Fundamentals Exam 4 Review F

which factor would the nurse assess when determining the knowledge base of a middle aged adult with chronic illness and his or her family? select all that apply 1. the medical course of illness 2. the prognosis for the patient 3. coping mechanisms of the patient and family 4. the need for community and social services 5. the family's nutritional needs

1 2,3

A nurse is consoling the partner of a client who just expired after a long battle with liver cancer. The partner is displaying grief and states, "I hate him for leaving me." Which of the following statements by the nurse successfully facilitate mourning for the grieving partner? (Select all that apply.) A. "Would you like me to contact the chaplain to come speak with you?" B. "You will feel better soon. You have been expecting this for a while now." C. "Let's talk about your children and how they are going to react." D. "You know, it is quite normal to feel anger toward your husband at this time." E. "Tell me more about how you are feeling."

A. "Would you like me to contact the chaplain to come speak with you?" D. "You know, it is quite normal to feel anger toward your husband at this time." E. "Tell me more about how you are feeling."

The nurse is caring for a patient who has just had a near-death experience (NDE) following a cardiac arrest. Which intervention by the nurse best promotes the spiritual well-being of the patient after the NDE? 1. Allowing the patient to discuss the experience 2. Referring the patient to pastoral care 3. Having the patient talk to another patient who had an NDE 4. Offering to pray for the patient

Answer: 1. Patients who have a near death experience (NDE) are often reluctant to speak of the experience. Allowing the patient to discuss the NDE helps the patient find acceptance of and meaning from the event. It also allows the patient to explore what happened and promotes spiritual well-being.

Which symptoms is the nurse addressing when advising the patient's caregiver to increase fiber in the patient's diet ? 1 Fatigue 2 Nausea 3 Diarrhea 4 Constipation

Constipation

When assessing a young woman who was a victim of a home invasion 3 months earlier, the nurse learns that the woman has vivid images of the event whenever she hears loud yelling or a sudden noise. The nurse recognizes this as ____________.

PTSD

A nurse is reviewing CDC immunization recommendations with a young adult client. Which of the following vaccines should the nurse recommends routine, rather than catch-up, during young adulthood (select all that apply) a. influenza b. measles mumps rubella c. pertussis d. tetanus e. polio

a., c., d.

5. A patient who is newly diagnosed with breast cancer states, "Although I am really scared about what is going to happen to me, I know my family will learn from this experience, and we will be stronger in the end." What term does the nurse use in the patient's medical record to describe the characteristic displayed in this statement? 1. Resiliency 2. End-of-life care 3. Family functioning 4. Family's culture

1

A patient who is having difficulty managing his diabetes mellitus responds to the news that his hemoglobin A1c, a measure of blood sugar control over the past 90 days, has increased by saying, "The hemoglobin A1c is wrong. My blood sugar levels have been excellent for the last 6 months." Which defense mechanism is the patient using? 1. Denial 2. Conversion 3. Dissociation 4. Displacement

1

While assessing a patient of a different culture, the nurse wants to know the patient's perception of the etiology of the disease. Which is the most appropriate question asked by the nurse using a patient's explanatory model? 1 "What do you call your problem?" 2 "Why do you think it started when it did?" 3 "What do you think your sickness does to you?" 4 "What are the chief problems your sickness has caused you?"

1 "What do you call your problem?"

The nurse at an outpatient clinic asks a Chinese American patient with newly diagnosed hypertension if he is limiting sodium intake as directed. The patient nods his head but does not make eye contact with the nurse. Which action would the nurse take next? 1 Ask the patient how much salt he is consuming each day. 2 Discuss the health implications of sodium and hypertension. 3 Remind the patient that many foods such as soy sauce contain hidden sodium. 4 Suggest some low-sodium dietary alternatives.

1 Ask the patient how much salt he is consuming each day.

The nurse uses an interpreter to facilitate communication with a non-English-speaking patient. Which nursing action during this process will help promote a good nurse-patient relationship? 1 Direct the questions to the patient. 2 Pace the speech by breaking the sentences. 3 Ask the patient's family members to interpret. 4 Ask the interpreter to translate statements word for word

1 Direct the questions to the patient.

If the family of a dying patient is highly emotional and critical of the nursing care, which action by the nurse would be appropriate? 1 Listen to concerns 2 Explain intervention in technical terms 3 Request that the nursing supervisor talk to the family 4 Avoid the patient family to reduce confrontations

1 Listen to concerns

Which concept of intersectionality refers to limited access to certain facets of society? 1 Marginalization 2 Under inclusion 3 Social inequality 4 Matrix of domination

1 Marginalization

What factor is the nurse least likely to associate with health disparities among marginalized groups? 1 Self-care 2 Quality of health care 3 Public and health policy 4 Complex interaction among individual genetics

1 Self-care

To best assist a patient in the grieving process, which factors are most important for the nurse to assess? (Select all that apply.) 1. Previous experiences with grief and loss 2. Religious affiliation and denomination 3. Ethnic background and cultural practices 4. Current financial status 5. Current medications

1, 2, 3 Previous experiences, religious affiliation, and cultural practices help individuals develop coping and can be a source of support at the end of life.

The nurse recognizes that which factors influence a person's approach to death? (Select all that apply.) 1. Culture 2. Spirituality 3. Personal beliefs 4. Previous experiences with death 5. Gender 6. Level of education

1, 2, 3, 4 Culture, spirituality, personal beliefs and values, and previous experiences with death influence how a person approaches death.

4. A family is facing job loss of the father, who is the major wage earner, and relocation to a new city where there is a new job.The children will have to switch schools, and his wife will have to resign from the job she enjoys. Which of the following contribute to this family's hardiness? (Select all that apply.) 1. Family meetings 2. Established family roles 3. New neighborhood 4. Willingness to change in time of stress 5. Passive orientation to life

1, 2, 4

8. A family consisting of a grandparent, two adults, and three school-age children just immigrated to the United States. They come to a community wellness center to establish health care. Which of the following questions does the nurse ask to assess the family's function? (Select all that apply.) 1. "What does your family do to keep members healthy?" 2. "How does your family usually make decisions?" 3. "What health services are available in your neighborhood?" 4. "Which rituals or celebrations are important for your family?" 5. "Is there a lot of crime in your neighborhood?" 6. "How many parks are there in your community?"

1, 2, 4

Which comments to a patient by a new nurse regarding palliative care needs are correct? (Select all that apply.) 1. "Even though you're continuing treatment, palliative care is something we might want to talk about." 2. "Palliative care is appropriate for people with any diagnosis." 3. "Only people who are dying can receive palliative care." 4. "Children are able to receive palliative care." 5. Palliative care is only for people with uncontrolled pain.

1, 2, 4 Palliative care is available to all patients regardless of age, diagnosis, and prognosis.

When planning care for a dying patient, which interventions promote the patient's dignity? (Select all that apply.) 1. Providing respect 2. Viewing the patient as a whole 3. Providing symptom management 4. Showing interest 5. Being present 6. Inserting a straight catheter when the patient has difficulty voiding

1, 2, 4, 5 A sense of dignity includes a person's positive self-regard, the ability to find meaning in life, to feel valued by others, and by how one is treated by caregivers.

While assessing an older woman who is recently widowed, the nurse suspects that this woman is experiencing a developmental crisis. Which questions provide information about the impact of this crisis? (Select all that apply.) 1. With whom do you talk on a routine basis? 2. What do you do when you feel lonely? 3. Tell me what your husband was like. 4. I know this must be hard for you. Let me tell you what might help. 5. Have you experienced any changes in lifestyle habits, such as sleeping, eating, smoking, or drinking?

1, 2, 5

3.A nurse is caring for a 66-year-old patient who lives alone and is receiving chemotherapy and radiation for a new cancer diagnosis. He is unable to care for himself because of severe pain and fatigue. He moves into his 68-year-old brother's home so his brother can help care for him. Which assessment findings indicate that this family caregiving situation will be successful? (Select all that apply.) 1. Both the patient and his brother attend church together regularly 2. The brothers are living together and enjoy eating the same foods. 3. Other siblings live in the same city and are willing to help. 4. The patient and his brother have a close network of friends. 5.The patient has obsessive-compulsive disorder and has difficulty throwing away possessions.

1, 3, 4

A crisis intervention nurse is working with a mother whose child with Down syndrome has been hospitalized with pneumonia and who has lost her child's disability payment while the child is hospitalized. The mother worries that her daughter will fall behind in her classes during hospitalization. Which strategies are effective in helping this mother cope with these stressors? (Select all that apply.) 1. Referral to social service process reestablishing the child's disability payment 2. Sending the child home in 72 hours and having the child return to school 3. Coordinating hospital-based and home-based schooling with the child's teacher 4. Teaching the mother signs and symptoms of a respiratory tract infection 5. Telling the mother that the stress will decrease in 6 weeks when everything is back to normal

1, 3, 4

Which family function is important? select all that apply. 1. providing care and protection 2. creating an insecure environment 3. developing conflict and using power 4. cooperatively meeting financial needs 5. socializing and nurturing relationships

1, 4, 5

which physiological change would the nurse expect to find in a pregnant patient in her first trimester? select all that apply 1. morning sickness 2. breast tenderness 3. Braxton hicks contractions 4. milk secretion from the breast perception of fetal movements

1,2

Which option contributes to family hardiness? select all that apply. 1. family meetings 2. established family roles 3. willingness to change in times of stress 4. passive orientation to life 5. positive perceptions of self

1,2,3

Which factor has been linked to intimate partner violence (IPV)? select all that apply. 1. alcohol abuse 2. pregnancy 3. unemployment 4. drug use 5. religion

1,2,3,4

The nurse is caring for a 5 year old girl whose family includes her mother and her grandmother who is 65 years old. Her father is in the military. the girls parents divorced the year before. Her mother works in a store, and the grandmother takes care of the girl. what societal factor has led to this new parenting responsibility for the grandparents? select all that apply. 1. single parenthood 2. both parents are working 3. rich grandparents 4. increased rates of divorce 5. blended family

1,2,4

which type of family would the nurse classify as a crisis proof family? select all that apply 1. families with a flexible structure 2. families who exhibit control over their envionrment 3. families lacking control over their environment 4. families who accept help from outside the family system 5. families with a rigid structure without any adaptability

1,2,4

which positive health habit may prevent the development of chronic illness later in life? select all that apply 1. routine screening and diagnostic tests 2. unprotected sexual activity 3. regular exercise

1,3

Which nursing intervention would the nurse include in the care plan for a terminally ill patient? Select all that apply. One, some, or all responses may be correct. 1 Maintain comfort 2 Discuss options for euthanasia 3 Preserve dignity and quality of life 4 Provide social support to family members 5 Offer economic support to family member

1,3,4 Maintain comfort Preserve dignity and quality of life Provide social support to family members

Which physical change in the patient suggests that death is near? Select all that apply. 1 Noisy respiration 2 Increase urine 3 Decreased muscle tone 4 Decreased intake of food 5 Decreased periods of sleeping

1,3,4 Noisy respiration Decreased muscle tone Decreased intake of food

Which actions by the nurse help grieving families? (Select all that apply.) 1. Encourage involvement in nonthreatening group social activities. 2. Follow up with the family in their home. 3. Remind them that feelings of sadness or pain can return around anniversaries. 4. Encourage survivors to ask for help. 5. Look for overuse of alcohol, sleeping aids, or street drugs.

1,3,4,5 A deceased person's body deserves the same respect and dignity as that of a living person and needs to be prepared in a manner consistent with the patient's cultural and religious beliefs.

which condition is linked to obesity? select all that apply 1. asthma 2. hypotension 3. type 1 diabetes 4. psoratic arthritis 5. hypercholesteromia

1,4,5

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

1. "After teaching a patient how to use an inhaler, I need to use the teach-back technique to test my patient's technique."

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

1. Alcohol abuse 3. Pregnancy 4. Unemployment 5. Drug use

A nurse describes arterial blood pressure as "like water flowing through a hose." Which teaching technique does this exemplify? 1. Analogy 2. Role play 3. Demonstration 4. Simulation

1. Analogy

A nurse is completing an assessment on a 27-year-old female patient. Which questions best assess the psychosocial aspects of this young woman's health? (Select all that apply.) 1. Do you feel safe in your home and at work? 2. How many fruits and vegetables do you typically eat every day? 3. Describe your relationship with your family. 4. Have you had the vaccine to prevent HPV? 5. What are your long-term career goals?

1. Do you feel safe in your home and at work? 3. Describe your relationship with your family. 5. What are your long-term career goals?

Match the cultural concepts on the left with the correct definitions on the right. 1. Etic world view 2. World view 3. Cultural desire 4. Intersectionality 5. Emic world view a. Factor that shapes how people perceive others and how they relate to reality b. Insider's perspective in an intercultural encounter c. A policy model that describes factors and power structures that shape and influence life d. An outsider's perspective in an intercultural encounter e. The motivation of a health care professional to "want to" engage in cultural competency

1. Etic world view (d) 2. World view (a) 3. Cultural desire (e) 4. Intersectionality (c) 5. Emic world view (b)

While teaching a patient, the nurse determines that the patient is not able to read above the fifth-grade level. This describes which inability? 1. Health literacy 2. Health illiteracy 3. Learning disability 4. Functional illiteracy

1. Health literacy

Which explanation provided by the nurse is the most accurate meaning for "providing culturally congruent care"? 1. It fits the patient's valued life patterns and set of meanings. 2. It is the same set of values as those of the health care team member providing daily care. 3. It holds one's own way of life as superior to those of others. 4. It redirects the patient to a more socially expected set of values.

1. It fits the patient's valued life patterns and set of meanings.

A nurse desires to communicate with a young woman who is Serbian and who has limited experience with being in a hospital. The nurse has 10 years of experience caring for Serbian women. The patient was admitted for a serious pregnancy complication. Apply the LEARN model and match the nurse's behaviors with each step of the model. L E A R N a. The nurse notes that she has learned that fathers can visit mothers at any time in both Serbia and the United States. b. The nurse shares her perception of the woman's experiences as a patient. c. The nurse asks the patient how she can maintain bed rest when she returns home. d. The nurse attends to the patient and listens to her story about hospitals in Serbia. e. The nurse involves the patient in a discussion of the treatment options for her condition.

1. L (d) 2. E (b) 3. A (a) 4. R (e) 5. N (c)

A 35-year-old woman has Medicaid coverage for herself and two young children. She missed an appointment at the local health clinic to get an annual mammogram because she has no transportation. She gets the annual screening because her mother had breast cancer. Which of the following are social determinants of this woman's health? (Select all that apply.) 1. Medicaid insurance 2. Annual screening 3. Mother's history of breast cancer 4. Lack of transportation 5. Woman's age

1. Medicaid insurance 4. Lack of transportation 5. Woman's age

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

1. Medical course of the illness 2. Prognosis for the patient 3. Coping mechanisms of the patient and family 5. Need for community and social services.

During a nursing assessment a patient displayed several behaviors. Which behavior suggests the patient may have a health literacy problem? 1. Patient has difficulty completing a registration form at a medical office 2. Patient asks for written information about a health topic 3. Patient speaks Spanish as primary language 4. Patient states unfamiliarity with a newly ordered medicine

1. Patient has difficulty completing a registration form at a medical office

Which basic step of the Nursing process includes setting priorities based on the patient's immediate needs? 1. Planning 2. Evaluation 3. Assessment 4. Implementation

1. Planning

Health care organizations must provide which of the following based on federal civil rights laws? (Select all that apply.) 1. Provide language assistance services at all points of contact free of charge. 2. Provide auxiliary aids and services, such as interpreters, note takers, and computer-aided transcription services. 3. Use patients' family members to interpret difficult topics. 4. Ensure that interpreters are competent in medical terminology. 5. Provide language assistance to all patients who speak limited English or are deaf.

1. Provide language assistance services at all points of contact free of charge. 2. Provide auxiliary aids and services, such as interpreters, note takers, and computer-aided transcription services. 4. Ensure that interpreters are competent in medical terminology. 5. Provide language assistance to all patients who speak limited English or are deaf.

A 36-year-old patient newly diagnosed with type 1 diabetes shares with you that he is frustrated with the time it takes to prepare meals and monitor his exercise and blood sugar. He also is having trouble understanding his insulin schedule. Which of the following suggestions would be most appropriate? (Select all that apply.) 1. Provide patient education materials that are easy to read. 2. Refer this patient to a diabetes support group. 3. Refer the patient to his endocrinologist. 4. Suggest that the patient make an appointment with a registered dietitian. 5. Suggest ways to modify his schedule.

1. Provide patient education materials that are easy to read. 2. Refer this patient to a diabetes support group. 4. Suggest that the patient make an appointment with a registered dietitian. 5. Suggest ways to modify his schedule.

During a teaching session, a parent approaches the nurse for advice about managing a child's temper tantrums. The nurse enacts the role of the child to evaluate the parent's response to the child's behavior. The nurse is using which instructional method to teach the parent? 1. Role play 2. Analogies 3. Simulation 4. Demonstration

1. Role play

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

1. Routine screening and diagnostic tests 3. Regular exercise 4. Consistent seat belt use

A nurse is teaching an older patient about ways to detect a melanoma. Which of the following are age appropriate teaching techniques for this patient? (Select all that apply.) 1. Speak in a low tone 2. Begin and end the session with the most important information regarding melanoma 3. Provide a pamphlet about melanoma with large font in blues and greens 4. Provide specific information in frequent, small amounts for older adult patients 5. Speak quickly so that you do not take up too much of the patient's time

1. Speak in a low tone 2. Begin and end the session with the most important information regarding melanoma 4. Provide specific information in frequent, small amounts for older adult patients

Which teaching approach would be effective for informing a patient of an emergency appendectomy and the postoperative recovery he or she will experience? 1. Telling 2. Participating 3. Entrusting 4. Reinforcing

1. Telling

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

1. The woman works in an executive position that is very demanding. 2. The woman says that she has little time to prepare meals at home and eats out at least four nights a week.

which applied to the people who find themselves balancing responsibilities related to employment, family life, care of children, and care of aging parents? 1. the sandwich generation 2. the millennial generation 3. generation X 4. generation Y

1. the sandwich generation

10.During a visit to a family clinic, a nurse teaches a mother about immunizations, the use of car seats, and home safety for an infant and toddler. Which type of nursing interventions are these? 1. Restorative 2. Health promotion 3. Acute care 4. Growth and development

2

6. hospice nurse is caring for a family that is providing end-oflife care for their grandmother, who has terminal breast cancer. The nurse focuses on symptom management for the grandmother and on helping the family with developing coping skills. This approach is an example of which of the following? 1. Family as context 2. Family as patient 3. Family as a system 4. Family as structure

2

What are the physical circulatory changes that occur as death approaches? 1. Skin irritation 2. Mottling 3. Increased urine output 4. Weakness

2 Patients experience circulatory changes resulting in mottling. Weakness, skin irritation, and incontinence are some of the physical changes that occur as death nears but are not related to circulatory changes.

What does the nurse teach the student nurse about quality health care to prevent health disparities? 1 "Quality health care should be variable." 2 "Quality health care should be effective." 3 "Quality health care should be slow and thorough." 4 "Quality health care should be health care organization-centered."

2 "Quality health care should be effective."

Which action would the nurse take for a dying patient with chronic dull pain who does not have a support person to provide home care? 1 Hospitalize the patient in the intensive care unit 2 Arrange for inpatient hospice care 3 Provide acute care to the patient 4 Seclude the patient in a separate room

2 Arrange for inpatient hospice care

Which term best describes the type of elements that people in Western cultures believe cause illness? 1 Supernatural 2 Biomedical 3 Medico-religious 4 Imbalance between humans and nature

2 Biomedical

What is the similarity between patient-centered care and cultural competence? 1 Both involve individualized care. 2 Both improve health care quality. 3 Both emphasize personal relationships. 4 Both concentrate on the qualities of disadvantaged groups.

2 Both improve health care quality.

During their clinical postconference meeting, several nursing students were discussing their patients with their instructor. One student from a middle-class family shared that a patient was homeless. Which difference was being described between the student and the patient? 1 Ethnicity 2 Culture 3 Heritage 4 Religion

2 Culture

Which action would the nurse take for a dying patient who is breathing loudly? 1 Administer narcotics 2 Elevate the head of the bed 3 Apply lip balm to the patients lips 4 Position patient on the right side

2 Elevate the head of the bed

Which strategy would the nurse use to assist the patient newly diagnosed with colon cancer who is withdrawn? 1 Obtain prescription for a psychiatric evaluation 2 Encourage the patient to identify fears and verbalize feelings 3 Allow the patient to remain withdraw to avoid drawing attention to this behavior 4 Explain to the patient that newer treatments permit many people to survive colon cancer.

2 Encourage the patient to identify fears and verbalize feelings

A patient is diagnosed with a diabetic ulcer with gangrene to his foot. The health care provider advises surgery, but the patient refuses because removal of a body part is not permitted according to his or her religion. Which concept justifies this scenario? 1 Marginalization 2 Iceberg analogy 3 Intersectionality 4 Health disparity

2 Iceberg analogy

The registered nurse prepares a mutually agreeable, culturally oriented patient-centered plan. Which step of the LEARN communication technique is the nurse using? 1 Perception 2 Negotiation 3 Recommend 4 Acknowledge

2 Negotiation

Which critical thinking model component will the nurse use to deliver empathetic, high-quality, supportive care while planning treatment for a patient experiencing grief and loss? 1 Attitudes 2 Standards 3 Experience 4 Knowledge

2 Standards

The nurse finds that a patient has not understood the health education provided on personal hygiene. How does the nurse ensure that the patient understands the teachings? 1 The nurse provides reading material on personal hygiene. 2 The nurse clarifies the information and requests a teach-back. 3 The nurse provides a video demonstration of personal hygiene. 4 The nurse requests that a family member help the patient understand.

2 The nurse clarifies the information and requests a teach-back.

Which statement is true regarding the goal of core measures? 1 They help recognize prejudices and assumptions about other people. 2 They help reduce mortality, complications, and inpatient readmissions. 3 They help provide care that fits with the patient's own values, beliefs, and traditions. 4 They help assess social, cultural, and biophysical factors that influence patient treatment and care.

2 They help reduce mortality, complications, and inpatient readmissions.

The nurse plans care for a 16-year-old male, taking into consideration that stressors experienced most commonly by adolescents include which of the following? (Select all that apply.) 1. Loss of autonomy caused by health problems 2. Physical appearance and body image 3. Accepting one's personal identity 4. Separation from family 5. Taking tests in school

2, 3, 4, 5

Which interventions does a nurse implement to help a patient at the end of life maintain autonomy while in a hospital? (Select all that apply.) 1. Use therapeutic techniques when communicating with the patient. 2. Allow the patient to determine timing and scheduling of interventions. 3. Allow patients to have visitors at any time. 4. Provide the patient with a private room close to the nurses' station. 5. Encourage the patient to eat whenever he or she is hungry

2, 3, 5 Allowing patients to make choices about their care and end-of-life experience provides opportunities for them to maintain their autonomy

A patient is receiving palliative care for symptom management related to anxiety and pain. A family member asks whether the patient is dying and now in "hospice." What does the nurse tell the family member about palliative care? (Select all that apply.) 1. Palliative care and hospice are the same thing. 2. Palliative care is for any patient, any time, any disease, in any setting. 3. Palliative care strategies are primarily designed to treat the patient's illness. 4. Palliative care relieves the symptoms of illness and treatment. 5. Palliative care selects home health care services

2, 4 Palliative care and hospice care are different. Palliative care is available to all patients regardless of age, diagnosis, and prognosis. The focus of palliative care is on management of symptoms.

A 10-year-old girl was playing on a slide at a playground during a summer camp. She fell and broke her arm. The camp notified the parents and took the child to the emergency department according to the camp protocol for injuries. The parents arrive at the emergency department and are stressed and frantic. The 10-yearold is happy in the treatment room, eating a Popsicle and picking out the color of her cast. List in order of priority what the nurse should say to the parents. 1. "Can I contact someone to help you?" 2. "Your daughter is happy in the treatment room, eating a Popsicle and picking out the color of her cast." 3. "I'll have the doctor come out and talk to you as soon as possible." 4. "I want to be sure you are ok. Let's talk about what your concerns are about your daughter before we go see her."

2, 4, 3, 1

2. A mother and her two children are homeless and enter a free health care clinic. Which statements most likely describe the effects of homelessness on this family? (Select all that apply.) 1. The children have stability in their education. 2. The family members may have symptoms of malnutrition, such as anemia. 3. The family is at a low risk for experiencing violence. 4. The children are at higher risk for developing ear infections. 5. All family members may have mental health issues.

2, 4, 5

which pathophysiological change cause by smoking can increase the risk of cardiac disease in young adults? select all that apply 1. obstruction of airways 2. peripheral vasoconstriction 3. coronary vasocontriction 4. deposition of fats in coronary arteries 5. vasodilation of coronary arteries

2,3,4

which factor may influence how well a patient with diabetes adheres to a self care and drug regimen? select all that apply 1. family of the patient 2. education level of the patient 3. socioeconomic status of the patient 4. physical status of the patient 5. motivation level of the patient

2,3,5

Which type of family structure needs to be modified? select all that apply. 1. open structure 2. very rigis structure 3. blended family 4. extremely open structure 5. adaptable family structure

2,4

which factor affects the young adult's adherence to decisions about smoking cessation? select all that apply 1. workplace 2. desire to learn 3. family history 4. education level 5. socioeconomic staus

2,4,5

which professional is permitted to perform a prenatal assessment of a pregnant woman? select all that apply 1. lay doula 2. obstetrician 3. registered nurse 4. certified midwife 5. nurse practitioner

2,4,5

Which of the following scenarios demonstrate that learning has taken place? (Select all that apply.) 1. A patient listens to a nurse's review of the warning signs of a stroke 2. A patient describes how to set up a pill organizer for newly ordered medicines 3. A patient attends a spinal cord injury support group 4. A patient demonstrates how to take his blood pressure at home 5. A patient reviews written information about resources for cancer survivors

2. A patient describes how to set up a pill organizer for newly ordered medicines 4. A patient demonstrates how to take his blood pressure at home

Which of the following is an example of a patient with a health disparity? (Select all that apply.) 1. A patient who has a homosexual sexual preference 2. A patient unable to access primary care services 3. A patient living with a chronic disease 4. A family who relies on public transportation 5. A patient who has had a history of smoking for 10 years

2. A patient unable to access primary care services 3. A patient living with a chronic disease 5. A patient who has had a history of smoking for 10 years

Which teaching method does the nurse use for a patient newly diagnosed with diabetes who will be self-administering insulin? 1. Simulation 2. Demonstration 3. Group instruction 4. One-on-one Discussion

2. Demonstration

communication is a component of which family attribute? 1. hardiness or resiliency 2. functioning 3. structure 4. development

2. Functioning

While teaching pregnant women about nutrition and diet planning, the nurse randomly selects several women and gives them an opportunity to share their diet plans to correct mistakes and reinforce the correct information. The nurse is following which method of teaching? 1. Role play 2. Group discussion 3. Demonstration 4. One-on-one discussion

2. Group discussion

A nurse is caring for a young patient who has been told he has multiple sclerosis. The nurse has planned time to conduct a teaching session that will focus on the disease and principles of management. The nurse chooses to use the EDUCATE model to proceed with instruction. Which of the following are components of the model? (Select all that apply.) 1. State the goals of the session for the patient. 2. Repeat the most important information 3. Practice empathetic skills 4. Be aware of nonverbal messages 5. Use a standard question list for the chosen topic

2. Repeat the most important information 3. Practice empathetic skills 4. Be aware of nonverbal messages

Which approach by the nurse helps assess the patient's retention of information? 1. Telling 2. Teach-back 3. Reinforcing 4. Participating

2. Teach-back

Which approach is used to determine the outcome of patient teaching? 1. Entrusting 2. Teach-back 3. Reinforcing 4. Participating

2. Teach-back

A patient suddenly experiences a severe headache with numbness and decreased movement in the left arm. The emergency room physician suspects a stroke and is going to have the patient undergo an emergent angiogram to remove the clot. Which teaching approach is most appropriate? 1. Selling approach 2. Telling approach 3. Entrusting approach 4. Participating approach

2. Telling approach

a family that includes a mother, a stepfather, two teenage biological daughters of the mother and a biological daughter of the father. This family belongs to which category? 1. A nuclear family 2. a blended family 3. an extended family 4. an alternative family

2. a blended family

which reason is the most common for grandparents to raise their grandchildren? 1. single parenthood 2. legal interventions 3. dual income families 4. increased divorce rate

2. legal interventions

which statement about perimenopause is true? 1. menstruation cycles no longer occur 2. menstrual cycles become irregular 3. estrogen and progesterone are no longer produced 4. the neurophormonal system fails to simulate the endocrine system

2. menstrual cycles become irregular

A patient who delivered a baby 2 days ago is irritable, has mood swings, and is experiencing overall emotional instability. These signs are indicative of which condition? 1. schizophrenia 2. postpartum depression 3. postpartum psychosis 4. bipolar mood disorder

2. postpartum depression

1. A family includes a mother, a stepfather, two teenage biological daughters of the mother, and a biological daughter of the father. The father's daughter just moved home following the loss of her job in another city. The family is converting a study into a bedroom and is in the process of distributing household chores. Nursing assessment reveals all members of the family think that their family can adjust to lifestyle changes. This is an example of family: 1. Diversity. 2. Durability. 3. Resiliency. 4. Configuration.

3

When assessing an older adult who is showing symptoms of anxiety, insomnia, anorexia, and mild confusion, what is the first assessment the nurse conducts? 1. The amount of family support 2. A 3-day diet recall 3. A thorough physical assessment 4. Threats to safety in her home

3

When providing postmortem care, which actions are necessary for the nurse to complete? 1. Locating the patient's clothing 2. Calling the funeral home 3. Providing culturally and religiously sensitive care in body preparation 4. Providing postmortem care to protect the family of the deceased from having to view the body

3 A deceased person's body deserves the same respect and dignity as that of a living person and needs to be prepared in a manner consistent with the patient's cultural and religious beliefs.

Which question does the nurse ask a patient to assess the beliefs and practices of the patient? 1 "What caused your problem?" 2 "What is your main source of income?" 3 "What do you do to keep yourself well?" 4 "How should we address you or what should we call you?"

3 "What do you do to keep yourself well?"

How can a nurse develop cultural knowledge? 1 Become self-aware of personal biases. 2 Understand the forces that influence one's own world view. 3 Avoid unwarranted generalizations about any particular group. 4 Engage in an in-depth self-examination of one's own background.

3 Avoid unwarranted generalizations about any particular group.

What concept of intersectionality addresses the fact that some groups have limited access to certain facets of society such as the labor market? 1 Overinclusion 2 Social location 3 Marginalization 4 Social inequality

3 Marginalization

The senior nurse observes that a newly appointed nurse is having trouble relating to a patient from a different culture. What advice can the senior nurse give this nurse to enhance cultural competency? 1 Obtain in-depth knowledge about medical concepts and nursing care. 2 Learn at least three foreign languages. 3 Obtain sufficient knowledge about a patient's cultures and beliefs. 4 Learn about various dialects prevalent in the country.

3 Obtain sufficient knowledge about a patient's cultures and beliefs.

The nurse is caring for a Korean woman who has just delivered her first baby. Which soup would the nurse anticipate the family to provide as the first meal to the woman? 1 Tomato soup 2 Sweet corn soup 3 Seaweed soup 4 Hot garlic soup

3 Seaweed soup

9. A married couple has three children. The youngest child just graduated from college and is moving to a different city to take a job. The other two children left the home several years ago. Both of their parents are older and are beginning to need help to maintain their home. What assessment questions will help the nurse determine the family's functioning? (Select all that apply). 1. Which transitions or changes in your family are you currently experiencing? 2. Are your children having any problems that are affecting your family right now? 3. Describe a recent family conflict and how your family resolved it. 4. What coping strategies do you typically use as a family? 5. Who is involved in helping care for your parents?

3, 4, 5

The nurse is interviewing a patient in the community clinic and gathers the following information about her: she is intermittently homeless, a single parent with two children who have developmental delays. She has had asthma since she was a teenager. She does not laugh or smile, does not volunteer any information, and at times appears close to tears. She has no support system and does not work. She is experiencing an allostatic load. As a result, which of the following would be present during complete patient assessment? (Select all that apply.) 1. Post-traumatic stress disorder 2. Rising hormone levels 3. Chronic illness 4. Insomnia 5. Depression

3, 4, 5

The nurse is evaluating how well a patient newly diagnosed with multiple sclerosis and psychomotor impairment is coping. Which statements indicate that the patient is beginning to cope with the diagnosis? (Select all that apply.) 1. "I'm going to learn to drive a car, so I can be more independent." 2. "My sister says she feels better when she goes shopping, so I'll go shopping." 3. "I'm going to let the occupational therapist assess my home to improve efficiency." 4. "I've always felt better when I go for a long walk. I'll do that when I get home." 5. "I'm going to attend a support group to learn more about multiple sclerosis."

3, 5

which relationship may represent an alternative family? select all that apply 1. single person adopting a child 2. foster children 3. Adults living alone 4. grandparents caring for grandchildren 5. homosexual couples

3,4,5

Which right according to the dying person's bill of rights would the nurse be aware of when treating terminally ill patients? Select all that apply. One, some, or all responses may be correct. 1 To die alone 2 To be judged 3 To be free from pain 4 To retain individuality 5 To make decisions about care

3,4,5 To be free from pain To retain individuality To make decisions about care

A patient is scheduled for coronary artery bypass graft surgery. When is an appropriate time to teach breathing exercises and coughing techniques to the patient? 1. During discharge 2. After the surgery 3. Before the surgery 4. At the next follow-up visit

3. Before the surgery

A patient asks a nurse to provide instruction on how to perform a breast self-exam. Which domains are required to learn this skill? (Select all that apply.) 1. Affective domain 2. Sensory domain 3. Cognitive domain 4. Attentional domain 5. Psychomotor domain

3. Cognitive domain 5. Psychomotor domain

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

3. Health education.

A nurse is completing an assessment on a male patient, age 24. Following the assessment, the nurse notes that his family history is not significant for chronic illnesses, and his physical and laboratory findings are within normal limits. Because of these findings, nursing interventions are directed toward activities related to: (Select all that apply.) 1. Instructing him to return in 2 years. 2. Instructing him in secondary prevention. 3. Instructing him in health promotion activities. 4. Instructing him about routine screenings. 5. Instructing him about proper vaccinations.

3. Instructing him in health promotion activities. 4. Instructing him about routine screenings. 5. Instructing him about proper vaccinations

Which factor affects a middle-age adult's adherence to a treatment plan? 1. Gender 2. Lifestyle 3. Motivation 4. Family history

3. Motivation

A patient recovering from open heart surgery is taught how to cough and deep breathe using a pillow to support or splint the chest incision. Following the teaching session, which of the following is the best way for the nurse to evaluate whether learning has taken place? 1. Verbalization of steps to use in splinting 2. Selecting from a series of flash cards the images showing correct technique 3. Return demonstration 4. Cloze test

3. Return demonstration

A 63-year-old woman is a family caregiver for her 88-year-old mother who has dementia. The caregiver asked the home health nurse how to manage her mother when she becomes confused and violent. The best instructional method a nurse can use for this situation is: 1. Demonstration 2. Preparatory instruction 3. Role playing 4. Group instruction with other family caregivers

3. Role playing

A nurse is preparing to teach a patient who has sleep apnea how to use a CPAP machine at night. Which action is most appropriate for the nurse to perform first? 1. Allow patient to manipulate machine and look at parts 2. Provide a teach-back session 3. Set mutual goals for the education session 4. Discuss the purpose of the machine and how it works

3. Set mutual goals for the education session

A nurse working in a large occupational health clinic knows that many of the workers at her company are marginalized and at risk for poor health outcomes. Which of the following individuals are most likely to be marginalized? 1. Wives of the employees 2. The head supervisors of the company 3. Workers who have a high school education 4. Workers employed for less than a year at the company

3. Workers who have a high school education

which term correlates with " the ability of a family to cope with expected and unexpected stressors"? 1. family diversity 2. family durability 3. family residency 4. family dynamics

3. family resiliency

which factor aside from educational level and socioeconomic status, affects a patient's compliance with a prescribed course of therapy? 1. gender 2. lifestyle 3. motivation 4. family history

3. motivation

Which describes the ability of a family to cope with expected and unexpected stressors? 1. love 2. integrity 3. resiliency 4. hardiness

3. resiliency

7. A 7-year-old child was recently diagnosed with asthma. A nurse is providing education to the child and her parents about the treatment and management of asthma and changes they need to make in their home environment to promote her health. Which statement made by the parents requires follow-up by the nurse? 1. "We have made an appointment to talk with the school nurse about the change in our child's health." 2. "We forgot to give our daughter her medications before bedtime, so we made a list of her medications to help us remember." 3. "We have worked out a schedule to check on her before and after school." 4. "We have not been spending time with our parents because we are so busy taking care of our daughter."

4

A 34-year-old single father who is anxious, tearful, and tired from caring for his three young children tells the nurse that he feels depressed and doesn't see how he can go on much longer. Which statement would be the nurse's best response? 1. "Are you thinking of suicide?" 2. "You've been doing a good job raising your children. You can do it!" 3. "Is there someone who can help you during the evenings and weekends?" 4. "Tell me what you mean when you say you can't go on any longer."

4

Which student nurse statement regarding cultural competence indicates a need for further teaching? 1 "Culturally competent organizations adapt to diversity." 2 "Culturally competent organizations conduct cultural self-assessment." 3 "Culturally competent organizations institutionalize cultural knowledge." 4 "Culturally competent organizations manage the dynamics of homogeny."

4 "Culturally competent organizations manage the dynamics of homogeny."

While measuring the vital signs of a Muslim patient, the nurse observes that the patient is anxious. Which statement by the nurse indicates a good understanding of transcultural nursing? 1 "I know modesty is very important for you, but you'll have to adjust this time." 2 "I know modesty is very important for you, but it should not interrupt the assessment." 3 "I know modesty is very important for you. However, we have to adhere to hospital rules." 4 "I know modesty is very important for you. Is there any way I can make you comfortable?"

4 "I know modesty is very important for you. Is there any way I can make you comfortable?"

The nurse is using the teach-back technique to evaluate a patient after teaching about medication adherence. Which question by the nurse is appropriate to verify the patient's understanding? 1 "Did you understand?" 2 "Do you have any questions?" 3 "Was this information useful to you." 4 "Please review what we talked about. How will you make it work at home?"

4 "Please review what we talked about. How will you make it work at home?"

Which is required in the delivery of culturally congruent care? 1 Learning about a variety of cultures 2 Being motivated and committed to caring 3 Influencing treatment and care of patients 4 Acquiring specific knowledge, skills, and attitudes

4 Acquiring specific knowledge, skills, and attitudes

Which criterion listed by a nursing student as covered under engagement, continuous improvement, and accountability as per the Culturally and Linguistically Appropriate Standards (CLAS) indicates a need for further teaching? 1 Conduct ongoing assessments of the organization's activities related to CLAS. 2 Communicate the organization's progress in implementing and sustaining CLAS. 3 Collect and maintain reliable demographic data to monitor the effect of CLAS. 4 Advance and sustain organizational governance and leadership that promotes CLAS.

4 Advance and sustain organizational governance and leadership that promotes CLAS.

Which technique would the nurse use to communicate actively with a terminally ill patient? 1 Asking closed ended questions 2 Sympathizing with the patient 3 Avoiding sensitive issue 4 Asking open ended questions

4 Asking open ended question

What step is the nurse least likely to take while providing culturally congruent care to the patient? 1 Taking care of any discomfort related to the patient's religious beliefs 2 Trying to bridge religious gaps to provide meaningful and supportive care 3 Combining knowledge about a religion with an attitude of helpfulness and flexibility 4 Recognizing that his or her religious preference automatically applies to all patients

4 Recognizing that his or her religious preference automatically applies to all patients

Which action would the nurse take for a patient newly diagnosed with a serious, live-changing illness whose conversations are abrupt, superficial, and unrelated to the illness? 1 Strongly suggest the patient talk about feelings 2 Focus on the family o obtain the information needed 3 Avoid discussing illness-related topics with quiet patients. 4 Remain alert for the signals that the patient wants to talk

4 Remain alert for the signals that the patient wants to talk

A 34-year-old female executive has a job with frequent deadlines. She notes that when the deadlines appear, she tends to eat high-fat, high-carbohydrate foods. She also explains that she gets frequent headaches and stomach pain during these deadlines. After receiving health education from the nurse, the executive decides to try yoga. In this scenario yoga is used as a(n): 1. Outpatient referral. 2. Counseling technique. 3. Health promotion activity. 4. Stress-management technique.

4 Stress-management technique.

Which common issue might the nurse observe while assessing patients who are between 35 and 64 years of age? select all that apply 1. gender identity 2. sexual preference 3. vocational choices 4. career related changes 5. caring for aging patients

4,5

Which teaching tool is suitable for patients who have strong reading comprehension and psychomotor skills? 1. Physical objects 2. Printed material 3. Audiovisual materials 4. Computer instruction

4. Computer instruction

A mother is concerned about her child's flulike symptoms. You learn from the health assessment that the mother practices use of "hot" and "cold" foods to treat ailments. Which of the following foods do you expect the mother to use to treat her child? 1. Chicken 2. Yogurt 3. Fresh fruits 4. Eggs

4. Eggs

A patient is in labor with her first baby, which is coming 2 weeks early. her husband is in the military and might not get back in time, and neither family is able to be with her during labor. Which support person employed by the birthing area is the health care professional most likely to call in to be present during the labor? 1. nurse 2. midwife 3. Assistant 4. Lay doula

4. Lay doula

Which assessment determines the patient's motivation to learn? 1. Reading level 2. Sensory deficits 3. Cognitive Function 4. Learning style preference

4. Learning style preference

A 55-year-old adult male has been in the hospital over a week following surgical complications. The patient has had limited activity but is not finally ordered to begin a mobility program. The patient just returned from several diagnostic tests and tells the nurse he is feeling quite fatigued. The nurse prepares to instruct the patient on the mobility program protocol. Which of the following learning principles will likely be affected by this patient's condition? 1. Motivation to learn 2. Developmental stage 3. Stage of grief 4. Readiness to learn

4. Readiness to learn

which description best matches lay doula? 1. a person who assists in the personal tasks of a mother 2. a woman who is skilled in aiding the delivering of babies 3. a certified health care provider focused on the care of patients 4. a support person to assist with women who have no other source of support during labor

4. a support person to assist with women who have no other source of support during labor

Which is the definition to family durability? 1. the uniqueness of each family unit 2. the ability of a family to cope with expected and unexpected stressors 3. the interactions between family members that are affected by a family's makeup and function 4. a system of support and structure within a family that and the walls of the household

4. a system of support and structure within a family that and the walls of the household

which factor affects a family's access to adequate health care, the opportunity for education, sound nutrition, and decreased stress? 1. development 2. family function 3. family structure 4. economic stability

4. economic stability

Sharing eating utensils with a person who has a contagious illness is an example of a health risk resulting from which factor? 1. lifestyle 2. community 3. Family History 4. perosnal hygiene habits

4. personal hygiene habits

Which action falls under the role of a lay doula? 1. deliver the infant 2. administrator pain medication to the patient in labor 3. monitor vital signs while the patient is in labor 4. provide emotional support and physical assistance to the patient in labor

4. provide emotional support and physical assistance to the patient in labor

what is the normal duration of the postpartum period? (in weeks)

6 weeks

A nurse has the responsibility of managing a patient's postmortem care. What is the proper order for postmortem care when there is no autopsy ordered? 1. Bathe the body of the deceased. 2. Collect any needed specimens. 3. Remove all tubes and indwelling lines. 4. Position the body for family viewing. 5. Speak to the family members about their possible participation. 6. Ensure that the request for organ/tissue donation and/or autopsy was completed. 7. Notify support person (e.g., spiritual care provider, bereavement specialist) for the family. 8. Accurately tag the body, including the identity of the deceased and safety issues regarding infection control. 9. Elevate the head of the bed.

6, 9, 2, 5, 7, 3, 1, 4, 8. This order provides dignity to the deceased and ensures that the nurse is adhering to all policies and laws concerning autopsies, organ donation, or an investigation.

a nurse is preparing a health promotion course for a group of middle adults. which of the following strategies should the nurse recommend? (select all that apply) A. eye examination every 1-3 years B. decrease intake of calcium supplements C. DXA screening for osteoporosis D. increase intake of carbohydrate in the diet E. screening for depressive disorders

A C D E

a nurse is collecting history and physical examination data from a middle adult. the nurse should expect to find decreases in which of the following physical examination data from a middle adult. the nurse should expect to find decreases in which of the following physiological functions? (select all that apply) A. metabolism B. ability to hear low pitched sounds C. gastric secretions D. Far vision E. Glomerular filtration

A C E

The nurse is caring for a 50-year-old woman visiting the outpatient medicine clinic. The patient has had type 1 diabetes since age 13. She has numerous complications from her disease, including reduced vision, heart disease, and severe numbness and tingling of the extremities. Knowing that spirituality helps patients cope with chronic illness, which of the following principles should the nurse apply in practice? (Select all that apply.) 1. Pay attention to the patient's spiritual identity throughout the course of her illness. 2. Select interventions that you know scientifically support spiritual well-being. 3. Listen to the patient's story each visit to the clinic, and offer a compassionate presence. 4. When the patient questions the reason for her long-time suffering, try to provide answers. 5. Consult with a spiritual care adviser, and have the adviser recommend useful interventions.

Answer: 1, 3. A person's spiritual well-being can change over time; therefore, it is important to pay attention to it over the course of his or her illness. Listening is a powerful way to support a patient's spirituality. Evidence-based interventions are preferred, but they must be agreed on by the patient and tailored to his or her perspectives and not just those of the nurse. Patients are not looking for answers. What is spoken as a spiritual question is most often an expression of spiritual pain. Using spiritual care advisers is a valuable resource but should be selected by the patient, not independently by the nurse, and any interventions should be mutually agreed on among nurse, patient, and adviser.

The nurse is caring for a patient who is very depressed and decides to complete a spiritual assessment using the FICA tool. Using the FICA assessment tool, match the criteria on the left with the appropriate assessment question on the right. 1. F—Faith ___ 2. I—Importance of spirituality ___ 3. C—Community ___ 4. A—Interventions to address spiritual needs ___ a. Tell me if you have a higher power or authority that helps you act on your beliefs b. Describe which activities give you comfort spiritually c. To whom do you go for support in times of difficulty? d. Your illness has kept you from attending church. Is that a problem for you?

Answer: 1a, 2d, 3c, 4b.

A nurse is preparing to teach an older adult who has chronic arthritis how to practice meditation. Which of the following strategies are appropriate? (Select all that apply.) 1. Encourage family members to participate in the exercise. 2. Have patient identify a quiet room in the home that has minimal interruptions. 3. Suggest the use of a quiet fan running in the room. 4. Explain that it is best to meditate about 5 minutes 4 times a day. 5. Show the patient how to sit comfortably with the limitation of his arthritis and focus on a prayer

Answer: 2, 3, 5. A quiet room with no distractions is conducive to meditation. The low buzz of a fan also blocks distractive noises. A patient should relax comfortably during meditation. Meditation is usually recommended 10 to 20 minutes twice a day. The activity should be conducted alone without distraction.

A 44-year-old male patient has just been told that his wife and child were killed in an auto accident while coming to visit him in the hospital. Which of the following statements are assessment findings that support a nursing diagnosis of Spiritual Distress related to loss of family members? (Select all that apply.) 1. "I need to call my sister for support." 2. "I have nothing to live for now." 3. "Why would my God do this to me?" 4. "I need to pray for a miracle." 5. "I want to be more involved in my church."

Answer: 2, 3. Patients most likely to have a diagnosis of Spiritual Distress are facing loss or terminal or serious illness and have poor personal relationships. Indicating that there is nothing to live for now and wondering why God would do this to him reflect dispiritedness (e.g., expressing lack of hope, meaning, or purpose in life; anger toward God). The other responses show a potential for enhancement of spiritual well-being.

A patient has just learned she has been diagnosed with a malignant brain tumor. She is alone; her family will not be arriving from out of town for an hour. The nurse has been caring for her for only 2 hours but has a good relationship with her. What is the most appropriate intervention for support of her spiritual well-being at this time? 1. Make a referral to a professional spiritual care adviser. 2. Sit down and talk with the patient; have her discuss her feelings and listen attentively. 3. Move the patient's Bible from her bedside cabinet drawer to the top of the over-bed table. 4. Ask the patient whether she would like to learn more about the implications of having this type of tumor

Answer: 2. Establishing presence contributes to a patient's sense of well-being. It helps to prevent emotional and environmental isolation. Automatically making a referral to a spiritual care adviser might not be the patient's wish. She may not see an adviser as a resource. Reading a Bible can be an important ritual, but at this time the patient needs to make a connection with someone who can help minimize loneliness and powerlessness. Providing instruction will be important, but the patient is unlikely to be receptive at this time.

A nursing student is developing a plan of care for a 74-year-old-female patient who has spiritual distress over losing a spouse. As the nurse develops appropriate interventions, which characteristics of older adults should be considered? (Select all that apply.) 1. Older adults do not routinely use complementary medicine to cope with illness. 2. Older adults dislike discussing the afterlife and what might have happened to people who have passed on. 3. Older adults achieve spiritual resilience through frequent expressions of gratitude. 4. Have the patient determine whether her husband left a legacy behind. 5. Offer the patient her choice of rituals or participation in exercise.

Answer: 3, 4, 5. Older-adult patients achieve spiritual resiliency in expressing gratitude and finding ways to maintain purpose in life. Leaving legacies maintains a connection between the person left behind and the lost loved one. Older adults frequently use complementary medicine, rituals, and exercise to cope with illness and pain. Belief in the afterlife grows with aging

A nurse is caring for a patient who is Muslim and has diabetes. Which of the following items does the nurse need to remove from the meal tray when it is delivered to the patient? 1. Small container of vanilla ice cream 2. A dozen red grapes 3. Bacon and eggs 4. Garden salad with ranch dressing

Answer: 3. Islam prohibits the consumption of pork.

A nurse used spiritual rituals as an intervention in a patient's care. Which of the following questions is most appropriate to evaluate its efficacy? 1. Do you feel the need to forgive your wife over your loss? 2. What can I do to help you feel more at peace? 3. Did either prayer or meditation prove helpful to you? 4. Should we plan on having your family try to visit you more often in the hospital?

Answer: 3. Rituals include participation in worship, prayer, sacraments (e.g., baptism, Holy Eucharist), fasting, singing, meditating, scripture reading, and making offerings or sacrifices. When you include the use of rituals in a patient's plan of care, evaluate whether the patient perceived these activities as useful. If not, other interventions will be necessary

Which statement made by a patient who is recovering after recently experiencing third-degree burns shows connectedness? 1. "My pain medicine helps me feel better." 2. "I know I will get better if I just keep trying." 3. "I see God's grace and become relaxed when I watch the sun set at night." 4. "I feel so much closer to God after I read my Bible and pray."

Answer: 4. Connectedness is a dimension of spirituality that is related to the human need of belonging. Individuals can be connected to themselves, others, God or another Supreme Being, or nature. Individuals often stay connected to God through prayer

A patient's cultural background affects the motivation for learning. Using the ACCESS model, match the nursing approach with the correct model component.

Assessment: Learn about the patient's health beliefs and practices Communication: Remain aware of verbal and nonverbal responses Cultural: Become aware of your patient's culture and your own cultural biases Establishment: Show respect by creating a caring rapport Sensitivity: Be aware of how patients from diverse backgrounds perceive their care needs Safety: Help patients feel culturally secure and able to maintain their cultural identity

a nurse is counseling a middle adult client who describes having difficulty dealing with several issues. which of the following client statements should the nurse identify as the priority to assess further? A. "i am struggling to accept that my parents are aging and need so much help." B. "Its been so stressful for me to think about having intimate relationships." C. "i know i should volunteer my time for a good cause, but maybe I am just selfish." D. "i love my grandchildren, but my child expects me to relive my parenting days."

B

a nurse is collecting data to evaluate a middle adult's psychosocial development. the nurse should expect middle adults to demonstrate which of the following developmental tasks? (select all that apply) A. develop an acceptance of diminished strength and increased dependence on others. B. spend time focusing on improving job performance C. welcome opportunities to be creative and productive D. commit to finding friendship and companionship E. become involved with community issues and activities

B C E

A nurse in a provider's office is collecting data from the mother of a 1-year-old child. The client states that her child is old enough for toilet training. Following an educational session by the nurse, the client now states that her earlier ideas have changed. She is now willing to postpone toilet training until the child is older. Learning has occurred in which of the following domains of learning? A. Cognitive B. Affective C. Psychomotor D. Kinesthetic

B. Affective

A nurse is evaluating how well a client learned the information 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 by the nurse should assist the nurse in evaluating the clients 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 fil out an evaluation form D. Ask the client if she has resources for further instruction of this topic

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

When a nurse is observing a client drawing up and mixing insulin injections, which of the following best demonstrates 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. The client is able to demonstrate the appropriate technique

A nurse is counseling a young adult who describes having difficulty with dealing with several issues. Which of the following client statements should the nurse identify as the priority to assess further? a. "I have my own apartment now, but its not easy living away from my parents" b. "its been so stressful for me to even think about having my own family" c. "I don't even know who I am yet, and now im supposed to know what to do" d. "my girlfriends pregnant, and I don't think I have what it takes to be a good father"

C.

A nurse is providing preoperative teaching for a client who is scheduled for a mastectomy the next day. Which of the following client statements indicates that the client is ready to learn? A. "I don't want my spouse to see my incision." B. "Will you be able to give me pain medicine after the surgery?" C. "Can you tell me about how long the surgery will take?" D. "My roommate listens to everything I say."

C. "Can you tell me about how long the surgery will take?"

a charge nurse is explaining the various stages of the lifespan to a group of newly licensed nurses. which of the following examples should the nurse include as a developmental task for middle adulthood? A. the client evaluates their behavior after a social interaction B. the client states they are learning to trust others C. the client wishes to find meaningful friendhsips D. the client expresses concerns about the next generation.

D

A nurse is preparing an instructional session about managing stress incontinence for an older adult. Which of the following actions should the nurse take first 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 the client agree are reasonable. D. Determine what the client knows about stress incontinence.

D. Determine what the client knows about stress incontinence

Which statement about hospice care needs correction? 1 It is available in homes 2 It provides care for terminally ill patients 3 It gives priority to managing a patient pain and other symptoms 4 It accepts the patient into the program when the survival period is 10 months

It accepts the patient into the program when the survival period is 10 months

A nurse is using an interpreter to communicate with a client. Which of the following actions should the nurse use when communicating with a client and family members? (select all that apply) a. talk to the interpreter about the family while the family is in the room b. determine client understanding several times during the conversation c. look at the interpreter when asking the family questions d. use lay terms if possible. e. do not interrupt the interpreter and the family as they talk

b, d, e

A nurse is teaching a young adult client about health promotion and illness prevention. Which of the following statements by the client indicates an understanding of the teach? a. "I already had my immunizations as a child, so im protected in that area" b. "it is important to schedule routine health care visits even if I am feeling well." c. "I will just go to an urgent care center for my routine medical care" d. "theres no reason to seek help if I am feeling stressed because its just part of life"

b.

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

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

A nurse is reviewing safety precautions with a group of young adults at a community health fair. Which of the following recommendations. should the nurse include to address common health risks for this age group? (select all that apply) a. install bath rails and grab bars in the bathrooms b. wear a helmet while skiing c. install a carbon monoxide detector d. secure firearms in a safe location e. remove throw rugs from the home

b., c., d.

A charge nurse is explaining the various stages of the lifespan to a group of newly licensed nurses. Which of the following examples should the charge nurse include as a developmental task for a young adult? a. becoming actively involved providing guidance to the next generation b. adjusting to major changes in roles and relationships due to losses c. devoting a great deal of time to establishing an occupation d. finding oneself sandwich between and being responsible for two generations

c.

A nurse is caring for a client who has stage IV lung cancer and is 3 days postop following a wedge resection. the client states, i told myself that i would go through with the surgery if i quit smoking, if i could just live long enough to attend my daughters wedding. based on kubler-ross's model, which stage of grief is the client experiencing? a. anger b. denial c. bargaining d. acceptance

c. bargaining

The nurse enters the room of a client who is crying while reading from a religious book and asks to be left alone. Which of the following actions should the nurse take? a. contact the hospital's spiritual services b. ask what is making the client cry c. ensure no visitors or staff enter the room for a short period of time d. turn on the television for a distraction

c. ensure no visitors or staff enter the room for a short period of time

a nurse is assisting a newly licensed nurse with postmortem care to a client. the family wishes to view the body. which of the following statements by the newly licensed nurse indicate an understanding of this procedure? select all that apply a. i will remove the dentures from the body b. i will make sure the body is lying completely flat c. i will apply fresh linens and place a clean gown on the body d. i will remove all equipment from the bedside e. i will dim the lights in the room

c. i will apply fresh linens and place a clean gown on the body d. i will remove all equipment from the bedside e. i will dim the lights in the room

A nurse is caring for a client who has terminal lung cancer. The nurse observes the client's family assisting with all ADLs. which of the following rationales for self-care should the nurse communicate to the family? a. allowing the client to function independently will strengthen her muscles and promote healing b. the client needs to be given privacy at times for self- reflecting and organizing her life. c. the client's sense of loss can be lessened through retaining control of certain areas of her life d. performing ADLs is required prior to discharge from an acute care facility

c. the client's sense of loss can be lessened through retaining control of certain areas of her life

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

c. the same religious beliefs can influence individuals differently

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

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

a nurse is caring for a client who has a terminal illness. death is expected within 24 hr. the client's family is at the bedside and asks the nurse about anticipated findings at this time. which of the following findings should the nurse include in the discussion? a. regular breathing patterns b. warm extremities c. increased urine output d. decreased muscle tone

d. decreased muscle tone- expected finding when client is approaching death