Fundamentals Ch1-5,9-10,24,31

A nurse practicing in a primary care center uses the ANA's Nursing's Social Policy Statement as a guideline for practice. Which purposes of nursing are outlined in this document? Select all that apply.

A definition of the scope of nursing practice The establishment of a knowledge base for nursing practice A description of nursing's social responsibility (The ANA Social Policy Statement (2010) describes the social context of nursing, a definition of nursing, the knowledge base for nursing practice, the scope of nursing practice, standards of professional nursing practice, and the regulation of professional nursing.)

A nurse working in a rehabilitation facility focuses on the goal of restoring health for patients. Which examples of nursing interventions reflect this goal? Select all that apply.

A nurse counsels adolescents in a drug rehabilitation program A nurse performs range-of-motion exercises for a patient on bedrest A nurse shows a diabetic patient how to inject insulin (Activities to restore health focus on the person with an illness and range from early detection of a disease to rehabilitation and teaching during recovery. These activities include drug counseling, teaching patients how to administer their medications, and performing range-of-motion exercises for bedridden patients. Recommending a yoga class for stress reduction is a goal of preventing illness, and teaching a nutrition class is a goal of promoting health. A hospice care nurse helps to facilitate coping with disability and death.)

A nurse is using the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model PET as a clinical decision-making tool when delivering care to patients. Which steps reflect the intended use of this tool? Select all that apply.

A nurse recruits an interprofessional team to develop and refine an EBP question. A nurse searches the Internet to find the latest treatments for type 2 diabetes. A nurse questions the protocol for assessing postoperative patients in the ICU. (The JHNEBP model is a powerful problem-solving approach to clinical decision making, and is accompanied by user-friendly tools to guide individual or group use. It is designed specifically to meet the needs of the practicing nurse and uses a three-step process called PET: practice question, evidence, and translation. The goal of the model is to ensure that the latest research findings and best practices are quickly and appropriately incorporated into patient care. Steps in PET include, but are not limited to, recruiting an interprofessional team, developing and refining the EBP question, and conducting internal and external searches for evidence.)

Nurses perform health promotion activities at a primary, secondary, or tertiary level. Which nursing actions are considered tertiary health promotion? Select all that apply.

A nurse teaches a patient with an amputation how to care for the residual limb. A nurse provides range-of-motion exercises for a paralyzed patient. (Tertiary health promotion and disease prevention begins after an illness is diagnosed and treated to reduce disability and to help rehabilitate patients to a maximum level of functioning. These activities include providing ROM exercises and patient teaching for residual limb care. Providing immunizations and teaching parents how to childproof their homes and use an appropriate car seat are primary health promotion activities. Providing screenings is a secondary health promotion activity.)

In addition to standard precautions, the nurse would initiate droplet precautions for which patients? Select all that apply.

A patient diagnosed with rubella A patient diagnosed with diphtheria An infant diagnosed with adenovirus infection (Rubella, diphtheria, and adenovirus infection are illnesses transmitted by large-particle droplets and require droplet precautions in addition to standard precautions. Airborne precautions are used for patients who have infections spread through the air with small particles; for example, tuberculosis, varicella, and rubeola. Contact precautions are used for patients who are infected or colonized by a multidrug-resistant organism (MDRO), such as MRSA.)

A nurse working in an "Aging in Place" facility interviews a married couple in their late seventies. Based on Duvall's Developmental Tasks of Families, which developmental task would the nurse assess for this couple?

Adjustment to retirement years (The developmental tasks of the family with older adults are to adjust to retirement and possibly to adjust to the loss of a spouse and loss of independent living. Maintaining a supportive home base and strengthening marital relationships are tasks of the family with adolescents and young adults. Coping with loss of energy and privacy is a task of the family with children.)

Nursing in the United States is regulated by the state nurse practice act. What is a common element of each state's nurse practice act?

Defining the legal scope of nursing practice (Nurse practice acts are established in each state to regulate the practice of nursing by defining the legal scope of nursing practice, creating a state board of nursing to make and enforce rules and regulations, define important terms and activities in nursing, and establish criteria for the education and licensure of nurses. The acts do not determine the content covered on the NCLEX, but they do have the legal authority to allow graduates of approved schools of nursing to take the licensing examination. The acts also may determine educational requirements for licensure, but do not provide the education. Institutional policies are created by the institutions themselves.)

A nurse is preparing to teach a patient with asthma how to use his inhaler. Which teaching method would be the BEST choice to teach the patient this skill?

Demonstration (Demonstration of techniques, procedures, exercises, and the use of special equipment is an effective patient-teaching strategy for a skill. Lecture can be used to deliver information to a large group of patients but is more effective when the session is interactive; it is rarely used for individual instruction, except in combination with other strategies. Discovery is a good method for teaching problem-solving techniques and independent thinking. Panel discussions can be used to impart factual material but are also effective for sharing experiences and emotions.)

A nurse working in a primary care facility assesses patients who are experiencing various levels of health and illness. Which statements define these two concepts? Select all that apply.

Health and illness are individually defined by each person. Health is more than the absence of illness. Illness is the response of a person to a disease. (Each person defines health and illness individually, based on a number of factors. Health is more than just the absence of illness; it is an active process in which a person moves toward his or her maximum potential. An illness is the response of the person to a disease.)

A charge nurse meets with staff to outline a plan to provide transcultural nursing care for patients in their health care facility. Which theorist promoted this type of caring as the central theme of nursing care, knowledge, and practice?

Madeline Leininger (Madeline Leininger's theory provides the foundations of transcultural nursing care by making caring the central theme of nursing. Jean Watson stated that nursing is concerned with promoting and restoring health, preventing illness, and caring for the sick. The central theme of Dorothy E. Johnson's theory is that problems arise because of disturbances in the system or subsystem or functioning below optimal level. Betty Newman proposed that humans are in constant relationship with stressors in the environment and the major concern for nursing is keeping the patient system stable through accurate assessment of these stressors.)

A nurse is teaching first aid to counselors of a summer camp for children with asthma. This is an example of what aim of health teaching?

Preventing illness (Teaching first aid is a function of the goal to prevent illness. Promoting health involves helping patients to value health and develop specific health practices that promote wellness. Restoring health occurs once a patient is ill, and teaching focuses on developing self-care practices that promote recovery. When facilitating coping, nurses help patients come to terms with whatever lifestyle modification is needed for their recovery or to enable them to cope with permanent health alterations.)

A nurse is caring for patients in an isolation ward. In which situations would the nurse appropriately use an alcohol-based handrub to decontaminate the hands? Select all that apply.

Providing a bed bath for a patient Removing gloves when patient care is completed Inserting a urinary catheter for a female patient Removing old magazines from a patient's table (It is recommended to use an alcohol-based handrub in the following situations: before direct contact with patients; after direct contact with patient skin; after contact with body fluids if hands are not visibly soiled; after removing gloves; before inserting urinary catheters, peripheral vascular catheters, or invasive devices that do not require surgical placement; before donning sterile gloves prior to an invasive procedure; if moving from a contaminated body site to a clean body site; and after contact with objects contaminated by the patient. Keep in mind that handrubs are not appropriate for use with C. difficile infection.)

A nurse is teaching a 50-year-old male patient how to care for his new ostomy appliance. Which teaching aid would be most appropriate to confirm that the patient has learned the information?

Teach-back method (The teach-back tool is a method of assessing literacy and confirming that the learner understands health information received from a health professional. The Ask Me 3 is a brief tool intended to promote understanding and improve communication between patients and their providers. The NVS is a reliable screening tool to assess low health literacy, developed to improve communications between patients and providers. The TEACH acronym is used to maximize the effectiveness of patient teaching by tuning into the patient, editing patient information, acting on every teaching moment, clarifying often, and honoring the patient as a partner in the process.)

Chapter 10 A charge nurse in a busy hospital manages a skilled nursing unit using an autocratic style of leadership. Which leadership tasks BEST represent this style of leadership? Select all that apply.

The charge nurse dictates break schedules for the other nurses. The charge nurse schedules a mandatory in-service training on new equipment. The charge nurse delegates nursing responsibilities to the staff. (Autocratic leadership involves the leader assuming control over the decisions and activities of the group, such as dictating schedules and work responsibilities, and scheduling mandatory in-service training. Polling other nurses is an example of democratic leadership, which is characterized by a sense of equality among the leader and other participants, with decisions and activities being shared. In laissez-faire leadership, the leader relinquishes power to the group and encourages independent activity by group members. Examples of laissez-faire leadership style are allowing the nurses to divide up the tasks and encouraging them to work independently.)

A nurse is teaching patients of all ages in a hospital setting. Which examples demonstrate teaching that is appropriately based on the patient's developmental level? Select all that apply.

The nurse designs an exercise program for a sedentary older adult male patient based on the activities he prefers. The nurse includes an 8-year-old patient in the teaching plan for managing cystic fibrosis. The nurse continues a teaching session on STIs for a sexually active male adolescent despite his protest that "I've heard enough already!" (Successful teaching plans for older adults incorporate extra time, short teaching sessions, accommodation for sensory deficits, and reduction of environmental distractions. Older adults also benefit from instruction that relates new information to familiar activities or information. School-aged children are capable of logical reasoning and should be included in the teaching-learning process whenever possible; they are also open to new learning experiences but need learning to be reinforced by either a parent or health care provider as they become more involved with their friends and school activities. Teaching strategies designed for an adolescent patient should recognize the adolescent's need for independence, as well as the need to establish a trusting relationship that demonstrates respect for the adolescent's opinions.)

A nurse is asked to act as a mentor to a new nurse. Which nursing action is related to this process?

The nurse mentor advises and assists the new nurse to adjust to the work environment of a busy emergency department (Mentorship is a relationship in which an experienced person (the mentor) advises and assists a less experienced person (protégé). This is an effective way of easing a new nurse into leadership responsibilities. An experienced nurse who is paid to introduce an employee to new responsibilities through teaching and guidance describes a preceptor, not a mentor. The nurse mentor does not hire or schedule new nurses. Nurses do not need mentors to join professional organizations.)

A nurse is a servant leader working in an economically depressed community to set up a free mobile health clinic for the residents. Which actions by the leader BEST exemplify a key practice of servant leaders? Select all that apply

The nurse motivates coworkers to solicit funding to set up the clinic. The nurse spends time with supporters to help them grow in their roles. The nurse prizes leadership because of the need to serve others. (In order to serve as servant leaders, nurses need to invest in those who support the organization's values, show passion, can play to their strengths, and demonstrate a positive attitude. They should develop their vision to see the future related to a current anticipated need, and motivate others to follow and engage. They also need to provide ongoing opportunities for collaborations, sharing, reflection, encouragement, and celebration, as well as hard work. The servant leader allows others to have a voice, to exercise control, and to practice leading themselves. The servant first makes sure that other people's highest priority needs are being served. The best test, and most difficult to administer, is: Do those served grow as people? Do they, while being served, become healthier, wiser, freer, more autonomous, more likely themselves to become servants?)

A nurse is scheduling hygiene for patients on the unit. What is the priority consideration when planning a patient's personal hygiene?

The patient's usual hygiene practices and preferences (Bathing practices and cleansing habits and rituals vary widely. The patient's preferences should always be taken into consideration, unless there is a clear threat to health. The patient and nurse should work together to come to a mutually agreeable time and method to accomplish the patient's personal hygiene. The availability of staff to assist may be important, but the patient's preferences are a higher priority.)

A nurse is using general systems theory to describe the role of nursing to provide health promotion and patient teaching. Which statements reflect key points of this theory? Select all that apply.

The whole system is always greater than the sum of its parts. Boundaries separate systems from each other and their environments. To survive, open systems maintain balance through feedback (According to general systems theory, a system is a set of interacting elements contributing to the overall goal of the system. The whole system is always greater than its parts. Boundaries separate systems from each other and their environments. Systems are hierarchical in nature and are composed of interrelated subsystems that work together in such a way that a change in one element could affect other subsystems, as well as the whole. To survive, open systems maintain balance through feedback. An open system allows energy, matter, and information to move freely between systems and boundaries, whereas a closed system does not allow input from or output to the environment.)

A nurse performs an assessment of a family consisting of a single mother, a grandmother, and two children. Which interview questions directed to the single mother could the nurse use to assess the affective and coping family function? Select all that apply.

Who is the person you depend on for emotional support? Who keeps your family together in times of stress? (The five major areas of family function are physical, economic, reproductive, affective and coping, and socialization. Asking who provides emotional support in times of stress assesses the affective and coping function. Assessing the breadwinner focuses on the economic function. Inquiring about having more children assesses the reproductive function, asking about family traditions assesses the socialization function, and checking the environment assesses the physical function.)

Chapter 9 Terms

adherence: affective learning: changes in attitudes, values, and feelings andragogy: the study of teaching adults cognitive learning: storing and recalling of new knowledge in the brain compliance: act of completing what is expected of one contractual agreement: pact made between two persons or parties for the achievement of mutually set goals counseling: giving guidance, assisting with problem solving formal teaching: planned teaching based on learner objectives health literacy: ability to read, understand, and act on health information informal teaching: unplanned teaching sessions dealing with the patient's immediate learning needs and concerns instructional materials: objects or vehicles used to communicate information that supplements the teaching method learning: increasing one's knowledge; having one's behavior changed in a measurable way as a result of an experience learning readiness: patient's willingness to engage in the teaching-learning process (emotional readiness) and experiential readiness to begin the challenge of learning negative reinforcement: an ineffective teaching strategy that uses criticism or punishment nonadherence: noncompliance: nonadherence to a therapeutic recommendation nurse coach: a registered nurse who integrates coaching competencies into any setting or specialty area of practice to facilitate a process of change or development that assists individuals or groups to realize their potential patient education: process of influencing the patient's behavior to effect changes in knowledge, attitudes, and skills needed to maintain and improve health pedagogy: science of teaching that generally refers to the teaching of children and adolescents positive reinforcement: affirmation of the efforts of patients psychomotor learning: acquisition of physical skills teaching method: the way information is taught that brings the learner into contact with what is to be learned

Chapter 31 Terms

alopecia: hair loss or baldness caries: cavities of the teeth cerumen: wax in the external ear canals, consisting of a heavy oil and brown pigment cheilosis: ulceration of the lips gingivitis: inflammation of the gingivae or gums glossitis: inflammation of the tongue halitosis: offensive breath pediculosis: infestation with lice periodontitis: marked inflammation of the gums that also involves degeneration of the dental periosteum (tissues) and bone plaque: invisible, destructive, bacterial film that builds up on teeth and eventually leads to the destruction of tooth enamel stomatitis: inflammation of the oral mucosa tartar: hard deposit on the teeth near the gum line formed by plaque buildup and dead bacteria

Chapter 2 Terms

applied research: research designed to directly influence or improve clinical practice basic research: research designed to generate and refine theory; the findings are often not directly useful in practice concept: abstract images (ideas) that are formed as impressions from the environment and organized into symbols of reality conceptual framework or model: set of concepts, along with the statements that arrange the concepts into an understandable pattern data: information deductive reasoning: cognitive process in which one examines a general idea and then considers specific actions or ideas evidence-based practice (EBP): nursing care provided that is supported by sound scientific rationale evidence-based practice guideline: guideline guidelines written by a panel of experts that synthesize information from multiple studies and recommend best practices to treat patients with a disease, a symptom, or a disability inductive reasoning: cognitive process in which one identifies a specific idea or action and then makes conclusions about general ideas informed consent: knowledgeable, voluntary permission obtained from a patient to perform a specific test or procedure nursing research: encompasses both research to improve the care of people in the clinical setting and to study people and the nursing profession, including education, policy development, ethics, and nursing history nursing theory: differentiates nursing from other disciplines and activities by serving the purposes of describing, explaining, predicting, and controlling desired outcomes of nursing care practices qualitative research: method of research conducted to gain insight by discovering meanings quality improvement (QI): the commitment and approach used to continuously improve every process in every part of an organization, with the intent of meeting and exceeding customer expectations and outcomes—also known as continuous quality improvement (CQI) or total quality management (TQM) quantitative research: research involving the concepts of basic and applied research research: process that uses observable and verifiable information (data), collected in a systematic manner, to describe, explain, or predict events systematic review: summarized findings from multiple studies of a specific clinical practice question or topic that recommend practice changes and future directions for research; one of the strongest sources of evidence for evidence-based practice theory: statement based on observed facts that explains or characterizes a process, an occurrence, or an event, but cannot be proved directly or absolutely as a fact

Chapter 4 Terms

basic human needs: something essential to the health and survival of humans; common to all people blended family: two single-parent families joined together to form a new family unit community: specific population or group of people living in the same geographic area under similar regulations and having common values, interests, and needs extended family: nuclear family and other related people family: any group of people who live together and depend on one another for physical, emotional, or financial support love and belonging needs: understanding and acceptance of others in giving and receiving love nuclear family: family unit, family of marriage, parenthood, or procreation, and their immediate children physiologic needs: need for oxygen, food, water, temperature, elimination, sexuality, activity, and rest; these needs have the highest priority and are essential for survival safety and security needs: person's need to be protected from actual or potential harm and to have freedom from fear self-actualization needs: highest level on the hierarchy of needs, which include the need for individuals to reach their full potential through development of their unique capabilities self-esteem needs: need to feel good about oneself and to believe others hold one in high regard

Chapter 1 Terms

burnout: (1) cumulative state of frustration with the work environment that develops over a long time; (2) behaviors exhibited as the result of prolonged occupational stress compassion fatigue: loss of satisfaction from providing good patient care health: state of optimal functioning or well-being licensure: to be given a license to practice nursing in a state or province after successfully meeting requirements mindfulness: capacity to intentionally bring awareness to present-moment experience with an attitude of openness and curiosity; mindfulness promotes healing as you pause, focus on the present, and listen nurse practice act: law established to regulate nursing practice nursing: profession that focuses on the holistic person receiving health care services and provides a unique contribution to the prevention of illness and maintenance of health nursing process: five-step systematic method for giving patient care; involves assessing, diagnosing, planning, implementing, and evaluating profession: an occupation that meets specific criteria including a well-defined body of specific and unique knowledge, a code of ethics and standards, ongoing research, and autonomy reciprocity: process allowing a nurse to apply for and be endorsed as a registered nurse by another state secondary traumatic stress: feeling of despair caused by the transfer of emotional distress from a victim to a caregiver, which often develops suddenly standards: rules or guidelines that allow nurses to carry out professional roles, serving as protection for the nurse, the patient, and the institution where health care is given

Chapter 5 Terms

cultural assimilation: process that occurs when a minority group, living as part of a dominant group within a culture, loses the cultural characteristics that made it different cultural blindness: the process of ignoring differences in people and proceeding as though the differences do not exist cultural competence: care delivered with an awareness of the aspects of the patient's culture cultural diversity: (1) coexistence of different ethnic, biological sex, racial, and socioeconomic groups within one social unit; (2) diverse groups in society, with varying racial classifications and national origins, religious affiliations, languages, physical size, biological sex, sexual orientation, age, disability, socioeconomic status, occupational status, and geographic location cultural imposition: tendency of some to impose their beliefs, practices, and values on another culture because they believe that their ideas are superior to those of another person or group cultural respect: enables nurses to deliver services that are respectful of and responsive to the health beliefs, practices, and cultural and linguistic needs of diverse patients; critical to reducing health disparities and improving access to high-quality health care culture: sum total of human behavior or social characteristics particular to a specific group and passed from generation to generation or from one to another within the group culture conflict: situation that occurs when people become aware of cultural differences, feel threatened, and respond by ridiculing the beliefs and traditions of others to make themselves feel more secure about their own values culture shock: those feelings, usually negative, a person experiences when placed in a different culture ethnicity: sense of identification that a cultural group collectively has; the sharing of common and unique cultural and social beliefs and behavior patterns, including language and dialect, religious practices, literature, folklore, music, political interests, food preferences, and employment patterns ethnocentrism: belief that one's own ideas, beliefs, and practices are best, superior, or most preferred to those of others; using one's cultural norms as the standard to evaluate others' beliefs linguistic competence: ability of caregivers and organizations to understand and effectively respond to the linguistic needs of patients and their families in a health care encounter personal space: external environment surrounding a person that is regarded as being part of that person race: division of human beings based on distinct physical characteristics stereotyping: assigning characteristics to a group of people without considering specific individuality subculture: group of people with different interests or goals than the primary culture transcultural nursing: providing nursing care that is planned and implemented in a way that is sensitive to the needs of individuals, families, and groups representing the diverse cultural populations within our society

Chapter 24 Terms

aerobic: requiring oxygen to live and grow airborne transmission: spreading of microorganisms that are less than 5 mcm when an infected host coughs, sneezes, or talks, or when the organism becomes attached to dust particles anaerobic: capable of living without oxygen antibody: immunoglobin produced by the body in response to a specific antigen antigen: foreign material capable of inducing a specific immune response antimicrobial: antibacterial agent that kills bacteria or suppresses their growth asepsis: absence of disease-producing microorganisms; using methods to prevent infection bacteria: the most significant and most commonly observed infection-causing agents bundles: evidence-based best practices that have proven positive outcomes when implemented together to prevent infection colonization: presence of an organism residing in an individual's body but with no clinical signs of infection direct contact: way for organisms to enter the body that involves proximity between the susceptible host and an infected person or a carrier, such as through touching, kissing, or sexual intercourse disinfection: process used to destroy microorganisms; destroys all pathogenic organisms except spores droplet transmission: transmission of particles greater than 5 mcm endemic: something that occurs with predictability in one specific region or population and can appear in a different geographical location endogenous: infection in which the causative organism comes from microbial life harbored within the person exogenous: infection in which the causative organism is acquired from outside the host fomite: fungi: plant-like organisms (molds and yeasts) that can cause infection health care-associated infection (HAI): an infection that was not present on admission to a health care institution and develops during the course of treatment for other conditions (nosocomial) host: animal or person on or within which microorganisms live iatrogenic: infection that occurs as a result of a treatment or diagnostic procedure indirect contact: personal contact with either a vector, a living creature that transmits an infectious agent to a human, usually an insect; or an inanimate object, called a fomite, such as equipment or countertops infection: disease state resulting from pathogens in or on the body isolation: protective procedure designed to prevent the transmission of specific microorganisms; also called protective aseptic techniques and barrier techniques medical asepsis: practices designed to reduce the number and transfer of pathogens; synonym for clean technique nosocomial: something originating or taking place in the hospital (i.e., infection) parasites: organism that lives on or in a host and relies on it for nourishment pathogens: disease-producing microorganism personal protective equipment (PPE): gloves, gowns, masks, and protective eye gear designed to minimize or prevent the health care worker's exposure to infectious material reservoir: natural habitat for the growth and multiplication of microorganisms standard precautions: CDC precautions used in the care of all patients regardless of their diagnosis or possible infection status; this category combines universal and body substance precautions sterilization: (1) the process by which all microorganisms, including spores, are destroyed; (2) surgical procedure performed to render a person infertile surgical asepsis: practices that render and keep objects and areas free from microorganisms; synonym for sterile technique transmission-based precautions: CDC precautions used in patients known or suspected to be infected with pathogens that can be transmitted by airborne, droplet, or contact routes; used in addition to standard precautions vector: nonhuman carriers—such as mosquitoes, ticks, and lice—that transmit organisms from one host to another virulence: ability to produce disease virus: smallest of all microorganisms; can be seen only by using an electron microscope

Females:

0-14 days: 4.12-5.74 x 10(12)/L 15 days-4 weeks: 3.32-4.80 x 10(12)/L 5 weeks-7 weeks: 2.93-3.87 x 10(12)/L 8 weeks-5 months: 3.45-4.75 x 10(12)/L 6 months-23 months: 3.97-5.01 x 10(12)/L 24 months-35 months: 3.84-4.92 x 10(12)/L 3-5 years: 4.00-5.10 x 10(12)/L 6-10 years: 4.10-5.20 x 10(12)/L 11-14 years: 4.10-5.10 x 10(12)/L 15-17 years: 3.80-5.00 x 10(12)/L Adults: 3.92-5.13 x 10(12)/L

A nurse is counseling a 19-year-old athlete who had his right leg amputated below the knee following a motorcycle accident. During the rehabilitation process, the patient refuses to eat or get up to ambulate on his own. He says to the nurse, "What's the point. My life is over now and I'll never be the football player I dreamed of becoming." What is the nurse counselor's best response to this patient?

"I understand this is difficult for you. Would you like to talk about it now or would you prefer me to make a referral to someone else?" (This answer communicates respect and sensitivity to the patient's needs and offers an opportunity to discuss his feelings with the nurse or another health care professional. The other answers do not allow the patient to express his feelings and receive the counseling he needs.)

A nurse forms a contractual agreement with a morbidly obese patient to achieve optimal weight goals. Which statement best describes the nature of this agreement?

"This agreement will motivate the two of us to do what is necessary to meet your weight goals." (A contractual agreement is a pact two people make, setting out mutually agreed-on goals. Contracts are usually informal and not legally binding. When teaching a patient, such an agreement can help motivate both the patient and the teacher to do what is necessary to meet the patient's learning outcomes. The agreement notes the responsibilities of both the teacher and the learner, emphasizing the importance of the mutual commitment.)

A nurse is interviewing a newly admitted patient. Which question is considered culturally sensitive?

"What types of food do you eat for meals?" (Asking patients what types of foods they eat for meals is culturally sensitive. The other questions are culturally insensitive.)

Females:

0-14 days: 13.4-20.0 g/dL 15 days-4 weeks: 10.8-14.6 g/dL 5 weeks-7 weeks: 9.2-11.4 g/dL 8 weeks-5 months: 9.9-12.4 g/dL 6 months-35 months: 10.2-12.7 g/dL 3-5 years: 11.4-14.3 g/dL 6-8 years: 11.5-14.3 g/dL 9-10 years: 11.8-14.7 g/dL 11-17 years: 11.9-14.8 g/dL Adults: 11.6-15.0 g/dL

HEMOGLOBIN Males:

0-14 days: 13.9-19.1 g/dL 15 days-4 weeks: 10.0-15.3 g/dL 5 weeks-7 weeks: 8.9-12.7 g/dL 8 weeks-5 months: 9.6-12.4 g/dL 6 months-23 months: 10.1-12.5 g/dL 24 months-35 months: 10.2-12.7 g/dL 3-5 years: 11.4-14.3 g/dL 6-8 years: 11.5-14.3 g/dL 9-10 years: 11.8-14.7 g/dL 11-14 years: 12.4-15.7 g/dL 15-17 years: 13.3-16.9 g/dL Adults: 13.2-16.6 g/dL

Females:

0-14 days: 39.6-57.2% 15 days-4 weeks: 32.0-44.5% 5 weeks-7 weeks: 27.7-35.1% 8 weeks-5 months: 29.5-37.1% 6 months-23 months: 30.9-37.9% 24 months-35 months: 31.2-37.8% 3-7 years: 34-42% 8-17 years: 35-43% Adults: 35.5-44.9%

HEMATOCRIT Males:

0-14 days: 39.8-53.6% 15 days-4 weeks: 30.5-45.0% 5 weeks-7 weeks: 26.8-37.5% 8 weeks-5 months: 28.6-37.2% 6 months-23 months: 30.8-37.8% 24 months-35 months: 31.0-37.7% 3-7 years: 34-42% 8-11 years: 35-43% 12-15 years: 38-47% 16-17 years: 40-50% Adults: 38.3-48.6%

RED BLOOD CELL COUNT (RBC) Males:

0-14 days: 4.10-5.55 x 10(12)/L 15 days-4 weeks: 3.16-4.63 x 10(12)/L 5 weeks-7 weeks: 3.02-4.22 x 10(12)/L 8 weeks-5 months: 3.43-4.80 x 10(12)/L 6 months-23 months: 4.03-5.07 x 10(12)/L 24 months-35 months: 3.89-4.97 x 10(12)/L 3-5 years: 4.00-5.10 x 10(12)/L 6-10 years: 4.10-5.20 x 10(12)/L 11-14 years: 4.20-5.30 x 10(12)/L 15-17 years: 4.30-5.70 x 10(12)/L Adults: 4.35-5.65 x 10(12)/L

A nurse manager is attempting to update a health care provider's office from paper to electronic health records (EHR) by using the eight-step process for planned change. Place the following actions in the order in which they should be initiated:

1. The nurse records the time spent on written records versus EHR. 2. The nurse explores possible barriers to changing to EHR. 3. The nurse records the time spent on written records versus EHR. 4. The nurse attains approval from management for new computers. 5. The nurse devises a plan to switch to EHR. 6. The nurse installs new computers and provides an in-service for the staff. 7. The nurse evaluates the effects of changing to EHR. 8. The nurse follows up with the staff to check compliance with the new system. (Planned change involves the following steps: (1) recognize symptoms that indicate a change is needed and collect data, (2) identify a problem to be solved through change, (3) determine and analyze alternative solutions, (4) select a course of action from possible solutions, (5) plan for making the change, (6) implement the change, (7) evaluate the change, and (8) stabilize the change.)

The nurse assesses patients to determine their risk for HAIs. Which hospitalized patient would the nurse consider most at risk for developing this type of infection?

A 65-year-old patient who has an indwelling urinary catheter in place (Indwelling urinary catheters have been implicated in most HAIs. Cigarette smoking, a normal white blood cell count, and a vegetarian diet have not been implicated as risk factors for HAIs.)

A nurse caring for culturally diverse patients in a health care provider's office is aware that patients of certain cultures are more prone to specific disease states than the general population. Which patients would the nurse screen for diabetes mellitus based on the patient's race? Select all that apply.

A Native American patient An Alaska Native A White patient A Hispanic patient (Native Americans, Alaska Natives, Hispanics, and Whites are more prone to developing diabetes mellitus. African Americans are prone to hypertension, stroke, sickle cell anemia, lactose intolerance, and keloids. Asians are prone to hypertension, liver cancer, thalassemia, and lactose intolerance.)

In order to provide culturally competent care, nurses must be alert to factors inhibiting sensitivity to diversity in the health care system. Which nursing actions are examples of cultural imposition? Select all that apply.

A hospital nurse tells a nurse's aide that patients should not be given a choice whether or not to shower or bathe daily. A Catholic nurse insists that a patient diagnosed with terminal bladder cancer see the chaplain in residence. (Cultural imposition occurs when a hospital nurse tells a nurse's aide that patients should not be given a choice whether or not to shower or bathe daily, and when a Catholic nurse insists that a patient diagnosed with terminal bladder cancer see the chaplain in residence. Cultural blindness occurs when a nurse treats all patients the same whether or not they come from a different culture. Culture conflict occurs when a nurse ridicules a patient by telling another nurse that Jewish diet restrictions are just a way for Jewish patients to get a special tray of their favorite foods. When a nurse refuses to respect an older adult's ability to speak for himself or herself, or if the nurse refuses to treat a patient based on that patient's sexual orientation, the nurse is engaging in stereotyping.)

Despite a national focus on health promotion, nurses working with patients in inner-city clinics continue to see disparities in health care for vulnerable populations. Which patients are considered vulnerable populations? Select all that apply.

An African American teenager who is 6 months pregnant A Hispanic male who has type II diabetes A low-income family living in rural America A White baby who was born with cerebral palsy (National trends in the prevention of health disparities are focused on vulnerable populations, such as racial and ethnic minorities, those living in poverty, women, children, older adults, rural and inner-city residents, and people with disabilities and special health care needs.)

A nurse is removing rigid gas-permeable (RGP) contact lenses from the eyes of a patient who is unable to assist with removal. The nurse notices that one of the lenses is not centered over the cornea. What would be the nurse's first action in this procedure?

Apply gentle pressure on the lower eyelid to center the lens prior to removing it. (If the lens is not centered over the cornea, the nurse should apply gentle pressure on the lower eyelid to center the lens, gently pull the outer corner of the eye toward the ear, position the hand below the lens to receive it, and ask the patient to blink. Moving the eyelids toward one another to cause the lens to slide out between the eyelids is a later step in the procedure. Having the patient look forward, retracting the lower lid and moving the lens down on the sclera occurs during removal of soft contact lenses. It is not necessary to call in an eyecare specialist unless there is damage to the eye.)

A young Hispanic mother comes to the local clinic because her baby is sick. She speaks only Spanish and the nurse speaks only English. What is the appropriate nursing intervention?

Ask an interpreter for help. (The nurse should ask an interpreter for help. Many facilities have a qualified interpreter who understands the health care system and can reliably provide assistance. Using short words, talking loudly, and providing instructions in writing will not help the nurse communicate with this patient. Explaining why care can't be provided is not an acceptable choice because the nurse is required to provide care; also, since the patient doesn't speak English, she won't understand what the nurse is saying.)

A nurse is assisting an older adult with an unsteady gait with a tub bath. Which action is recommended in this procedure?

Assist the patient in and out of the tub to prevent falling. (Safe nursing practice requires that the nurse assist a patient with an unsteady gait in and out of the tub. Adding Alpha Keri oil to the bath water is dangerous for this patient because it makes the tub slippery. Although privacy is important, if the patient locks the door, the nurse cannot help if there is an emergency. The water should be comfortably warm at 43° to 46°C. Older adults have an increased susceptibility to burns due to diminished sensitivity.)

A nurse is providing foot care for patients in a long-term care facility. Which actions are recommended guidelines for this procedure? Select all that apply.

Bathe the feet thoroughly in a mild soap and tepid water solution. Dry feet thoroughly, including the area between the toes. Use an antifungal foot powder if necessary to prevent fungal infections. (The following are recommended guidelines for foot care: bathe the feet thoroughly in a mild soap and tepid water solution; dry feet thoroughly, including the area between the toes; and use an antifungal foot powder if necessary to prevent fungal infections. The nurse should avoid soaking the feet, use moisturizer if the feet are dry, and avoid digging into or cutting the toenails at the lateral corners when trimming the nails.)

The nurse caring for families in a free health care clinic identifies psychosocial risk factors for altered family health. Which example describes one of these risk factors?

Both parents work and leave a 12-year-old child to care for his younger brother. (Inadequate childcare resources is a psychosocial risk factor. Not having access to dental care and obese family members are lifestyle risk factors. Having a family member with birth defects is a biologic risk factor.)

A nurse working in a long-term care facility personally follows accepted guidelines for a healthy lifestyle. How does this nurse promote health in the residents of this facility?

By being a role model for healthy behaviors (Good personal health enables the nurse to serve as a role model for patients and families.)

A nurse has taught a patient with diabetes how to administer his daily insulin. How should the nurse evaluate the teaching-learning process?

By deciding if the learning outcomes have been achieved (The nurse cannot assume that the patient has actually learned the content unless there is some type of proof of learning. The key to evaluation is meeting the learner outcomes stated in the teaching plan.)

A patient has an eye infection with a moderate amount of discharge. Which action is an appropriate step for the nurse to perform when cleaning this patient's eyes?

Cleanse the eye using a different section of the cleaning cloth for each stroke until clean. (When cleaning the eyes, the nurse should wear gloves during the cleaning procedure, use water or normal saline, and a clean washcloth or compress to clean the eyes. The nurse should dampen a cleaning cloth with the solution of choice and wipe once while moving from the inner canthus to the outer canthus of the eye. This technique minimizes the risk for forcing debris into the area drained by the nasolacrimal duct. The nurse should turn the cleaning cloth and use a different section for each stroke until the eye is clean.)

Nurses performing skin assessments on patients must pay careful attention to cleanliness, color, texture, temperature, turgor, moisture, sensation, vascularity, and lesions. Which guidelines should nurses follow when performing these assessments? Select all that apply.

Compare bilateral parts for symmetry. Use standard terminology to report and record findings. Perform the appropriate skin assessment when risk factors are identified. (When performing a skin assessment, the nurse should compare bilateral parts for symmetry, use standard terminology to report and record findings, and perform the appropriate skin assessment when risk factors are identified. The nurse should proceed in a head-to-toe systematic manner, and allow data from the nursing history to direct the assessment. When documenting a physical assessment of the skin, the nurse should describe exactly what is observed or palpated, including appearance, texture, size, location or distribution, and characteristics of any findings)

The nurse has opened the sterile supplies and put on two sterile gloves to complete a sterile dressing change, a procedure that requires surgical asepsis. Which action by the nurse is appropriate?

Consider the outer 1 in of the sterile field as contaminated (Considering the outer inch of a sterile field as contaminated is a principle of surgical asepsis. Moisture such as from splashes contaminates the sterile field, and sneezing would contaminate the sterile gloves. Forceps soaked in disinfectant are not considered sterile.)

A nurse is assisting a patient with dementia with bathing. Which guideline is recommended in this procedure?

Consider using music to soothe anxiety and agitation. (The nurse should consider the use of music to soothe anxiety and agitation. The nurse should also shift the focus of the interaction from the "task of bathing" to the needs and abilities of the patient, and focus on comfort, safety, autonomy, and self-esteem, in addition to cleanliness. The nurse should wash the face and hair at the end of the bath or at a separate time. Water dripping in the face and having a wet head are often the most upsetting parts of the bathing process for people with dementia. The nurse should also consider other methods for bathing. Showers and tub baths are not the only options in bathing. Towel baths, washing under clothes, and bathing "body sections" one day at a time are other possible options.)

A nurse incorporates concepts from current models of health when providing health promotion classes for patients. What is a key concept of both the health-illness continuum and the high-level wellness models?

Health as a constantly changing state (Both these models view health as a dynamic (constantly changing state).)

When conducting quantitative research, the researcher collects information to support a hypothesis. This information would be identified as:

Data (Data refer to information that the researcher collects from subjects in the study (expressed in numbers). A variable is something that varies and has different values that can be measured. Instruments are devices used to collect and record the data, such as rating scales, pencil-and-paper tests, and biologic measurements.)

A nurse working in a hospital setting cares for patients with acute and chronic conditions. Which disease states are chronic illnesses? Select all that apply.

Diabetes mellitus Rheumatoid arthritis Cystic fibrosis (Diabetes, arthritis, and cystic fibrosis are chronic diseases because they are permanent changes caused by irreversible alterations in normal anatomy and physiology, and they require patient education along with a long period of care or support. Pneumonia, fractures, and otitis media are acute illnesses because they have a rapid onset of symptoms that last a relatively short time.)

A nurse uses Maslow's hierarchy of basic human needs to direct care for patients on an intensive care unit. For which nursing activities is this approach most useful?

Establishing priorities of care (Maslow's hierarchy of basic human needs is useful for establishing priorities of care.)

A nurse studies the culture of Native Alaskans to determine how their diet affects their overall state of health. Which method of qualitative research is the nurse using?

Ethnography (Ethnographic research was developed by the discipline of anthropology and is used to examine issues of culture of interest to nursing. Historical research examines events of the past to increase understanding of the nursing profession today. The basis of grounded theory methodology is the discovery of how people describe their own reality and how their beliefs are related to their actions in a social scene. The purpose of phenomenology (both a philosophy and a research method) is to describe experiences as they are lived by the subjects being studied.)

A nurse manager who is attempting to institute the SBAR process to communicate with health care providers and transfer patient information to other nurses is meeting staff resistance to the change. Which action would be most effective in approaching this resistance?

Explaining the change and listing the advantages to the person and the organization (Change is ubiquitous, as is resistance to change. The manager should explain the proposed change to all affected, list the advantages of the proposed change for all parties, introduce the change gradually, and involve everyone affected by the change in the design and implementation of the process. The manager should not use the reward/punishment style to overcome resistance to change.)

A nurse is formulating a clinical question in PICOT format. What does the letter P represent?

Explicit descriptions of the population of interest (The P in the PICOT format represents an explicit description of the patient population of interest. I represents the intervention, C represents the comparison, O stands for the outcome, and T stands for the time.)

Dosage Calculations

Figuring IV Flow Rate, Infusion Time, and Total Volume Whenever you're administering intravenous (IV) infusions, you need to know the flow rate, infusion time, and total volume. Fortunately, calculating any one of these three variables is easy to do when you know the other two variables. Use the following equations: flow rate (mL/hr) = total volume (mL) ÷ infusion time (hr) infusion time (hr) = total volume (mL) ÷ flow rate (mL/hr) total volume (mL) = flow rate (mL/hr) × infusion time (hr) For example, if you must administer 1 L (1,000 mL) of fluid over 4 hours, use the first formula to calculate the flow rate, like so: flow rate (mL/hr) = total volume (mL) ÷ infusion time (hr) flow rate (mL/hr) = 1,000 ÷ 4 flow rate (mL/hr) = 250 The flow rate is 250 mL/hr. Converting lb to kg and kg to lb lb = kg × 2.2 kg = lb ÷ 2.2 Converting mL to L and L to mL mL = L × 1,000 L = mL ÷ 1,000 Converting mg to g, g to mg, mg to mcg, and mcg to mg mg = g × 1,000 g = mg ÷ 1,000 mcg = mg × 1,000

Nurses today complete a nursing education program, and practice nursing that identifies the personal needs of the patient and the role of the nurse in meeting those needs. Which nursing pioneer is MOST instrumental in this birth of modern nursing?

Florence Nightingale- elevated the status of nursing to a respected occupation, improved the quality of nursing care, and founded modern nursing education. Clara Barton established the Red Cross in the United States in 1882. Lillian Wald was the founder of public health nursing. Lavinia Dock was a nursing leader and women's rights activist instrumental in establishing women's right to vote.

A nurse is teaching a student nurse how to cleanse the perineal area of both male and female patients. What are accurate guidelines when performing this procedure? Select all that apply.

For male and female patients, wash the groin area with a small amount of soap and water and rinse. For male and female patients, use a clean portion of the washcloth for each stroke. For a male patient, clean the tip of the penis first, moving the washcloth in a circular motion from the meatus outward. (Wash and rinse the groin area (both male and female patients) with a small amount of soap and water, and rinse. For male and female patients, always proceed from the least contaminated area to the most contaminated area and use a clean portion of the washcloth for each stroke. For a male patient, clean the tip of the penis first, moving the washcloth in a circular motion from the meatus outward. For a female patient, spread the labia and move the washcloth from the pubic area toward the anal area. In an uncircumcised male patient (teenage or older), retract the foreskin (prepuce) while washing the penis.)

A nurse is using the ESFT model to understand a patient's conception of a diagnosis of chronic obstructive pulmonary disease (COPD). Which interview question would be MOST appropriate to assess the E aspect of this model—Explanatory model of health and illness?

How does having COPD affect your lifestyle? (The ESFT model guides providers in understanding a patient's explanatory model (a patient's conception of her or his illness), social and environmental factors, and fears and concerns, and also guides providers in contracting for therapeutic approaches. Asking the questions: "How does having COPD affect your lifestyle?" explores the explanatory model, "How do you get your medications?" refers to the social and environmental factor, "Are you concerned about the side effects of your medications?" addresses fears and concerns, and "Can you describe how you will take your medications?" involves therapeutic contracting.)

A nurse is performing oral care on a patient who is in traction. The nurse notes that the mouth is extremely dry with crusts remaining after the oral care. What should be the nurse's next action?

Increase the frequency of the oral hygiene and apply mouth moisturizer to oral mucosa. (If the mouth is extremely dry with crusts that remain after oral care provided, the nurse should increase frequency of oral hygiene, apply mouth moisturizer to oral mucosa, and monitor fluid intake and output to ensure adequate intake of fluid. It is not necessary to report this condition prior to providing the interventions mentioned above. The crusts should not be scraped with a tongue depressor.)

A nurse is practicing community-based nursing in a mobile health clinic. What typically is the central focus of this type of nursing care?

Individual and family health care needs (In contrast to community health nursing, which focuses on populations within a community, community-based nursing is centered on individual and family health care needs. Community-based nurses may help families in crisis and work in health care facilities, but these are not the focus of community-based nursing.)

A nurse is caring for an obese 62-year-old patient with arthritis who has developed an open reddened area over his sacrum. What risk factor would be a priority concern for the nurse when caring for this patient?

Infection (The priority risk factor in this situation is the possibility of an infection developing in the open skin area. The other risk factors may be potential problems for this patient and may also require nursing interventions after the first diagnosis is addressed.)

A visiting nurse working in a new community performs a community assessment. What assessment finding is indicative of a healthy community?

It offers access to health care services (A healthy community offers access to health care services to treat illness and to promote health. A healthy community does not usually meet all the needs of its residents, but should be able to help with health issues such as nutrition, education, recreation, safety, and zoning regulations to separate residential sections from industrial ones. The age of housing is irrelevant as long as residences are maintained properly according to code.)

A nurse caring for patients in a critical care unit knows that providing good oral hygiene is an essential part of nursing care. What are some of the benefits of providing this care? Select all that apply.

It promotes the patient's sense of well-being. It prevents deterioration of the oral cavity. It contributes to decreased incidence of aspiration pneumonia. (Adequate oral hygiene is essential for promoting the patient's sense of well-being and preventing deterioration of the oral cavity. Diligent oral hygiene care can also improve oral health and limit the growth of pathogens in oropharyngeal secretions, decreasing the incidence of aspiration pneumonia and other systemic diseases. Oral care does not eliminate the need for flossing, decrease oropharyngeal secretions, or compensate for poor nutrition.)

CBC (complete blood count)

MEAN CORPUSCULAR VOLUME (MCV) Males: 0-14 days: 91.3-103.1 fL 15 days-4 weeks: 89.4-99.7 fL 5 weeks-7 weeks: 84.3-94.2 fL 8 weeks-5 months: 74.1-87.5 fL 6 months-23 months: 69.5-81.7 fL 24 months-35 months: 71.3-84.0 fL 3-5 years: 77.2-89.5 fL 6-11 years: 77.8-91.1 fL 12-14 years: 79.9-93.0 fL 15-17 years: 82.5-98.0 fL Adults: 78.2-97.9 fL Females: 0-14 days: 92.7-106.4 fL 15 days-4 weeks: 90.1-103.0 fL 5 weeks-7 weeks: 83.4-96.4 fL 8 weeks-5 months: 74.8-88.3 fL 6 months-23 months: 71.3-82.6 fL 24 months-35 months: 72.3-85.0 fL 3-5 years: 77.2-89.5 fL 6-11 years: 77.8-91.1 fL 12-14 years: 79.9-93.0 fL 15-17 years: 82.5-98.0 fL Adults: 78.2-97.9 3 fL RED CELL DISTRIBUTION WIDTH (RDW) Males: 0-14 days: 14.8-17.0% 15 days-4 weeks: 14.3-16.8% 5 weeks-7 weeks: 13.8-16.1% 8 weeks-5 months: 12.4-15.3% 6 months-23 months: 12.9-15.6% 24 months-35 months: 12.5-14.9% 3-5 years: 11.3-13.4% 6-17 years: 11.4-13.5% Adults: 11.8-14.5% Females: 0-14 days: 14.6-17.3% 15 days-4 weeks: 14.4-16.2% 5 weeks-7 weeks: 13.6-15.8% 8 weeks-5 months: 12.2-14.3% 6 months-23 months: 12.7-15.1% 24 months-35 months: 12.4-14.9% 3-5 years: 11.3-13.4% 6-17 years: 11.4-13.5% Adults: 12.2-16.1% WHITE BLOOD CELL COUNT (WBC) Males: 0-14 days: 8.0-15.4 x 10(9)/L 15 days-4 weeks: 7.8-15.9 x 10(9)/L 5 weeks-7 weeks: 8.1-15.0 x 10(9)/L 8 weeks-5 months: 6.5-13.3 x 10(9)/L 6 months-23 months: 6.0-13.5 x 10(9)/L 24 months-35 months: 5.1-13.4 x 10(9)/L 3-5 years: 4.4-12.9 x 10(9)/L 6-17 years: 3.8-10.4 x 10(9)/L Adults: 3.4-9.6 x 10(9)/L Females: 0-14 days: 8.2-14.6 x 10(9)/L 15 days-4 weeks: 8.4-14.4 x 10(9)/L 5 weeks-7 weeks: 7.1-14.7 x 10(9)/L 8 weeks-5 months: 6.0-13.3 x 10(9)/L 6 months-23 months: 6.5-13.0 x 10(9)/L 24 months-35 months: 4.9-13.2 x 10(9)/L 3-5 years: 4.4-12.9 x 10(9)/L 6-17 years: 3.8-10.4 x 10(9)/L Adults: 3.4-9.6 x 10(9)/L PLATELETS Males: 0-14 days: 218-419 x 10(9)/L 15 days-4 weeks: 248-586 x 10(9)/L 5 weeks-7 weeks: 229-562 x 10(9)/L 8 weeks-5 months: 244-529 x 10(9)/L 6 months-23 months: 206-445 x 10(9)/L 24 months-35 months: 202-403 x 10(9)/L 3-5 years: 187-445 x 10(9)/L 6-9 years: 187-400 x 10(9)/L 10-13 years: 177-381 x 10(9)/L 14-17 years: 139-320 x 10(9)/L Adults: 135-317 x 10(9)/L Females: 0-14 days: 144-449 x 10(9)/L 15 days-4 weeks: 279-571 x 10(9)/L 5 weeks-7 weeks: 331-597 x 10(9)/L 8 weeks-5 months: 247-580 x 10(9)/L 6 months-23 months: 214-459 x 10(9)/L 24 months-35 months: 189-394 x 10(9)/L 3-5 years: 187-445 x 10(9)/L 6-9 years: 187-400 x 10(9)/L 10-13 years: 177-381 x 10(9)/L 14-17 years: 158-362 x 10(9)/L Adults: 157-371 x 10(9)/L NEUTROPHILS Males: 0-14 days: 1.60-6.06 x 10(9)/L 15 days-4 weeks: 1.18-5.45 x 10(9)/L 5 weeks-7 weeks: 0.83-4.23 x 10(9)/L 8 weeks-5 months: 0.97-5.45 x 10(9)/L 6 months-23 months: 1.19-7.21 x 10(9)/L 24 months-35 months: 1.54-7.92 x 10(9)/L 3-5 years: 1.60-7.80 x 10(9)/L 6-16 years: 1.40-6.10 x 10(9)/L 17 years: 1.80-7.20 x 10(9)/L Adults: 1.56-6.45 x 10(9)/L Females: 0-14 days: 1.73-6.75 x 10(9)/L 15 days-4 weeks: 1.23-4.80 x 10(9)/L 5 weeks-7 weeks: 1.00-4.68 x 10(9)/L 8 weeks-5 months: 1.04-7.20 x 10(9)/L 6 months-23 months: 1.27-7.18 x 10(9)/L 24 months-35 months: 1.60-8.29 x 10(9)/L 3-5 years: 1.60-7.80 x 10(9)/L 6-14 years: 1.50-6.50 x 10(9)/L 15-17 years: 2.00-7.40 x 10(9)/L Adults: 1.56-6.45 x 10(9)/L LYMPHOCYTES Males: 0-14 days: 2.07-7.53 x 10(9)/L 15 days-4 weeks: 2.11-8.38 x 10(9)/L 5 weeks-7 weeks: 2.47-7.95 x 10(9)/L 8 weeks-5 months: 2.45-8.89 x 10(9)/L 6 months-23 months: 1.56-7.83 x 10(9)/L 24 months-35 months: 1.13-5.52 x 10(9)/L 3-5 years: 1.60-5.30 x 10(9)/L 6-11 years: 1.40-3.90 x 10(9)/L 12-17 years: 1.00-3.20 x 10(9)/L Adults: 0.95-3.07 x 10(9)/L Females: 0-14 days: 1.75-8.00 x 10(9)/L 15 days-4 weeks: 2.42-8.20 x 10(9)/L 5 weeks-7 weeks: 2.29-9.14 x 10(9)/L 8 weeks-5 months: 2.14-8.99 x 10(9)/L 6 months-23 months: 1.52-8.09 x 10(9)/L 24 months-35 months: 1.25-5.77 x 10(9)/L 3-5 years: 1.60-5.30 x 10(9)/L 6-11 years: 1.40-3.90 x 10(9)/L 12-17 years: 1.00-3.20 x 10(9)/L Adults: 0.95-3.07 x 10(9)/L MONOCYTES Males: 0-14 days: 0.52-1.77 x 10(9)/L 15 days-4 weeks: 0.28-1.38 x 10(9)/L 5 weeks-7 weeks: 0.28-1.05 x 10(9)/L 8 weeks-5 months: 0.28-1.07 x 10(9)/L 6 months-23 months: 0.25-1.15 x 10(9)/L 24 months-35 months: 0.19-0.94 x 10(9)/L 3-5 years: 0.30-0.90 x 10(9)/L 6-17 years: 0.20-0.80 x 10(9)/L Adults: 0.26-0.81 x 10(9)/L Females: 0-14 days: 0.57-1.72 x 10(9)/L 15 days-4 weeks: 0.42-1.21 x 10(9)/L 5 weeks-7 weeks: 0.28-1.21 x 10(9)/L 8 weeks-5 months: 0.24-1.17 x 10(9)/L 6 months-23 months: 0.26-1.08 x 10(9)/L 24 months-35 months: 0.24-0.92 x 10(9)/L 3-5 years: 0.30-0.90 x 10(9)/L 6-17 years: 0.20-0.80 x 10(9)/L Adults: 0.26-0.81 x 10(9)/L EOSINOPHILS Males: 0-14 days: 0.12-0.66 x 10(9)/L 15 days-4 weeks: 0.08-0.80 x 10(9)/L 5 weeks-7 weeks: 0.05-0.57 x 10(9)/L 8 weeks-5 months: 0.03-0.61 x 10(9)/L 6 months-23 months: 0.02-0.82 x 10(9)/L 24 months-35 months: 0.03-0.53 x 10(9)/L 3-11 years: 0.00-0.50 x 10(9)/L 12-17 years: 0.10-0.20 x 10(9)/L Adults: 0.03-0.48 x 10(9)/L Females: 0-14 days: 0.09-0.64 x 10(9)/L 15 days-4 weeks: 0.06-0.75 x 10(9)/L 5 weeks-7 weeks: 0.04-0.63 x 10(9)/L 8 weeks-5 months: 0.02-0.74 x 10(9)/L 6 months-23 months: 0.02-0.58 x 10(9)/L 24 months-35 months: 0.03-0.46 x 10(9)/L 3-11 years: 0.00-0.50 x 10(9)/L 12-17 years: 0.10-0.20 x 10(9)/L Adults: 0.03-0.48 x 10(9)/L BASOPHILS Males: 0-14 days: 0.02-0.11 x 10(9)/L 15 days-7 weeks: 0.01-0.07 x 10(9)/L 8 weeks-35 months: 0.01-0.06 x 10(9)/L 3-17 years: 0.00-0.10 x 10(9)/L Adults: 0.01-0.08 x 10(9)/L Females: 0-14 days: 0.02-0.07 x 10(9)/L 15 days-4 weeks: 0.01-0.06 x 10(9)/L 5 weeks-7 weeks: 0.01-0.05 x 10(9)/L 8 weeks-5 months: 0.01-0.07 x 10(9)/L 6 months-35 months: 0.01-0.06 x 10(9)/L 3-17 years: 0.00-0.10 x 10(9)/L Adults: 0.01-0.08 x 10(9)/L

A nurse is practicing as a nurse-midwife in a busy OB-GYN office. Which degree in nursing is necessary to practice at this level?

MSN (Master Degree) (A master's degree (MSN) prepares advanced practice nurses. Many master's graduates gain national certification in their specialty area, for example, as family nurse practitioners (FNPs) or nurse midwives.)

A nurse instructor outlines the criteria establishing nursing as a profession. What teaching point correctly describes this criteria? Select all that apply.

Nursing is a recognized authority by a professional group Nursing has a code of ethics Nursing is influenced by ongoing research (Nursing is recognized increasingly as a profession based on the following defining criteria: well-defined body of specific and unique knowledge, strong service orientation, recognized authority by a professional group, code of ethics, professional organization that sets standards, ongoing research, and autonomy and self-regulation.)

According to the National Advisory Council on Nurse Education and Practice, what is a current health care trend contributing to 21st century challenges to nursing practice?

Older and more acutely ill patients (The National Advisory Council on Nurse Education and Practice identifies the following critical challenges to nursing practice in the 21st century: A growing population of hospitalized patients who are older and more acutely ill, increasing health care costs, and the need to stay current with rapid advances in medical knowledge and technology.)

A nurse is caring for patients of diverse cultures in a community health care facility. Which characteristics of cultural diversity that exist in the United States should the nurse consider when planning culturally competent care? Select all that apply.

People may be members of multiple cultural groups at one time. Culture guides what is acceptable behavior for people in a specific group. Cultural practices may evolve over time but mainly remain constant. (A person may be a member of multiple cultural, ethnic, and racial groups at one time. Culture guides what is acceptable behavior for people in a specific group. Cultural practices and beliefs may evolve over time, but they mainly remain constant as long as they satisfy a group's needs. The United States has become more (not less) inclusive of same-sex couples. The definition of cultural diversity includes, but is not limited to, people of varying cultures, racial and ethnic origin, religion, language, physical size, biological sex, sexual orientation, age, disability, socioeconomic status, occupational status, and geographic location. Cultural diversity, including culture, ethnicity, and race, is an integral component of both health and illness.)

A student nurse interacting with patients on a cardiac unit recognizes the four concepts in nursing theory that determine nursing practice. Of these four, which is most important?

Person (Of the four concepts, the most important is the person. The focus of nursing, regardless of definition or theory, is the person.)

A nurse has volunteered to give influenza immunizations at a local clinic. What level of care is the nurse demonstrating?

Primary (Giving influenza injections is an example of primary health promotion and illness prevention.)

A school nurse is performing an assessment of a student who states, "I'm too tired to keep my head up in class." The student has a low-grade fever. The nurse would interpret these findings as indicating which stage of infection?

Prodromal stage (During the prodromal stage, the person has vague signs and symptoms, such as fatigue and a low-grade fever. There are no obvious symptoms of infection during the incubation period, and they are more specific during the full stage of illness before disappearing by the convalescent period.)

A new nurse manager at a small hospital is interested in achieving Magnet status. Which action would help the hospital to achieve this goal?

Promoting self-governance at the unit level (Magnet hospitals use a decentralized decision-making process, self-governance at the unit level, and respect for and acknowledgment of professional autonomy. In Magnet hospitals, 14 characteristics, the Forces of Magnetism, have been recognized that identify quality patient care, excellent nursing care, and innovations in professional nursing practice.)

A nurse is caring for a 25-year-old male patient who is comatose following a head injury. The patient has several piercings in his ears and nose. The piercing in his nose appears to be new and is crusted and slightly inflamed. Which action would be appropriate when caring for this patient's piercings?

Rinse the sites with warm water and remove crusts with a cotton swab. (When providing care for piercings, the nurse should perform hand hygiene and put on gloves, then cleanse the site of all crusts and debris by rinsing the site with warm water, removing the crusts with a cotton swab. The nurse should then apply a dab of liquid-medicated cleanser to the area, turn the jewelry back and forth to work the cleanser around the opening, rinse well, remove gloves, and perform hand hygiene. The nurse should not use alcohol, peroxide, or ointments at the site or remove the piercings unless it is absolutely necessary (e.g., when an MRI is ordered.)

The nurse uses the agent-host-environment model of health and illness to assess diseases in patients. This model is based on what concept?

Risk factors (The interaction of the agent, host, and environment creates risk factors that increase the probability of disease.)

The nurse caring for patients postoperatively uses careful hand hygiene and sterile techniques when handling patients. Which of Maslow's basic human needs is being met by this nurse?

Safety and security (By carrying out careful hand hygiene and using sterile technique, nurses provide safety from infection. An example of a physiologic need is clearing a patient's airway. Self-esteem needs may be met by allowing an older adult to talk about a past career. An example of helping meet a love and belonging need is contacting a hospitalized patient's family to arrange a visit.)

A nurse is caring for a patient in the ICU who is being monitored for a possible cerebral aneurysm following a loss of consciousness in the emergency department (ED). The nurse anticipates preparing the patient for ordered diagnostic tests. What aspect of nursing does this nurse's knowledge of the diagnostic procedures reflect?

Science of nursing - the knowledge base for care that is provided. In contrast, the skilled application of that knowledge is the art of nursing. Providing holistic care to patients based on the science of nursing is considered the art of nursing.

A nurse is caring for a patient who is admitted to the hospital with injuries sustained in a motor vehicle accident. While he is in the hospital, his wife tells him that the bottom level of their house flooded, damaging their belongings. When the nurse enters his room, she notes that the patient is visibly upset. The nurse is aware that the patient will most likely be in need of which type of counseling?

Short-term situational (Short-term counseling might be used during a situational crisis, which occurs when a patient faces an event or situation that causes a disruption in life, such as a flood. Long-term counseling extends over a prolonged period; a patient experiencing a developmental crisis, for example, might need long-term counseling. Motivational interviewing is an evidence-based counseling approach that involves discussing feelings and incentives with the patient. A caring nurse can motivate patients to become interested in promoting their own health.)

A nurse manager of a busy cardiac unit observes disagreements between the RNs and the LPNs related to schedules and nursing responsibilities. At a staff meeting, the manager compliments all the nurses on a job well done and points out that expected goals and outcomes for the month have been met. The nurse concludes the meeting without addressing the disagreements between the two groups of nurses. Which conflict resolution strategy is being employed by this manager?

Smoothing (The manager who resolves conflict by complimenting the parties involved and focusing on agreement rather than disagreement is using smoothing to reduce the emotion in the conflict. The original conflict is rarely resolved with this technique. Collaborating is a joint effort to resolve the conflict with a win-win solution. All parties set aside previously determined goals, determine a priority common goal, and accept mutual responsibility for achieving this goal. Competing results in a win for one party at the expense of the other group. Compromising occurs when both parties relinquish something of equal value.)

A nurse is following the principles of medical asepsis when performing patient care in a hospital setting. Which nursing action performed by the nurse follows these recommended guidelines?

The nurse moves the patient table away from the nurse's body when wiping it off after a meal (According to the principles of medical asepsis, the nurse should move equipment away from the body when brushing, scrubbing, or dusting articles to prevent contaminated particles from settling on the hair, face, or uniform. The nurse should carry soiled items away from the body to prevent them from touching the clothing. The nurse should not put soiled items on the floor, as it is highly contaminated. The nurse should also clean the least soiled areas first and then move to the more soiled ones to prevent having the cleaner areas soiled by the dirtier areas.)

A registered nurse assumes the role of nurse coach to provide teaching to patients who are recovering from a stroke. Which nursing intervention directly relates to this role?

The nurse uses discovery to identify the patients' personal goals and create an agenda that will result in change. (A nurse coach establishes a partnership with a patient and, using discovery, facilitates the identification of the patient's personal goals and agenda to lead to change rather than using teaching and education strategies with the nurse as the expert. A nurse coach explores the patient's readiness for coaching, designs the structure of a coaching session, supports the achievement of the patient's desired goals, and with the patient determines how to evaluate the attainment of patient goals.)

The role of nurses in today's society was influenced by the nurse's role in early civilization. Which statement best portrays this earlier role?

The nurse was the mother who cared for her family during sickness by using herbal remedies. This nurturing and caring role of the nurse has continued to the present. At the beginning of the 16th century, the shortage of nurses led to the recruitment of women who had committed crimes to provide nursing care instead of going to jail. In the early Christian period, women called deaconesses made the first organized visits to sick people, and members of male religious orders gave nursing care and buried the dead. The influences of Florence Nightingale were apparent from the middle of the 19th century to the 20th century; one of her accomplishments was identifying the personal needs of the patient and the nurse's role in meeting those needs.

A nurse is using personal protective equipment (PPE) when bathing a patient diagnosed with C. difficile infection. Which nursing action related to this activity promotes safe, effective patient care?

The nurse works from "clean" areas to "dirty" areas during bath (When using PPE, the nurse should work from "clean" areas to "dirty" ones, put on PPE before entering the patient room, always use goggles instead of personal glasses, and remove PPE in the doorway or anteroom just before exiting.)

A nurse caring for patients in a long-term care facility uses available resources to help patients achieve Maslow's highest level of needs: self-actualization needs. Which statements accurately describe these needs? Select all that apply.

The self-actualization process continues throughout life. A person achieves self-actualization by focusing on problems outside self. Self-actualization needs may be met by creatively solving problems. (Self-actualization, or reaching one's full potential, is a process that continues throughout life. A person achieves self-actualization by focusing on problems outside oneself and using creativity as a guideline for solving problems and pursuing interests. Humans are not born with a fully developed sense of self-actualization, and self-actualization needs are not met specifically by depending on others for help. Loneliness and isolation are not always the result of unmet self-actualization needs.)

A nurse teaches a patient at home to use clean technique when changing a wound dressing. What would be a consideration when preparing this teaching plan?

The use of clean technique is safe for the home setting (In the home setting, where the patient's environment is more controlled, medical asepsis is usually recommended, with the exception of self-injection. This is the appropriate procedure for the home and is not a personal preference or a negligent action.)

A nurse is about to bathe a female patient who has an intravenous access in place in her forearm. The patient's gown, which does not have snaps on the sleeves, needs to be removed prior to bathing. What is the appropriate nursing action?

Thread the bag and tubing through the gown sleeve, keeping the line intact. (Threading the bag and tubing through the gown sleeve keep the system intact. Opening an IV line, even temporarily, causes a break in a sterile system and introduces the potential for infection. Cutting a gown is not an alternative except in an emergency.)

A nurse is finished with patient care. How would the nurse remove PPE when leaving the room?

Untie gown waist strings, remove gloves, goggles, gown, mask; perform hand hygiene (If an impervious gown has been tied in front of the body at the waist, the nurse should untie the waist strings before removing gloves. Gloves are always removed first because they are most likely to be contaminated, followed by the goggles, gown, and mask, and hands should be washed thoroughly after the equipment has been removed and before leaving the room.)

A nurse assisting with a patient bed bath observes that an older female adult has dry skin. The patient states that her skin is always "itchy." Which nursing action would be the nurse's best response?

Use an emollient on the dry skin. (An emollient soothes dry skin, whereas frequent bathing increases dryness, as does alcohol. Discouraging fluid intake leads to dehydration and, subsequently, dry skin.)

A nurse who is caring for a patient diagnosed with HIV/AIDS incurs a needlestick injury when administering the patient's medications. What would be the first action of the nurse following the exposure?

Wash the exposed area with warm water and soap (When a needlestick injury occurs, the nurse should wash the exposed area immediately with warm water and soap, report the incident to the appropriate person and complete an incident injury report, consent to and await the results of blood tests, consent to PEP, and attend counseling sessions regarding safe practice to protect self and others.)

A nurse is caring for an adolescent with severe acne. Which recommendations would be most appropriate to include in the teaching plan for this patient? Select all that apply.

Wash the skin twice a day with a mild cleanser and warm water. Keep hair off the face and wash hair daily. Avoid sun-tanning booth exposure and use sunscreen. (Washing the skin removes oil and debris, hair should be kept off the face and washed daily to keep oil from the hair off the face, and sunbathing should be avoided when using acne treatments. Liberal use of cosmetics and emollients can clog the pores. Squeezing blackheads is always discouraged because it may lead to infection.)

A nurse is performing hand hygiene after providing patient care. The nurse's hands are not visibly soiled. Which steps in this procedure are performed correctly? Select all that apply.

Washes hands to 1 in above the wrists Uses approximately one teaspoon of liquid soap Uses friction motion when washing for at least 20 seconds Rinses thoroughly with water flowing toward fingertips (Proper hand hygiene includes removing jewelry (with the exception of a plain wedding band), wetting the hands and wrist area with the hands lower than the elbows, using about one teaspoon of liquid soap, using friction motion for at least 20 seconds, washing to 1 in above the wrists with a friction motion for at least 20 seconds, and rinsing thoroughly with water flowing toward fingertips.)

Chapter 3 Terms

acute illness: rapidly occurring illness that runs its course, allowing a person to return to one's previous level of functioning chronic illness: irreversible illness that causes permanent physical impairment and requires long-term health care disease: pathologic change in the structure or function of the body or mind exacerbation: period in chronic illness when the symptoms of the disease reappear health: state of optimal functioning or well-being health disparity: a specific difference that is closely linked to social, economic, and/or environmental disadvantage health equity: attainment of the highest level of health for all people health promotion: behavior of an individual motivated by a personal desire to increase well-being and health potential holistic health care: health care that takes into account the whole person interacting in the environment illness: abnormal process in which any aspect of the person's functioning is altered (in comparison to the previous condition of health) morbidity: frequency that a disease occurs mortality: number of deaths remission: period in a chronic illness when the disease is present, but the person does not experience symptoms of the disease risk factor: something that increases a person's chance for illness or injury social determinants of health: conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality of life outcomes and risks vulnerable population: disadvantaged subsegment of a community requiring utmost care, specific ancillary considerations, and augmented protection in research; includes those living in poverty, women, children, older adults, rural and inner-city residents, new immigrants, the homeless, mentally ill patients, and people with disabilities and special health care needs wellness: an active process in which an individual progresses toward the maximum possible potential, regardless of current state of health

Chapter 10 Terms

autocratic leadership: leadership style in which the leader assumes complete control over the decisions and activities of the group care coordination: deliberate organization of patient care activities between two or more participants (including the patient) to facilitate the appropriate delivery of quality health care services in an efficient person-centered manner; mechanism to make sure that patients get the right care at the right time in the most efficient and cost-effective manner, by the right person in the right setting change: process of transforming, altering, or modifying something conflict engagement: method by which nurses can comfortably and respectfully address conflict in the workplace (rather than avoiding conflict) by creating connections with others to build trust conflict management: process used to work through conflicts in a way that minimizes negative effects and promotes positive consequences decentralized decision-making process: autonomous, accountable professional nursing practice; a characteristic of a democratic leadership style and the heart of a self-governance model of unit organization delegation: the transfer of responsibility for the performance of an activity to another individual while retaining accountability for the outcome democratic leadership: leadership style characterized by a sense of equality between the leader and followers explicit power: power obtained by virtue of a person's position implied power: power obtained by force of a person's personality that might enable that person to have more power to influence others than designated leaders just culture: refers to an organization's commitment to accountability and a focus supporting universal safety in health care laissez-faire leadership: leadership style in which the leader relinquishes all power to the group leadership: ability to direct or motivate others toward the achievement of predetermined goals management: the act of planning, organizing, directing, and controlling available human resources and financial resources to deliver quality care to patients and families mentorship: relationship in which an experienced person (the mentor) advises and assists a less experienced person planned change: change agent's purposeful, systematic effort to bring about change power: ability to influence others to achieve a desired effect quantum leadership: leadership that moves beyond the traditional modes previously experienced by all levels of workers; spawned by the impact of the information age on work and the worker servant leadership: philosophy and set of practices that begins with the natural feeling of wanting to serve; its aim is to enrich the lives of individuals, build better organizations, and ultimately creates a more just and caring world transactional leadership: leadership style based on maintaining control by rewarding good behavior and punishing negative or detrimental behavior transformational leadership: type of leadership in which the person creates revolutionary change and commits to the personal and professional growth of self and others

A nurse caring for patients in a skilled nursing facility performs risk assessments on the patients for foot and nail problems. Which patients would be at a higher risk? Select all that apply.

A patient diagnosed with type II diabetes A patient who is obese A patient who has a nervous habit of biting his nails A patient whose job involves frequent handwashing (Variables known to cause nail and foot problems include deficient self-care abilities, vascular disease, arthritis, diabetes mellitus, history of biting nails or trimming them improperly, frequent or prolonged exposure to chemicals or water, trauma, ill-fitting shoes, and obesity.)

A nurse is preparing a sterile field using a packaged sterile drape for a confused patient who is scheduled for a surgical procedure. When setting up the field, the patient accidentally touches an instrument in the sterile field. What is the appropriate nursing action in this situation?

Discard the supplies and prepare a new sterile field with another person holding the patient's hand (If the patient touches a sterile field, the nurse should discard the supplies and prepare a new sterile field. If the patient is confused, the nurse should have someone assist by holding the patient's hand and reinforcing what is happening.)

An RN on a surgical unit is behind schedule administering medications. Which of the RN's other tasks can be safely delegated to a UAP?

Documentation of a patient's I & O on the flow chart (Professional nurses are responsible for the initial patient assessment, discharge planning, health education, care planning, triage, interpretation of patient data, care of invasive lines, administering parenteral medications. What they can delegate are assistance with basic care activities (bathing, grooming, ambulation, feeding) and things like taking vital signs, measuring intake and output, weighing, simple dressing changes, transfers, and post mortem care.)

The nurse practitioner sees patients in a community clinic that is located in a predominately White neighborhood. After performing assessments on the majority of the patients visiting the clinic, the nurse notes that many of the minority groups living within the neighborhood have lost the cultural characteristics that made them different. What is the term for this process?

Cultural assimilation (When minority groups live within a dominant group, many members lose the cultural characteristics that once made them different in a process called assimilation. Cultural imposition occurs when one person believes that everyone should conform to his or her own belief system. Culture shock occurs when a person is placed in a different culture perceived as strange, and ethnocentrism is the belief that the ideas, beliefs, and practices of one's own cultural group are best, superior, or most preferred to those of other groups.)

A nurse states, "That patient is 78 years old—too old to learn how to change a dressing." What is the nurse demonstrating?

Cultural competency Stereotyping is assuming that all members of a group are alike. This is not an example of cultural competence nor is the nurse imposing her culture on the patient. Clustering is not an applicable concept.)

A nurse is telling a new mother from Africa that she shouldn't carry her baby in a sling created from a large rectangular cloth. The African woman tells the nurse that everyone in Mozambique carries babies this way. The nurse believes that bassinets are safer for infants. This nurse is displaying what cultural bias?

Cultural imposition (The nurse is trying to impose her belief that bassinets are preferable to baby slings on the African mother—in spite of the fact that African women have safely carried babies in these slings for years.)

A patient in a community health clinic tells the nurse, "I have a high temperature, feel awful, and I am not going to work." What stage of illness behavior is the patient exhibiting?

Stage 2: Assuming the sick role (Stage 2: Assuming the sick role. When people assume the sick role, they define themselves as ill, seek validation of this experience from others, and give up normal activities. In stage 1: Experiencing symptoms, the first indication of an illness usually is recognizing one or more symptoms that are incompatible with one's personal definition of health. The stage of assuming a dependent role is characterized by the patient's decision to accept the diagnosis and follow the prescribed treatment plan. In the achieving recovery and rehabilitation role, the person gives up the dependent role and resumes normal activities and responsibilities.)

Nurses today work in a wide variety of health care settings. What trend occurred during World War II that had a tremendous effect on this development in the nursing profession?

There was a shortage of nurses and an increased emphasis on education. During World War II, large numbers of women worked outside the home. They became more independent and assertive, which led to an increased emphasis on education. The war itself created a need for more nurses and resulted in a knowledge explosion in medicine and technology. This trend broadened the role of nurses to include practicing in a wide variety of health care settings.

A nurse works with families in crisis at a community mental health care facility. What is the BEST broad definition of a family?

A group of people who live together and depend on each other for support (Although all the responses may be true, the best definition is a group of people who live together and depend on each other for physical, emotional, or financial support.)

The nurse caring for patients in a hospital setting institutes CDC standard precaution recommendations for which category of patients?

All patients receiving care in hospitals (Standard precautions apply to all patients receiving care in hospitals, regardless of their diagnosis or possible infection status. These recommendations include blood; all body fluids, secretions, and excretions except sweat; nonintact skin; and mucous membranes.)

A nurse is using time management techniques when planning activities for patients. Which nursing action reflects effective time management?

Centralizing the decision-making process (By asking the patient to prioritize what they want to accomplish each day, the nurse is demonstrating an effective time management technique. In order to manage time, the nurse should establish goals and priorities for each day, differentiating "need to do" from "nice to do" tasks; the nurse should include the patient in this process. The nurse should also establish a time line, allocating priorities to hours in the workday in order to keep track of falling behind and correct the problem before the day is lost. The nurse should use teamwork appropriately to enhance the schedule.)

The nurse is prioritizing nursing care for a patient in a long-term care facility. Which examples of nursing interventions help meet physiologic needs? Select all that apply.

Changing a patient's oxygen tank Helping a patient eat his dinner (Physiologic needs—oxygen, water, food, elimination, temperature, sexuality, physical activity, and rest—must be met at least minimally to maintain life. Providing food and oxygen are examples of interventions to meet these needs. Preventing falls helps meet safety and security needs; providing art supplies may help meet self-actualization needs; facilitating visits from loved ones helps meet self-esteem needs; and referring a patient to a support group helps meet love and belonging needs.)

A nurse who created a sterile field for a patient is adding a sterile solution to the field. What is an appropriate action when performing this task?

Pour the solution from a height of 4 to 6 in (10 to 15 cm) (To add a sterile solution to a sterile field, the nurse would open the solution container according to directions and place the cap on the table away from the field with the edges up. The nurse would then hold the bottle outside the edge of the sterile field with the label side facing the palm of the hand and prepare to pour from a height of 4 to 6 in (10 to 15 cm).

A nurse manager schedules a clinic for the staff to address common nursing interventions used in the facility and to explore how they can be performed more efficiently and effectively. The nurse manager's actions to change clinical practice are an example of a situation described by which nursing theory?

Prescriptive theory (Prescriptive theories address nursing interventions and are designed to control, promote, and change clinical nursing practice. Descriptive theories describe a phenomenon, an event, a situation, or a relationship. Developmental theory outlines the process of growth and development of humans as orderly and predictable, beginning with conception and ending with death. General systems theory describes how to break whole things into parts and then to learn how the parts work together in "systems.")

A nurse is conducting quantitative research to examine the effects of following nursing protocols in the emergency department (ED) on patient outcomes. This is also known as what type of research?

Quasi-experimental (Quasi-experimental research is often conducted in clinical settings to examine the effects of nursing interventions on patient outcomes. Descriptive research is often used to generate new knowledge about topics with little or no prior research. Correlational research examines the type and degree of relationships between two or more variables. Experimental research examines cause-and-effect relationships between variables under highly controlled conditions.)

A nurse who is newly hired to manage a busy pediatric office is encouraged to use a transactional leadership style when dealing with subordinates. Which activities best exemplify the use of this type of leadership? Select all that apply.

The manager institutes a reward program for employees who meet goals and work deadlines. The manager promotes compliance by reminding subordinates that they have a good salary and working conditions. (Instituting a reward program and reminding workers that they have a good salary and working conditions are examples of transactional leadership, which is based on a task-and-reward orientation. Team members agree to a satisfactory salary and working conditions in exchange for commitment and compliance to their leader. Encouraging nurses to participate in health care reform is an example of a transformational leadership style. Ensuring that employees keep abreast of new developments in nursing care is a characteristic of quantum leadership. The group and leader work together to accomplish mutually set goals and outcomes with the democratic leadership style, and the laissez-faire style encourages independent activity by group members, such as setting their own schedules and work activities.)

A nurse is planning teaching strategies based on the affective domain of learning for patients addicted to alcohol. What are examples of teaching methods and learning activities promoting behaviors in this domain? Select all that apply.

The nurse explores the reasons alcoholics drink and promotes other methods of coping with problems. The nurse helps patients to reaffirm their feelings of self-worth and relate this to their addiction problem. The nurse reinforces the mental benefits of gaining self-control over an addiction. (Affective learning includes changes in attitudes, values, and feelings (e.g., the patient expresses renewed self-confidence to be able to give up drinking). Cognitive learning involves the storing and recalling of new knowledge in the brain, such as the learning that occurs during a lecture or by using a pamphlet for teaching. Learning a physical skill involving the integration of mental and muscular activity is called psychomotor learning, which may involve a return demonstration of a skill.)

Chapter 2 A student nurse asks an experienced nurse why it is necessary to change the patient's bed every day. The nurse answers: "I guess we have just always done it that way." This answer is an example of what type of knowledge?

Traditional knowledge (Traditional knowledge is the part of nursing practice passed down from generation to generation, often without research data to support it. Scientific knowledge is that knowledge obtained through the scientific method (implying thorough research). Authoritative knowledge comes from an expert and is accepted as truth based on the person's perceived expertise. Instinct is not a source of knowledge.)

A nurse is teaching a novice nurse how to provide care for patients in a culturally diverse community health clinic. Although all these actions are recommended, which one is MOST basic to providing culturally competent care?

Treating each patient at the clinic as an individual (In all aspects of nursing, it is important to treat each patient as an individual. This is also true in providing culturally competent care. This basic objective can be accomplished by learning the predominant language in the community, researching the patient's culture, and recognizing the influence of family on the patient's life.)

Based on the components of the physical human dimension, the nurse would expect which clinic patient to be most likely to have annual breast examinations and mammograms?

Tricia, who has a family history of breast cancer (The physical dimension includes genetic inheritance, age, developmental level, race, and biological sex. These components strongly influence the person's health status and health practices. A family history of breast cancer is a major risk factor.)