S1 T6

A patient has begun smoking again and drinks six alcoholic beverages per day since experiencing the loss of his job. The nurse recognizes that the patient is exhibiting symptoms of which type of stress?

Behavioral

paresthesia

abnormal sensation such as burning, pricking, tingling, or numbness

A nursing instructor and a student nurse are talking about caregivers and their role in the caring process. The instructor reminds the student that caregivers experience many emotions and face many obstacles as they care for someone, including Select all that apply.

anxiety, denial, social isolation

What is a stressor?

any stimuli that can produce tension and cause instability within the system

perception

medically, refers to the awareness of characteristics of the environment through the senses

Which nursing interventions are likely to help the patient to cope by addressing the mediators of stress? Select all that apply.

"A divorce, while stressful, can be the beginning of a new, better phase of life." "Journaling gives one more awareness of how experiences have affected them." "Perhaps a short-term loan from your father will make your layoff less stressful." "I have found a support group for newly divorced persons in your neighborhood."

A client whose spouse recently died appears extremely depressed. The client says, "What's the use in talking? I'd rather be dead. I can't go on without my spouse." What is the best response by the nurse?

"Are you thinking about killing yourself?"

A registered nurse is teaching a nursing student about how to communicate with a client who is cognitively impaired. Which statements made by the nursing student indicate a need for further education? Select all that apply.

"I should use visual cues." "I should speak in a normal tone of voice." "I should face the client so that he or she can see my mouth."

A patient voices an understanding of instructions about furosemide (Lasix) when he makes which statement?

"If I notice ringing in my ears, I will call the doctor."

The nurse is teaching a family about sensory alterations. The nurse needs to provide additional teaching if a family member makes which statement?

"My cousin has autism, and I am going to hug him more so he understands how much I care."

A registered nurse is teaching an adolescent female client with irregular menstruation about contraception. Which statements made by the client indicates the need for further education? Select all that apply.

"The calendar method of oral contraception is best suitable for me." "Condoms do not offer protection against sexually transmitted infections." "Oral contraceptive pills offer protection from sexually transmitted diseases."

A family is talking with a nurse because one family member is experiencing a chronic illness. The family asks the nurse how they should cope with their changing roles. What is the nurse's best response?

"The family should discuss the changing roles and what is needed for everyone."

What instruction would the nurse be most likely to give a client with reduced sensory perception to prevent injury from scalding?

"Use a bath thermometer."

Which of the following is an example of a medical malpractice tort liability?

A surgeon does not complete the postprocedure count process, and a sponge is retained in the patient's abdominal cavity.

The embryonic period is critical because external and internal structures in the fetus are forming. All teratogens should be avoided from

4 to 8 weeks.

A married couple present to the preconceptual clinic with questions about how a fetus's chromosomal sex is established. What is the nurse's best response?

At fertilization, chromosomal sex is established.

The nurse should document which physiological stressor after performing a screening assessment on a patient?

Dementia

A diabetic patient who is hospitalized asks the nurse what factors are associated with increased blood glucose while in the hospital. Which response(s) by the nurse are appropriate? Select all that apply.

Blood sugar may be higher in the hospital due to the increased bed rest. Stressors such as illness cause the release of hormones that increase blood sugar. Medications such as steroids may increase glucose levels.

As the nurse working in the intensive care unit you are asked to help develop a policy and procedure for weaning patients from the mechanical ventilator. What steps will you take to insure that the research you are reviewing is from a credible source? Identify the steps in the order in which they are performed. (Separate letters by a comma and space as follows: A, B, C, D.)a. Make a clinical decision.b. Find the evidence.c. Frame the clinical question.d. Assess the evidence.e. Discern the evidence.

C, B, D, E, A

A nurse researcher is trying to determine what dose of medication is most therapeutic for patients with hypertension and cerebral vascular accidents (CVA). What type of research studies would be best for looking at quantitative measures? Select all that apply.

Descriptive, Correlational, Cause-comparative

Mr. Walker is caring for his ailing wife, who was diagnosed with a terminal illness. Mr. Walker is talking with a nurse, and he states, "I miss my old life. I don't see any of my friends any more. Caring for my wife is much more difficult than I thought. I want things to be the way they used to be." The nurse realizes that Mr. Walker is experiencing which emotional strain?

Caregiver stress

A nurse is talking with a woman who is caring for her elderly father. The woman states that she has very little time for herself or any of the activities she used to enjoy. The nurse is using which of the following processes to assess the situation?

Cognitive ability of appraisal

Which of the following best describes terms related to research that attempts to determine an association between or among variables?

Correlational

Which of the following is the conglomerate of morals, values, beliefs, norms, and meanings that a group of people share and communicate from one generation to the next?

Culture

A stress-laden patient has elected to learn deep breathing as a means of reducing stress. Rank the following statements in the order in which the nurse should give information when teaching this technique. (Separate letters by a comma and space as follows: A, B, C, D.) a. "Focus on your breathing; repeat the exercise for 2 to 5 minutes."b. "With each breath, pay attention to muscular sensations that accompany abdominal expansion."c. "Hold the breath for 3 seconds."d. "Find a comfortable position. Relax the shoulders and chest; let the body relax."e. "Take a deep breath through the nose, expanding the abdomen."f. "Exhale slowly through the nose, telling the body to relax."

D, E, C, F, B, A

A female patient comes to the clinic at 8 weeks' gestation. She lives in a house beneath electrical power lines, which is located near an oil field. She drinks two caffeinated beverages a day, is a daily beer drinker, and has not stopped eating sweets. She takes a multivitamin and exercises daily. She denies drug use. Which finding in the history has the greatest implication for this patient's plan of care?

Drinking alcohol should be avoided during pregnancy because of its teratogenic effects.

Which of the following relationships and differences would one find when comparing evidence-based practice (EBP) and research utilization? Select all that apply.

EBP implies internal decision making on the nurse's part. EBP was a later historical development than was research utilization. EBP considers values before it mandates utilization. Research utilization is more like performing a meta-analysis than is EBP.

A student in the RN-BSN program is taking a research course and finds they are having difficulty. The instructor asks "What are the components of evidence-based practice (EBP)"? How should the student reply? Select all that apply.

EBP relies on practice and research. Research utilization occurs after evaluation of all available evidence. EBP assists the nurse in the decision-making process.

Optimal symptom management is primarily based upon which type of care?

Evidence-based practice

Despite the importance of sexual health to overall well-being, many nurses and patients are uncomfortable discussing issues related to sexuality. It is for this reason that the nurse must include questions regarding a sexual health history as part of a comprehensive health assessment. A 15-year-old female patient has come to the office for her annual physical and first pelvic examination. In this situation, which nursing action is most important?

Excuse the parent.

The pediatric nurse compares the sources of stress in preschoolers of different ages. Which source creates stress in both 3-year-olds and 4-year-olds?

Fears

The nurse is surveying the assisted living facility regarding safety features for patients with sensory deficits. Which are the most appropriate accommodations?

Fire and smoke alarms with both sound and flashing lights

In order to fully understand the concept of sexuality, it is necessary to become familiar with the terms used when discussing this topic. Which term best describes how one views oneself as masculine or feminine?

Gender identity

The nurse is assessing a client with impaired hearing. Which action of the nurse is most important for establishing a good communication with the client?

Getting the client's attention before speaking

End-of-life care is most synonymous with which of the following types of care?

Hospice care

A 20-year-old woman comes for preconceptual counseling. She wants to get pregnant soon. Which of the following health-promoting habits would have the highest priority at this time?

Immediate tobacco cessation

A nurse is educating a group of adolescent girls about the risk of pregnancy. Which statements does the nurse include to help ensure adequate teaching? Select all that apply.

Infants born to adolescent mothers have low birth weights. Infants born to adolescent mothers are more likely to be premature. Infants born to adolescent girls have an increased risk of alcohol and drug exposure.

A new nurse needs further teaching when stating a valid consent involves which action?

It must be presented to the patient by a nurse.

What are some challenges faced in the process of delegation? Select all that apply.

Limited resources Large geographic area Vulnerable populations receiving care

Comfort care is an intervention carried out by which of the following professional disciplines?

Nursing

You are working with a college student who is planning to become sexually active. She is requesting a reliable method of birth control that could be easily discontinued if necessary. Which option should be given the strongest recommendation?

Oral contraceptive pills

What are the most important reasons for considering the use of palliative care in patient care management? Select all that apply.

Patients live with multiple chronic diseases several years before dying. Patients live with debilitating symptoms that interfere with the quality of life. Palliative care is used to reduce the symptoms associated with chronic disease.

Palliative care can be used to promote which of the following items? Select all that apply.

Physical functioning, Reduction in disease exacerbations, Improved quality of life, Discussion on advance directives

Human sexuality is interrelated with a variety of other nursing concepts that may affect sexuality or be affected by healthy sexual functioning. Prompt diagnosis and treatment of potential concerns related to concept overlap is an important nursing function. Which other concept is most likely to overlap with sexuality?

Reproduction

Which nursing diagnoses for patients with sensory perceptual variances may be included in a plan of care? Select all that apply.

Risk for injury, Impaired mobility, Altered nutrition that is less than the body requirements

The ability to receive and interpret stimuli has nursing implications that are a priority in what human need?

Safety

Which of the following statements is true regarding The Joint Commission's authority relating to health care organizations?

The Joint Commission regulations may be seen as having the effect of law because they accredit organizations to bill Medicare and the standards are frequently used in malpractice cases.

Which of the following would be a violation of the Consolidated Omnibus Budget Reconciliation Act and Emergency Medical Treatment and Active Labor Act of 1986?

The hospital emergency room physician suspects that a patient is not competent in making decisions for his post-care treatment. The physician does not complete a competency evaluation prior to transfer for a non-emergent treatment and allows the patient with suspected incompetence to sign the consent for transfer.

Although sexual activity is considered a normative process, some individuals place themselves at increased risk for negative consequences related to this process. Which nonsexual behavior is likely to increase risk-taking activities?

Using alcohol, marijuana, or illicit substances

A nurse protecting a patient's right to consent to a procedure is represented in which of the following answers?

When the nurse finds that the informed consent document is not yet complete, she holds the patient's pre-procedure narcotics until the physician can obtain patient consent.

A nurse is assessing a menopausal female and discussing sexuality. Which statement is accurate regarding physiological effects of menopause on sexual health?

Women who have undergone hysterectomy no longer desire to be sexually active.

sensation

a feeling experienced as a result of the stimulation of the sense organs

presbycusis

a progressive sensorineural hearing loss that occurs with aging

A nursing student is recalling information about hospice care. What is hospice care?

a system of family-centered care that allows clients to remain at home in comfort while easing the pains of terminal illness

ototoxicity

damage to the organs of hearing or balance function of the inner ear as a result of exposure to drugs or chemicals

sensory perception

the ability to receive sensory input and, through various physiologic processes in the body, translate the stimulus or data into meaningful information

pain

whatever the experiencing person says it is, existing whenever he or she says it does