NURS 290: Exam 2

What is the Anal Stage ?

(12/18 months-3 years): Experience is dominated by the pleasures associated with the anus, retention and expulsion of feces and urine involved with toilet training.

What is the Phallic stage?

(3-6 years): Experience dominated by the pleasure, conflict, and frustration associated with coping with powerful incestuous feelings of love, hate, jealousy, and conflict. Children learn that boys have penis and girls don't, develops penis envy

What is the Oral Stage?

(birth- 12/18 months): The first psychosexual stage, in which experiences centers on the pleasure and frustrations associated with the mouth, sucking, being fed.

Maslow's Hierarchy of Needs

(level 1) Physiological Needs, (level 2) Safety and Security, (level 3) Relationships, Love and Affection, (level 4) Self Esteem, (level 5) Self Actualization

What is the Genital Stage?

(puberty-adult): Time for the coming together of the mature adult personality with a capacity to love, work, and relate to others in a mutually satisfying and reciprocal manner. Sexual urges reawaken.

What is Chess and Thomas Theory, about basic childhood temperament ?

- Easy going child (easy going, predictable, open, and adaptable to change) -The Difficult child (irritable, irregular, highly active, doesn't like change) -The slow to warm up child (adapts slowly, passive resistance to change in routine)

What are some current trends that are affect the family dynamic?

- People are marrying later -Couples are having fewer children or none at all -Adolescent pregnancy is increasing -America is aging -Women are delaying childbirth -Remarriage results in blended families -Many homosexual couples are creating family units -More people are living alone

What is moral development theory? Who Moral development theory do we follow?

-Attempts to define how moral reasoning matures for an individual -Refers to changes in a person's thoughts, emotions, and behaviors that influence the perception of right or wrong -Kohlberg's moral developmental theory

What is the difference between cultural competence and patient centered care?

-Each emphasizes different aspects of quality -Patient-centeredness provides individualized care and restores an emphasis on personal relationships -Cultural competence aims to increase health equity and reduce disparities by concentrating on people of color and other disadvantaged populations

External variables affecting health are?

-Family practices: the way you grow up affects your health beliefs and what you practice. Affects perception of disease, history of prevention, and how the patient thinks about health -Psychosocial factors: A person generally seeks approval and support from social networks, the desire for approval affects health beliefs. Economic factors can play into this, what job they have or if they have health insurance. Also what health services are available to them within their community. -Cultural Background: influences approach to health care

Kohlberg's Critics

-Moral thought and behavior: Too much emphasis on thought, not enough emphasis on behavior -Culture and moral reasoning: Theory is culturally biased -Families and moral development: Kohlberg underestimated -Mostly white males raised with western tradition

How do you address health care disparities?

-New standards -Focus on cultural competency, health literacy, and patient- and family-centered care -Recognize that valuing each patient's unique needs improves the overall safety and quality of care and helps to eliminate health disparities -Quality of care is care that is safe, effective, pt centered, timely, efficient.

Define family

-The family can be defined biologically, legally, or as a social network with personally constructed ties and ideologies. -No two families are alike; each has its own strengths, weaknesses, resources, and challenges.

What are McGoldrick and Carter family life cycle?

-Unattached young adult -Joining of families through marriage -Family with young children -Family with adolescents -Family with young adults -Family without children -Family later in life Use this model to promote family behaviors to achieve essential tasks and help families prepare for later transitions.

Nurses in a community clinic have seen an increase in the numbers of obese children. The nurses who care for children are discussing ways to reduce childhood obesity. One nurse asks a colleague, "I wonder what the most effective ways are to help school-aged children maintain a healthy weight?" This question is an example of a/an 1. Hypothesis 2. PICOT question 3. Problem-focused trigger 4. Knowledge-focused trigger

. Answer: 3. A problem-focused trigger is a clinical problem you face while caring for patients; the nurses in this question have identified a clinical problem which they desire to investigate further.

What are the steps of evidence based practice?

0. Cultivate a spirit of inquiry. 1. Ask a clinical question in PICOT format. 2. Search for the most relevant evidence. 3. Critically appraise the evidence you gather. 4. Integrate all evidence with your clinical expertise and patient preferences and values. 5. Evaluate the outcomes of practice decisions or changes using evidence. 6. Share the outcomes with others.

Erickson's Psychosocial Stages

1)Trust v mistrust 2)autonomy v shame & doubt 3)initiative v guilt 4)industry v inferiority 5)identity v role confusion 6)intimacy v isolation 7)generativity v stagnation 8)integrity v despair

Which of the following are considered social determinants of health? Select all that apply. 1. Lack of primary health care providers in a zip code 2. Poor-quality public school education that prevents a person from developing adequate reading skills 3. Lack of affordable health insurance 4. Employment opportunities that do not provide paid vacation or sick leave The number of times a person exercises during a week 5. Neighborhood safety that prevents a person from walking around the block or socializing with neighbors outside of his or her home

1, 2, 3, 4, 6. 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.

How can a nurse work on developing cultural awareness? Select all that apply. 1. Reflect on his or her past learning about health, illness, race, gender, and sexual orientation 2. Develop greater self-knowledge about personal biases 3. Recognize consciously the multiple factors that influence his or her own world view 4. Engage in an in-depth self-examination of his or her own background 5. Learn as many facts as possible about an ethnic group

1, 2, 3, 4. Remember that developing cultural awareness is a life-long process. It is a foundation of becoming culturally competent. Choice 5 does not involve developing awareness about personal views, attitudes, and perceptions about ethnicity.

Which of the following changes can help create a more inclusive environment for lesbian, gay, bisexual, and transgender (LGBT) patients? Select all that apply. 1. Explicitly including sexual orientation and gender identity into nondiscrimination policies 2. Displaying art that reflects LGBT community 3. Modifying health care forms to provide opportunities for gender identity and sexual orientation disclosure 4. Not asking patients about their gender identity and sexual orientation to avoid making them uncomfortable 5. Ensuring access to unisex or single-stall bathrooms

1, 2, 3, 5. 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 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 1. Cultural practices 2. Decision making 3. Neighborhood services 4. Rituals and celebrations 5. Neighborhood crime data 6. Availability of parks

1, 2, 4,

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 1. Family meeting 2. Establishing family roles 3. New neighborhood 4. Willingness to change in times of stress 5. Passive orientation

1, 2, 4. 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

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 1. Communication 2. Decision making 3. Development 4. Economic status 5. Family structure

1, 2. 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.

Which of the following are possible outcomes with clear family communication? Select all that apply 1. Family goals 2. Increased socialization 3. Decision making 4. Methods of discipline 5. Improved education 5. Impaired coping

1, 3, 4

Which of the following are examples of problems with the health care system that contribute to health disparities? Select all that apply. 1. 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. 2. The discharge nurse at a hospital uses Teach Back with a patient to ensure that she has communicated the discharge instructions clearly. 3. 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. 4. A hospital discharges a patient without ensuring that the patient has a primary care provider and has made a follow-up appointment. 5. A nurse uses a family member as an interpreter to explain the patient's medications. 6. The hospital conducts quality improvement without stratifying data by race, ethnicity, language, socioeconomic status, sexual orientation, and other axes of social group identities.

1, 3, 4, 5, 6. 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.

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. 1. The nurse requests a professional interpreter. 2. Since this is an emergent situation, the nurse will interpret and identify the patient's priority needs. 3. The nurse determines the interpreter's qualifications and makes sure that the interpreter can speak the patient's dialect. 4. The nurse uses short sentences to explain the treatments provided in the ED. 5. The nurse directs questions to the patient by looking at the patient instead of at the interpreter.

1, 3, 4, 5. 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.

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 Select all that apply 1. Resuming full-time work when spouses loses job 2. Increasing problem among siblings 3. Developing hobbies when children leave home 4. Placing blame on family members 5. Expecting children to help financially 6. Consulting a financial planner

1, 3, 6

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. 1. Difficulty paying his bills 2. Seeing his pastor as a means of support 3. Age of patient (46 years) 4. Stress from the divorce and the loss of a job 5. Family practice of not routinely seeing a health care provider

1, 5. External factors impacting health practices include family beliefs and economic impact. The way that patients' families use health care services generally affects their health practices. Their perceptions of the seriousness of diseases and their history of preventive care behaviors (or lack of them) influence how patients think about health. Economic variables may affect a patient's level of health by increasing the risk for disease and influencing how or at what point the patient enters the health care system

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, 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

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? 1. health promotion activities 2. Acute care activities 3. restorative care activities 4. growth and development care activities

1. 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 nurse is presenting a program to workers in a factory covering safety topics, including the wearing of hearing protectors when workers are in the factor. Which level of prevention is the nurse practicing? 1. primary prevention 2. secondary prevention 3. tertiary prevention 4. quaternary prevention

1. Primary prevention is aimed at health promotion and includes health education programs, immunizations, and physical and nutritional fitness activities. It can be provided to an individual and includes activities that focus on maintaining or improving the general health of individuals, families, and communities. It also includes specific protection such as hearing protection in occupational settings.

Which statement made by a new graduate nurse about the teachback technique requires intervention and further instruction by the nurse's preceptor? 1. "After teaching a patient how to use an inhaler, I need to use the Teach Back technique to test my patient's understanding." 2. "The Teach Back technique is an ongoing process of asking patients for feedback." 3. "Using Teach Back will help me identify explanations and communication strategies that my patients will most commonly understand." 4. "Using pictures, drawings, and models can enhance the effectiveness of the Teach Back technique."

1. 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.

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? 1.Holistic 2. Health belief 3. Transtheoretical 4. Health promotion

1. The nurse is using a holistic model of care that takes a more holistic view of health by considering emotional and spiritual well-being and other dimensions of an individual to be important aspects of physical wellness. The holistic health model of nursing attempts to create conditions that promote optimal health. Nurses using the holistic nursing model recognize the natural healing abilities of the body and incorporate complementary and alternative interventions such as music therapy, reminiscence, relaxation therapy, therapeutic touch, and guided imagery because they are effective, economical, noninvasive, nonpharmacological complements to traditional medical care.

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? 1. Physiological 2. Safety and security 3. Love and belonging 4. Self-actualization

1. The nurse's actions address the basic physiological needs of nutrition, fluids, elimination, and oxygen. According to Maslow, basic needs must be met before meeting higher level needs.

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. Adolescents are quite egocentric and have the belief that everyone is focused on them and sees all of their flaws.

When Ryan was 3 months old, he had a toy train; when his view of the train was blocked, he did not search for it. Now that he is 9 months old, he looks for it, reflecting the presence of: 1. Object permanence. 2. Sensorimotor play. 3. Schemata. 4. Magical thinking.

1. Object permanence. He is now in Piaget's later stage of sensorimotor thought and has learned that objects exist even though he cannot see or touch them.

What is the health belief model?

1. Perceived susceptibility: the person must recognize that they may be susceptible to the disease (grandma and grandpa died of heart failure, will I?) 2. Individual's perception of the seriousness of the illness. This perception is influenced and modified by demographics and sociopsychological variables, perceived threats of the illness, and cues to action. ( if the patient doesn't think heart failure is sereious it will affect how they react) 3. The likelihood that a person will take preventive action. This component results from a person perception of the benefits of and barriers to taking action. prevenative actions include lifestyle changes, increased adherence to medical therapies, or a search for medical advice. a patients perception of susceptibility to disease and his/her perception of the seriousness of illness help to determine the likelihood that the patient will or will not partake in healthy behaviors.

You are caring for a recently retired man who appears withdrawn and says he is "bored with life." Applying the work of Havinghurst, you would help this individual find meaning in life by: 1. Encouraging him to explore new roles. 2. Encouraging relocation to a new city. 3. Explaining the need to simplify life. 4. Encouraging him to adopt a new pet.

1. encouraging him to explore new roles. The activity theory states that continuing an active, involved lifestyle results in greater satisfaction and well-being.

Which of the following are symptoms of secondary traumatic stress and burnout that commonly affect nurses? Select all that apply. 1. Regular participation in a book club 2. Lack of interest in exercise 3. Difficulty falling asleep 4. Lack of desire to go to work 5.Anxiety while working

2, 3, 4, 5. Nurses are particularly susceptible to the development of secondary traumatic stress and burnout—the components of compassion fatigue. Symptoms include decline in health, emotional exhaustion, irritability, restlessness, impaired ability to focus and engage with patients, feelings of hopelessness, inability to take pleasure from activities, and anxiety.

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 1. designing a nurturing family to raise children 2. providing physical and emotional care for a family member 3. establishing a safe physical environment for a family member 4. monitoring for side effects of illness and treatments 5. reducing the use of community resources

2, 3, 4. 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.

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. 1.Sedentary lifestyle 2. Mother died from CAD at age 48 3. History of hypertension 4. Eats diet high in sodium 5. Elevated cholesterol level

2, 3, 5. Genetic and physiological risk factors include those related to heredity, genetic predisposition to an illness, or those that involve the physical functioning of the body. Certain physical conditions such as being pregnant or overweight place increased stress on physiological systems (e.g., the circulatory system), increasing susceptibility to illness in these areas. A person with a family history of diabetes mellitus is at risk for developing the disease later in life because of a hereditary and genetic predisposition to the disease.

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. 1. Expect the interpreter to interpret your statements word-for-word so there is no misunderstanding by the patient. 2. If you feel an interpretation is not correct, stop and address the situation directly with the interpreter. 3. Pace a conversation so there is time for the patient's response to be interpreted. 4. Direct your questions to the interpreter. 5. Ask the patient for feedback and clarification at regular intervals.

2, 3, 5. 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.

in the United States, there has never been a president of Asian or Hispanic culture. This is an example of: 1. Social inequality 2. Marginalization 3. Under inclusion 4. Social location

2. 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.

Which statement made by a nurse shows that the nurse is engaging in an activity to help cope with secondary traumatic stress and burnout? 1. "I don't need time for lunch since I am not very hungry." 2. "I am enjoying my quilting group that meets each week at my church." 3. "I am going to drop my gym membership because I don't have time to go." 4. "I don't know any of the other nurses who met today to discuss hospital-wide problems with nurse satisfaction."

2. Nurses experience secondary traumatic stress and burnout. Personal strategies to help prevent or cope with secondary traumatic stress or burnout include healthy eating, making time for yourself to pursue personal interests, getting plenty of sleep, and regular exercise and relaxation.

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? 1. "I have a door hanging tag in my bathroom to remind me to do my breast self-examination monthly." 2. "Since my mother had breast cancer, I know that I am at increased risk for developing breast cancer." 3. "Since I am only 25 years of age, the risk of breast cancer for me is very low." 4. "I participate every year in our local walk/run to raise money for breast cancer research."

2. On the basis of health belief model, the statement indicates that the patient is concerned about developing breast cancer and feels that there is a risk or susceptibility based on recognition of a familial link for the disease. Once this link is recognized, the patient may perceive the personal risk.

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? 1. "Walking is OK. I really think running is better." 2. "Yes, walking is great exercise. Do you think you could go for a 5-minute walk next week?" 3. "Yes, I want you to begin walking. Walk for 30 minutes every day and start to eat more fruits and vegetables." 4. "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."

2. The patient's response indicates she is in the contemplative state, possibly intending to make a behavior change within the next 6 months. The nurse's statement reinforces the behavior and provides a specific goal for the patient to begin her walking plan.

What is the most common reason for calling on grandparents to raise their grandchildren? 1. single parenthood 2. legal interventions 3. dual-income families 4. increased divorce rates

2. 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 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? 1. family as context 2. family as a patient 3. family as a system 4. family as a structure

2. 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.

After a class on Pender's health promotion model, students make the following statements. Which statement does the faculty member need to clarify? 1. "The desired outcome of the model is health-promoting behavior." 2. "Perceived self-efficacy is not related to the model." 3. "The individual has unique characteristics and experiences that affect his or her actions." 4. "Patients need to commit to a plan of action before they adopt a health-promoting behavior."

2. Within the model, perceived self-efficacy is one of the behavior-specific cognitions and affect. The behavior-specific cognitions have motivational significance within the model.

An 18-month-old child is noted by the parents to be "angry" about any change in routine. This child's temperament is most likely to be described as: 1. Slow to warm up. 2. Difficult. 3. Hyperactive. 4. Easy.

2. Difficult. Children described as "difficult" adapt slowly to new routines and express their emotions forcefully; they like consistent structure.

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 As adolescents mature, their thinking moves to abstract and theoretical subjects. They have the capacity to reason with respect to possibilities.

The nurse teaches parents how to have their children learn impulse control and cooperative behaviors. This would be during which of Erikson's stages of development? 1. Trust versus mistrust 2. Initiative versus guilt 3. Industry versus inferiority 4. Autonomy versus sense of shame and doubt1.

2. initiative versus guilt Toddlers are learning that parents and society have expectations about behaviors and that they must learn to control their behavior.

A patient registered at the local fitness center and purchased a pair of exercise shoes. The patient is in what stage of behavioral change? 1. Precontemplation 2. Contemplation 3. Preparation 4.Action

3 The individual is in the preparation stage, making small changes toward preparation for a change in the next month. In this stage the patient believes that the advantages outweigh the disadvantages.

Using the transtheoretical model of change, order the steps that a patient goes through to make lifestyle changes 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, 5, 4, 2. This sequence follows the order of the steps of transtheoretical model of change: precontemplation, contemplation, preparation, action, and maintenance.

Which of the following family assessments are most important for successful family caregiving? Select all that apply 1. Educational level of family members 2.Cultural food preferences 3. Collaboration between family members 4. social support 5. conflict resolution practices

3, 4, 5. 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.

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? 1. The nurse begins a discussion with the patient by asking, "Tell me about your family members who live with you?" 2. The nurse asks, "What do you believe is needed to make you feel better?" 3. The nurse silently reflects about how her biases regarding poverty can influence how she assesses the patient. 4. The nurse uses a therapeutic and caring approach to how she interacts with the patient.

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

Which activity shows a nurse engaged in primary prevention? 1. A home health care nurse visits a patient's home to change a wound dressing. 2. A nurse is assessing risk factors of a patient in the emergency department admitted with chest pain. 3. A school health nurse provides a program to the first-year students on healthy eating. 4. A nurse schedules a patient who had a myocardial infarction for cardiac rehabilitation sessions weekly.

3. Primary prevention aimed at health promotion includes health education programs, immunizations, and physical and nutritional fitness activities. Primary prevention includes all health promotion efforts and wellness education activities that focus on maintaining or improving the general health of individuals, families, and communities.

A patient has surgery for a total knee replacement a week ago and is currently participating in daily physical rehabilitation session at the surgeon's office. In what level of prevention is the patient participating? 1. primary prevention 2. secondary prevention 3. tertiary prevention 4. quaternary prevention

3. Tertiary prevention involves minimizing the effects of long-term disease or disability by interventions directed at preventing complications and deterioration following surgery. Tertiary prevention activities are directed at rehabilitation rather than diagnosis and treatment. Care at this level aims to help patients achieve as high a level of functioning as possible, despite the limitations caused by illness or impairment. This level of care is called preventive care because it involves preventing further disability or reduced functioning.

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? 1. Listen 2. Explain 3. Acknowledge 4. Recommend treatment 5. Negotiate agreement

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

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!" 1. "That's fine. Some people who smoke live a long life." 2. "OK. I want you to decrease the number of cigarettes you smoke by one each day, and I'll see you in 1 month." 3. "I understand. Can you think of the greatest reason why stopping smoking would be challenging for you?" 4."I'd like you to attend a smoking cessation class this week and use nicotine replacement patches as directed."

3. The patient's response indicates that he is in the precontemplation stage and not intending to make a change in behavior in the next 6 months. In this stage the patient is not interested in information about the behavior and may be defensive when confronted with the information. Asking an open-ended question about smoking may stimulate the patient to identify a reason to begin a behavior change. Nurses are challenged to motivate and facilitate health behavior change in working with individuals.

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? 1. The nurse shifts her focus to understanding the patient by asking her, "Describe for me the course of your illness." 2. The nurse tells the patient, "Your choices of foods and unwillingness to exercise are adding to your health problems." 3. The nurse asks the patient, "Tell me about the main problems you have had with your health from not having a home." 4. The nurse explains, "Because you have obesity, it is important to know the effects it has on wound healing because of reduced tissue perfusion."

3. This response enables the nurse to elicit the patient's explanation of her health problems and their causes. Choice 1 uses a biomedical explanatory model instead of the patient's explanatory model. Choice 2 shows the nurse's disrespect and unwillingness to understand the patient's perceptions and health beliefs.

Nine-year-old Brian has a difficult time making friends at school and being chosen to play on the team. He also has trouble completing his homework and, as a result, receives little positive feedback from his parents or teacher. According to Erikson's theory, failure at this stage of development results in: 1. A sense of guilt. 2. A poor sense of self. 3. Feelings of inferiority. 4. Mistrust.

3. Feelings of inferiority. School-age children need to feel real accomplishment and be accepted by peers to develop a sense of industry.

A nurse is preparing to perform a cultural assessment of a patient. Which of the following questions is an example of a contrast question? 1. Tell me about your ethnic background. 2. Have you had this problem in the past? 3. Where do other members of your family live? 4. How different is this problem from the one you had previously?

4. Choice 1 is an example of an ethnohistory question, Choice 2 is an example of a focused question, and Choice 3 is an example of a social organization question.

Which of the following most greatly affects a family's access to adequate health care, opportunity for education, and sound nutrition? 1. Development 2. Family function 3. Family structure 4. Economic stability

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

In viewing the family as context, what is the primary focus? 1. family members within a system 2. family process and relationships 3. family relational and transactional concepts 4. health needs of an individual members

4. 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.

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? 1. Diverse Family relationship 2. Blended family relationship 3. Extended family relationships 4. Alternative family relationships

4. Alternative family relationships

The nurse is aware that preschoolers often display a developmental characteristic that makes them treat dolls or stuffed animals as if they have thoughts and feelings. This is an example of: 1. Logical reasoning. 2. Egocentrism. 3. Concrete thinking. 4.Animism.

4. Animism. This is the belief that inanimate objects have lifelike qualities; it is a component of magical thinking evident in preoperational thought.

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. Each of the life stages can be achieved successfully and result in satisfaction, including old age.

A nurse who works on a pediatric unit asks, "I wonder if children who interact with therapy dogs have reduced anxiety when they are in the hospital." In this example of a PICOT question, which of the following is the O? 1. Children 2. Therapy dogs 3. The pediatric unit 4. Anxiety

4. O stands for outcome; in this PICOT question, the outcome the nurse is concerned about is anxiety.

When preparing a 4-year-old child for a procedure, which method is developmentally most appropriate for the nurse to use? 1. allowing the child to watch another child undergoing the same procedure 2. Showing the child pictures of what he or she will experience 3. Talking to the child in simple terms about what will happen 4. Preparing the child through play with a doll and toy medical equipment

4. Preparing the child through play with a doll and toy medical equipment Preschoolers are in the preoperational stage of cognitive development and learn more easily when play is used to teach.

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. Adolescents can be risk takers and believe that they are immune to the negative consequences of behaviors; they are just beginning to be future oriented in their thought process and see everything as black or white.

What is Under inclusion

A group has been overlooked in research and the design of interventions

What is a randomized controlled trial?

A study in which people are at random chosen to receive one of several clinical interventions. Remove any chance of bias. Have control group vs experimental group. RCT is the gold standard for research it is conducted in such a way that any source of bias is removed, very useful evidence for EBP.

What is Cultural Skills?

Ability to access social, cultural, biophysical factors that influences patient treatment and care.

What is cultural awareness?

An in-depth self-examination of one's own background, recognizing biases, prejudices, and assumptions about other people

What is a quantitative data?

An observation you make using numbers and / or measurement

A researcher is studying the effectiveness of an individualized evidence-based teaching plan on young women's intention to wear sunscreen to prevent skin cancer. In this study, which of the following research terms best describes the individualized evidence-based teaching plan? 1. Sample 2. Intervention 3. Survey 4. Results

Answer 2. An intervention is an action or treatment performed by a researcher on a sample.

A nursing student is preparing to read the methods section of a research article. What type of information will the student expect to find in this section? Select all that apply 1. How the researcher conducted the study 2. A description about how to use the findings of the study 3. The number and type of subjects who participated in the study 4. Summaries of other research articles that support the need for this study 5. Implications for future research studies

Answer: 1, 3. The methods section explains how a research study was organized and conducted to answer the research question or test the hypothesis as well as how many subjects or people participated in the study.

A nurse is reading a research article. The nurse just finished reading a brief summary of the research study that included the purpose of the study and its implications for nursing practice. Which part of the article did the nurse just read? 1. Abstract 2. Analysis 3. Discussion 4.Literature View

Answer: 1. An abstract is a brief summary that summarizes the purpose of the article. It also includes the major themes or findings and the implications for nursing practice.

Which of the following statements about evidence-based practice (EBP) made by a nursing student would require the nursing professor to correct the student's understanding? 1. "In evidence-based practice, the patients are the subjects." 2."It is important to talk with experts and patients when making an evidence-based decision." 3. "A nurse wanting to investigate the evidence to solve a problem starts by forming a PICOT question." 4. "It is important to ask a librarian for help when searching for literature to help you answer your PICOT question."

Answer: 1. Multiple research studies, expert opinion, personal experience, and patient preferences create the data source for evidence-based practice. Patients are not the subjects of EBP; they are typically the subjects in a research study.

A nurse researcher wants to conduct historical research. Which of the following ideas for a study could the nurses conduct? Select all that apply 1. Determining the effect of unemployment on emergency room usage 2. Understanding how Clara Barton shaped nursing in America 3. Evaluating the effect of the Vietnam war on nursing leadership and practice 4. Analyzing the evolution of nursing and patient care during recent disasters 5. Investigating barriers to exercise in women who have become mothers in the past year

Answer: 2, 3, 4. Historical studies are designed to establish facts and relationships concerning past events.

A group of nurses on the research council of a local hospital are measuring nursing-sensitive outcomes. Which of the following is a nursing-sensitive outcome that the nurses need to consider measuring? Select all that apply. 1. Frequency of low blood sugar episodes in children at a local school 2. The number of patients who develop a urinary tract infection from a Foley catheter 3. Number of patients who fall and experience subsequent injury on the evening shift 4. Number of sexually active adolescent girls who attend the community-based clinic for birth control 5. Patient reported quality of life following coronary artery bypass graft surgery and cardiac rehabilitation

Answer: 2, 3. Nurse sensitive indicators are outcomes that are sensitive to nursing practice; these outcomes will improve if the quantity or quantity of nursing care improves.

Arrange the following steps of evidence based practice in the appropriate order 1. Integrate the evidence 2 ask the burning clinical question 3. Create a spirit in inquiry 4. Evaluate the practice decision or change 5. Share the results with others 6. critically evaluate the evidence you gather 7. collect the most relevant and best evidence

Answer: 3, 2, 7, 6, 1, 4, 5.

A nurse researcher is collecting data following approval from the institutional review board (IRB). In which part of the research process is this nurse? 1. Analyzing the data 2. Designing the study 3.Conducting the study 4. Identifying the problem

Answer: 3. Conducting the study includes tasks such as obtaining necessary approvals and implementing the study protocol to guide data collection.

When recruiting subjects to participate in a study about the effects of an educational program to help patients at home take their medications as ordered, the researcher tells the subjects that their names will not be used and no one but the research team will have access to their information and responses. This is an example of: 1.Bias. 2.Anonymity. 3.Confidentiality. 4.Informed consent.

Answer: 3. Confidentiality - Confidentiality guarantees that any information a subject provides will not be reported in any manner that identifies the subject and will not be accessible to people outside the research team.

A nurse researcher wants to know what factors are associated with a person's decision to exercise. The nurse distributes a survey to people who recently joined an exercise wellness program and analyzes the data to determine what factors and characteristics are most significantly linked to the decision to start exercising. What type of a research study is this? 1. Qualitative 2.Descriptive 3. Correlational 4. Randomized controlled trial

Answer: 3. Correlational: in this study the nurse researcher is correlating characteristics or factors with the decision to start exercising.

The nurses on a medical unit have seen an increase in the number of medication errors on their unit. They decide to evaluate the medication administration process based on data gained from chart reviews and direct observation of nurses administering medications. Which process are the nurses using? 1. Evidence based practice 2. Research 3. Quality improvement 4. Problem identification

Answer: 3. Quality improvement studies evaluate how processes work in an organization. The nurses in this example are evaluating the medication administration process.

A nurse researcher studies the effectiveness of a new program designed to educate parents to promote the immunization of children. The nurse divides the parents randomly into two groups. One group receives the typical educational program and the other group receives the new program. This is an example of which type of study? 1.Historical 2.Qualitative 3.Correlational 4.Experimental

Answer: 4. Experimental; in experimental studies, the subjects are randomly assigned into groups with one group receiving the standard treatment and the other group receiving the intervention.

A group of nurses have identified that the elderly patients on their unit have a high incidence of pressure ulcers after they have a stroke. During a unit meeting, they discuss different interventions they think may reduce the development of pressure ulcers. What is the nurses' next step to investigate this clinical problem further? 1.Conduct a literature review. 2.Share the findings with others. 3.Conduct a statistical analysis. 4.Create a well-defined PICOT question.

Answer: 4. In this case, the nurses need to develop a PICOT question next to search for appropriate evidence that might offer answers to this clinical problem.

What is the nursing process?

Assessment Diagnosis Planning Implementation Evaluation

2. Trevor knows that receiving an immunization is included in which hierarchy of need according to Maslow? A. Physiological B. Safety and security C. Love and belonging needs D. Self-esteem E. Self-actualization

B

Tracy is in her last semester of nursing school where she is taking a course in which her class learns about the importance of evidence-based practice. Dr. Minturn, the nursing professor who teaches the course, has asked the students to write a paper about a mock research study of their choosing. The students are to pose a clinical question and then map how they would create a research study around the question. They are not to actually carry out the research, but they are to envision what their study would look like and then map it on paper. 1. Tracy uses the six steps of evidence-based practice to help formulate her mock research study. Rank in order the six steps of evidence-based practice. A. Evaluate the practice decision or change. B. Ask a clinical question. C. Critically appraise the evidence you gather. D. Collect the most relevant and best evidence. E. Share the outcomes of evidence-based changes with others. F. Integrate all evidence with one's clinical expertise and patient preferences and values in making a practice decision or change.

B, D, C, F, A, E Rationale: The six steps of evidence-based practice are: ask a clinical question; collect the most relevant and best evidence; critically appraise the evidence you gather; integrate all evidence with one's clinical expertise and patient preferences and values in making a practice decision or change; evaluate the practice decision or change; and share the outcomes of evidence-based practice with others

3. Immunizations are not an objective as defined by Healthy People 2020 because immunizations are largely for children and children are not included in the Healthy People 2020 initiative. A. True B. False

B. False

What does CLARA stand for

C-LARA is the mnemonic for Calm, Listen, Affirm, Respond, and Add.

what does CLARA stand for

Calm: yourself down Listen: to the pt and families perspective Affirm: Express connection with something that was shared Respond: to what was said answer the question Add: share additional information for the pt and family to consider

According to Gesell's theory how does human growth occur?

Cephalocaudal: Head to toe Proximodistal: Spin must grow first then limbs

What are the 3 main things that affect a family form?

Changing Economic Status -Inadequate health insurance coverage -Increasing number of children living below poverty level Homelessness -Families with children Domestic Violence -Occurs across all social classes -Long-term physical and emotional consequences

What kind of theory is the Lawrence Kohlberg's theory of moral development?

Cognitive Development Theory

What are Developmental theories?

Comprehensive explanations about why people act and behave the way they do and how they change over time. Provide framework for examining, describing, and appreciating human development. Help nurses assess and treat a patient's response to illness

Define nuclear family

Consists of marries couple and children

What is Level 2 of Lawrence Kohlberg Theory of Moral Development, what stages does it include?

Conventional Reasoning: The person sees moral reasoning based on his/her own personal internalization of societal and others expectations. Move from 'whats in it for me' to 'how will it affect my relationship with others' Stage 3: Good boy nice girl- the individual want to win approval and maintain the expectations of one's immediate groups. Stage 4: Society maintaining orientation- Individuals expand their focus from a relationship with others to societal concerns. Moral decisions take into account societal perspectives. Right behavior is one's duty.

What is the goal of transcultural nursing?

Culturally congruent care -Care that fits a person's life patterns, values, and system of meaning

What is the psychoanalytic theory?

Describe development from personality, cognitive, and behavioral perspectives. Explains development as primarily unconscious and influenced by emotion. Maintain that unconscious drives influence development through universal stages experienced by all individuals

What are Biophysical developmental theories?

Examine how bodies grow and change

What does ETHNIC stand for?

Explanation: pt explains perception of problem Treatment: which types of treatment has the pt tried Healers: Which other alternative medicine have they tried Negotiate: option that is mutually acceptable Intervention: agree on appropriate intervention Collaboration: include pt, family, other health care professionals

What is secondary prevention?

Focuses on individuals who are experiencing health problems or illness and are at risk for developing complications or worsening conditions. Activities are directed at diagnosis and prompt intervention, thereby reducing severity and enabling the patient to return to a normal level of health as early as possible. Is delivered in homes, hospitals, or skilled nursing facilities. Includes screenings, treating early stages of a disease to delay the consequences of advanced disease.

what is social inequality

Groups have unequal access to resources, services, and positions

3. Tracy writes her mock research purpose statement. In the purpose statement she includes a ___________ that predicts the relationship between the study variables.

Hypothesis Rationale: A hypothesis or hypotheses are research questions found in the purpose statement of a research article that predicts the relationship or difference among study variables.

What is Quality Improvement?

Improves local work processes to improve patient outcomes and health system efficiency; results usually not generalized

Internal variables influencing health practices are?

Influence how a person thinks or acts, can have negative or positive affects on behavior -Developmental stage: a person's thoughts and behavior patterns change throughout life. Need to consider a patients level of development -Intellectual background: a person's beliefs about health care is shaped by their knowledge or lack of knowledge. Cognitive abilities can also by a role. -Perception of Functioning: how people perceive their physical functioning affects their health behaviors. -Emotional Factors: how patients deal with stress, depression, fear all influence their health beliefs. -Spiritual Factors: reflected in how a person lives their life, including the values and beliefs, how they establish family and friends and the ability to find hope and meaning in life.

What is the emic perspective?

Intercultural encounter insider perspective

What is Oedipus Conflict?

Is a developmental experience in which a child's conflicting feelings toward the opposite-sex parent are resolved by identifying with the same sex parent. Discovering difference between male and female.

What is the iceberg analogy?

Is a tool that helps you to visualize the visible and invisible aspects of your world view and recognize that the same applies to your pt

What is the teach back method?

Is an intervention that helps you to confirm that you have explained what a patient needs to know in a manner that the patient understands. Use open ended question, if they make a mistake don't be cruel means you didn't teach them in a way they could understand.

What is the impact of trauma on a family?

Is sudden unplanned, and sometime life threatening. Family members often struggle to cope with the challenges and can include many stressors. Families during this time are very vulnerable, don't give them false hope. Help the family leave the bedside and make sure they are taking care of themselves.

What is the id?

Is the part of the mind containing the drives present at birth. It is the source of our bodily needs, want, desires, and impulses, particularly our sexual and aggressive drives, operates according to the pleasure principle (devil).

What is primary prevention?

Is true prevention, it precedes disease and is applied to patients considered physically and emotionally healthy. Is aimed at health promotion includes health education, immunizations, nutritional programs, and physical fitness activities. Focus on maintaining health or improving general health.

Family as a system

It is important to understand that, although you are able to make theoretical and practical distinctions between the family as context and the family as patient, they are not necessarily mutually exclusive. When you care for a family as a system, you are caring for each family member (family as context) and the family unit (family as patient), using all available environmental, social, psychological, and community resources

What is Jean Piaget most known for?

Known for his theory of cognitive development in children. Includes 4 stages sensorimotor, preoperational, concrete operations, formal operations.

What does LEARN stand for?

Listen: with empathy Explain: your perceptions of the problem Acknowledge: and discuss cultural differences Recommend: treatment Negotiate: agreement

define disease

Malfunctioning biological or psychological process

What is cultivate spirit inquiry?

Need to have a never ending spirit of inquiry. Constantly questioning current clinical practices and believing in the value of EBP leads to the consistent use of EBP.

What is the goal of a cultural assessment?

Obtain accurate information from the patient that allows you to formulate mutually acceptable and culturally relevant plans of care for each health problem or the patient

what is Tertiary prevention?

Occurs when a defect or disability is permanent and irreversible. It involves minimizing the effects of long term disease or disability by interventions directed at preventing complications. Activities directed at rehab. Care at this level helps patient achieve as high level of functioning as possible, despite limitations of the disease.

Social location

One's place in society is based on membership in a social group that determines access to resources

What does PICOT stand for?

P: Population Identify patient age, gender, race, disease I: Intervention of interest what treatment, diagnostic test C: Comparison of interest what is the usual standard of the care or current intervention used in practice now O: Outcome what results do we wish to see or achieve T: Time what amount of time is need for the intervention

precontemplation stage

Person does not think about changing his or her behavior in the next 6 months patient is not interested in information about behavior and may be defensive when confronted with it

What is Level 3 of Lawrence Kohlberg Theory of Moral Development, what stages does it include?

Posconventional Reasoning: The person finds a balance between basic human rights and obligations and social rules and regulations. What an ideal society would look like. Stage 5: Social Contract orientation- An individual follows the societal law but recognizes the possibility of changing the law to improve society. Knows different social groups have different values. Stage 6: Universal Ethical Principle Orientation- Defines right by the decision of conscience in according with self chosen ethical principles. These principles are abstract like the golden rule.

What is Level 1 of Lawrence Kohlberg Theory of Moral Development, what stages does it include?

Preconventional Reasoning: At this stage thinking is mostly based on likes and pleasures. This stage progresses toward having punishment guide behavior. A person's moral reason for acting, the 'why' Stage 1: Punishment and obedience orientation- How children respond to a moral dilemma. "I must follow the rules or I will be punished" Physical consequences guide right or wrong choices. Children view illness as a punishment. Stage 2: Instrumental Relativist Orientation- Child recognizes that there is more than one right view; a teacher has one view that is different from parents. The child views punishment not as proof of being wrong (stage 1) but as something they want to avoid.

What are the levels of preventive care?

Primary Prevention Secondary Prevention Tertiary Prevention

What does RESPECT stand for?

Rapport: connect on a social level, seek pt view Empathy: remember pt came to you for help Support: ask about and try to understand barriers Partnership: be flexible Explanations: check often for understanding Cultural Competence: respect pt and their beliefs Trust: do not assume trust

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: 1. Diversity 2. Durability 3. Resiliency 4. 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.

What is the difference between a rigid or flexible family?

Rigid; specifically dictate who accomplishes different tasks Flexible; let children and family members do as they please Too much of either is not good

4. Tracy knows that the __________ __________ is the foundation of research; thus she includes this in her mock research paper objectively test her hypothesis.

Scientific method Rationale: The scientific method is the foundation of research and is the most reliable and objective of all methods of gaining knowledge.

Goal of Gesell's theory of development

Sequential development is evident in fetus, in which there is a specified order or organ system development. Growth and development is unique and is directed by gene activity.

action stage

Stage of change in which people are actively changing a negative behavior or adopting a new, healthy behavior

What is research?

Systematic inquiry answers questions, solves problems, and contributes to the generalization knowledge base of nursing, may or may not improve patient care

Define ethocentrism

Tendency to hold one's own way of life as superior to that of others

Holistic Health Model

The *holistic health model* assesses the whole person because it views the mind, body, and spirit as interdependent and functioning as a whole within the environment. Health depends on all these factors working together. Recognize the natural healing ablities of the body.

What is culture?

The body of customary beliefs, material traits, and social forms that constitute the distinct tradition of a group of people. -Norms, values, and traditions -Ethnicity, race, nationality, and language -Gender, sexual orientation, location, class, and immigration status

What is the Ego?

The component of personality, developed through contact with the external world, that enables us to deal with life life's practical demands. Ego operates according to the reality principle, the regulating mechanism that enables us to delay gratifying immediate needs and function effectively in the real world. It is the mediator between the id and the superego. The ego helps you resist the impulse to snatch others food and also pay your checks.

Family as a patient?

The family process and relationships (parenting or family caregiver) are the primary focus of nursing care. Focus your nursing assessment on family patterns vs. characteristics on individual members. Concentrate on patterns and process that are consistent with reaching and maintaining family and individual health. Plan care to meet not only the patients needs but also the changing needs of the family.

what is the superego?

The mental system that reflects the Internalization of cultural rules, mainly learned as parents exercise their authority. Consists of set guidelines, internal standards, code of conduct that regulate and controls our behaviors. Punishes us when it finds we are doing or thinking something wrong, by producing guilt, or rewarding us with pride for living up to the ideal standards (angle).

What is family as a context?

The primary focus is on the health and development of an individual member exiting within specific environment. Although the focus is on the individual's health status, assess how much the family provides individual's basic needs

Define illness

The way that individuals and families react to disease

What is Family diversity?

Uniqueness of each family unit. Examples can be young parents or grandparents raising grandchildren.

What is evidence based practice?

Use of information form research and other sources to determine safe and effective nursing care with the goal of improving patient care and out comes

Biocultural history

Way of understanding takes local, cultural views and understanding of illness and disease and the local practices of traditional or biomedical healing

What is transcultural nursing?

a comparative study of cultures to understand their similarities and differences

Define blended family

a family whose members were once part of other families

What is a health disparity?

a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage. Are the difference among populations in the incidence, prevalence, and outcome of health conditions.

What is the definition of health?

a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity a state of being that people define in relation to their own values, personality, and lifestyle

What is family resiliency?

ability to cope with expected and unexpected stressors. Families ablilty to adapt to role of structual changes.

What is the research process vs research process

assessment - identify are of interest or clinical problem diagnosis - develop research question/ hypotheses planning - determine how study will be conducted implementation - conduct the study evaluation - analyze results of the study. Use of the findings

What where some critics about Sigmund Fred?

based his theory on biological determinants and ignored influence of culture and experience His assumptions are not applicable across different cultures

What is postformal thought?

cognitive development beyond Piaget's formal operational stage, thinking characterized by recognizing that the correct answer varies from one situation to another, that solutions should be realistic, that ambiguity and contradiction are typical, and that subjective factors play a role in thinking

contemplation stage

considering a change within the next 6 months ambivalence may be present, but patient will more likely accept information

What is the proper order by age progression for the stages of Freud's psychosexual development?1. Phallic 2. Latent 3. Oral 4. Genital 5. Anal a. 3, 5, 1, 4, 2 b. 3, 5, 2, 1, 4 c. 5, 3, 2, 1, 4 d. 3, 5, 1, 2, 4

d. 3, 5, 1, 2, 4

Health Promotion Model

defines health as a positive, dynamic state, not merely the absence of disease. 1. individual characteristics and experiences 2. Behavior-specific knowledge and affects 3. behavioral outcomes, in which that patient commits to or changes behavior

What is qualitative data?

descriptive data, patients perception of illness or quality of life

What are health care disparities?

differences among populations in the availability, accessibility, and quality of health care services. Amid at prevention, treatment, and management of disease and their complication.

What is Latency Stage?

fourth stage occurring during the school years, in which the sexual feelings of the child are repressed while the child develops in other ways. (6-12 years): Primary focus is on the further development of intellectual creative, interpersonal, and athletic skills.

define single parent family

household in which one adult has the sole responsibility to be the children's caregiver.

Define extended family

household made up of several generations of family members

What is Evidence based care?

improves quality, safety, and patient outcomes increase nurse satisfaction reduces cost Helps you make effective, timely, and appropriate clinical decisions in recponce to a broad political professional and societal forces present in today's health care environment

What is the preoperational stage?

in Piaget's theory, the stage (from 2 to about 7 years of age) during which a child learns to use language but does not yet comprehend the mental operations of concrete logic. During this time children learn to think with the use of symbols and mental images. They exhibit 'egocentrism' in that they see objects and people from only one point of view, their own. They believe that everyone experiences the world exactly as they do. Early in this stage children demonstrate 'animism' in which they personify objects. They believe that inanimate objects have lifelike thoughts, wishes, and feelings. Children at this stage have difficulty conceptualizing time. Play comes primary means by which they foster their cognitive development and learn about the world.

What is the sensorimotor stage?

in Piaget's theory, the stage (from birth to about 2 years of age) during which infants know the world mostly in terms of their sensory impressions and motor activities. Infants develop a schema or action pattern for dealing with the environment. These schemas include hitting, looking, grasping, or kicking. Schemas become self-initiated activities (learns that sucking on thumb feels good so sucks on toys and clothes). Success achievement leads to greater exploration. During this stage a child learns about himself and his environment through motor and reflex actions. He/she learns that they are separate from the environment and that aspects of the environment (parents or favorite toy) continue to exist even though they cannot always be seen. Termed this understanding that object continue to exist even when they cannot be seen, heard, or touched, object permanence and considered.

What is the concrete operational stage?

in Piaget's theory, the stage of cognitive development (from about 6 or 7 to 11 years of age) during which children gain the mental operations that enable them to think logically about concrete events. Children now are able to perform mental operations. For example, the child thinks about an action that before was performed physically. Children are now able to describe a process without actually doing it. At this time they are able to coordinate two concrete perspectives in social and scientific thinking so they are able appreciate the difference between their perspective and that of a friend. Children can now mentally picture a series of steps and reverse the steps to get back to the starting point. Correctly order or sort objects by size, length, weight, etc.

What is the formal operational stage?

in Piaget's theory, the stage of cognitive development (normally beginning about age 11- adulthood) during which people begin to think logically about abstract concept.The transition from concrete to formal operational thinking occurs in stages during which there is a prevalence of egocentric thought, the egocentricity leads adolescents to demonstrate feelings and behaviors characterized by self-consciousness: a belief that their actions and appearances are constantly scrutinized, that their thoughts and feelings are unique, and that they are invulnerable. These feelings of invulnerability frequently lead to risk taking behaviors especially in early adolescent. Share thoughts and feelings with peers, learn many share their feelings. They have the capacity to reason with respect to possibilities.

What is family durability?

intrafamilial system of support and structure that may extend beyond the walls of the household. Examples include parents remarry, children leave home as adults.

What is cultural desire?

motivation to engage in intercultural encounters and acquire cultural competence

What is the etic perspective?

outsider's interpretation of the experiences of the culture

What is the transtheoretical model of change?

proposes that intentional behavior change occurs in stages -as people attempt to change their behavior, they move through a variety of stages using different processes to help them get from one stage to the next until a desired behavior is attained -A model used to determine a patient's willingness to change: pre-contemplation, contemplation, preparation, action, maintenance, termination -Can be very difficult to change negative behaviors

Define alternative family

relationships include multi-adult hose holds, skip-generation families, communal groups with children, nonfamilies (adults living alone)

preparation stage

stage of change in which people are getting ready to make a change within the coming month, slowly making small changes patient believes that advantages outweigh disadvantages of behavior change

maintance stage

sustained change over time begins 6 months after action has started and continues indefinitely relapse can occur, a person will return to the start of the stages

What did Sigmund Freud Propose?

that a person's basic personality is formed before 6 years of age during a series of sensitive periods of life stages. These early life stages formed children's personality through experiences of sexual pleasures from specific body areas. Any conflicts from a given stage could cause a permanent fixation; a phenomenon in which a person's pleasure-seeking drive becomes

What is Linguistic competence?

the ability of an organization and its staff to communicate effectively and convey information in a manner that is easily understood by diverse audiences (don't speak English, deaf, low literacy skills)

define ethohistory

the branch of anthropology concerned with the history of people and culture, especially non-western ones

What are the social determinants of health?

the conditions in which people are born, grow, live, work, and age, shaped by the distribution of money, power, and resources at global, national, and local levels. income, wealth, family, household, social support, education, discrimination. -Poor access to health care is one social determinant of health that contributes to health disparities

What is health literacy?

the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Know what they are taking their medications, know when to take them, interpret labels can affect groups like elderly, immigrants, low income families, people how don't graduate high school, chronic mental illness.

What is the structure within a family?

the ongoing membership of the family and the pattern of relationships. Who performs which tasks, who makes decisions?

what is cultural knowledge?

the process of seeking and obtaining a sound educational foundation concerning the various world views of different culture. What the nurse beings to the caring situation and what the nurse learns about older adults, their families, their communities, their behaviors, and their expectation

what is the function within a family?

what the family does, and why they do it.

What are perspectives on adult development?

• Aging changes come more slowly as people continue to develop new abilities to adapt to shifting environments. • Stage-crisis theory focused on developmental tasks; has six stages (infancy and early childhood, middle childhood, adolescence, early adulthood, middle adulthood, late adulthood) • Life span approach considers personal circumstances

What are cultural encounters?

•Are interventions that involve a nurse directly interacting with patients from culturally diverse backgrounds •Have the potential for conflict •Enable new forms of community and collective identity •Provide the opportunity to show compassion

What does intersectionality mean?

•Belonging simultaneously to multiple social groups

What is cultural competency?

•Defined as the enabling of health care providers to deliver services that are respectful of and responsive to the health beliefs, practices, and cultural and linguistic needs of diverse patients.