Concepts Modules 10, 11 and 12

b. All of my personal information will be kept secure.

A client tells the nurse that she has been using a health information website to find information about her illness. Which statement by the client does the nurse need to correct? a. Some of the websites do not have very accurate information. b. All of my personal information will be kept secure. c. I should speak to my physician before using any alternative therapies. d. Other people seem to be having the same symptoms I have.

communication on health care teams

A large body of literature shows that bc of the complexity of medical care, coupled with inherent limitations of human performance, it is critically important that clinicians have standardized communication tools and create an environment in which individuals can speak up and express concerns; this literature concurs that when a team needs to communicate complex info in a short period of time, it is helpful to used structured communication techniques to ensure accuracy.

B. Assess the knowledge of the certified nursing assistant.

A newly graduated nurse is assigned to care for a team consisting of herself and a certified nursing assistant. When delegating skills, she needs to first: A. Assign only bed-making and feeding skills. B. Assess the knowledge of the certified nursing assistant. C. Remind the staff member that she is working under the license of the RN. D. Allow the staff member to perform only skills that the RN is able to teach certified nursing assistants to perform.

B. role modeling

A nurse chooses a low-calorie meal for himself when having lunch with an obese patient A. AV materials B. role modeling C. lecture D. role playing

B. affective The clients ideas about toilet training have changed.

A nurse in a provider's office is collecting data from the mother of a 12 month old infant. The client states that her son is old enough for toilet training. Following an educational session with the nurse, the client now states that she will postpone toilet training until her son is older. Learning has occurred in which of the following domains? A. cognitive B. affective C. psychomotor D. kinesthetic

B. C. D. B. the client ambulates with his slippers on over his anti embolic stockings C. the client uses a front-wheeled walker when ambulating D. the client had pain meds 30 min ago

A nurse is delegating the ambulation of a client who had knee arthroplasty 5 days ago to an AP. Which of the following info should the nurse share with the AP? (SATA) A. the roommate ambulates independently B. the client ambulates with his slippers on over his anti embolic stockings C. the client uses a front-wheeled walker when ambulating D. the client had pain meds 30 min ago E. the client is allergic to codeine F. the client ate 50% of his breakfast this morning

A. B. D. A. home health care B. rehabilitation facilities D. skilled nursing facilities Diagnostic is secondary health care and oncology is tertiary.

A nurse is discussing restorative health care with a newly licensed nurse. Which of the following examples should the nurse include in the teaching? (SATA) A. home health care B. rehabilitation facilities C. diagnostic centers D. skilled nursing facilities E. oncology centers

B. ensuring that health care providers comply with regulations A. utilization review committees have this responsibility C. The Joint Commission is responsible for this D. U.S. Food and Drug administration is responsible for this

A nurse is discussing the purpose of regulatory agencies during a staff meeting. Which of the following tasks should the nurse identify as the responsibility of state licensing boards? A. monitoring evidence based practice for clients who have specific diagnosis B. ensuring that health care providers comply with regulations C. setting quality standards for accreditation of health care facilities D. determining if meds are safe for administration to clients

B. ask the client to explain how to select or prepare meals

A nurse is evaluating how well a client learned the info he presented in an instructional session about following a heart healthy diet. The client states that she understands what to do now. Which of the following actions should the nurse take to evaluate the client's learning? A. encourage the client to ask questions B. ask the client to explain how to select or prepare meals C. encourage the client to fill out an evaluation form D. ask the client if she has resources for further instruction on this topic

B. medicare E. medicaid

A nurse is explaining the various types of health care coverage clients might have to a group of nursing students. Which of the following healthcare financing mechanisms are federally funded? (SATA) A. preferred provider organization (PPO) B. medicare C. long term care insurance D. exclusive provider organization E. medicaid

A. B. C. A. intensive care unit B. oncology treatment center C. burn center D is restorative care E. is restorative care

A nurse is explains the various levels of health care services to a group of newly licensed nurses. Which of the following examples of care or care settings should the nurse classify as tertiary care (SATA) A. intensive care unit B. oncology treatment center C. burn center D. cardiac rehab E. home health care

C. Notify the health care provider of the findings before leaving the home

A nurse is making a home visit and discovers that a patient's wound infection has gotten worse. After cleaning and re-dressing the wound, what should the nurse do? A. Ask the home health agency nurse manager to contact the health care provider B. Document the findings and confirm with the patient the date of the next home visit C. Notify the health care provider of the findings before leaving the home D. Tell the patient that the health care provider will be notified before the next visit

B. the client is able to demonstrate the appropriate technique

A nurse is observing a client drawing up and mixing insulin. Which of the following findings should the nurse identify as an indication that psychomotor learning has taken place? A. the client is able to discuss the appropriate technique B. the client is able to demonstrate the appropriate technique C. the client states that he understands D. the client is able to write the steps on a piece of paper

B. C. D. E. B. Right supervision and evaluation C. Right direction and communication D. Right time E. Right circumstances

A nurse is preparing an in-service program about delegation. Which of the following elements should she identify when presenting the 5 rights of delegation? (SATA) A. Right client B. Right supervision and evaluation C. Right direction and communication D. Right time E. Right circumstances

D. determine what the client knows about stress incontinence NURSE SHOULD ASSESS FIRST

A nurse is preparing an instructional session for an older adult about managing stress incontinence. which of the following actions should the nurse first take when meeting with the client? A. encourage the client to participate actively in learning B. select instructional materials appropriate for the older adult C. identify goals the nurse and client agree are reasonable D. determine what the client knows about stress incontinence

C. can you tell me about how long my surgery will take

A nurse is providing preoperative education for a client who will undergo a mastectomy the next day. Which of the following statements should the nurse identify as an indication that the client is ready to learn? A. I don't want my spouse to see my incision B. will you give me pain meds after the surgery C. can you tell me about how long my surgery will take D. my roommate listens to everything I say

A. collaborating with providers to perform obesity screenings during routine office visits The nurse should identify obesity screenings at office visits as an example of primary health care. Primary healthcare emphasizes health promotion and disease control, is often delivered during office visits, and includes screenings. B. is restorative care C. is tertiary care D. is secondary care (acute care of clients)

A nurse manager is developing strategies to care for the increasing number of clients who have obesity. Which of the following actions should the nurse include as a primary health care strategy? A. collaborating with providers to perform obesity screenings during routine office visits B. ensuring the availability of specialized beds in rehab centers for clients who have obesity C. providing specialized intraoperative training regarding surgical treatments for obesity D. educating acute care nurses on postoperative complications r/t obesity

B. RN Client returning from surgery reqs an RNs assessment and establishment of a plan of care, esp if client is potentially unstable.

A nurse manager of a med surg unit is assigning care responsibilities for the oncoming shift. A client is awaiting transfer back to the unit from PACU following thoracic surgery. To which of the following staff members should the nurse assign this client? A. charge nurse B. RN C. PN D. AP

A. printed material

A nurse obtains pamphlets for a 16-year-old that describes how STDs are transmitted A. printed material B. role modeling C. lecture D. demonstration

C. reapplying a condom catheter for a client who has urinary incontinence A. would be inappropriate bc client is at risk for further aspiration B. either RN or PN D. either RN or PN

A nurse on a med surg unit has received change of shift reports and will care for four clients. Which of the following clients needs should the nurse assign to the AP? A. feeding a client who was admitted 24 hours ago with aspiration pneumonia B. reinforcing teaching with a client who is learning to walk using a cane C. reapplying a condom catheter for a client who has urinary incontinence D. applying a sterile dressing to a pressure ulcer

D. demonstration

A nurse performs a bathing procedure on a newborn in front of several new mothers A. AV materials B. role modeling C. lecture D. demonstration

C. lecture

A nurse speaks to a group of patients about the dangers of smoking A. AV materials B. role modeling C. lecture D. role playing

A. AV materials

A nurse uses a video to teach a patient about heart disease A. AV materials B. role modeling C. lecture D. demonstration

A. Go to the patient's room and assess the skin

A nursing assistant reports seeing a reddened area on the patient's hip while bathing the patient. The nurse should: A. Go to the patient's room and assess the skin B. Document the findings per the nursing assistants report C. Request a wound nurse consult D. Instruct the nursing assistant to apply a dressing to the area

B. Restorative care setting.

A patient who needs nursing and rehabilitation following a stroke would most benefit from receiving care at a A. Primary care center. B. Restorative care setting. C. Assisted-living center. D. Respite center.

Team/Functional Nursing

A specific group of caregivers' works with a group of pts, and team members are assignment specific care functions or procedures to perform for all the pts; members of the team usually include RNs, LVNs, and UAPs; the team leader is the nurse who manages the team by using effective management techniques; is a collaborative care style that encourages each member of the team to work with and help other members; hierarchical communication from charge nurse to charge nurse, charge nurse to team leader and team leader to team members; decision making occurs at a clinical level.

highest; lowest

A systematic review of RCTs (random controlled trials) represent the ________ level of evidence and expert opinions and/or reports of expert committees are the ___________ level of evidence.

B. Primary nursing.

A travel nurse has taken an assignment at a health care facility where nurses assume responsibility for a caseload of patients over a period of time. This type of nursing exemplifies A. Team nursing. B. Primary nursing. C. Functional nursing. D. Decentralized management.

assessment

After _________________, priorities are set as high, intermediate and low. Clients may have all three priorities. Additionally you will need to recognize and deal with the priorities for the groups of clients you are caring for.

A. Provide an opportunity for the nurses to express their feelings and emotions

After her first week working on a busy medical-surgical unit, a new charge nurse notes that the individual nurses are highly competent but seem to be unable to function productively as a team. Select the action the charge nurse should take first that would best facilitate team building among the staff: A. Provide an opportunity for the nurses to express their feelings and emotions B. Hire more staff members to reduce stress and fatigue from understaffing C. Allow the staff more input into important policy decision-making D. Give the staff members more time to adjust to the change in charge nurses

Democratic

Also called supportive, participative, and transformational leadership style; in this style all aspects of the process of achieving a goal, from planning and goal setting to implementing and taking credit for success of the project are shared by the group; is based off of four beliefs (1. every member of the group needs to participate in all decision-making, 2. within the limits established by the groups, freedom of expression is allowed to maximize creativity, 3. individuals in the group accept responsibility for themselves and the welfare of the whole group. 4. Each member must respect all other embers of the group as unique and valuable contributors); the leader provides guidance to the group, all members share control; works best with groups who's members have equal status and who know each other well because they have worked together before; seen in most nursing units; hallmarks of this style are trust, collaboration, confidence and autonomy; followers of this have a high level of commitment and strong work ethic. Looking for supportive, goal-oriented action.

D. teaching a client who has asthma to use a metered dose inhaler The RN is responsible for primary teaching; the PN may only reinforce.

An RN is making assignments for a PN at the beginning of the shift. Which of the following assignments should the PN question? A. assisting a client who is 24hr postoperative to use an incentive spirometer B. collecting a clean catch urine specimen from a client who has a wound infection C. providing nasopharyngeal suctioning for a client who has pneumonia D. teaching a client who has asthma to use a metered dose inhaler

Accountability

Answerable for the actions.

Affordable Care Act

Because of this act, substantial changes in the way health-care services are delivered and how health care professionals interact with these systems has evolved.

A. Obtains informed consent B. Minimizes risks to subjects C. Ensures confidentiality

Before conducting any study with human subjects, the researcher must obtain approval from the agency's human subjects committee or institutional review board (IRB). The IRB ensures that the researcher (Select all that apply.) A. Obtains informed consent B. Minimizes risks to subjects C. Ensures confidentiality D. Ensures that subjects complete the study

role

Being able to locate, read, and critically evaluate research and determine the implications for practice; identify researchable clinical problems in practice; and collaborating with experienced researches to design studies, collect data, interpret/implement AND disseminate findings are all part of the ________ of the BSN professional nurse in research.

begin

Clinical decisions __________ with your first assessment of your client's condition.

clinical care coordination

Clinical decisions, priority setting (Determining whats highest/lowest priority), organizational skills, use of resources, time management, and evaluation are all part of _____________ ________ ______________.

Holistic teaching

Considering the whole person rather than focusing on specific content, this is done during the assessemnt phase and throughout the process. This is a teaching.

Closed

Do you know how to give yourself insulin? Is it hard for you to deal with your illness? Are you taking your medicine every day? Are you in pain? Are you upset? Will you be able to take care of yourself at home? Are you ready to go home today? Are all what kind of questions?

Phase One

During this step/phase of nursing research the problem is identified, informed consent is obtained (when using human subjects), literature is reviewed, and a theoretical framework is applied/developed. Ex. the forearm is being used for automatic BP measurement and we lack info on accuracy, previous studies of BP measurement had inconsistencies in data collection/results.

Phase Two

During this step/phase of the nursing research process, a research design is selected (quantitative, use of descriptive, correlational, comparative study based on purposes of the study), the setting/sample is identified (ex. 780 bed hospital, 5 med-surg units; 203 English speaking pts > 18 meeting inclusion), a data collection/instrumentation is chosen (ex. Welch-Allyn vital spot 420; demographic/clincal data form).

Phase Three

During this step/phase of the nursing research process, a study is conducted (a procedure is determined for data collection, train data collectors, identify subjects, obtain informed consent and collect data).

Phase Four

During this step/phase of the nursing research process, data is analyzed (descriptive stats to describe sample).

Phase Five

During this step/phase of the nursing research process, findings/limitations/implications are discussed (BP measurements in forearm higher up to 33 mmHg; if forearm must be used: correct cuff size, arm placement, documentation and consistent use is recommended)

Responsibility

Duties and activites an individual is employed to perform.

Total Patient Care Nursing

Each nurse is given full responsibility for a client or group of clients, depending on acuteness of the setting. Assignments are often based on each nurses skill and experience. Ex. experienced nurses may be assigned clients who are unstable or req complex care (the assigned nurse performs all of the client's care; RN works directly with pt, family and health care team members; RN is responsible for pts during shift of care, although care may be delegated; approach may not be cost-effective owing to high number of RNs needed; pt satisfaction is high.

Numeracy

Health literacy includes _____________ skills, it is a person's ability to interpret numbers, for example, calculating cholesterol and blood sugar levels, measuring medications, and understanding nutrition labels all require math skills; choosing between health plans or comparing prescription drug coverage requires calculating premiums, copays and deductibles.

Open-ended

How would you describe your pain? What concerns you most about going home? How do you give yourself insulin? What are some of the problems caused by your illness? How and when do you take your medication? What problems do you think you will have at home? What is bothering you? Are all what kind of questions?

P= children <6 yo on antibiotics I= probiotics C= none/placebo O= decrease risk of antibiotic associated diarrhea T= while on antibiotics

Identify PICOT in this example: In children <6 yo requiring antibiotics, do probiotics decrease the risk of developing antibiotic associated diarrhea? P= I= C= O= T=

P= family members of pts undergoing diagnostic procedures I= listening to music/comedy routine CDs C= compared to no intervention O= reduce anxiety by family members T= while undergoing diagnostic procedures

Identify PICOT: Among family members of pts undergoing diagnostic procedures, does listening to music or comedy routine CD's compared with no intervention reduce reported anxiety by family members P= I= C= O= T=

P= pt's 65 years and older I= use the influenza vaccine C= compared with those who do not get the vaccine O= reduce risk of pneumonia T= during flu season

Identify PICOT: For pt's 65 years and older, does the use of the influenza vaccine compared with those who do not get the vaccine reduce the risk of pneumonia during flu season. P= I= C= O= T=

P= women over age 40 I= do pelvic exercises C= compared with those who do not perform the exercise O= reduced reported incidence of urinary incontinence T= within 6 months

Identify PICOT: For women over the age of 40, who do pelvic exercises compared with those who do not perform the exercise is there a reduced reported incidence of urinary incontinence within 6 months. P= I= C= O= T=

A. Primary nursing

Identify a type of care delivery model that focuses on the whole person and gives the nurse responsibility for all of the client's nursing needs during a given hospitalization: A. Primary nursing B. Case management C. Team nursing D. Total patient care

A. often a APN role B. improves quality and cost effectiveness of care

Identify advantages of case management nursing (SATA) A. often a APN role B. improves quality and cost effectiveness of care C. nurse knowledge of pt is enhanced D. less expensive

A. B. C. D. F. G. A. increased continuity of care B. improved interdisciplinary communication C. enhanced coordination of the total therapy plan D. improved quality and consistency of nursing care F. increased job satisfaction for nurses G. close working relationships with clients and families

Identify advantages of primary care nursing (SATA) A. increased continuity of care B. improved interdisciplinary communication C. enhanced coordination of the total therapy plan D. improved quality and consistency of nursing care E. expensive RN staff F. increased job satisfaction for nurses G. close working relationships with clients and families

A. B. C. D. A. team collaboration B. less expensive than all RNs C. experienced nurses can monitor less experienced personnel D. high level of autonomy

Identify advantages of team/functional nursing (SATA) A. team collaboration B. less expensive than all RNs C. experienced nurses can monitor less experienced personnel D. high level of autonomy E. low level of autonomy

A. B. A. improved communication and continuity of care B. nurses knowledge of the pt is enhanced

Identify advantages of total patient care nursing (SATA) A. improved communication and continuity of care B. nurses knowledge of the pt is enhanced C. team collaboration D. high level of autonomy

A. B. C. E. A. reducing health care costs while maintaining high-quality care for pts B. improving access and coverage for more people C. encouraging healthy behaviors E. earlier hospital discharges resulting in more pts needing nursing homes or home care

Identify challenges to health care (SATA) A. reducing health care costs while maintaining high-quality care for pts B. improving access and coverage for more people C. encouraging healthy behaviors D. increasing health care costs for better care E. earlier hospital discharges resulting in more pts needing nursing homes or home care

A. C. A. age (between now and 2050, the number of persons 65 years of age or older is expected to double) C. chronicity (long term and expensive nature of many health problems; although steps have been made in treating some acute infectious diseases, many challenges still exist in management of health concerns like cancer, heart disease, Alzheimer's, diabetes, COPD and HIV; also environmental and occupational safety, drug abuse, and mother and child health care).

Identify demographics affecting health care delivery (SATA) A. age B. obesity C. chronicity D. life expectancy

A. clients with complex problems may not receive individualized care

Identify disadvantages of case management nursing A. clients with complex problems may not receive individualized care B. no APN role C. continuity is lost D. decreased accountability

A. B. C. A. Expensive RN staff B. lack of built in system for experienced nurses to supervise and teach less experienced nurses C. economically inefficient

Identify disadvantages of primary care nursing (SATA) A. Expensive RN staff B. lack of built in system for experienced nurses to supervise and teach less experienced nurses C. economically inefficient D. close working relationships

A. B. D. E. A. care may be fragmented B. decreased accountability for overall plan and delivery of care D. pts less likely to receive consistent care E. decreased rapport between pt and nurse

Identify disadvantages of team/functional nursing (SATA) A. care may be fragmented B. decreased accountability for overall plan and delivery of care C. decreased autonomy D. pts less likely to receive consistent care E. decreased rapport between pt and nurse

A. C. A. increased cost of RN salaries C. in agencies that hire part time nurses, continuity may be lost

Identify disadvantages of total pt care nursing (SATA) A. increased cost of RN salaries B. decreased cost C. in agencies that hire part time nurses, continuity may be lost D. decreased job satisfaction

A. C. D. A. Pt expressing his love of his wife's high fat cooking C. Pt develops coping skills in relation to managing diabetes D. Pt expresses fear of dying

Identify examples of affective domain (SATA) A. Pt expressing his love of his wife's high fat cooking B. Pt verbalizes understanding of managing blood glucose C. Pt develops coping skills in relation to managing diabetes D. Pt expresses fear of dying

A. B. C. A. One-on-one discussion B. Pt verbalizes the role of high fat foods and cholesterol C. Pt verbalizes understanding of managing blood glucose NOT EXPRESSES FEAR BC IS NOT KNOWLEDGE.

Identify examples of cognitive domain (SATA) A. One-on-one discussion B. Pt verbalizes the role of high fat foods and cholesterol C. Pt verbalizes understanding of managing blood glucose D. Pt expresses fear of dying

A. B. A. Pt correctly administers insulin B. Pt uses the IS correctly

Identify examples of psychomotor domain (SATA) A. Pt correctly administers insulin B. Pt uses the IS correctly C. Pt develops coping skills in relation to managing diabetes D. One-on-one discussion

A. health literacy B. health numeracy C. teaching D. learning

Identify health literacy, learning, teaching and health numeracy. A. the ability to understand health information and to use that info to make good decisions about health and medical care. B. understanding and using quantitative health info C. an interactive process that promotes learning D. the purposeful acquisition of knowledge, skills, behaviors and attitudes

ALL OF THE ABOVE A. nursing shortage B. competency C. evidenced-based practice D. quality and safety in health care E. health care organizations being evaluated on basis of outcomes such as prevention of complications, pt's functional outcomes and pt satisfaction F. Magnet Recognition program G. Nursing informatics and tech advancements H. globalization of health care

Identify issues/key factors affecting health care delivery and nursing practice (SATA) A. nursing shortage B. competency C. evidenced-based practice D. quality and safety in health care E. health care organizations being evaluated on basis of outcomes such as prevention of complications, pt's functional outcomes and pt satisfaction F. Magnet Recognition program G. Nursing informatics and tech advancements H. globalization of health care

ALL OF THE ABOVE A. clear communication (eye contact, pleasant, ask for suggestions, avoid allowing person to whom tasks are being delegated to control exchange by intimidation/resistance) B. careful monitoring (are they doing what they should be doing? do they understand the responsibilities involved? help them! say thank you and good job when done) C. assessing the client (before delegating, RN should give consideration to client condition and health care needs; critical needs may remain unidentified by less trained personnel) D. knowing staff availability and skills (know education and competency, match staff with level of care req by pt, know what units delegate has worked on and feels comfortable) E. knowing the job description (know institution's official position description for UAP, LPN/LVN and others) F. educating the staff member (if person is unfamiliar, RN should demonstrate how task is performed, document training, tell person what is expected, explain what complications to watch for and report to RN)

Identify key skills for delegation (SATA) A. clear communication B. careful monitoring C. assessing the client D. knowing staff availability and skills E. knowing the job description F. educating the staff member

A. B. C. D. F. G. H. I. J. A. dependable B. problem solver C. communicator D. competent F. evaluator G. delegator H. accountable I. coordinator J. educator

Identify leadership qualities (SATA) A. dependable B. problem solver C. communicator D. competent E. autonomic F. evaluator G. delegator H. accountable I. coordinator J. educator

A. B. C. D. A. assess the client and know staff availability B. know legalities in the nurse practice act C. know the job description D. educate the staff member

Identify nursing responsibilities when delegating (SATA) A. assess the client and know staff availability B. know legalities in the nurse practice act C. know the job description D. educate the staff member E. give staff member assignments

ALL OF THE ABOVE A. goal setting B. time analysis C. priority setting D. interruption control E. evaluation

Identify principles of time management (SATA) A. goal setting B. time analysis C. priority setting D. interruption control E. evaluation

A. B. C. E. A. ethical leader B. business leader C. quality of care promoter E. cost-effectiveness promotor

Identify roles that a nurse executive possesses (SATA) A. ethical leader B. business leader C. quality of care promoter D. financial guidance E. cost-effectiveness promotor

A. B. C. A. eliminating the insurance industry's stranglehold on the health care system B. addressing inequities in current coverage C. help struggling senior citizens

Identify secondary goals of the health care reform (SATA) A. eliminating the insurance industry's stranglehold on the health care system B. addressing inequities in current coverage C. help struggling senior citizens D. help the youth

ALL OF THE ABOVE A. motivation B. ability C. attitude D. learning environment E. developmental capacity

Identify the basic learning principles (SATA) A. motivation B. ability C. attitude D. learning environment E. developmental capacity

A. A systematic process to test or discover information with the goal of improving client care

Identify the best and most inclusive definition of nursing research: A. A systematic process to test or discover information with the goal of improving client care B. An emphasis on systematic reviews and meta-analysis C. Scientific knowledge generated through an exhaustive review of the literature D. A study that will be implemented after a review by the institutional review board of the hospital

A. C. A. hierarchy of evidence C. strongest clinical recommendations from systematic reviews

Identify the best evidence for pt care (SATA) A. hierarchy of evidence B. databases C. strongest clinical recommendations from systematic reviews D. concrete evidence

A. B. D. E. F. G. H. A. research question B. subjects D. randomization E. treatment group F. control group G. outcome measure H. analysis

Identify the components of random controlled trials (RCTs) (SATA) A. research question B. subjects C. objects D. randomization E. treatment group F. control group G. outcome measure H. analysis

A. B. D. E. A. Team/functional nursing B. Total pt care nursing D. Primary care nursing E. Case management nursing

Identify the different types of nursing care delivery models (SATA) A. Team/functional nursing B. Total pt care nursing C. Secondary care nursing D. Primary care nursing E. Case management nursing

A. B. D. A. Cognitive (understanding) B. Affective (attitudes) D. Psychomotor (motor skills)

Identify the domains of learning (SATA) A. Cognitive B. Affective C. Domain D. Psychomotor

P=Patient population I=Intervention C=Comparison O=Outcome T=Time

Identify the elements of a PICOT question.

a. Client control c. Customized to each client d. Continuous tracking

Identify the elements that are considered essential to include in an electronic client-education tracking system. Select all that apply. [mark all correct answers] a. Client control b. Physician input c. Customized to each client d. Continuous tracking e. Successful outcomes

Circumstance, task, supervision, person, and direction/communication. Right circumstance (the situation needs to be one that is stable and does not require advanced decision making) Right task (be sure task you are assigning is w/in delegates scope of practice and w/in delegates job description) Right supervision (be sure to give directions that are clear, concise, correct, and complete. Give guidelines concerning data to be reported immediately.) Right person (competency to perform a delegated task is determined by the following measures: certification/licensure, job description, skills checklist, demonstrated skill.) Right direction/communication (be sure to give directions that are clear, concise, correct, and complete. Give guidelines concerning data to be reported immediately.)

Identify the five rights when delegating

A. B. C. A. is a form of covert institutional licensure B. takes away authority of the RN to assign personnel tasks C. RN remains accountable for safe completion of tasks

Identify the issues with indirect delegation (SATA) A. is a form of covert institutional licensure B. takes away authority of the RN to assign personnel tasks C. RN remains accountable for safe completion of tasks D. RN has no authority at all

B. Increasing need for long term care

Identify the most significant element in the continued rise in health-care costs in the United States: A. Expensive new technology B. Increasing need for long term care C. Poor consumer input into health care programs D. Cost of medications

A. B. D. E. F. G. A. pt and family engagement B. population health D. safety/eliminating errors as possible E. care coordination F. palliative care for advanced illnesses G. overuse/reducing waste

Identify the national priorities (SATA) A. pt and family engagement B. population health C. geriatric healthcare D. safety/eliminating errors as possible E. care coordination F. palliative care for advanced illnesses G. overuse/reducing waste

B. to provide affordable healthcare to US citizens who could not pay for or obtain insurance before

Identify the primary goal of the health care reform A. to provide health care B. to provide affordable healthcare to US citizens who could not pay for or obtain insurance before C. help struggling senior citizens D. address inequities in current coverage

A. B. D. A. maintenance and promotion of health and illness prevention B. restoration of health D. coping with impaired function

Identify the purposes of patient education (SATA) A. maintenance and promotion of health and illness prevention B. restoration of health C. lowering the cost of medication D. coping with impaired function

A. B. C. A. provide info and skills enabling pt community to achieve healthier behavior and quality of life B. enable recovery process by empowering clients and families with resources needed to participate in optimal recovery C. critical thinking to gage clients willingness and motivation to learn

Identify the role of the nurse in pt education (SATA) A. provide info and skills enabling pt community to achieve healthier behavior and quality of life B. enable recovery process by empowering clients and families with resources needed to participate in optimal recovery C. critical thinking to gage clients willingness and motivation to learn D. always restoring health

A. centralized/top down B. decentralized/vertical C. matrix

Identify the three different types of organizational structures (SATA) A. centralized/top down B. decentralized/vertical C. matrix D. concrete/middle up

A. B. D. A. Laissez-faire B. Democratic D. Authoritarian

Identify the various styles of leadership (SATA) A. Laissez-faire B. Democratic C. Decentralized D. Authoritarian

A. C. D. E. F. G. A. historical C. exploratory D. evaluation E. descriptive F. experimental G. correlational

Identify typology of nursing research (SATA) A. historical B. histological C. exploratory D. evaluation E. descriptive F. experimental G. correlational

A. B. C. A. avoid assumptions B. with a translator talk directly to the pt C. be aware of cultural differences

Identify ways to enhance communication with different cultures (SATA) A. avoid assumptions B. with a translator talk directly to the pt C. be aware of cultural differences D. hate cultural differences

ALL OF THE ABOVE A. clinical decision making B. priority setting C. organizational skills D. resources E. time management F. evaluation G. communication H. delegation

Identify what is included in becoming a clinical nursing leader (SATA) A. clinical decision making B. priority setting C. organizational skills D. resources E. time management F. evaluation G. communication H. delegation

A. B. D. A. Self-help devices B. speech therapy D. rehabilitation of remaining function

Identify which fall under the health education topic of coping with impaired function (SATA) A. Self-help devices B. speech therapy C. Prenatal care and normal childbearing D. rehabilitation of remaining function

A. B. D. E. A. Immunizations B. Nutrition D. Prenatal care and normal childbearing E. Screenings

Identify which fall under the health education topic of health maintenance and promotion (SATA) A. Immunizations B. Nutrition C. Diagnostic examinations D. Prenatal care and normal childbearing E. Screenings

A. B. C. A. Surgery B. Medications C. diagnostic examinations

Identify which fall under the health education topic of restoration of health (SATA) A. Surgery B. Medications C. diagnostic examinations D. self-help devices

nursing research

Identifying the problem, reviewing the literature, applying/developing theoretical framework, conducting the study, analyzing data, and discussing the findings/limitations/implications are the five phases/steps of the ___________ ___________ process. This is a way to identify new knowledge, improve professional education and practice, and use nursing and health care resources effectively; is a systematic process that asks and answers questions to generate knowledge which provides a scientific basis for nursing practice and validates effectiveness of nursing interventions; helps to improve professional education and practice and helps nurses use resources effectively.

acute=no chronic=yes unstable=no stable=yes

If a pt's status is acute can the nurse delegate? what about chronic? unstable? stable?

collaborative practice

Implies working together for the greater good but encompasses more; these health care practices facilitate better pt outcomes; healthcare team works as a group utilizing individual skills and talents to reach the highest pt care standards; a multidisciplinary plan of care should be decided by all of the team members; individual disciplines must be willing to work together, have the same objectives and goals, and provide a plan of care which is individualized to the pt's needs.

B. maintenance and promotion of health

In childbearing classes, the nurse teaches expectant parents about physical and psychological changes in a woman. After learning about normal childbearing, the mother who applies new knowledge is more likely to eat healthy foods, engage in physical exercise, and avoid substances that can harm the fetus. What is this an example of A. restoration of health B. maintenance and promotion of health C. illness prevention D. coping with impaired function

A. A systematic review of randomized control trials

In collecting the best evidence, the gold standard is: A. A systematic review of randomized control trials B. Position statements by specialty medical organizations C. A consensus of expert clinicians D. Peer reviewed articles

A. Research design

In nursing research, what is the critical link necessary to connect the researcher's framework with the appropriate type of data collection? A. Research design B. Research question C. Hypothesis statement D. Analysis

education and building a nursing team

In the 21st century, the health challenges facing the nation have shifted dramatically. The American population is older—Americans 65 and older will be nearly 20 percent of the population by 2030—as well as more diverse with respect not only to race and ethnicity but also other cultural and socioeconomic factors. In addition to shifts in the nation's demographics, there also have been shifts in that nation's health care needs. Most health care today relates to chronic conditions, such as diabetes, hypertension, arthritis, cardiovascular disease, and mental health conditions, due in part to the nation's aging population and compounded by increasing obesity levels. While chronic conditions account for most of the care needed today, the U.S. health care system was primarily built around treating acute illnesses and injuries, the predominant health challenges of the early 20th century. The ways in which nurses were educated during the 20th century are no longer adequate for dealing with the realities of health care in the 21st century. As patient needs and care environments have become more complex, nurses need to attain requisite competencies to deliver high-quality care. These competencies include leadership, health policy, system improvement, research and evidence-based practice, and teamwork and collaboration, as well as competency in specific content areas such as community and public health and geriatrics. Nurses also are being called upon to fill expanding roles and to master technological tools and information management systems while collaborating and coordinating care across teams of health professionals.

primary; preventative; primary

In the US, traditionally, the _____________ purpose of health care was to provide services to those who were ill or injured in a hospital or clinic; this is movement toward _____________ care and _________ care as ways to promote health.

Case Management Nursing

In this model a health care facility uses a predetermined critical or clinical pathway to establish and monitor for the extent and timing of care within an anticipated length of stay. For common conditions, an interdisciplinary team develops a standard plan of care that includes time frames; as the client moves through the critical pathway, variances (deviations from normal) are noted and dealt with; collaborative process of assessing, planning, facilitating, and advocating for options and services to meet an individual's health needs; clinicians oversee the management of pts with specific, complex health problems and are usually held accountable for some standard of cost management and quality; often the case manager is an advanced practice nurse, who helps improve pt outcome via specific interventions.

Autonomy

Independent decisions about pt care (is w/in context, depends on the situation).

CANNOT DO ANY OF THIS Give IV push meds Write nursing diagnoses Do most teaching Do complex skills Take care of clients with acute conditions Take care of unstable clients

LVNs can do most skills but for NCLEX they (can or cannot) Give IV push meds Write nursing diagnoses Do most teaching Do complex skills Take care of clients with acute conditions Take care of unstable clients

Authority

Legitimate power to give commands and make final decisions specific to a given position.

health care research

National/Professional organizations (NINR, AACN) identify issues/research priorities such as chronic illness self management and improving end of life care. Ex. What are the successful self management practices of pts with chronic HF? How do expert, certified critical care nurses provide quality end of life care in the ICU? These are current key areas for ____________ ______ ____________.

are not bc assessments are the job of the nurse

Nurses (are/are not) allowed to delegate assessments.

ethical responsibility

Nurses have a(n) ___________ _____________ to teach pt's. The Patient Care Partnership of the American Hospital Association indicates that pt's have the right to make informed decisions regarding their care. The information given to pt's must be accurate, complete and relevant. Good communication is of paramount importance.

fundamental

Nursing is a profession and research is inherent in the definition; as professionals, nurses are accountable for interventions/outcome; consumer demands; requirements of external agencies are all reasons why research is ________________.

consequences; effects

Nursing sensitive pt outcomes represent the ________________ or _________ of nursing interventions and result in changes in pt's symptom experience, functional status, safety, psychological distress and/or costs; research into falls, skin care, pain, RN job satisfaction, restraints, and staffing ratios.

A. B. C. D. E. G. H. A. agency policy B. quality improvement data C. existing clinical practice guidelines D. standards from specialty nursing groups E. peer-reviewed articles (panel of experts has reviewed the article) G. use comprehensive data bases (MEDLINE and CINHAL) to search your topic H. use the Cochrane Database of Systematic Reviews (synthesized evidence)

Once you have a PICOT question, identify ways you apply evidence in practice (SATA) A. agency policy B. quality improvement data C. existing clinical practice guidelines D. standards from specialty nursing groups E. peer-reviewed articles (panel of experts has reviewed the article) F. quantitative data G. use comprehensive data bases (MEDLINE and CINHAL) to search your topic H. use the Cochrane Database of Systematic Reviews (synthesized evidence)

C. role playing

One student pretends to be a patient while another student conducts a nursing interview A. printed material B. role modeling C. role playing D. demonstration

C. Research development and utilization as a part of the concept of evidence-based practice

Over the past several decades, nursing research has expanded and its direction has altered as demographics change and health care evolves. What is the current focus of nursing research? A. Plan and implement studies directly related to meeting specific client care needs B. Conduct research addressing the profession of nursing and nursing education C. Research development and utilization as a part of the concept of evidence-based practice D. Collaboration with other health-care workers to implement research related to client satisfaction

Philosophy of care

Part of an empowered nursing team; professional nursing staff's values and concerns for the way they view and care for pt's; selection of nursing care delivery model that supports professional nursing practice; selection of a management structure that supports professional nursing practice.

Assessing Diagnosis Planning Implementing Evaluation/documenting

Pt education can be broken down into steps A: D: P: I: E: While the nursing process focuses on all pt needs, the teaching process looks at the nursing diagnoses specifically r/t improving the pt's (and family's) ability to manage health care.

B. tertiary health care C. secondary health care E. primary health care A. clinical preventative services D. population-based health care services

Put the health services pyramid in order from top to bottom: A. clinical preventative services B. tertiary health care C. secondary health care D. population-based health care services E. primary health care

HIGHEST: B. Systematic reviews and met analysis of RCTs (randomized control trail) D. One well-designed RCT (having ONE is NOT enough) E. Well-designed controlled trial w/o randomization C. Well-designed case control studies (no test groups, controlling everything) F. Systematic reviews of descriptive and qualitative studies (getting better but not research behind it) G. Internal organization-quality/risk management data LOWEST: A. opinion of authorities/expert committees

Put the hierarchy of evidence from highest to lowest: A. opinion of authorities/expert committees B. systematic reviews and met analysis of RCTs C. Well-designed case control studies D. One well-designed RCT E. Well-designed controlled trial w/o randomization F. Systematic reviews of descriptive and qualitative studies G. Internal organization-quality/risk management data

c. A college education

Select the factor that is most likely to increase a client's motivation to learn: a. A severe illness with the potential to be fatal b. The presence of the client's significant other during teaching session c. A college education d. A high socioeconomic level

a. Relationship centered b. Education based c. Culturally sensitive e. Evaluated

Select the key element(s) that the Pew Commission Final Report identified as key to constructive interpersonal encounters. Select all that apply. [mark all correct answers] a. Relationship centered b. Education based c. Culturally sensitive d. Caring e. Evaluated f. Collaborative

C. A client with a new colostomy who requires the first colostomy bag change BC everything else reqs assessment which cannot be delegated

Select the most appropriate client for the RN to assign to the CNA: A. A client with difficulty swallowing food and fluids B. A client with constipation who needs a tap-water enema C. A client with a new colostomy who requires the first colostomy bag change D. A client that requires a sterile dressing change

systematic reviews

Strongest clinical recommendations come from ______________ ___________ (concise summaries of the best evidence, uses a rigorous scientific approach to combine results from a body of original research studies).

True

T/F Delegation is necessary to improve time management and efficiency. When you delegate, you are transferring responsibility for the performance of an activity or task while retaining accountability for the outcome. Never delegate a task you are unwilling to do.

True

T/F For the future of health care: Change opens up opportunities for improvement. Health care delivery systems need to address the needs of the uninsured and the underserved. Health care organizations are striving to become better prepared to deal with these and other challenges in health care. The solutions necessary to improve the quality of health care depend largely on the active participation of nurses.

True

T/F Maintenance and promotion of health and illness prevention is a key function of the professional nursing role; the nurse provides information and skills that enable the pt/client/family/community to achieve healthier behaviors and quality of life.

False; MOST effective

T/F Teaching is LEAST effective when it responds to the learner's needs.

True

T/F The US is acknowledged as having the best health care in the world; the US spends more per person on health care than does any other country, yet in overall quality, its care ranks 37th in the world; many different systems of care are available in the US. Health care is also one of the largest industries in the US; total expenditures on health accounted for 14.6% of the gross domestic product in the US.

True

T/F When teaching clients from different cultures, a nurse should assess/consider components of diversity such as race, ethnicity, religion, health beliefs and sexual orientation and roles.

True

T/F a pt's learning style will affect their preferences for learning; people process info by seeing and hearing, reflecting and acting, reasoning logically and intuitively, and analyzing and visualizing.

true

T/F good time management is to develop a client activity sheet.

True

T/F when delegating to UAPs, CNAs and Aides, look for lowest level of skill req for the task, look for most uncomplicated task, look for most stable client and look for client with chronic illness.

D. Do not replace sound personal judgment.

Technological advances in health care A. Make the nurse's job easier. B. Depersonalize bedside patient care. C. Threaten the integrity of the health care industry. D. Do not replace sound personal judgment.

A. B. C. A. demonstrate nursing knowledge and display confidence in knowledge basis B. demonstrate knowledge of roles, responsibilities, and functions of a nurse C. recognize own limitations and see support of validation of decisions as needed

The National Council of State Boards of Nursing (NCSBN) identified competencies that RNs and practical/vocational nurses need on entry practice. Three of these are: (SATA) A. demonstrate nursing knowledge and display confidence in knowledge basis B. demonstrate knowledge of roles, responsibilities, and functions of a nurse C. recognize own limitations and see support of validation of decisions as needed D. be able to make decisions on medications

organizational structure decentralized organizational structure

The _________________ ________________ of hospitals may conflict with the practice of professional nursing, adversely affecting pt outcomes. The ability of nurses to practice in a professional manner may be influenced by ___________________ culture of their work environment. There are different types of structures: centralized or top down, d-centralized or vertical, and matrix, a mix of both of these structures. A ___________________ ________________ structure in which decisions may be made at the lowest possible level; in this type of structure, everyone becomes involved. A key element is that responsibility reflects ownership, autonomy leads to innovation, creativity, increased productivity, higher retention rates and increased pt satisfaction. A couple of key terms relevant to this are authority which is the legitimate power to make final decisions and accountability in which decision makers are answerable for their actions.

A. B. E. F. G. A. Right task B. Right circumstance E. Right supervision F. Right direction G. Right person

The five rights of delegation include (Select all that apply.) A. Right task B. Right circumstance C. Right opinion D. Right monetary compensation E. Right supervision F. Right direction G. Right person

Nursing and Scientific Method

The foundation of research and the most reliable and objective of all methods of gaining knowledge; a systematic inquiry designed to develop knowledge about issues of importance to the nursing profession, including nursing clinical practice, education, administration, and informatics.

ALL OF THE ABOVE A. shared governance B. collaborative practice C. education D. magnet status

The key components to building a successful nursing team include (SATA) A. shared governance B. collaborative practice C. education D. magnet status

B. Identify new knowledge C. Improve professional practice

The nurse is doing a literature review related to a potential problem that has been identified on the nursing unit. The nurse realizes that nursing research is important because it will: (Select all that apply.) A. Improve the nurse's chance at promotion B. Identify new knowledge C. Improve professional practice D. Lead to decreased unit expenditures

B. C. E. F. B. Multidisciplinary care plans are used C. Case managers coordinate discharge planning E. There is enhanced communication with all health care team members F. The model improves patient safety and quality

The nurse is explaining the case management model to a group of nursing students. Which of the following characteristics best describe the model? (Select All That Apply) A. Case managers provide direct patient care B. Multidisciplinary care plans are used C. Case managers coordinate discharge planning D. Case management is expensive and does not decrease health care costs E. There is enhanced communication with all health care team members F. The model improves patient safety and quality

A. Experimental Research B. Surveys

The nurse is preparing to conduct research that will allow precise measurement of a phenomenon. Which of the following methods will provide the nurse with the right kind of data? (Select all that apply.) A. Experimental Research B. Surveys C. Grounded Theory D. Phenomenology

A. Introduction

The nurse is writing a research article on a patient care topic. The nurse realizes that the section that will get the reader to read the article because of the value of the topic for the reader is the: A. Introduction B. Abstract C. Literature Review D. Methods

Health care reform

The primary goal of this is to provide affordable health care to US citizens who before its passage were unable to pay for or obtain health insurance; secondary goals include eliminating insurance industry's stranglehold on the health care system, addressing inequities in current coverage and helping struggling senior citizens.

health care; health care delivery

The purpose of ____________ ______ is to provide services to maintain health, detect illness and cure those who are ill or injured (the US is acknowledged as having the best in the world); while the purpose of __________ _______ __________ is to make health care available to individuals.

promotion; maintenance

The purpose of health _____________ and health _______________ are to support the pt physical and psychological well-being. In the school, home, clinic or workplace, the nurse provides info and skills that allow clients to assume healthier behaviors (ex. childbearing classes)

Evidence-Based Practice

The use of current best evidence from nursing research, clinical expertise, practice trends, and pt preferences to guide nursing decisions about care provided to pts; integration of best research evidence with clinical expertise and pt values; is important because it promotes use of a scientific process driven by evidenced based standards and practice guidelines to improve quality of care (reduce variation in care and improve pt outcomes).

key management behaviors

These behaviors involve analyzing and solving problems, running the organization on a day-to-day basis, establishing goals and outcome measures, preparing budgets, managing finances, maintaining external relationships, developing personnel, delegating tasks and motivating personnel.

leadership skills

These for nursing students include developing clinical skills; The core role of nursing remains the clinical staff nurse. Staff nurses fulfill many functions in the delivery of client care, including provider of care, decision maker, client advocate, team member, communicator, and educator. Regardless of the role, staff nurses use the nursing process to make decisions. In addition, staff nurses consult with other healthcare professionals, report the most current client status, and coordinate the care given by other professionals. They use management skills to integrate nursing plans of care with the therapy plans of other healthcare professionals. They use _________________ _________ to coordinate interdisciplinary care for clients.

Adult day care centers

These provide a variety of health and social services to specific pt populations who live alone or with family in the community; may be associated with a hospital or nursing home or may operate independently; offer services to pts such as daily physical rehab and counseling.

Quantitative Approach/Research

This approach involves the collection of numerical data in order to explain, predict, and/or control phenomena of interest, data analysis is mainly statistical (deductive process). Ex. study of dealing with a new pain therapy ______________ measures participants pain severity; a study testing different forms of surgical dressings measures the extent of wound healing.

Nursing Care Delivery Model

This assists nurses in achieving desirable outcome for their pts; results in success via decision making authority for nurses and effective methods of communicating with colleagues.

Restorative Care

This care is used to help individuals regain maximal functional status and enhance quality of life through promotion of independence and self-care; pts recovering from acute or chronic illness/disability often req additional services to return to their previous level of function or reach a new level of function limited by their illness or disability; reqs a multidisciplinary approach; settings include home care, rehab and extended care; ex. cardio and pulmonary rehab, orthopedic rehab, sports medicine, spinal cord injury programs and home care.

Affective (attitudes)

This domain of learning deals with expression of feelings and acceptance of attitudes, opinions, or values; values clarification is an example of this; it is often difficult to identify, however, it impacts the positive or negative success of the education process, it is the emotional or feeling part of learning (feelings, how you are able to cope, stress coping)

Cognitive (understanding)

This domain of learning includes all intellectual behaviors and requires thinking (knowledge); this is the knowledge the pt needs to acquire; it includes acquisition of knowledges, comprehension or ability to understand, application, analysis, relating ideas in an abstract manner, synthesis, recognizing parts of a whole and evaluation (thoughts, what's inside the brain, ability to understand and comprehend things).

Psychomotor (motor skills)

This domain of learning involves acquiring skills that require the integration of mental and muscular activity, such as the ability to walk or use utensils (skills); for this skill to be acquired, the pt needs to have the knowledge, physical ability and attitude to learn the skills; (action, knowing how to do skill and perform skill)

Tertiary Care

This focuses on diagnosis and treatment of disease; disease management is the most common and expensive service of the health care delivery system (20% req 80% of health care spending); settings are hospitals, ICUs, rural hospitals, psychiatric care; Ex. intensive and subacute care.

Secondary acute care

This focuses on diagnosis and treatment of disease; disease management is the most common and expensive service of the health care delivery system (20% req 80% of health care spending); settings are hospitals, ICUs, rural hospitals, psychiatric care; ex. emergency care, acute med-surg care, radiological procedures for acute problems (e.g. x-rays, computer tomography CT scans).

Health services pyramid

This has emphasis on population wellness; involves managing health instead of illness and injury prevention programs; includes tertiary health care, secondary health care, primary health care, clinical preventative services and population-based health care services.

Staff involvement

This helps with establishing nursing practice or problem solving committees or professional shared governance councils; nurse/physician collaborative practice, interdisciplinary collaboration; staff communication and staff education; to get work done we have to communicate well and with other disciplines.

Implementing

This involves breaking through barriers (can be denial, anger, anxiety, depression, physical pain, acute illness, language differences and physical disability); pt should now have ability to complete necessary self-care tasks, should know how to monitor their own health, be able to recognize problems and know who to call about concerns.

Motivation to learn

This is a basic learning principle; determined by the pt's attitudinal set, their readiness to learn, and their willingness to participate actively; because learning is such a complex process, different theories and models are available to help guide client education; using a theory that matches the clients needs in practice will assist the nurse in provide effective education; a person's desire or willingness to learn and desire to become involved in learning influences a nurse's teaching approach (previous knowledge, attitudes and sociocultural factors impact this).

Ability to learn

This is a basic learning principle; it depends on the pt's developmental level (children learn differently than adults); this also depends on the pt's level of physical development and overall physical health. Ex. for a person to learn a new psychomotor skill, the person must possess the necessary level of strength, and coordination. A condition, like pain, that depletes a person's energy will also impair this.

Attitude

This is a basic learning principle; it includes emotions such as denial, anxiety, anger or fear; ex. when a pt tells you he'll do just fine without making lifestyle changes, even though he has newly diagnosed diabetes and a serious weight problem, you may have trouble motivating him to learn; it is important for him to know that he'll make gains by learning new skills, but ultimately it is his choice.

Developmental capacity

This is a basic learning principle; learning in children and adults all require special adaptation to special education processes;

Learning environment

This is a basic learning principle; this either makes learning difficult or a pleasure; ideal _________________ must be well lit, have good ventilation, appropriate furniture, and a proper temperature; this allows a person to attend to instruction (the number of people being taught, need for privacy, room temperature, lighting, ventilation and room furniture are all important factors.

Governance

This is a broader concept than management; making decisions at a higher level that determine expectations, grant power to individuals, establish performance standards, maintain consistent management, set cohesive policies and processes, and provide organizational guidance.

National Guidlines Clearinghouse (NGC)

This is a database supported by the AHRQ; it contains clinical guidelines (systematically developed statements about a plan of care for a specific set of clinical circumstances involving a specific pt population); ex. clinical guidelines on _______________ _______________ __________________ include care of children and adolescents with type 1 diabetes and practice guidelines for the treatment of adults with low back pain; this is invaluable when developing a plan of care for a pt.

time management

This is a part of clinical care coordination; remain goal oriented, identify priorities and establish personal goals.

Respite Care

This is a service that provides short term relief or :"time off" for person providing home care to an individual who is ill, disabled, or frail; is offered in the home, a day care setting or health care institution that provides overnight care (the family caregiver is able to leave home for errands or social time while a responsible person stays in the home to care for the loved ones); there are few programs like this is the US because of cost and currently Medicare does not cover this and Medicaid has strict requirements for services and eligibility.

Nursing Research

This is a systematic inquiry designed to develop knowledge about issues of importance to the nursing profession, including nursing clinical practice, education, administration, and informatics.

Nursing Centers or Facilities

This is a type of continuing care that provides 24 hour intermediate and custodial care (nursing, rehab, diet, social, recreational and religious services; residents of any age with chronic or debilitating illness); is regulated by standards: Omnibus Budget Reconciliation Act of 1987; interdisciplinary functional assessment is the focus of clinical practice: MDs RAIs.

Assisted Living

This is a type of continuing care; offers a long term care setting with a home environment and greater resider autonomy; provides services like laundry, assistance with meals, personal care, housekeeping and 24 hour oversight.

Direct Delegation

This is a type of delegation; a specific decision made by the RN about who can perform what tasks.

Home care

This is a type of restorative care; includes provision of medically related professional and paraprofessional services and equipment to pts and families in their homes for health maintenance, education, illness prevention, diagnosis and treatment of disease, palliation and rehab; involves coordination of services; usually reimbursed by gov (such as Medicare and Medicaid in the US), private insurance and private pay sources.

Diagnosis in pt education

This is after you have completed your assessment, interpreted data, clustered data; this defines the entire teaching plan; is a pt has many learning needs, you will need to prioritize the most critical need. Ex. deficient knowledge (affective, cognitive, psychomotor), ineffective health maintenance, impaired home maintenance, ineffective family therapeutic regiment management, ineffective self-health management, and noncompliance.

Qualitative Approach/Research

This is also referred to as ethnographic research; is involved in the study of current events rather than past events; involves the collection of extensive narrative data (non-numerical data) on many variables over an extended period of time in a naturalistic setting. Participant observation, where the researcher lives wit hate subjects being observed is frequently used in this kind of research. Case studies are also used. Ex. What self-care activities enhance the well being in women following double mastectomies? The study of phenomena that are difficult to quantify or categorize such as a pts perceptions of illness or quality of life; describes info obtained in a nonnumeric form; these researchers aim to understand pt experiences with health problems and the contexts in which the experiences occur. ex. pt perception of nurses.

Delegation

This is an essential component of client care and of management of nursing units; it allows health care managers to maximize the use of caregivers who are educated at multiple levels, allows nurses to meet the reqs of quality care for all clients and is a basic skill that RNs must learn; the goal is to meet cost restraints of limited health care budgets by using less expensive personnel that maximize the use of time by RNs and promotes teamwork; it is the designation of a COMPETENT individual to the responsibility of carrying out a specific group of nursing tasks in the provision of care for certain clients.

Assignment

This is designating tasks for ancillary personnel that fall under their own level of practice according to facility policies, position descriptions and, if applicable, state practice act (LPN and LVN).

Hospice

This is family centered care that allows pts to live and remain at home; focuses on palliative (not curative) care: comfort, independence and dignity; provides pt and family support during terminal illness and time of death; many programs provide respite care, which is important in maintaining the health of the primary caregiver and family.

Patient Education

This is one of the most important nursing interventions in any health care setting (this has long been a standard for professional nursing practice), this is an essential component of providing safe, patient-centered care, it helps reduce health care costs and hardships on individuals and those surrounding them; part of this process is designing patient-centered action plans that are essential components of chronic disease self-management and are associated with improved health outcomes; part of this is to integrate educational approaches that acknowledge patients' understanding of their own health. Pt's often need to play a bigger role in their own health care, ideally, this leads to an improved quality of life (this is more than just telling pt's to take their medicine, its about skill-building and responsibility , helping a pt learn when and how, and even why, to make a change.

evaluation

This is part of clinical care coordination; ______________ the process, pt response, therapy efficacy and pt and expected outcomes; you will compare client outcomes with expected outcomes.

priority setting

This is part of clinical care coordination; determine which pts needs should be addressed first; high ___________: immediate threat to pt survival or safety; intermediate _____________: non emergent, non-life threatening; low _____________: actual or potential problems may or may not be directly r/t pt's illness or disease.

organizational skills

This is part of clinical care coordination; perform tasks correctly, perform correct tasks, utilize resources, manage time, evaluate outcomes, progress to an improved level of health.

shared governance

This is shared decision making based in principles of partnership, equity, accountability, and ownership at the point of service; this management process model empowers all members of the healthcare workforce to have a voice in decision-making, thus encouraging diverse and creative input that will help advance the business and healthcare missions of the organization; in essence, it makes every employee feel like he or she is part manager with a personal stake in the success of the organization.

Teaching

This is the act or process of imparting knowledge through a series of directed activities; an interactive process that promotes learning a deliberate set of actions that help individuals gain new knowledge, change attitudes, or perform new skills; the nurse is responsible for ______________ information the pt and family needs to make informed decisions regarding their care, determining what the pt needs to know, and identifying when the pt's are ready to learn. A key element of the nurse is determining how essential the info is to the learner's ability to function; nurses must develop mutuality and trust in order for this to be effective; regardless of the topic all _________ should be language specific, developmentally appropriate, and culturally sensitive. An educator needs to be knowledgable about the subject matter and pt _________ principles in order to provide individuals with guidance, appropriately set the learning pace, and creatively introduce concepts to successfully achieve desired learning outcomes.

Health Literacy

This is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions; it includes the ability to understand instructions on prescription drug bottles, appointment slips, medical education, brochures, doctor's directions and consent forms, and the ability to negotiate complex health care systems (Is NOT simply the ability to read); it requires complex group of reading, listening, analytical, and decision-making skills, and the ability to apply these skills to health situations; it varies by context and setting and is not necessarily related to years of education or general reading ability; a person who functions adequately at home or work may have marginal or inadequate literacy in a health care environment; with a move towards a more "consumer-centric" health care system as part of an overall effort to improve the quality of health care and to reduce health care costs, individuals need to take an even more active role in health care related decisions (to accomplish this, people need strong health information skills). When you assess this, ensure you are preserving pt dignity.

scientific method

This is the foundation of all types of nursing research and is a systematic approach that uses disciplined methods to answer questions/solve problems.

Supervision

This is the initial direction and periodic evaluation of a person performing an assigned task to ensure that he/she is meeting the standards of care.

Learning

This is the purposeful acquisition of new knowledge, attitude and skills (processing and internalizing knowledge then acting on it) through an experience or external stimuli; a change in meaning of ideas or concepts based on previous meaningful experiences; bc each individual is unique, the nurse must ensure appropriate strategies are employed to maximize __________. Ex. a mother exhibits this when she demonstrates how to bathe her newborn

Primary Care

This kind of care focuses on improved health outcome for an entire population; includes prenatal and well-baby care, nutrition counseling, family planning, exercise, yoga, and meditation classes and health education; it requires collaboration among health professionals, health care leaders and community members. Health promotion lowers overall costs: reduces incidence of disease, minimizes complications, reduces need for more expensive resources and occurs in home, work and community settings.

Preventative Care

This kind of care includes blood pressure and cancer screenings, immunizations, mental health counseling and crisis prevention, and community legislation (e.g. seatbelts, airbags, bike helmets, no texting while driving)

Laissez-faire

This leadership style is also described as permissive, non directive, or passive; it allows the group members to determine their own goals and the methods to achieve them; there is little planning, minimal decision making, and a lack of involvement by the leader; this style works well in only a few settings, for example, in a research lab that is staffed by self motivated scientists who know what they want to achieve and are familiar with the means of achieving it; works best when members of the group have the same level of education as the leader and the leader performs the same tasks as group members; can leave people feeling lost and frustrated bc of lack of direction by the leader; these types of leaders usually avoid making decisions in hopes that the problem will resolve itself. Whatever happens happens.

Correlational research

This nursing research attempts to determine whether and to what degree a relationship exists between two or more quantifiable (numerical variables). However, it is important to remember that just because there is a significant relationship between two variables, it does not follow that one variable causes the other. When two variable are _____________, you can use the relationship to predict the value on one variable for a subject if you know that subject's value on the other variable. _______________ implies prediction but not causation. The investigator frequently uses the correlation coefficient to report the results of this type of research. Ex. comparing noninvasive measurements of blood pressure in the forearm and upper arm in pts who are supine or at a 45-degree angle.

Descriptive research

This nursing research involves collecting data in order to test hypotheses or answer questions regarding the subjects of the study; in contrast with the qualitative approach, the data are numerical; the data are typically collected through a questionnaire, an interview, or through observation; in this research, the investigator reports the numerical results for one or more variables on the subjects of the study. Ex. how engaged in the political process are RNs in TX?

Evaluation research

This nursing research is a study that determines how well a program, practice or policy is working; ex. a study measuring pt's ability to self-inject Lovenox following watching an educational video on the technique.

Exploratory research

This nursing research is an initial study done to refine and develop a hypothesis about a relationship between phenomenon; ex. a pilot study to determine if CHF pts who participate in a cardiac rehab program have fewer hospitalizations than those who do not.

Historical research

This nursing research is involved with the study of past events. Ex. factors leading to development and growth of Team Based Learning, effects of recommendations from the CDC on Influenza vaccine use in the US and Trends in nursing education (1940-1945).

Planning

This occurs once you know your pt's needs and concerns and have formulated your nursing diagnostic statements; you and your pt should now set some mutually agreed upon goals (they must be measurable); must contain info your pt needs to know and wants to known; should understand needs and concerns, beliefs and attitudes, skills and behavior.

matrix

This organizational structure is a mix of decentralized and centralized.

Assessment

This provides essential info about your pt and his/her support network; success of pt eduction depends on how well you _________ pt needs, concerns and preferences; although you may focus on _____________ during your first few meetings with your pt, continue to _______ later on. The best time to start this is before the pt checks in (ex. over phone, through survey), when you greet the pt for the first time, as you lead pt to examining room, while changing bed, delivering meds, checking dressings, or other therapeutic interventions, while visiting with a family member or friend who's with the pt. During this you should grasp pt concerns, avoid assumptions, get to know your pt, establish rapport, learn the pt perspective, ask the right questions, determining readiness to learn, __________ pt skills and recognizing diversity.

Institute of Medicine (IOM)

This states the nurses need to be transformed by: practicing to the full extent of their education and training, achieving higher levels of education and training through an improved education system that provides seamless progression, becoming full partners, with physicians and other providers, in redesigning the health care system and improving data collection and the information infrastructure for effective workforce planning and policy making.

Authoritarian

This style of leadership is also known as controlling, directive or autocratic; this style maintains a strong control over all aspects of the group and its activities; leaders provide direction by giving orders that the group is expected to carry out without question; final decision making rests with the leader alone although input from the group may be considered; authority consists of micro managers who closely monitor everything that the group members do and often make on spot changes when they believe they know a better way to achieve a task or goal; seen in military, mass casualty events; leader is usually dependable/problem solver; this style works best in emergency situations; this style surpasses creativity of group members and may reduce long term effectiveness of group; motivation is also reduced.

Continuing Care

This type of care is for people who are disabled, functional dependent, or suffering a terminal disease; is available within institutional settings or in the home (assisted living, respite care, adult day care centers and hospice).

Experimental research

This type of nursing research attempts to establish cause-effect relationship among the groups of subjects that make up the independent variable of the study, the cause (independent variable) is under control of the experimenter; that is, the experimenter can randomly assign subjects to the groups that make up the independent variable in the study. in the typical ________________ research design, the experimenter randomly assigns subjects to the groups or conditions that constitute the independent variable of the study and then measures the effect this group membership has on another variable, i.e. the dependent variable of the study. Ex. Does melatonin have an effect on the sleep of pt's who have AIDS?

Magnet Recognition Program/Status

This was established by the ANCC (America Nurses Credentialing Center) to recognize health care organizations that achieve excellence in nursing practice; to hospitals that satisfy a set of criteria designed to measure the strength and quality of their nursing; organizations that apply for this status must demonstrate quality pt care nursing excellence and innovation in professional practice; the professional work environment needs allow nurses to practice with a sense of empowerment and autonomy to deliver quality nursing care; this has 5 components that are affected by global issues including Transformational Leadership, Structural Empowerment, Exemplary Professional Practice, New Knowledge, Innovation, and Improvements and Empirical Quality Results. A _________ hospital is stated to be one where nursing delivers excellent pt outcomes, where nurses have high level of job satisfaction and where there is a low staff nurse turnover rate and appropriate grievance resolution; it is also said to indicate nursing involvement in data collection and decision-making in pt care delivery; ____________ nursing leaders value staff nurses, involve them in shaping research based nursing practice and encourage and reward them for advancing in nursing practice; these hospitals are supposed to have open communication between nurses and other members of the health care team and an appropriate personnel mix to attain the best pt outcomes and staff work environment.

Indirect Delegation

Type of delegation; a list produced by the health-care facility of tasks that certain health-care personnel can perform.

Extended care

Type of restorative care; includes ___________ care facility that provides intermediate medical, nursing or custodial care for pts recovering from acute illness/disabilities; skilled nursing facility (intermediate care) that provides care for pt's until they can return to their community or residential care location.

Rehabilitation

Type of restorative care; the focus is to restore pts to their fullest, physical, mental, social, vocational and economic potential; includes physical, occupational and speech therapy, as well as social services; occurs in many health care settings, both inpatient and outpatient.

delegate; assignment

We ___________ to unlicensed and we give ______________ to licensed.

Ask clinical question Collect most relevant/best evidence Appraise evidence Integrate evidence with clinical expertise and pt values in making a practice decision/change Evaluate practice decision/change (share information) "Always Come Around In Evening"

What are the steps of EBP? (5)

quantitative and qualitative

What are the two major research approaches?

C. Seek input from all nurses who have a stake in the intervention or changes

What is the best intervention for a nurse to use when seeking to implement new research on a hospital unit? A. Ask the nurse manager to determine how the change will be implemented B. Ask hospital leadership to develop a new policy and procedure related to the research C. Seek input from all nurses who have a stake in the intervention or changes D. Have staff education sessions letting nurses know how the change will impact practice

A. Health promotion

What is the primary focus of nurse-run clinics? A. Health promotion B. Disease cure C. Pregnancy counseling services D. Cost control

a. The nurse clarifies what actions or behaviors are expected.

What is the primary reason a nurse should develop learning objectives for all client teaching? a. The nurse clarifies what actions or behaviors are expected. b. It is a requirement by the Joint Commission on Accreditation of Healthcare Organizations. c. Learning objectives help the nurse to organize the teaching materials. d. Clients who do not have objectives will learn material poorly.

A. Gaining an understanding of how individuals find meaning in their world

What is the purpose of qualitative inquiry research? A. Gaining an understanding of how individuals find meaning in their world B. Measuring the variables identified as dependent C. Testing an identified hypothesis and proving a theory D. Generalizing relationships between concepts

D. The nurse who assigned the task

When a nurse delegates a task, who is first responsible for ensuring that the task was completed as assigned? A. The person to whom the task was delegated B. The physician who ordered the task C. The nurse manager D. The nurse who assigned the task

legally responsible; licensed

When nurses delegate nursing tasks to non-nurses, the RN are always ______________ ______________ for supervising that person to ensure that the care given meets the standards of care; legally, the power to delegate is restricted to professionals who are ____________ and governed by a statutory practice act. Ex. RN gives blood to pt, policy says TN has to start blood infusion but after blood has started to infuse, it's ok for LVN to monitor pt but RN is still responsible for infusion.

a. Psychomotor

When teaching a patient how to use a walker correctly most, which domain of learning would be most effective to use? a. Psychomotor b. Intellectual c. Cognitive d. Affective

C. Rapidly increasing average age of the population

Which demographic factor has the most significant effect on the health-care delivery system of the future? A. Large numbers of babies born to immigrant families B. Increasing use of alcohol and tobacco among teenagers C. Rapidly increasing average age of the population D. The nursing shortage

a. Hospital staff must act as skilled client educators

Which is a Joint Commission on Accreditation of Healthcare Organizations (JCAHO) requirement for client education? a. Hospital staff must act as skilled client educators b. All clients must receive some type of education during their care c. Physicians are primarily responsible for client education d. Documentation of client education must use a flow sheet

b. What is the client's fluency in both the primary and secondary languages?

Which is an important element for the nurse to remember when conducting a client language assessment? a. Did the client bring an interpreter to the hospital? b. What is the client's fluency in both the primary and secondary languages? c. How long has the client been living in America? d. What cultural health-care practices does the client use on a regular basis?

C. Decentralized management

Which organizational structure approach has fewer directors with managers accountable 24 hours for staff, budget, and day-to-day management? A. Matrix B. 360 degree management C. Decentralized management D. Business management

d. Tell me what your greatest concern is about being discharged.

Which statement by the nurse would best indicate the nurse's use of the shared power concept in client teaching? a. If you do the procedure just as I showed you, you will not have any infections. b. The physician wants you to take this medication at the same time every day. c. Once you get home, you can do whatever you want. d. Tell me what your greatest concern is about being discharged.

differentiate; best; accurate

While the internet offers endless health care info as well as ease of access, it is crucial for the nurse to help clients _____________ what is _______ and __________ information. Nurses must learn to integrate the internet into their health teaching. Ex. a good resource to share with pt's is Healthfinder.

Primary Care Nursing

With this nursing care delivery model, an RN assumes responsibility for developing a 24-hour nursing plan of care and for integrating that plan with the therapy plans of other health care professionals; the ___________ nurse accepts total responsibility for the quality of nursing care for a client; one RN assumes responsibility for caseload; communication is lateral from nurse to nurse and caregiver to caregiver; flexible model uses a variety of staffing levels and mixes; RN works with limited number of pts.

organizational

Your ________________ skills will be utilized when you implement your plan of care.

Coping with impaired function

____________ with ___________ function occurs when a client will not recover function to level prior to illness or injury; changes in function can be both physical and psychological; families and friends are key to assisting the client to adapt to ___________ function; the nurses role may involve teaching the family to help the client with health care management (the family's ability to provide support results in part from education which begins as soon as you identify the pt's needs and the family displays a willingness to help; teach family members to help the pt with health care management (ex. giving meds through gastric tubes and doing passive ROM exercises); many chronic illnesses such as alcoholism require the nurse to assist the family in developing ____________ skills. New knowledge and skills are often necessary for pt's to continue ADLs. Not everyone will recover from illness or injury to previous levels; teaching in this arena support the knowledge and skills that are necessary for pt's to continue their ADLs Ex. a pt loses the ability to speak after larynx surgery and has to learn new ways of communicating. Ex. a pt learning how to speak or eat after a CVA.

Patient Education

_____________ ____________ is an important role that student nurses undertake; nurses contend with multiple factors that affect pt's, including shorter lengths of stay and the increased demand on the nurse's time (at times, these two factors can compromise your ability to provide quality ______________ _________); creating a well-designed, comprehensive teaching plan that fits your pt's unique learning needs can reduce health care costs, improve quality of care, and keep pt's better informed about their individualized treatment plan.

decentralized management

__________________ _________________ means that decision making occurs at the level of the staff; this encompasses responsibility, autonomy, authority and accountability. This structure approach has fewer directors with managers accountable 24 hours for staff, budget, and day to day management.

Restoration

___________________ of health occurs with clients who are recovering or adapting to changes caused by illness or injury; nurses are key to enabling the recovery process by empowering clients and families with the resources they need to participate in optimal recovery; the nurse must use critical thinking to identify the clients willingness and motivation to learn, and thus participate in their recovery. Injured and ill pt's need info and skills that will allow them to regain a level of health. The family is often a vital part of the pt's return to health. Ex. learning how to change a dressing, using an IS, monitoring medication efficacy.

Empowered nursing team

an ______________ nursing team includes nurse executive, nurse manager, and nursing staff.

leadership

clinical care coordination, team communication, delegation and knowledge building are all _________________ skills.