. Laura firmly believes that John and everyone else will notice the blemish right away. This is an example of the: 1. Imaginary audience. 2. False-belief syndrome. 3. Personal fable. 4. Personal absorption syndrome.

1. Imaginary audience.

Mrs. Langman is in the hospital recovering from hip replacement surgery. Her surgery involved insertion of a new type of hip replacement prosthesis and newer postsurgical care. The advanced practice registered nurse is preparing her discharge medication and rehabilitation prescriptions. The staff nurse is preparing to transfer Mrs. Langman to a rehabilitation facility. The nurse educator is conducting bedside rounds to explain the new prosthesis and related postoperative care. 1. Identify similarities and differences in the roles of the staff nurse, advanced practice registered nurse, and nurse educator. 2. What is the educational preparation for each role? 3. Use information in this chapter to consider career objectives for yourself over the next 5 years. Obviously the first would be to complete your nursing program. But decide what you want to do as a professional nurse and then outline strategies to achieve these goals.

1. Similarities and differences in roles: All nurses follow the professional roles and responsibilities for a professional nurse. a. Staff nurse provides direct care for a group of patients in a health care setting. This practice is guided by the standards of professional practice and the agency practice philosophy. b. Advanced practice registered nurse (APRN) is the most independently functioning nurse. An APRN has a master's degree in nursing; advanced education in pathophysiology, pharmacology, and physical assessment; and certification and expertise in a specialized area of practice. c. Nurse educator works primarily in schools of nursing, staff development departments of health care agencies, and patient education departments. Nurse educators need experience in clinical practice to provide them with practical skills and theoretical knowledge. A faculty member in a school of nursing educates students to become professional nurses. Nursing faculty members are responsible for teaching current nursing practice, trends, theory, and necessary skills in laboratories and clinical settings. 2. Educational preparation a. Staff nurse—Basic nursing education and registered nurse licensure b. Advanced Practice Registered Nurse—Master's degree preparation and advance practice certification c. Nurse educator—Master's or doctoral degree in nursing 3. Discussion and self-reflection to determine future goals

Resolution of an ethical dilemma involves discussion with the patient, the patient's family, and participants from all health care disciplines. Which of the following best describes the role of the nurse in the resolution of ethical dilemma? 1. To articulate the nurses' unique point of view, including knowledge based on clinical and psychosoical observation 2. To study the literature on current research about the possible clinical interventions available for the patient in question 3. To hold a point of view but realize that respect for the authority of administrators and physicians takes precedence over personal opinion 4. To allow the patient and the physician to resolve the dilemma on the basis of ethical principles without regard to personal held values or opinions

1. To articulate the nurses' unique point of view, including knowledge based on clinical and psychosoical observation

A patient with chest pain is having an emergency cardiac Catherine is Asian. Which teaching approach does the nurse use in this situation? 1. telling approach 2. selling approach 3. trusting approach 4. participating approach

1. telling approach

11. Traditional Chinese medicine (TCM) is used by many patients. Which statement most accurately describes intervention(s) offered by TCM providers? 1. Uses acupuncture as its primary intervention modality 2. Uses many modalities based on the individual's needs 3. Uses primarily herbal remedies and exercise 4. Is the equivalent of medical acupuncture

2

5. In addition to an adequate patient assessment, when a nurse uses one of the nursing-accessible complementary therapies, he or she must ensure that which of the following has occurred? 1. The family has provided permission. 2. The patient has provided permission and consent. 3. The health care provider has given approval or provided orders for the therapy. 4. He or she has documented that the patient has a complete understanding of complementary and alternative medicine.

2

6. What role do patients have in complementary and alternative therapies? 1. Submissive to the practitioner 2. Actively involved in the treatment 3. Allow practitioner to experiment 4. Total believer in what is being taught

2

A 50-year-old male patient is seen in the clinic. He tells a nurse that he has recently lost his job and his wife of 26 years has asked for a divorce. He has a flat affect. Family history reveals that his father committed suicide at the age of 53. The nurse assesses for the following: 1. Cardiovascular disease 2. Depression 3. Sexually transmitted infection 4. Iron deficiency anemia

2

A nurse conducted an assessment of a new patient who came to the medical clinic. The patient is 82 years old and has had osteoarthritis for 10 years and diabetes mellitus for 20 years. He is alert but becomes easily distracted during the assessment. He recently moved to a new apartment, and his pet beagle died just 2 months ago. He is most likely experiencing: 1. Dementia. 2. Depression. 3. Delirium. 4. Hypoglycemic reaction.

2

A nurse is assessing an older adult brought to the emergency department following a fall and wrist fracture. She notes that the patient is very thin and unkempt, has a stage 3 pressure ulcer to her coccyx, and has old bruising to the extremities in addition to her new bruises from the fall. She defers all of the questions to her caregiver son who accompanied her to the hospital. The nurse's next step is to: 1. Call social services to begin nursing home placement. 2. Ask the son to step out of the room so she can complete her assessment. 193 3. Call adult protective services because you suspect elder mistreatment. 4. Assess patient's cognitive status.

2

The nurse is providing information on prevention of sudden infant death syndrome (SIDS) to the mother of a young infant. Which of the following statements indicates that the mother has a good understanding? (Select all that apply.) 1 "I won't use a pacifier to help my baby sleep." 2 "I'll be sure my baby does not spend any time on her abdomen." 3 "I'll place my baby on her back for sleep." 4 "I'll be sure to keep my baby's room cold." 5 "I'll keep a crib bumper in the bed to prevent drafts.

2 "I'll be sure my baby doesn't spend anytime sleeping on her abdomen". 3 "I'll place my baby on her back for sleep." 4 "I'll be sure to keep my baby's room cold." Pg. 144; Safeguards include proper positioning; removing stuffed animals, soft bedding, and pillows; and avoiding overheating the infant. Individuals should avoid smoking during pregnancy and around the infant because it places the infant at a greater risk for SIDS

You are caring for a 4-year-old child who is hospitalized for an infection. He tells you that he is sick because he was "bad." Which is the most correct interpretation of his comment? 1 Indicative of extreme stress 2 Representative of his cognitive development 3 Suggestive of excessive discipline at home 4 Indicative of his developing sense of inferiority

2 Representative of his cognitive development Pg. 150; Erikson recommends that parents help their children strike a healthy balance between initiative and guilt by allowing them to do things on their own while setting firm limits and providing guidance.

The nurse would delegate which of the following to nursing assistive personnel (NAP)? (Select all that apply.) 1. Repositioning and retaping a patient's nasogastric tube 2. Performing glucose monitoring every 6 hours on a patient 3. Documenting PO intake on a patient who is on a calorie count for 72 hours 4. Administering enteral feeding bolus after tubing placement has been verified 5. Hanging a new bag of enteral feeding

2, 3 2. Performing glucose monitoring every 6 hours on a patient 3. Documenting PO intake on a patient who is on a calorie count for 72 hours The skills of measuring blood glucose level after skin puncture (capillary puncture) and writing down the amount the patient ate can be delegated to NAP. The nurse needs to administer enteral feeding because of the risk of aspiration. The nasogastric tube should never be repositioned by the NAP for risk of causing injury to the patient.

It can be difficult to agree on a common definition of the word quantity when it comes to quality of life. Why? (select all that apply) 1. Average income varies in different regions of the country 2. Community vales influence definitions of quality, and are subject to change over time 3. Individual experiences influence perceptions of quality in different ways, making consensus difficult. 4. The value of elements such as cognitive skills, ability to perform meaningful work, and relationship to family is difficult to quantify using objective measures 5. Statistical analysis is difficult to apply when the outcome cannot be quantified 6. Whether or not a person has a job is an objective measure, but it does not play a role in understanding quality of life

2, 3, 4, 5

7. A nurse is caring for a patient experiencing a stress response. The nurse plans care with the knowledge that systems respond to stress in what manner? (Select all that apply.) 1. Always fail and cause illness and disease 2. Cause negative responses over time 3. React the same way for all individuals 4. Protect an individual from harm in the short term

2, 4

Which patients are at high risk for nutritional deficits? (Select all that apply.) 1. The divorced computer programmer who eats precooked food from a local restaurant. 2. The middle-aged female with celiac disease who does not follow her gluten-free diet 3. The 45-year-old patient with type II diabetes who monitors her carbohydrate intake and exercises regularly 4. The 25-year-old patient with Crohn's disease who follows a strict diet but does not take vitamins or iron supplements 5. The 65-year-old patient with gallbladder disease whose electrolyte, albumin, and protein levels are normal

2, 4 2. The middle-aged female with celiac disease who does not follow her gluten-free diet 4. The 25-year-old patient with Crohn's disease who follows a strict diet but does not take vitamins or iron supplements Patients suffering from celiac disease or Crohn's disease need to take vitamin and iron supplements regularly because they have a deficit resulting from malabsorption.

What are the correct steps to resolve an ethical dilemma on a clinical unit? Place the steps in correct order. 1. Clarify values 2. Ask the questions, Is this an ethical dilemma? 3. Verbalize the problem 4. Gather information 5. Identify course of action 5. Evaluate the plan 6. Negotiate the plan

2, 4, 1, 3, 5, 7, 6

A nurse is conducting a patient-centered interview. Place the statements from the interview in the correct order, beginning with the first statement a nurse would ask. 1. "You say you've lost weight. Tell me how much weight you've lost in the last month." 2. "My name is Todd. I'll be the nurse taking care of you today. I'm going to ask you a series of questions to gather your health history." 3. "I have no further questions. Thank you for your patience." 4. "Tell me what brought you to the hospital." 5. "So, to summarize, you've lost about 6 lbs in the last month, and your appetite has been poor—correct?" 4, 2, 1, 3, 5 2, 4, 3, 1, 5 4, 2, 5, 1, 3 2, 4, 1, 5, 3

2, 4, 1, 5, 3

A nurse works on a pediatric unit and is using a psychosocial developmental approach to child care. In which order from the first to the last will the nurse place the developmental stages? 1. Initiative versus guilt 2. Trust versus mistrust 3. Industry versus inferiority 4. Identity versus role confusion 5. Autonomy versus shame and doubt · 2, 5, 3, 1, 4 · 2, 1, 3, 5, 4 · 2, 3, 1, 5, 4 · 2, 5, 1, 3, 4

2, 5, 1, 3, 4

The nurse is organizing a disease prevention program for specific cultural group. To effectively meet the needs of this group the nurse will: (select all that apply) 1. assess the needs of the community in general 2. involve those affected by the problem in the planning process 3. develop generalize goals and objectives for the program 4. use educational materials that are simplistic and have many pictures 5. Assess commonly held beliefs among the cultural group 6. educate the specific cultural group about western concepts of health and illness 7. include cultural practices that are relevant to the specific community

2, 5, 7 2. involve those affected by the problem in the planning process 5. Assess commonly held beliefs among the cultural group 7. include cultural practices that are relevant to the specific community

The nurse is caring for a patient with pneumonia who has severe malnutrition. The nurse recognizes that, because of a nutritional status, the patient is at increased risk for: (select all that apply) 1. Heart Disease 2. Sepsis 3. Pleural Effusion 4. Cardiac arrhythmias 5. Diarrhea

2,3,4 Sepsis, pleural effusion, Cardiac arrhythmias Patients who are malnourished on admission are at greater risk of life-threatening complications such as arrhythmia, pleural effusions, sepsis, or hemorrhage during hospitalization.

A nurse is caring for a patient preparing for discharge from the hospital the next day. The patient does not read. His family caregiver will be visiting before discharge. What can the nurse do to facilitate the patient's understanding of his discharge instructions? (Select all that apply.) 1. Yell so the patient can hear you. 2. Sit facing the patient so he is able to watch your lip movements and facial expressions. 3. Present one idea or concept at a time. 4. Send a written copy of the instructions home with him and tell him to have the family review them. 5. Include the family caregiver in the teaching session.

2,3,5

During a home health visit a nurse talks with a patient and his family caregiver about the patient's medications. The patient has hypertension and renal disease. Which of the following findings place him at risk for an adverse drug event? (Select all that apply.) 1. Taking two medications for hypertension 2. Taking a total of eight different medications during the day 3. Having one physician who reviews all medications 4. Patient's health history of renal disease 5. Involvement of the caregiver in helping with medication administration

2,4

The application of utilitarianism does not always resolve and ethical dilemma. Which of the following statements best explains why? 1. Utilitarianism refers to usefulness and therefore eliminate the need to talk about spiritual values 2. In a diverse community it can be difficult to find agreement on a definition of usefulness, the focus of utilitarianism 3. Even when the agreement about a definition of usefulness exists in a community law, laws prohibit an application of utilitarianism 4. Difficult ethical decisions cannot be resolved by talking about the usefulness of a procedure

2. In a diverse community it can be difficult to find agreement on a definition of usefulness, the focus of utilitarianism

According to Piaget's cognitive theory, a 12-year-old child is most likely to engage in which of the following activities? 1. Using building blocks to determine how houses are constructed 2. Writing a story about a clown who wants to leave the circus 3. Drawing pictures of a family using stick figures 4. Writing an essay about patriotism

2. Writing a story about a clown who wants to leave the circus

The nurse teaches parents how to have their children learn impulse control and cooperative behaviors. This would be during which of Eriksons stages of development? 1. trust versus mistrust 2. initiative versus guilt 3. industry versus inferiority 4. autonomy versus sense of shame and doubt

2. initiative versus guilt

A nurse is talking with a young adult patient about the purpose of a new medication the nurse says "I want to be clear can you tell me in your own words the purpose of this medicine?" This exchange is an example of which element of the transactional communication process? 1. Message 2. obtaining feedback 3. channel 4. referent

2. obtaining feedback

12. A nurse is planning care for a group of patients who have requested the use of complementary health modalities. Which patient is not a good candidate for guided imagery? 1. Pregnant patient 2. Hypertensive patient 3. Patient with post-traumatic stress disorder (PTSD) 4. A pediatric patient

3

When determining the amount of information that a patient needs to make decisions about the prescribed course of therapy, many factors affect his or her compliance with the regimen, including educational level and socioeconomic factors. Which additional factor affects compliance? 1. Gender 2. Lifestyle 3. Motivation 4. Family history

3

A 4-month old infant has not been feeling well for 2 days. His mother has brought him to the clinic to be seen by his health care provider. Which number identifies the area of the infants head where the nurse can assess for dehydration? 1 2 3 4 5

3 Anterior fontanel Pg. 143;

Parents are concerned about their toddler's negativism. To avoid a negative response, which of the following is the best way for a nurse to demonstrate asking a toddler to eat his or her lunch? 1 Would you like to eat your lunch now? 2 When would you like to eat your lunch? 3 Would you like apple slices or applesauce with your sandwich? 4 Would you like to sit at the big table to eat?

3 Would you like apple slices or applesauce with your sandwich? Pg. 149; If parents struggle to control toddlers' dietary intake, problem behaviors and conflicts can result.

13. Several nurses on a busy unit are using relaxation strategies while at work. What is the desired workplace outcome from this intervention? (Select all that apply.) 1. Improved health among the staff 2. Increased patient safety 3. Improved staff satisfaction 4. Improved staff relationships 5. Fewer overtime assignments

3, 4

2. Which complementary therapies are most easily learned and applied by a nurse? (Select all that apply.) 1. Massage therapy 2. Traditional Chinese medicine 3. Progressive relaxation 4. Breathwork and guided imagery 5. Therapeutic touch

3, 4

The ANA code of nursing ethics articulates that the nurse "promotes, advocates for, and strives to protect the health, safety, and rights of the patient". This includes the protection of patient privacy. On the basis of this principle, if you participate in a public online social network such as Facebook, could you post images of a patient's x-ray film if you obscured or deleted all patient identifiers? 1. Yes, because the patient privacy would not be violated since patient identifiers were removed 2. Yes, because respect for autonomy implies that you have the autonomy to decide what constitutes as privacy 3. No, because even though the patient identifiers are removed, someone could identify the patient on the basis of other comments that you could make online about his or her conditions and your place of work 4. No, because the principle of justice requires you to allocate resources fairly

3. No, because even though the patient identifiers are removed, someone could identify the patient on the basis of other comments that you could make online about his or her conditions and your place of work

14. A nursing professor is teaching a nursing student about caring patients who use herbal preparations in addition to prescribed medications. Which of the following statements made by the student indicates that the student understands herbal preparations? 1. "Herbal preparations are regulated by the Food and Drug Administration (FDA); therefore I need to tell patients that they are completely safe." 2. "They are natural products and therefore are safe as long as you use them for the conditions that are indicated." 3. "These preparations are covered by insurance, including Medicare, Medicaid, and private payers." 700 4. "We need to treat herbal preparations as though they are "drugs" because many have active ingredients that can interact with other medications and change physiological responses."

4

9. A patient who has been using relaxation wants a better response. The nurse recommends the addition of biofeedback. What is the expected outcome related to using this additional modality? 1. To eat less food 2. To control diabetes 3. To live longer with acquired immunodeficiency syndrome (AIDS) 4. To learn how to control some autonomic nervous system responses

4

A 34-year-old female executive has a job with frequent deadlines. She notes that, when the deadlines appear, she has a tendency to eat high-fat, high-carbohydrate foods. She also explains that she gets frequent headaches and stomach pain during these deadlines. The nurse provides a number of options for the executive, and she chooses yoga. In this scenario yoga is used as a (n): 1. Outpatient referral. 2. Counseling technique. 3. Health promotion activity. 4. Stress-management technique.

4

A nursing student is caring for a 78-year-old patient with multiple sclerosis. The patient has had an indwelling Foley catheter in for 3 days. Eight hours ago the patient's temperature was 37.1° C (98.8° F). The student reports her recent assessment to the registered nurse (RN): the patient's temperature is 37.2° C (99° F); the Foley catheter is still in place, draining dark urine; and the patient is uncertain what time of day it is. From what the RN knows about presentation of symptoms in older adults, what should he recommend first? 1. Tell the student that temporary confusion is normal and simply requires reorientation 2. Tell the student to increase the patient's fluid intake since the urine is concentrated 3. Tell the student that her assessment findings are normal for an older adult 4. Tell the student that he will notify the patient's health care provider of the findings and recommend a urine culture

4

A patient is laboring with her first baby, who is about to be delivered 2 weeks early. Her husband is in the military and might not get back in time, and both families are unable to be with her during labor. The doctor decides to call in which of the following people employed by the birthing area as a support person to be present during labor? 1. Nurse 2. Midwife 3. Geneticist 4. Lay doula

4

Older adults frequently experience a change in sexual activity. Which best explains this change? 1. The need to touch and be touched is decreased. 2. The sexual preferences of older adults are not as diverse. 3. Physical changes usually do not affect sexual functioning. 4. Frequency and opportunities for sexual activity may decline.

4

Sexuality is maintained throughout our lives. Which of the following answers best explains sexuality in an older adult? 1. When the sexual partner passes away, the survivor no longer feels sexual. 2. A decrease in an older adult's libido occurs. 3. Any outward expression of sexuality suggests that the older adult is having a developmental problem. 4. All older adults, whether healthy or frail, need to express sexual feelings.

4

Sharing eating utensils with a person who has a contagious illness increases the risk of illness. This type of health risk arises from: 1. Lifestyle. 2. Community. 3. Family history. 4. Personal hygiene habits.

4

The nurse is completing an admission assessment with an 80-year-old man who experienced a hip fracture following a fall. He is alert, lives alone, and has very poor hygiene. He reports a 20-pound weight loss in the last 6 months following his wife's death, as well as estrangement from his only child. He admits to falls before this most recent fall. What should the nurse suspect? 1. Dementia. 2. Elder abuse. 3. Delirium. 4. Alcohol abuse.

4

Which of the following statements is most descriptive of the psychosocial development of school-age children? 1 Boys and girls play equally with each other. 2 Peer influence is not yet an important factor to the child. 3 They like to play games with rigid rules. 4 Children frequently have "best friends."

4 Children frequently have "best friends." Pg. 152; School age children often develop "best friends" with whom they share secrets and with whom they look forward to interacting on a daily basis.

The type of injury a child is most vulnerable to at a specific age is most closely related to which of the following? 1 Provision of adult supervision. 2 Educational level of the parent 3 Physical health of the child 4 Developmental level of the child

4 Developmental level of the child Pg. 146; An understanding of the major developmental accomplishments during this time period allows for injury prevention planning.

Which approach would be best for the nurse to use with a hospitalized toddler? 1 Always give several choices. 2 Set few limits to allow for open expression. 3 Use noninvasive methods when possible. 4 Establish a supportive relationship with the mother.

4 Establish a supportive relationship with the mother. Pg. 149; Establishing a trusting relationship with the parents often results in toddler acceptance of treatment.

The patient for whom you are caring needs a liver transplant to survive. This patient has been out of work for several months and doesn't have heath insurance or enough cash. Even though several ethical principles are at work in this case, list the principles from highest to lowest priority. 1. Accountability: You are the nurse are accountable for the well-being of this patient 2. Respect for autonomy: The patient's autonomy will be violated if he does not receive the liver transplant 3. Ethics of care: The caring thing that a nurse could provide this patient is resources for a liver transplant 4. Justice: The greatest question in this situation is how to determine the just distribution of the resources

4, 2, 3, 1

Ethical dilemmas often arise over a conflict of opinion. Reliance on a predictable series of steps can help people in a conflict find common ground. What is the best order of these actions in order to promote the resolution of an ethical dilemma? 1. List the actions that could be taken to resolve the action over time 2. Agree on a statement of the problem or dilemma that you are trying to resolve 3. Agree on a plan to evaluate action overtime 4. Gather all relevant information regarding the clinical, social and spiritual aspects of the dilemma. 5. Take time to clarify values and distinguish between two facts and opinions--your own and those of others involved. 6. Negotiate a plan

4, 5, 2, 1, 6, 3

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

4,1,2,3 Situation : 4. "The patient started complaining of nausea yesterday evening and has vomited several times during the night." Background: 1. "She is a 53-year-old female who is admitted to days ago with pneumonia and was started on Levaquin at 5 PM yesterday. She complains of a poor appetite." Assessment: 2. "The patient reported feeling very nauseated after her dose of Levaquin an hour ago." Recommendation: 3. "Would you like to make changes in antibiotics or could we give her a nutritional supplement before her medication?"

A patient's gastric residual volume was 250 mL @ 0800 and 350 mL @ 0900. What is the appropriate nursing action? 1. Assess bowel sounds 2. Raise the head of the bed to at least 45 degrees 3. Position the patient on his or her right side to promote stomach emptying 4. Do not reinstall aspirate and hold the feeding until you talk to the primary care provider.

4. Do not reinstall aspirate and hold the feeding until you talk to the primary care provider. Do not administer feeding when a single gastric residual volume exceeds 500 mL or when two consecutive measurements (taken 1 hour apart) each exceed 250 mL because of the potential for aspiration.

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

4. I'm going to alternate formula with whole milk starting next month. Infants should not have regular cow's milk during the first year of life. It is too concentrated for the infant's kidneys to manage. There is also an increased risk for developing milk-product allergies.

Dave reports being happy and satisfied with his life. What do we know about him? 1. He is in one of the later developmental periods, concerned with reviewing his life. 2. He is atypical, since most people in any of the developmental stages report significant dissatisfaction with their lives. 3. He is in one of the earlier developmental periods, concerned with establishing a career and satisfying long-term relationships. 4. It is difficult to determine Dave's developmental stage since most people report overall satisfaction with their lives in all stages.

4. It is difficult to determine Dave's developmental stage since most people report overall satisfaction with their lives in all stages.

Elizabeth, who is having unprotected sex with her boyfriend, comments to her friends, "Did you hear about Kathy? You know, she fools around so much; I heard she was pregnant. That would never happen to me!" This is an example of adolescent: 1. Imaginary audience. 2. False-belief syndrome 3. Personal fable. 4. Sense of invulnerability.

4. Sense of invulnerability.

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

4. When 75% of the patient's nutritional needs are met by the tube feedings When meeting 75% of nutritional needs by enteral feedings or reliable dietary intake, it is usually safe to discontinue PN therapy.

A nurse is assigned to care for a patient for the first time and states "I don't know a lot about your culture and want to learn how to better meet your health care needs." Which therapeutic communication technique did the nurse use in the situation? 1. validation 2. empathy 3. sarcasm 4. humility

4. humility

Sequence the skill in the expected order of gross-motor development in an infant beginning with the earliest skill: 1 Move from prone to sitting unassisted 2 Sit down from standing position 3 Sit upright without support 4 Roll from abdomen to back 5 Can turn from side to back

5 Can turn from side to back 4 Roll from abdomen to back 3 Sit upright without support 1 Move from prone to sitting unassisted 2 Sit down from standing position Pg. 145 Table 12-1

The nurse is inserting a small-bore nasoenteric tube before starting enteral feedings. Place the following steps in order to perform this procedure. 1. Place patient is high-fowler's position 2. Have patient flex head toward chest. 3. Assess patient's gag reflex. 4. Determine length of the tube to be inserted. 5. Obtain radiological confirmation of the tube placement. 6. Check pH of gastric aspirate for verifying placement. 7. Identify the patient with two identifiers.

7, 1, 3, 4, 2, 5, 6

"As long as my son is a full-time student in College, I will be able to keep him on my health insurance until he is 26 years old."

A community center is presenting a nurse-led program on the Patient Protection and Affordable Care Act. Which statement made by a participant indicates a need for further teaching? "My small company will now have to offer the 75 employees health insurance or pay a penalty." "As long as my son is a full-time student in College, I will be able to keep him on my health insurance until he is 26 years old." "I signed up for the state health insurance exchange before the designated deadline to make sure I had health insurance." "Since I have now been diagnosed with diabetes, my health insurance plan cannot charge me higher premiums."

Rapid-improvement event

A group of staff nurses notice an increased incidence of medication errors on their unit. After further investigation it is determined that the nurses are not consistently identifying the patient correctly. A change is needed quickly. What type of quality improvement method would be most appropriate? PDSA Six Sigma Rapid-improvement event A randomized controlled trial

-Difficulty paying his bills -Family practice of not routinely seeing a health care provider

A male patient has been laid off from his construction job and has many unpaid bills. He is going through a divorce from his marriage of 15 years and has been seeing his pastor to help him through this difficult time. He does not have a primary health care provider because he has never really been sick and his parents never took him to a physician when he was a child. Which external variables influence the patient's health practices? (Select all that apply.) Difficulty paying his bills Seeing his pastor as a means of support Age of patient (46 years) Stress from the divorce and the loss of a job Family practice of not routinely seeing a health care provider

Physiological

A nurse is conducting a home visit with an older-adult couple. While in the home the nurse weighs each individual and reviews the 3-day food diary with them. She also checks their blood pressure and encourages them to increase their fluids and activity levels to help with their voiced concern about constipation. The nurse is addressing which level of need according to Maslow? Physiological Safety and security Love and belonging Self-actualization

Patient will be able to walk 200 feet without shortness of breath

A nurse is providing restorative care to a patient following an extended hospitalization for an acute illness. Which of the following is an appropriate goal for restorative care? Patient will be able to walk 200 feet without shortness of breath Wound will heal without signs of infection Patient will express concerns related to return to home Patient will identify strategies to improve sleep habits

Quality improvement

A nurse is using data collected from the unit to monitor the incidence of falls after the unit implemented a new fall protocol. The nurse is working in which area? Quality improvement Health care patient system Nursing informatics Computerized nursing network

3. The nursing council develops a strategy for bedside change of shift report 1. Bedside change of shift report is piloted on two medical-surgical units 2. Patient satisfaction levels after implementation of the bedside report are compared to patient satisfaction levels before the change 4. After modifications are made in the shift report elements, bedside shift report is implemented on all nursing units

A nurse is using the Plan-Do-Study-Act (PDSA) strategy to do a quality improvement project to decrease patient falls on a nursing unit. What is the correct sequence for PDSA? 1. Bedside change of shift report is piloted on two medical-surgical units 2. Patient satisfaction levels after implementation of the bedside report are compared to patient satisfaction levels before the change 3. The nursing council develops a strategy for bedside change of shift report 4. After modifications are made in the shift report elements, bedside shift report is implemented on all nursing units 1, 3, 2, 4 2, 1, 3, 4 1, 2, 3, 4 3, 1, 2, 4

advocacy

A patient at the end of life wants to go home to die, but the family wants every care possible. The nurse contacts the primary care provider abut the patient's request

"Yes, walking is great exercise. Do you think you could go for a 5-minute walk next week?"

A patient comes to the local health clinic and states: "I've noticed how many people are out walking in my neighborhood. Is walking good for you?" What is the best response to help the patient through the stages of change for exercise? "Walking is OK. I really think running is better." "Yes, walking is great exercise. Do you think you could go for a 5-minute walk next week?" "Yes, I want you to begin walking. Walk for 30 minutes every day and start to eat more fruits and vegetables." "They probably aren't walking fast enough or far enough. You need to spend at least 45 minutes if you are going to do any good."

Preparation

A patient registered at the local fitness center and purchased a pair of exercise shoes. The patient is in what stage of behavioral change? Precontemplation Contemplation Preparation Action

This health plan gives you with a list of physicians and hospitals from which you can choose

A patient tells a nurse that she is enrolled in a preferred provider organization (PPO) but does not understand what this is. What is the nurse's best explanation of a PPO? This health plan is for people who cannot afford their own health insurance This health plan is operated by the government to provide health care to older adults This health plan gives you with a list of physicians and hospitals from which you can choose This is a fee-for-service plan in which you can choose any physician or hospital

A 72-year-old male patient comes to the health clinic for an annual follow-up. The nurse enters the patient's room and notices him to be diaphoretic, holding his chest and breathing with difficulty. The nurse immediately checks the patient's heart rate and blood pressure and asks him, "Tell me where your pain is." Which of the following assessment approaches does this scenario describe? Review of systems approach Use of a structured database format Back channeling A problem-oriented approach

A problem-oriented approach This is an example of a problem-focused approach. The nurse focuses on assessing one body system (cardiovascular) to determine the nature of the patient's pain and other presenting symptoms.

Evidence-based practice is defined as: 1. Nursing care based on tradition 2. Scholarly inquiry of nursing and biomedical research literature 3. A problem-solving approach that integrates best current evidence with clinical practice 4. Quality nursing care provided in an efficient and economically sound manner

A problem-solving approach that integrates best current evidence with clinical practice

The nurse asses a patient and collects a variety of data. Identify the human response that are subjective data. Select all that apply: · A. Nausea · B. Jaundice · C. Dizziness · D. Diaphoresis · E. Hypotension.

A, C

The following are true about Healthy People 2020 initiative (Select All That Apply) · A. Healthy People Initiative provides science-based, 10 year national objectives for improving the health of all Americans. · B. Healthy People initiative seeks to change the health practices of people who are most at risk to illness and injury thereby decreasing the cost of health care and maintenance. · C. For 3 decades, Healthy People initiative has established benchmarks and monitored progress over time in order to encourage collaborations across communities and sectors. · D. Healthy People initiative was developed to established health improvement priorities and measure the impact of prevention activates. · E. Healthy People initiative gives protocols to each state on how conduct community health prevention education and giving nurses standards on educational programs. · F. Healthy People initiative empower individuals towards making informed health decisions .

A, C, D, F

The leading health indicators found in Healthy People 2020 are the following: (Select all that apply) · A. Access to health services · B. Holistic and CAM strategies · C. Oral Health · D. Issues related to legal and illegal immigration · E. Environmental health · F. Holistic Care

A, C, E

12.) The nurse is discussing the importance of routine healthcare with a Hispanic family who has recently immigrated to the United States. Which factor will the nurse consider as a barrier to the family's interest to receive professional health care? (Select All That Apply?) · A. Lack of health insurance. · B. Concern about invasion of privacy. · C. Absence of transportation services. · D. Limited proficiency in the English language · E. Belief and accessibility to folk healers and remedies · F. The availability of family member for support and help.

A, D, E

9.) Which data represents objective findings? (Select All That Apply) · A. Lab values · B. Pain level state by the patients · C. Patients stated emotional status · D. Respiratory and pulse oximetry reading. · E. The nurse's description of the patient's gait.

A, D, E

The nurse is discussing the importance of routine preventive care with a Hispanic family who has recently immigrated to the United States. Which factor will the nurse consider as a barrier in the family's interest to receive professional health care? Select All That Apply A. Lack of health insurance B. Concern about invasion of privacy C. Absence of transportation services D. Limited proficiency in the English Language E. Belief and accessibility to folk healers and remedies F. The availability of family members for support and help

A, D, E

A 34-year-old man who is anxious, tearful, and tired from caring for his three young children tells you that he feels depressed and doesn't see how he can go on much longer. Your best response would be which of the following? A. "Are you thinking of suicide?" B. "You've been doing a good job raising your children. You can do it!" C. "Is there someone who can help you?" D. "You have so much to live for."

A. "Are you thinking of suicide?" Although this sounds abrupt, the patient usually is relieved that you've broached this issue. For safety reasons it is very important to discuss his suicidal thoughts with the patient.

24.) A patient is admitted to the hospital with cirrhosis of the liver causes by long-term alcohol abuse. Which is the best response by the nurse when the patient says "I really don't believe that my drinking a couple of beers a day has anything to do with my liver problem?" · A. "You find it hard to believe that beer can hurt the liver" · B. "How long is it that you have been drinking several beers a day?" · C. " Each beer is equivalent to one shot of liquor so its just as damaging to the liver as hard liquor." · D. " Do you believe that beer is not harmful even though research shows that it is just as bad for you as hard liquor?"

A. "You find it hard to believe that beer can hurt the liver"

A patient who is having difficulty managing his diabetes mellitus responds to the news that his hemoglobin A1C, a measure of blood sugar control over the past 90 days, has increased by saying, "The hemoglobin A1C is wrong. My blood sugar levels have been excellent for the last 6 months." The patient is using the defense mechanism: A. Denial. B. Conversion. C. Dissociation. D. Displacement.

A. Denial Denial is avoiding emotional stress by refusing to consciously acknowledge anything that causes intolerable anxiety. This patient's statements reflect denial about poorly controlled blood sugars.

When teaching a patient about the negative feedback response to stress, the nurse includes which of the following to describe the benefits of this stress response? A. Results in neurophysiological response. B. Reduces body temperature C. Causes a person to be hypervigilant D. Reduces level of consciousness to conserve energy.

A. Results in neurophysiological response. Negative feedback senses an abnormal state such as lowered body temperature and makes an adaptive response such as shivering to generate body heat to return the body to hormonal homeostasis.

15.) The American Nurses Association (ANA) has recommended the following competency for RNs? · A. The RN's to recognize their own values, beliefs, and cultural heritage. · B. The RNs to function independently and occasionally engage in collaboration. · C. The RNs to be concerned about the existence of vulnerable cultural groups. · D. The RNs to provide health care opportunities to those with financial capabilities.

A. The RN's to recognize their own values, beliefs, and cultural heritage.

10.) The steps included in the nursing process include: (Select All That Apply) · A. Use a nursing diagnosis to state the problem. · B. Plan care to help meet stated patient goals · C. Collect data and asses the patient · D. Establishes priorities, patient goals and outcomes. · E. Determine appropriate nursing interventions for patient care. · F. Order labs that are needed for the patient.

A. Use a nursing diagnosis to state the problem. · B. Plan care to help meet stated patient goals · C. Collect data and asses the patient · D. Establishes priorities, patient goals and outcomes. · E. Determine appropriate nursing interventions for patient care.

A nurse enters the examination room of the emergency clinic and meets a 29-year-old patient who missed her last two follow-up appointments. The nurse notes from the medical record that the patient has high blood pressure that the doctor has been trying to help her manage. The patient just spoke with her doctor who left the room frustrated because the patient has not been taking her medication as prescribed. The patient confronts the nurse, saying, "I'm tired of being treated this way; no one cares. I need to find another doctor!" Using the C-LARA mnemonic, match the nurse's response to the correct letter of the mnemonic. Term Definition a. The nurse acknowledges that it is absolutely reasonable for patients to expect that their health care providers care about their situations and that it is disappointing when they have experiences that make them feel like they do not. b. The nurse uses a relaxation technique before responding to the patient's concerns. Calm yourself. Take a deep breath. Check your pulse. c. The nurse says, "I want to help you. I can do that better if you tell me what's making it difficult for you to come to your appointments and take your medicine each day." d. The nurse maintains eye contact and allows the patient to discuss her perspective while remaining attentively quiet. e. The nurse explains, "One thing I want you to understand is that your blood pressure medicine will only work if you take the same amount each day. Your follow-up appointments are important so we can get this blood pressure under control. Let me get a social worker who can help you figure out these transportation issues or see if he can find a doctor closer to your house." Definitions 1. C ____ 2. L ____ 3. A ____ 4. R ____ 5. A ____

A3 B1 C4 D2 E5

Match each letter of the RESPECT mnemonic with a statement that describes the concept the letter represents. Term Definition a. Ask about and try to understand barriers to care and adherence, and then offer resources to help the patient overcome them, involving family members if appropriate, and reassuring the patient that you are and will be available to help. b. Patients may have different reasons for not disclosing important information. Earn a patient's confidence through actions and attitude that demonstrate respect, compassion, and your interest in partnership. c. Work closely together with the patient by being flexible with regard to issues of control, negotiating roles when necessary, and stressing that you will be working together to mutually address medical problems. d. Provide explanations for the process and your action, checking often for understanding and using verbal clarification techniques such as Teach Back. e. Approach each encounter thinking about cultural competence and how you can demonstrate respect for the patient and his or her culture and beliefs. f. Approach the encounter with empathy, remembering that the patient has come to you for help. Seek out and understand the patient's rationale for his or her behaviors or illness, verbally acknowledging and legitimizing his or her feelings. g. Connect on a social level, seeking the patient's point of view; consciously attempt to suspend judgment; and avoid making assumptions. Definitions 1. R 2. E 3. S 4. P 5. E 6. C 7. T

A3 B7 C4 D5 E6 F2 G1

How can a nurse work on developing cultural awareness? (Select all that apply.) A. Reflect on his or her past learning about health, illness, race, gender, and sexual orientation B. Develop greater self-knowledge about personal biases C. Recognize consciously the multiple factors that influence his or her own world view D. Engage in an in-depth self-examination of his or her own background E. Learn as many facts as possible about an ethnic group

ABCD Remember that developing cultural awareness is a life-long process. It is a foundation of becoming culturally competent. Learning as many facts as possible about an ethnic group does not involve developing awareness about personal views, attitudes, and perceptions about ethnicit

Which of the following are considered social determinants of health? (Select all that apply.) a. Lack of primary health care providers in a zip code b. Poor-quality public school education that prevents a person from developing adequate reading skills c. Lack of affordable health insurance d. Employment opportunities that do not provide paid vacation or sick leave e. The number of times a person exercises during a week f. Neighborhood safety that prevents a person from walking around the block or socializing with neighbors outside of his or her home

ABCDF The social determinants of health are the circumstances in which people are born and grow up; the neighborhood in which they live, work, and age; and the systems put in place to deal with illness. These circumstances are in turn shaped by a wider set of forces: economics, social policies, and politics.

Which of the following changes can help create a more inclusive environment for lesbian, gay, bisexual, and transgender (LGBT) patients? (Select all that apply.) a. Explicitly including sexual orientation and gender identity into nondiscrimination policies b. Displaying art that reflects LGBT community c. Modifying health care forms to provide opportunities for gender identity and sexual orientation disclosure e. Not asking patients about their gender identity and sexual orientation to avoid making them uncomfortable f. Ensuring access to unisex or single-stall bathrooms

ABCE All of these help to create a more inclusive environment for LGBT patients. It is important to ask patients about their gender identity and sexual orientation to avoid making them uncomfortable.

A patient is admitted through the emergency department (ED) after a serious car accident. The nurse assesses the patient and quickly learns that he speaks little English. Spanish is his primary language. The nurse speaks some Spanish. Which interventions would be appropriate at this time? (Select all that apply.) The nurse requests a professional interpreter. Since this is an emergent situation, the nurse will interpret and identify the patient's priority needs. The nurse determines the interpreter's qualifications and makes sure that the interpreter can speak the patient's dialect. The nurse uses short sentences to explain the treatments provided in the ED. The nurse directs questions to the patient by looking at the patient instead of at the interpreter.

ACDE In any situation the nurse should use an interpreter and not the family to convey information to the patient. As the nurse you need to question the interpreter about his or her ability to speak the patient's dialect. It is your responsibility to introduce the interpreter to the patient. You are communicating with the patient and should direct your questions and responses to the patient and not the interpreter. Short sentences make it easier for the patient to understand complex information

Which of the following are examples of problems with the health care system that contribute to health disparities? (Select all that apply.) a. A health care provider assumes that the patient missed two appointments because the patient does not care about his or her health and does not inquire about the reasons for missed visits. b. The discharge nurse at a hospital uses Teach Back with a patient to ensure that she has communicated the discharge instructions clearly. c. A community hospital lacks an adequate staff of social workers who are able to ensure patients' access to resources they need to take care of their health. d A hospital discharges a patient without ensuring that the patient has a primary care provider and has made a follow-up appointment.e e. A nurse uses a family member as an interpreter to explain the patient's medications. f The hospital conducts quality improvement without stratifying data by race, ethnicity, language, socioeconomic status, sexual orientation, and other axes of social group identities.

ACDEF A large body of research shows that health care systems and health care providers contribute significantly to the problem of health disparities. Inadequate resources (lack of social workers), poor patient-provider communication (discharge instructions), a lack of culturally competent care, system fragmentation (not ensuring that the patient has a primary care provider or a follow-up appointment), and inadequate language access (use of interpreters) are critical factors that contribute to inequities in patient outcomes. RESPECT is the mnemonic for Rapport, Empathy, Support, Partnership, Explorations, Cultural competence, Trust

"Perceived self-efficacy is not related to the model."

After a class on Pender's health promotion model, students make the following statements. Which statement does the faculty member need to clarify? "The desired outcome of the model is health-promoting behavior." "Perceived self-efficacy is not related to the model." "The individual has unique characteristics and experiences that affect his or her actions." "Patients need to commit to a plan of action before they adopt a health-promoting behavior."

The nurse enters the room of an 82-year-old patient for whom she has not cared previously. The nurse notices that the patient wears a hearing aid. The patient looks up as the nurse approaches the bedside. Which of the following approaches are likely to be effective with an older adult? (Select all that apply.) Listen attentively to the patient's story. Use gestures that reinforce your questions or comments. Stand back away from the bedside. Maintain direct eye contact. Ask questions quickly to reduce the patient's fatigue.

Answer: 1, 2, 4. Approaches for collecting an older adult assessment include listening patiently, using nonverbal communication when a patient has a hearing deficit, and maintaining patient-directed eye gaze. Leaning forward, not backward shows interest in what the patient has to say.