Intro to Nursing FINAL EXAM (Nur 103)

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

Community-Based Nursing Care

nursing care directed toward a specific group or population within the community; may be provided for individuals or groups

Risk Factors

o Age o Genetic Factors o Physiologic Factors o Health Habits o Lifestyle o Environment

Nursing v. Collaborative Problems

Nursing - Clinical judgement about the person or person(s) being assessed Collaborative - Certain physiologic complications that nurses monitor to detect onset of changes in status

Factors Affecting Health & Illness

1. Basic human needs 2. The human dimensions 3. Self-concept 4. Risk factors for illness and injury

Assessment and Clinical Reasoning should be...

1. Purposeful 2. Prioritized 3. Complete 4. Systematic 5. Factual & Accurate 6. Relevant 7. Recorded in a standard manner

Areas of Professional Liability for Nurses

1. assessment 2. diagnosis 3. outcome identification & planning 4. implementation 5. evaluation

Maslow's Hierarchy of Needs

1. physiological 2. safety 3. love/belonging 4. esteem 5. self-actualization

Types of Problem-Solving

1. trial and error 2. algorithms 3. deductive reasoning 4. inductive reasoning

An adolescent informs the nurse of a desire to learn about birth control. What response by the nurse would gather additional data?

"Would you like to tell me more?"

The nurse is caring for a client who practices Catholicism and was newly diagnosed with cancer. The client states, "God is punishing me for my past sins." How should the nurse respond?

"You sound upset. Would like you to talk about it?"

Establishing Priorities

1st priority: a life-threatening or potentially life-threatening occurrence 2nd priority: activities essential to safety (life saving medications, assisting others with lifting) 3rd priority: activities essential to the plan of care (symptom management, other medications)

ANA Standards of Professional Nursing Practice

- Includes identifying and acknowledging expertise of those inside and outside nursing profession - Includes referring client to others in order to meet client's needs

A nurse is reviewing a journal article about basic human needs and how they can be applied as a framework for prioritizing nursing care. Place the interventions listed below in order of priority, based on client needs. Use all options. 1. Ensuring adequate fluid intake 2. Encouraging the client to set attainable goals 3. Providing education focusing on the client's strengths to maximize potential 4. Referring the client to a support group 5. Encouraging the client's spiritual practices

1, 5, 4, 2, 3

Steps in Teaching/Learning Process

1. Assess Learning Needs and Learning Readiness 2. Diagnose the Patient's Learning Needs 3. Develop Learning Outcomes 4. Develop a Teaching Plan 5. Implement Teaching Plan and Strategies 6. Evaluate Learning

A nurse is assessing a client admitted to the hospital with reports of difficulty urinating, bloody urine, and burning on urination. What is a priority assessment for this client?

A focused assessment of the specific problems identified

The nurse is developing a plan of care for a client with a fractured femur who is in traction and will be restricted to bed for some time. Which domain should the nurse consider when developing a nursing diagnosis based on this client's musculoskeletal health problems?

Activity and rest

What does the term "AMA" stand for?

Against Medical Advice

Root Cause Analysis

An analytical technique used to determine the basic underlying reason that causes a variance or a defect or a risk. A root cause may underlie more than one variance or defect or risk.

CUS (communication tool)

C - I'm concerned U - I'm uncomfortable S - This is unsafe

Nurses practicing in a critical care unit must acquire specialized skills and knowledge to provide care to the critically ill client. These nurses can validate this specialty competence through what process?

Certification

Based on the Patient Protection and Affordable Care Act (ACA), nurses are to assume an important new role in health care. Which is an example of this new role?

Collaborating with all agencies to provide for the client's home health needs

An ambulatory care center that facilitates socialization and provides health-related services to seniors who are unable to fully care for themselves is best known by what name?

Day care center

A nurse informs the client that the client has no choice and must take a bath in the morning. What type of leadership does this exemplify?

Directive Leadership

A client is brought to the emergency department by an adult child, who states, "I am unable to care for my parent anymore. Although I would like to, financially and physically I can't do it anymore." What ethical problem is the adult child experiencing?

Distress

A registered nurse is providing community-based health care for a client diagnosed with early onset dementia. Which strategy is best for the nurse to employ to facilitate the family participating in the client's care?

Encourage active participation of the client and family in health care decisions.

Using the nursing process to make ethical decisions involves following several steps. Which step is the nurse implementing when reflecting on the decision-making process and the role it will play in making future decisions?

Evaluating

A nurse researcher is examining the cause-and-effect relationship between the consumption of tap water containing minimal amounts of bleach, and the incidence of cancer in rats. The research is taking place in a laboratory setting. What type of quantitative research is being used based upon this description?

Experimental research

A client is a poor historian of the client's past medical history. Whom should the nurse consult about the client's past history?

Family

Models of Health Promotion

Health promotion and illness prevention are useful when planning health care: Helps health care providers to understand health-related behaviors Helps overcome barriers to related to increased number of people without health care Are useful for adapting care to people from diverse backgrounds Helps to overcome barriers to care for low-income and rural populations

The statement, "More frequent handwashing will significantly lower the rate of infection in hospitalized clients," is an example of what research component?

Hypothesis

A parent of a 17-year-old high school student is allowing the child to decide which college the child will attend. When the child requests direction from the parent in making this decision, the parent responds by stating, "You will need to make this decision on your own." What type of value transmission is the parent displaying?

Laissez-faire

What is the central theme of Florence Nightingale's nursing theory?

Meeting the personal needs of the client within the environment.

A nurse is discussing the benefits of smoking cessation with a client. The nurse informs the client that smoking cessation will reduce the client's risk for cancer, improve respiratory status, and enhance the quality of life. The nurse also shares a personal story of smoking cessation, provides information on other individuals who have successfully quit, and encourages the client to attend a support group for smoking cessation. The client discusses feelings on smoking cessation and verbalizes a desire to quit smoking. What type of counseling did the nurse provide to this client?

Motivational

The nurse is preparing to teach a client about postsurgical care after a laparoscopic cholecystectomy. Which factor should the nurse most consider when determining whether the client is ready and able to learn?

Physical condition

Tertiary Health Promotions

Prevention begins after illness is diagnosed and treated, the goal is to reduce disability and helping rehabilitate patients to a maximum level of functioning. (Example. Medication, physical therapy, rehabilitation, ect..)

Formulation of Nursing Diagnosis

Problem—identifies what is unhealthy about patient Etiology—identifies factors maintaining the unhealthy state Defining characteristics—identify the subjective and objective data that signal the existence of a problem

QSEN

Quality and Safety Education for Nurses

A nurse who has been caring for a client for the past few days is preparing the client for discharge and termination of the nurse-client relationship. Which activity would the nurse be carrying out during this phase of the relationship?

Reviewing health changes

A mammogram represents which level of prevention?

Secondary

A nurse is educating a client with a new diagnosis of diabetes. Which example demonstrates cognitive learning by the client?

The client describes signs and symptoms of hypoglycemia.

A registered nurse is delegating activities to unlicensed assistive personnel (UAP) on a hospital unit. Which activities could this nurse normally delegate? Select all that apply. a. Giving a bed bath to a client b. Planning education for a client with a colostomy c. Taking routine vital signs d. Transferring a client to another floor

a, c, d

Reflective Practice

The process of teachers' thinking about and analyzing their work to assess its effectiveness.

A client says, "You guys are not doing anything for me. I am leaving." Which interventions are indicated by the nurse? Select all that apply. a. Inform the client of the risks of leaving. b. Insist that the client sign an against medical advice form before leaving. c. Witness the client's signature on the against medical advice form.

a, c

Standards

Voluntary standards, developed and implemented by the nursing profession itself, are not mandatory but are used as guidelines for peer review

The nurse administers pain medication to a postoperative client. Which nursing intervention will assist with the client's unrelieved pain? a. Repositioning the client b. Documenting opioid dependence

a

The nurse is caring for a client admitted to the hospital with pneumonia and associated pleuritic chest pain. Which would be a priority when creating the nursing care plan? a. Monitoring airway clearance. b. Effective infection control measures.

a

Which scenario is the best example of the nurse in the role of teacher/educator? a. Assessing whether the client is able to perform a dressing change b. Communicating discharge status to a home care agency

a

Servant Leadership

a philosophy and set of practices that enriches the lives of individuals, builds better organizations and ultimately creates a more just and caring world.

Nursing Code of Ethics

a set of principles that reflect the primary goals, values, and obligations of the profession

A nurse has been asked to serve as an expert witness in a malpractice case in which an infant died in the newborn nursery. Which questions should the nurse consider prior to accepting this job? Select all that apply. a. "How much education do I have about caring for newborns?" b. "How much clinical experience do I have in the newborn nursery?" c. "Have I ever worked in this hospital system?"

a, b

Transactional Leadership

leadership based on an exchange process in which followers are rewarded for good performance and punished for poor performance

Utilitarian

action-guiding theory of ethics that states that the rightness or wrongness of an action depends on the consequences of the action

Laissez-Faire Leadership

allows the group to function more or less on its own

Sentinel Event

an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof

Horizontal Violence

anger and aggressive behavior between nurses or nurse-to-nurse hostility

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

A nurse is caring for a client who has COPD, a chronic illness of the lungs. The client is in remission. Which statement best describes a period of remission in a client with a chronic illness? a. The disease is no longer present. b. Symptoms are not experienced.

b

Select the best description of how the nurse applies the nursing process in caring for clients. The nurse: a. uses scientific problem solving to meet client problems. b. uses critical thinking to direct care for the individual client.

b

The client is being discharged to the home setting following a stroke. The client requires assistance in relearning how to cook safely. To which home health care team member should the nurse refer the client? a. Home health aide b. Occupational therapist

b

The nurse is caring for a 14-year-old client who has just delivered a baby. The client reports living with an aunt and having no other family around. The delivery was uncomplicated and the newborn is healthy. Which would be the primary nursing diagnosis for this client? a. Risk for Loneliness b. Risk for Impaired Parenting

b

Which is a characteristic of nursing practiced from early civilization to the 16th century? a. The physician was the priest who treated disease with prayer. b. Most early civilizations believed that illness had supernatural causes.

b

Which is an example of an unintentional tort? a. Nurses discuss a client's laboratory values in the elevator. b. A nurse gives the client a medication, and the client has an adverse reaction to it.

b

Which term is most appropriate for describing a healthcare practitioner who is respectful of the healthcare traditions of other cultures? a. Culturally competent b. Culturally sensitive

b

A nurse is caring for a family consisting of three middle-aged adults. Which examples describe developmental tasks of this type of family structure? Select all that apply. a. The family must support moral and ethical family values. b. The family must prepare for retirement. c. The family must maintain ties with younger and older generations.

b, c

Which activities take place during the working phase of the nurse-client relationship? Select all that apply. a. The client and nurse identify goals of the relationship. b. The client participates actively in the relationship. c. The client genuinely expresses concerns to the nurse.

b, c

The nurse is creating a plan of care for a client. Which actions by the nurse demonstrate the components of the nursing process? Select all that apply. a. Plans medical care of the client b. Identifies the needs of the client c. Applies rationales for the actions of the nurse. d. Plans interventions to meet the client's health care needs e. Evaluates the effectiveness of the plan of care

b, d, e

Certification

demonstrate advanced proficiency and a commitment to ensuring competence in the context of the current U.S. health care crisis, evidenced by daily reports of unsafe care, rising litigation, escalating costs, and a worsening nursing shortage

A client has cancer, but the significant other does not want the client to know the diagnosis. The nurse demonstrates sensitivity to the significant other and works with the couple to achieve desired outcomes. What kind of behavior is the nurse exhibiting?

empathy

Deontologic

ethical system in which actions are right or wrong independent of the consequences they produce

The use of one's culture as a cultural standard is known as:

ethnocentrism.

Primary Health Promotions

focus on health risk assessments and preventive care (example. Immunizations, exercise, ect...)

Secondary Health Promotions

focus on screening for early detection of disease with prompt diagnosis and treatment of any found (the goal is to identify the illness, reverse or reduce its severity or provide a cure, and thereby return the person to maximum health as quickly as possible. (example . pap smears mammograms, etc...) screenings are important during this phase.

Accredidation

granting approval or belief in a school

The Nursing Agenda for Health Care Reform (American Nurses Association [ANA]) identifies the recipients of health care. This reform's main focus is on:

health promotion.

How to Relate to Patient's From Different Cultures

o Assess your personal beliefs surrounding people from different cultures. o Assess communication variables from a cultural perspective. o Plan care based on the communicated needs and cultural background. o Modify communication approaches to meet cultural needs. o Understand that respect for the patient and communicated needs is central to the therapeutic relationship. o Communicate in a nonthreatening manner. o Use validating techniques in communication. o Be considerate of reluctance to talk when the subject involves sexual matters. o Adopt special approaches when the patient speaks a different language. o Use interpreters to improve communication.

Principles of Bioethics

o Autonomy o Nonmaleficence o Beneficence o Justice o Fidelity

Intercalated Nursing Roles

o Caregiver o Communicator o Teacher o Counselor o Leader o Researcher o Advocate o Collaborator

Health Care Trends & Issues

o Changing demographics o Increasing diversity o Technology explosion o Globalization of economy and society o Educated and engaged customers o Increasing complexity of pt. care o Cost o Effect of health policy & regulation o Shortages of health professionals

Guidelines for Nursing Care

o Develop cultural self-awareness. o Develop cultural knowledge. o Accommodate cultural practices in healthcare. o Respect culturally based family roles. o Avoid mandating change. Seek cultural assistance.

Checklist for Informed Consent

o Disclosure o Comprehension o Competence o Voluntariness

Components of a Cultural Assessment

o Ethnic Heritage and Ethnohistory o Social Organization o Communication Patterns o Caring Beliefs and Practices o Biocultural History o Religious and Spiritual Beliefs o Time Orientation o Experiences With Professional Health Care

Universal Standards for Critical Thinking

o Identify goal o Assess knowledge o Address potential problems o Consult helpful resources o Critique decision

Dimensions Affecting Health

o Intellectual o Environmental o Spiritual o Sociocultural o Emotional o Physical

Nightingale Contributions

o Nursing apart from Medical o Changed nursing care

Personal Attributes

o Open-mindedness o A profound sense of the value of a person o Self-awareness o Responsibility for actions o Motivation o Leadership skills o Bravery

QSEN Competencies

o Patient-Centered Care o Teamwork and Collaboration o Evidence-Based Practice o Quality Improvement o Safety o Informatics

3 Largest Challenges Facing Health Care

o Population Health o Experience of Care o Per Capita Cost

Phases of Home Health Visit

o Pre-entry o Entry

Major Aims of Nursing

o Promoting Health o Prevent Illness o Restore Health o Facilitate with death & disability

Purpose of Nursing Theory

o Provide understanding o Help find meaning in nursing o Developed to define "nursing as an academic discipline"

Parts of a Diagnosis

o Related factors o Defining Characteristics o Associate condition

Sources of Nursing Knowledge

o Traditional o Authoritative o Scientific

Nursing as a Profession Components

o Well-defined body of specific and unique knowledge o Strong service orientation o Recognized authority by a professional group o Code of ethics o Professional organization that sets standards o Ongoing research o Autonomy and self-regulation

Conflict Resolution Strategies

o avoiding o collaborating o competing o compromising o cooperating/accommodating o smoothing

A nurse manager reviews an employee's contribution to the nursing division annually. This process is:

performance appraisal.

Purpose of Nursing Practice Acts

set up to protect public health, safety, welfare.

Etiology

the study of the causes of diseases

Transformational Leadership

type of leadership in which the person creates revolutionary change and commits to the personal and professional growth of self and others

Credentialing

ways in which professional competence is ensured and maintained