NR222 Exam 2

When completing the nursing data on a client, to complete the admission and develop a plan of care, the nurse will need to: A. test the family unit's ability to cope. B. evaluate communication patterns. C. identify family unit form and attitudes. D. gather health data from all family members.

C

You are caring for a patient. Visitors at the bedside include the patient's life partner, widowed father, brother, and niece. The nurse acknowledges that current trends in American families include: A. couples without children. B. more singles choosing to live alone. C. a very different look from 15 years ago. D. a mother, father, and more than one child.

C

Family as system

Caring for each family member( family as context) and family unit (family as patient)

A patient newly diagnosed with diabetes needs to learn how to use a glucometer. Use of a glucometer constitutes: A. affective learning. B. cognitive learning. C. motivational learning. D. psychomotor learning.

D

According to Kohlberg, moral development is a component of psychosocial development. Moral development depends on the child's ability to integrate: A. modeling of others. B. faith and optimism. C. self-control and independence. D. decisions of right and wrong.

D

Health disparities are unequal burdens of disease morbidity and mortality rates experienced by racial and ethnic groups. These disparities are often exacerbated by: A. bias. B. stereotyping. C. prejudice. D. all of the above.

D

You are invited to attend the weekly unit patient care conference. The staff discusses patient care issues. This type of communication is: A. public. B. intrapersonal. C. transpersonal. D. small group.

D

social inequality

Groups have unequal access to resources, services, and positions

alternative family

Relationships include multi-adult households, "skip-generation" families (grandparents caring for grandchildren), communal groups with children, "nonfamilies" (adults living alone), and cohabitating partners.

Molding

Shaping of the fetal head by overlapping of the cranial bones to facilitate movement through the birth canal during labor.

You are working in a clinic that provides services for homeless people. The current local regulations prohibit providing a service that you believe is needed by your patients. You adhere to the regulations but at the same time are involved in influencing authorities to change the regulation. This action represents ___________ stage of moral development.

Social contract orientation.

The ______________ is a closed-loop communication technique used to evaluate patient understanding and retention of material.

Teach Back method

transcultural nursing

a comparative study of cultures to understand their similarities and differences

health disparity

a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage

Apgar scale

appearance, pulse, grimace, activity, respiration -used to assess newborns condition

gross motor skills

birth-1mo: complete head lag, reflexes present, cant sit up 2-4mo: can lift head, able to sit, can turn from side to back 4-6mo: turn from abdomen to back, support own weight when pulling up to stand 6-8mo: sits alone without support, full weight on feet, sit to kneeling position 8-10mo: crawls and pulls body weight 10-12mo: stands alone, walks with support, sit to stand

fine motor skills

birth-1mo: reflexive grasp 2-4mo: brings object from hand to mouth, plays with fingers 4-6mo: grasps objects at will, pulls feet to mouth, can hold bottle 6-8mo: bangs objects together, transfers objects from hand to hand 8-10mo: picks up objects, use pincer grasp 10-12mo: place objects in containers, able to mark on paper with utensil

group identity

committing to an identity that is based on values and ideology of the groups one is connected to

sexual identity

development of masculine and feminine behaviors

Gesell's theory of development

each child's pattern of growth is unique and this pattern is directed by gene activity

translation from intrauterine to extrauterine life occurs during _______

first 24 hrs of life

neonatal period

first 28 days of life

Marginalization

groups are left out

Biophysical development

how our physical bodies grow and change

psychoanalytical/psychosocial development

human development from the perspectives of personality, thinking and behavior

nuclear fmaily

husband and wife (children if you have them)

family identity

ideas and feelings about the uniqueness and value of one's family unit

Social Contract Theory

individual follows societal law but recognizes the possibility of changing the law to improve society

Piaget's stages of cognitive development

infancy (birth-18mo): sensorimotor early childhood (18mo-3yr): preoperational preschool (3-5yr): use of symbols egocentric middle childhood (6-12yr): concrete operational, logical thinking adolescence (12-19yr): formal operations, abstract thinking

Erikson's Psychosocial Theory

infancy (birth-18mo): trust vs. mistrust early childhood (18mo-3yr): autonomy vs. shame and doubt preschool (3-5yr): initiative vs. guilt middle childhood (6-12yr): industry vs. inferiority adolescence (12-19yr): identity vs. role confusion young adult: intimacy vs. isolation adult: generactivity vs. self-absorption old age: integrity vs. despair

Preconventional reasoning

limited cognitive thinking and individual is primarily egocentric/ for personal gain

Culture

norms, values, and traditions passed down through generations

single-parent family

one parent leaves because of death, divorce, or desertion or a single person decides to adopt

health identity

one's organization of individual drives, abilities, beliefs, and experience into a consistent image of self *perception of health*

blended family

parents bring unrelated children from prior or adoptive/foster parenting relationships

Kohlberg's stages of moral development

pre-conventional level of punishment obedience orientation: early childhood (18mo-3yr) pre-conventional level of premoral instrumental orientation: preschool (3-5yr) conventional of good boy/nice girl orientation: middle childhood (6-12yr) post-conventional level of social contract orientation: adolescence (12-19yr)

Three trimesters of pregnancy

preembryonic- fertilization to 14days embryonic- day 15 to 8weeks fetal- week 8 to birth

Phases of the Helping Relationship

preinteraction phase: before meeting the patient orientation phase: nurse and patient meet and get to know each other working phase: nurse and patient work together to solve problems and accomplish goals termination phase: ending the relationship

health promotion during pregnancy

regular prenatal checkups, no smoking, no ETOH, avoid OTC med

extended family

relatives

Hardiness and resiliency are factors that moderate a families_________

stress

instrumental relativist stage

the child recognizes that there is more than one right view

cultural competency

the enabling of health care providers to deliver services that are respectful of and responsive to the health beliefs, practices, and cultural and linguistic needs of diverse patients

family as patient

-Family processes and relationships are the primary focuses of nursing care -assess patterns vs. characteristics

Intrauterine Life

-conception until birth -avg. 40weeks -3trimesters

sensormotor stage

-dealing with the environment -hitting, looking, grasping, kicking

formal operational stage

-egocentric thought -demonstrate feeling and behaviors characterized by self-consciousness

Infancy Stage

-from 1 month to 1 year of age -rapid physical growth and change occur

concrete operational stage

-mental operations -they think before they act -can describe the action before preforming the action

Family as context

-primary focus is on the health and development of an individual member existing within a specific environment -assesses how much the family provides the individuals basic needs

preoperational stage

-use symbols and mental images -see only through their own point of view -personify objects to have feelings

A new nurse complains to her preceptor that she has no time for therapeutic communication with her patients. Which of the following is the best strategy to help the nurse find more time for this communication? 1. Include communication while performing tasks such as changing dressings and checking vital signs. 2. Ask the patient if you can talk during the last few minutes of visiting hours. 3. Ask Pastoral care to come back a little later in the day. 4. Remind the nurse to complete all her tasks and then set up remaining time for communication.

1

A nurse has been gathering physical assessment data on a patient and is now listening to the patient's concerns. The nurse sets a goal of care that incorporates the patient's desire to make treatment decisions. This is an example of the nurse engaged in which phase of the nurse-patient relationship? 1. Working phase 2. Preinteraction phase 3. Termination phase 4. Orientation phase

1

A nurse needs to teach a young woman newly diagnosed with asthma how to manage her disease. Which of the following topics does the nurse teach first? 1. How to use an inhaler during an asthma attack 2. The need to avoid people who smoke to prevent asthma attacks 3. Where to purchase a medical alert bracelet that says she has asthma 4. The importance of maintaining a healthy diet and exercising regularly

1

A patient with chest pain is having an emergency cardiac catheterization. Which teaching approach does the nurse use in this situation? 1. Telling approach 2. Selling approach 3. Entrusting approach 4. Participating approach

1

Allison, age 15 years, calls her best friend Laura and is crying. She has a date with John, someone she has been hoping to date for months, but now she has a pimple on her forehead. Laura firmly believes that John and everyone else will notice the blemish right away. This is an example of the: 1. Imaginary audience. 2. False-belief syndrome. 3. Personal fable. 4. Personal absorption syndrome.

1

An 8-year-old child is being admitted to the hospital from the emergency department with an injury from falling off her bicycle. Which of the following will most help her adjust to the hospital? 158 1. Explain hospital routines such as mealtimes to her. 2. Use terms such as "honey" and "dear" to show a caring attitude. 3. Explain when her parents can visit and why siblings cannot come to see her. 4. Since she is young, orient her parents to her room and hospital facility.

1

At a well-child examination, the mother comments that her toddler eats little at mealtime, will only sit briefly at the table, and wants snacks all the time. Which of the following should the nurse recommend? 1. Provide nutritious snacks. 2. Offer rewards for eating at mealtimes. 3. Avoid snacks so she is hungry at mealtime. 4. Explain to her firmly why eating at mealtime is important.

1

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

1

In an interview with a pregnant patient, the nurse discussed the three risk factors that have been cited as having a possible effect on prenatal development. They are: 1. Nutrition, stress, and mother's age. 2. Prematurity, stress, and mother's age. 3. Nutrition, mother's age, and fetal infections. 4. Fetal infections, prematurity, and placenta previa.

1

When Ryan was 3 months old, he had a toy train; when his view of the train was blocked, he did not search for it. Now that he is 9 months old, he looks for it, reflecting the presence of: 1. Object permanence. 2. Sensorimotor play. 3. Schemata. 4. Magical thinking.

1

When nurses are communicating with adolescents, they should: 1. Be alert to clues to their emotional state. 2. Ask closed-ended questions to get straight answers. 3. Avoid looking for meaning behind adolescents' words or actions. 4. Avoid discussing sensitive issues such as sex and drugs.

1

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

1

You are caring for a recently retired man who appears withdrawn and says he is "bored with life." Applying the work of Having hurst, you would help this individual find meaning in life by: 1. Encouraging him to explore new roles. 2. Encouraging relocation to a new city. 3. Explaining the need to simplify life. 4. Encouraging him to adopt a new pet.

1

A family has decided to care for a grandparent with terminal cancer in the daughter's home. Family caregiving is new to the 130family. When helping this family as they begin to plan for their caregiving roles, what are the two top priority assessments to best learn about family functioning? (Select all that apply.) 1. Communication 2. Decision making 3. Development 4. Economic status 5. Family structure

1, 2

Which of the following are examples of the conventional reasoning form of cognitive development? (Select all that apply.) 1. A 35-year-old woman is speaking with you about her recent diagnosis of a chronic illness. She is concerned about her treatment options in relation to her ability to continue to care for her family. As she considers the options and alternatives, she incorporates information, her values, and emotions to decide which plan will be the best fit for her. 2. A young father is considering whether or not to return to school for a graduate degree. He considers the impact the time commitment may have on the needs of his wife and infant son. 3. A teenage girl is encouraged by her peers to engage in shoplifting. She decides not to join her peers in this activity because she is afraid of getting caught in the act. 4. A single mother of two children is unhappy with her employer. She has been unable to secure alternate employment but decides to quit her current job.

1, 2

How can a nurse work on developing cultural awareness? (Select all that apply.) 1. Reflect on his or her past learning about health, illness, race, gender, and sexual orientation 2. Develop greater self-knowledge about personal biases 3. Recognize consciously the multiple factors that influence his or her own world view 4. Engage in an in-depth self-examination of his or her own background 5. Learn as many facts as possible about an ethnic group

1, 2, 3, 4

Which of the following are considered social determinants of health? (Select all that apply.) 1. Lack of primary health care providers in a zip code 2. Poor-quality public school education that prevents a person from developing adequate reading skills 3. Lack of affordable health insurance 4. Employment opportunities that do not provide paid vacation or sick leave 5. The number of times a person exercises during a week 6. Neighborhood safety that prevents a person from walking around the block or socializing with neighbors outside of his or her home

1, 2, 3, 4, 6

Which of the following changes can help create a more inclusive environment for lesbian, gay, bisexual, and transgender (LGBT) patients? (Select all that apply.) 1. Explicitly including sexual orientation and gender identity into nondiscrimination policies 2. Displaying art that reflects LGBT community 3. Modifying health care forms to provide opportunities for gender identity and sexual orientation disclosure 4. Not asking patients about their gender identity and sexual orientation to avoid making them uncomfortable 5. Ensuring access to unisex or single-stall bathrooms

1, 2, 3, 5

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

1, 2, 4

A new immigrant family consisting of a grandparent, two adults, and three school-age children has decided to receive their health promotion care at the Community Wellness Center. This is their first visit, and a family assessment, a health history, and a physical of each family member are needed. Which of the following are included in a family function assessment? (Select all that apply.) 1. Cultural practices 2. Decision making 3. Neighborhood services 4. Rituals and celebrations 5. Neighborhood crime data 6. Availability of parks

1, 2, 4

Which of the following activities are examples of the use of activity theory in older adults? (Select all that apply.) 1. Teaching an older adult how to use e-mail to communicate with a grandchild who lives in another state 2. Introducing golf as a new hobby 3. Leading a group walk of older adults each morning 4. Engaging an older adult in a community project with a short-term goal 5. Directing a community play at the local theater

1, 2, 4

Which strategies should a nurse use to facilitate a safe transition of care during a patient's transfer from the hospital to a skilled nursing facility? (Select all that apply.) 1. Collaboration between staff members from sending and receiving departments 2. Requiring that the patient visit the facility before a transfer is arranged 3. Using a standardized transfer policy and transfer tool 4. Arranging all patient transfers during the same time each day 5. Relying on family members to share information with the new facility

1, 3

When working with an older adult who is hearing-impaired, the use of which techniques would improve communication? (Select all that apply.) 1. Check for needed adaptive equipment. 2. Exaggerate lip movements to help the patient lip read. 3. Give the patient time to respond to questions. 4. Keep communication short and to the point. 5. Communicate only through written information.

1, 3, 4

Which of the following are possible outcomes with clear family communication? (Select all that apply.) 1. Family goals 2. Increased socialization 3. Decision making 4. Methods of discipline 5. Improved education 6. Impaired coping

1, 3, 4

A patient is admitted through the emergency department (ED) after a serious car accident. The nurse assesses the patient and quickly learns that he speaks little English. Spanish is his primary language. The nurse speaks some Spanish. Which interventions would be appropriate at this time? (Select all that apply.) 1. The nurse requests a professional interpreter. 2. Since this is an emergent situation, the nurse will interpret and identify the patient's priority needs. 3. The nurse determines the interpreter's qualifications and makes sure that the interpreter can speak the patient's dialect. 4. The nurse uses short sentences to explain the treatments provided in the ED. 5. The nurse directs questions to the patient by looking at the patient instead of at the interpreter.

1, 3, 4, 5

Which of the following are examples of problems with the health care system that contribute to health disparities? (Select all that apply.) 1. A health care provider assumes that the patient missed two appointments because the patient does not care about his or her health and does not inquire about the reasons for missed visits. 2. The discharge nurse at a hospital uses Teach Back with a patient to ensure that she has communicated the discharge instructions clearly. 3. A community hospital lacks an adequate staff of social workers who are able to ensure patients' access to resources they need to take care of their health. 4. A hospital discharges a patient without ensuring that the patient has a primary care provider and has made a follow-up appointment. 5. A nurse uses a family member as an interpreter to explain the patient's medications. 6. The hospital conducts quality improvement without stratifying data by race, ethnicity, language, socioeconomic status, sexual orientation, and other axes of social group identities.

1, 3, 4, 5, 6

Motivational interviewing (MI) is a technique that applies understanding a patient's values and goals in helping the patient make behavior changes. What are other benefits of using MI techniques? (Select all that apply.) 1. Gaining an understanding of patient's motivations 2. Focusing on opportunities to avoid poor health choices 3. Recognizing patient's strengths and supporting their efforts 4. Providing assessment data that can be shared with families to promote change 5. Identifying differences in patient's health goals and current behaviors

1, 3, 5

You are caring for a family that consists of a father and 3-year-old boy who has well-managed asthma but misses care infrequently. They live in state-supported housing. The father is in school studying to be an information technology professional. His income and time are limited, and he admits to going to fast-food restaurants frequently for dinner. However, he and his son spend a lot of time together. The family receives state-supported health care for his son, but he does not have health insurance or a personal physician. He has his son enrolled in a government-assisted day care program. Which of the following are risks to this family's level of health? (Select all that apply.) 1. Economic status 2. Chronic illness 3. Underinsured 4. Government-assisted day care 5. Frequency of fast-food dinners 6. State-supported housing

1, 3, 5

A family is undergoing a major change. Just as twins graduate from college and leave home to begin their careers, the husband loses his executive well-paying job. Because the family had two children in college at the same time, they did not save for retirement. They planned to save aggressively after the children left college. In this situation, which of the following demonstrate family resiliency? (Select all that apply.) 1. Resuming full-time work when spouse loses job 2. Increasing problems among siblings 3. Developing hobbies when children leave home 4. Placing blame on family members 5. Expecting children to help financially 6. Consulting a financial planner

1, 3, 6

A school nurse is counseling an obese 10-year-old child. Which factors would be important to consider when planning an intervention to support the child's health? (Select all that apply.) 1. Consider both the child and the family when addressing the issue. 2. Consider the use of medications to suppress the appetite. 3. First plan for weight loss through dieting and then add activity as tolerated. 4. Plan food intake to allow for growth. 5. Consider consulting a bariatric surgeon if other measures fail.

1, 4

toddlerhood

1-3 yrs begin to remember events begin speech toilet training

MATCH: 1. Intrapersonal 2. Interpersonal 3. Transpersonal 4. Small group 5. Public A. One-to-one interaction between two people B. Occurs within an individual C. Interaction with an audience D. Interaction within a person's spiritual domain E. Interactions with a small number of people

1-B 2-A 3-D 4-E 5-C

MATCH: 1. Referent 2. Sender and receiver 3. Message 4. Channels 5. Feedback 6. Interpersonal variables 7. Environment A. One who encodes and one who decodes the message B. The setting for sender-receiver interactions C. Message the receiver returns D. Motivates one to communicate with another E. Means of conveying and receiving messages F. Factors that influence communication G. Content of the message

1-D 2-A 3-G 4-E 5-C 6-F 7-B

Freud's Psychosexual Stages

1. Oral Stage; infancy (birth-18mo) 2. Anal Stage; toddler (18mo-3yr) 3. Phallic Stage; preschool (3-5yr) 4. Latency Stage; middle childhood (6-12yr) 5. Genital Stage; adolescence (12-19yr)

1. Under inclusion 2. Social inequality 3. Social location a. Groups have unequal access to resources, services, and positions. b. A group has been overlooked in research and the design of interventions. c. One's place in society is based on membership in a social group that determines access to resources.

1b, 2a, 3c

1. C ____ 2. L ____ 3. A ____ 4. R ____ 5. A ____ a. The nurse acknowledges that it is absolutely reasonable for patients to expect that their health care providers care about their situations and that it is disappointing when they have experiences that make them feel like they do not. b. The nurse uses a relaxation technique before responding to the patient's concerns. Calm yourself. Take a deep breath. Check your pulse. c. The nurse says, "I want to help you. I can do that better if you tell me what's making it difficult for you to come to your appointments and take your medicine each day." d. The nurse maintains eye contact and allows the patient to discuss her perspective while remaining attentively quiet. e. The nurse explains, "One thing I want you to understand is that your blood pressure medicine will only work if you take the same amount each day. Your follow-up appointments are important so we can get this blood pressure under control. Let me get a social worker who can help you figure out these transportation issues or see if he can find a doctor closer to your house."

1b, 2d, 3a, 4c, 5e

1. R. ____ 2. E. ____ 3. S. ____ 4. P. ____ 5. E. ____ 6. C. ____ 7. T. ____ a. Ask about and try to understand barriers to care and adherence, and then offer resources to help the patient overcome them, involving family members if appropriate, and reassuring the patient that you are and will be available to help. b. Patients may have different reasons for not disclosing important information. Earn a patient's confidence through actions and attitude that demonstrate respect, compassion, and your interest in partnership. c. Work closely together with the patient by being flexible with regard to issues of control, negotiating roles when necessary, and stressing that you will be working together to mutually address medical problems. d. Provide explanations for the process and your action, checking often for understanding and using verbal clarification techniques such as Teach Back. e. Approach each encounter thinking about cultural competence and how you can demonstrate respect for the patient and his or her culture and beliefs. f. Approach the encounter with empathy, remembering that the patient has come to you for help. Seek out and understand the patient's rationale for his or her behaviors or illness, verbally acknowledging and legitimizing his or her feelings. g. Connect on a social level, seeking the patient's point of view; consciously attempt to suspend judgment; and avoid making assumptions.

1g, 2f, 3a, 4c, 5d, 6e, 7b

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

2

A nurse is planning a teaching session about healthy nutrition with a group of children who are in first grade. The nurse determines that after the teaching session the children will be able to name three examples of foods that are fruits. This is an example of: 1. A teaching plan. 2. A learning objective. 3. Reinforcement of content. 4. Enhancing the children's self-efficacy.

2

A nurse is talking with a young-adult patient about the purpose of a new medication. The nurse says, "I want to be clear. Can you tell me in your words the purpose of this medicine?" This exchange 334is an example of which element of the transactional communication process? 1. Message 2. Obtaining feedback 3. Channel 4. Referent

2

A patient needs to learn how to administer a subcutaneous injection. Which of the following reflects that the patient is ready to learn? 1. Describing difficulties a family member has had in taking insulin 2. Expressing the importance of learning the skill correctly 3. Being able to see and understand the markings on the syringe 4. Having the dexterity needed to prepare and inject the medication

2

A patient who is hospitalized has just been diagnosed with diabetes. He is going to need to learn how to give himself injections. Which teaching method does the nurse use? 1. Simulation 2. Demonstration 3. Group instruction 4. One-on-one discussion

2

According to Piaget's cognitive theory, a 12-year-old child is most likely to engage in which of the following activities? 1. Using building blocks to determine how houses are constructed 2. Writing a story about a clown who wants to leave the circus 3. Drawing pictures of a family using stick figures 4. Writing an essay about patriotism

2

An 18-month-old child is noted by the parents to be "angry" about any change in routine. This child's temperament is most likely to be described as: 1. Slow to warm up. 2. Difficult. 3. Hyperactive. 4. Easy.

2

In the United States, there has never been a president of Asian or Hispanic culture. This is an example of: 1. Social inequality 2. Marginalization 3. Under inclusion 4. Social location

2

The nurse teaches parents how to have their children learn impulse control and cooperative behaviors. This would be during which of Erikson's stages of development? 1. Trust versus mistrust 2. Initiative versus guilt 3. Industry versus inferiority 4. Autonomy versus sense of shame and doubt

2

What is the most common reason for calling on grandparents to raise their grandchildren? 1. Single parenthood 2. Legal interventions 3. Dual-income families 4. Increased divorce rate

2

When a nurse is teaching a patient about how to administer an epinephrine injection in case of a severe allergic reaction, the nurse tells the patient to hold the injection like a dart. Which of the following instructional methods did the nurse use? 1. Telling 2. Analogy 3. Demonstration 4. Simulation

2

You are caring for a 4-year-old child who is hospitalized for an infection. He tells you that he is sick because he was "bad." Which is the most correct interpretation of his comment? 1. Indicative of extreme stress 2. Representative of his cognitive development 3. Suggestive of excessive discipline at home 4. Indicative of his developing sense of inferiority

2

The nurse is planning to teach a patient about the importance of exercise. When is the best time for teaching to occur? (Select all that apply.) 1. When there are visitors in the room 2. When the patient states that he or she is pain free 3. Just before lunch, when the patient is most awake and alert 4. When the patient is talking about current stressors in his 5. When the patient is being transported for a procedure

2, 3

The nurse uses silence as a therapeutic communication technique. What is the purpose of the nurse's silence? (Select all that apply.) 1. Prevent the nurse from saying the wrong thing 2. Prompt the patient to talk when he or she is ready 3. Allow the patient time to think and gain insight 4. Allow time for the patient to drift off to sleep 5. Determine if the patient would prefer to talk with another staff member

2, 3

A family has decided to care for their father who is in the last stages of a debilitating neurological illness. Although he is alert, he cannot speak clearly or carry out self-care activities; he indicates that he wants to remain involved in family life as long as possible and loves spending time with his wife and two teenage children. Which best defines family caregiving? (Select all that apply.) 1. Designing a nurturing family to raise children 2. Providing physical and emotional care for a family member 3. Establishing a safe physical environment for a family 4. Monitoring for side effects of illness and treatments 5. Reducing the use of community resources

2, 3, 4

A nurse is providing information on prevention of sudden infant death syndrome (SIDS) to the mother of a young infant. Which of the following statements indicates that the mother has a good understanding? (Select all that apply.) 1. "I won't use a pacifier to help my baby sleep." 2. "I'll be sure that my baby doesn't spend any time sleeping on her abdomen." 3. "I'll place my baby on her back for sleep." 4. "I'll be sure to keep my baby's room cool." 5. "I'll keep a crib bumper in the bed to prevent drafts."

2, 3, 4

Nurses must communicate effectively with the health care team for which of the following reasons? (Select all that apply.) 1. Improve the nurse's status with the health team members 2. Reduce the risk of errors to the patient 3. Provide optimum level of patient care 4. Improve patient outcomes 5. Prevent issues that need to be reported to outside agencies

2, 3, 4

When you care for a patient who does not speak English, it is necessary to call on a professional interpreter. Which of the following are proper principles for working with interpreters? (Select all that apply.) 1. Expect the interpreter to interpret your statements word-for-word so there is no misunderstanding by the patient. 2. If you feel an interpretation is not correct, stop and address the situation directly with the interpreter. 3. Pace a conversation so there is time for the patient's response to be interpreted. 4. Direct your questions to the interpreter. 5. Ask the patient for feedback and clarification at regular intervals.

2, 3, 5

The nurse is organizing a disease prevention program for a specific cultural group. To effectively meet the needs of this group the nurse will: (Select all that apply.) 1. Assess the needs of the community in general. 2. Involve those affected by the problem in the planning process. 3. Develop generalized goals and objectives for the program. 4. Use educational materials that are simplistic and have many pictures. 5. Assess commonly held health beliefs among the cultural group. 6. Educate the specific cultural group about Western concepts of health and illness. 7. Include cultural practices that are relevant to the specific community.

2, 5, 7

A 4-month-old infant has not been feeling well for 2 days. His mother has brought him to the clinic to be seen by his health care provider. Which number identifies the area of the infant's head where the nurse can assess for dehydration?

3

A new nurse is caring for a hospitalized obese patient who is homeless. This is the first time the patient has been admitted to the hospital, and the patient is scheduled for surgery. Which of the following is a universal skill that will help the nurse work effectively with this patient? 1. The nurse shifts her focus to understanding the patient by asking her, "Describe for me the course of your illness." 2. The nurse tells the patient, "Your choices of foods and unwillingness to exercise are adding to your health problems." 3. The nurse asks the patient, "Tell me about the main problems you have had with your health from not having a home." 4. The nurse explains, "Because you have obesity, it is important to know the effects it has on wound healing because of reduced tissue perfusion."

3

A new nurse is experiencing lateral violence at work. Which steps could the nurse take to address this problem? 1. Challenge the nurses in a public forum to embarrass them and change their behavior 2. Talk with the department secretary and ask if this has been a problem for other nurses 3. Talk with the preceptor or manager and ask for assistance in handling this issue 4. Say nothing and hope things get better

3

A nurse has worked in a home health agency for a number of years. She goes to visit a patient who has diabetes and who lives in a public housing facility. This is the first time the nurse has cared for the patient. The patient has four other family members who live with her in the one-bedroom apartment. Which of the following, based on Campinha-Bacote's (2002) model of cultural competency, is an example of cultural awareness? 1. The nurse begins a discussion with the patient by asking, "Tell me about your family members who live with you?" 2. The nurse asks, "What do you believe is needed to make you feel better?" 3. The nurse silently reflects about how her biases regarding poverty can influence how she assesses the patient. 4. The nurse uses a therapeutic and caring approach to how she interacts with the patient.

3

A parent has brought her 6-month-old infant in for a well-child check. Which of her statements indicates a need for further teaching? 1. "I can start giving her whole milk at about 12 months." 2. "I can continue to breastfeed for another 6 months." 3. "I've started giving her plenty of fruit juice as a way to increase her vitamin intake." 4. "I can start giving her solid food now."

3

A patient is evaluated in the emergency department after causing an automobile accident while being under the influence of alcohol. While assessing the patient, which statement would be the most therapeutic? 1. "Why did you drive after you had been drinking?" 2. "We have multiple patients to see tonight as a result of this accident." 3. "Tell me what happened before, during, and after the automobile accident tonight." 4. "It will be okay. No one was seriously hurt in the accident."

3

A patient newly diagnosed with cervical cancer is going home. The patient is avoiding discussion of her illness and postoperative orders. What is the nurse's best plan in teaching this patient? 1. Teach the patient's spouse 2. Focus on knowledge the patient will need in a few weeks 3. Provide only the information that the patient needs to go home 4. Convince the patient that learning about her health is necessary

3

A patient who is Spanish-speaking does not appear to understand the nurse's information on wound care. Which action should the nurse take? 1. Arrange for a Spanish-speaking social worker to explain the procedure 2. Ask a fellow Spanish-speaking patient to help explain the procedure 3. Use a professional interpreter to provide wound care education in Spanish 4. Ask the patient to write down questions that he or she has for the nurse

3

During an encounter with an elderly patient, the nurse recognizes that a thorough cultural assessment is necessary because the patient has recently come to the United States from Russia and has never been hospitalized before. The nurse wants to discuss cultural similarities between herself and the patient. Which step of the LEARN mnemonic is this? 1. Listen 2. Explain 3. Acknowledge 4. Recommend treatment 5. Negotiate agreement

3

Nine-year-old Brian has a difficult time making friends at school and being chosen to play on the team. He also has trouble completing his homework and, as a result, receives little positive feedback from his parents or teacher. According to Erikson's theory, failure at this stage of development results in: 1. A sense of guilt. 2. A poor sense of self. 3. Feelings of inferiority. 4. Mistrust.

3

Parents are concerned about their toddler's negativism. To avoid a negative response, which of the following is the best way for a nurse to demonstrate asking the toddler to eat his or her lunch? 1. Would you like to eat your lunch now? 2. When would you like to eat your lunch? 3. Would you like apple slices or applesauce with your sandwich? 4. Would you like to sit at the big table to eat?

3

The Collins family includes a mother; stepfather, two teenage biological daughters of the mother; and a 25-year-old biological daughter of the father. The father's daughter just moved home following the loss of her job in another city. The family is converting a study into Stacey's bedroom and is in the process of distributing household chores. When you talk to members of the family, they all think that their family can adjust to lifestyle changes. This is an example of family: 1. Diversity. 2. Durability. 3. Resiliency. 4. Configuration.

3

When planning for instruction on cardiac diets to a patient with heart failure, which of the following instructional methods would be the most appropriate for someone identified as a visual/spatial learner? 1. Printed pamphlets on cardiovascular disease and dietary recommendations from the American Heart Association 2. A role-play activity requiring the patient to select proper foods from a wide selection 3. Colored visual diagrams that categorize foods according to fat and sodium content 4. A lecture-style discussion on heart healthy diet options

3

You are working in an adolescent health center when a 15-year-old patient shares with you that she thinks she is pregnant and is worried that she may now have a sexually transmitted infection (STI). Her pregnancy test is negative. What is your next priority of care? 1. Contact her parents to alert them of her need for birth control. 2. Refer her to a primary health care provider to obtain a prescription for birth control. 3. Counsel her on safe sex practices. 4. Ask her to have her partner come to the clinic for sexually transmitted infection testing.

3

Which of the following family assessments are most important for successful family caregiving? (Select all that apply.) 1. Educational level of family members 2. Cultural food preferences 3. Collaboration between family members 4. Social support 5. Conflict resolution practices

3, 4, 5

Place the following stages of Freud's psychosexual development in the proper order by age progression. 1. Oedipal 2. Latency 3. Oral 4. Genital 5. Anal

3, 5, 2, 1, 4

preschoolers

3-5 years classify objects by size and color vocabulary increases rapidly 12 hrs of sleep a night

placenta develops during the _______week of the embryonic stage

3rd

A nurse is assigned to care for a patient for the first time and states, "I don't know a lot about your culture and want to learn how to better meet your health care needs." Which therapeutic communication technique did the nurse use in this situation? 1. Validation 2. Empathy 3. Sarcasm 4. Humility

4

A nurse is preparing to perform a cultural assessment of a patient. Which of the following questions is an example of a contrast question? 1. Tell me about your ethnic background. 2. Have you had this problem in the past? 3. Where do other members of your family live? 4. How different is this problem from the one you had previously?

4

A nurse is teaching a group of young college-age women the importance of using sunscreen when going out in the sun. Which type of content is the nurse providing? 1. Simulation 2. Restoring health 3. Coping with impaired function 4. Health promotion and illness prevention

4

A nursing student is reviewing a process recording with the instructor. The student engaged the patient in a discussion about availability of family members to provide support at home once the patient is discharged. The student reviews with the instructor whether the comments used encouraged openness and allowed the patient to "tell his story." This is an example of which step of the nursing process? 1. Planning 2. Assessment 3. Intervention 4. Evaluation

4

A patient needs to learn to use a walker. Which domain is required for learning this skill? 1. Affective domain 2. Cognitive domain 3. Attentional domain 4. Psychomotor domain

4

An older adult is being started on a new antihypertensive medication. In teaching the patient about the medication, the nurse: 1. Speaks loudly. 2. Presents the information once. 3. Expects the patient to understand the information quickly. 4. Allows the patient time to express himself or herself and ask questions.

4

Dave reports being happy and satisfied with his life. What do we know about him? 1. He is in one of the later developmental periods, concerned with reviewing his life. 2. He is atypical, since most people in any of the developmental stages report significant dissatisfaction with their lives. 3. He is in one of the earlier developmental periods, concerned with establishing a career and satisfying long-term relationships. 4. It is difficult to determine Dave's developmental stage since most people report overall satisfaction with their lives in all stages.

4

Elizabeth, who is having unprotected sex with her boyfriend, comments to her friends, "Did you hear about Kathy? You know, she fools around so much; I heard she was pregnant. That would never happen to me!" This is an example of adolescent: 1. Imaginary audience. 2. False-belief syndrome. 3. Personal fable. 4. Sense of invulnerability.

4

In viewing the family as context, what is the primary focus? 1. Family members within a system 2. Family process and relationships 3. Family relational and transactional concepts 4. Health needs of an individual member

4

The nurse is aware that preschoolers often display a developmental characteristic that makes them treat dolls or stuffed animals as if they have thoughts and feelings. This is an example of: 1. Logical reasoning. 2. Egocentrism. 3. Concrete thinking. 4. Animism.

4

The type of injury to which a child is most vulnerable at a specific age is most closely related to which of the following? 1. Provision of adult supervision 2. Educational level of the parent 3. Physical health of the child 4. Developmental level of the child

4

Two single mothers are active professionals and have teenage daughters. They also have busy social lives and date occasionally. Three years ago they decided to share a house and housing costs, living expenses, and child care responsibilities. The children consider one another as their family. What type of family form does this represent? 1. Diverse family relationship 2. Blended family relationships 3. Extended family relationship 4. Alternative family relationship

4

When preparing a 4-year-old child for a procedure, which method is developmentally most appropriate for the nurse to use? 1. Allowing the child to watch another child undergoing the same procedure 2. Showing the child pictures of what he or she will experience 3. Talking to the child in simple terms about what will happen 4. Preparing the child through play with a doll and toy medical equipment

4

Which approach would be best for a nurse to use with a hospitalized toddler? 1. Always give several choices. 2. Set few limits to allow for open expression. 3. Use noninvasive methods when possible. 4. Establish a supportive relationship with the mother.

4

Which of the following most greatly affects a family's access to adequate health care, opportunity for education, and sound nutrition? 1. Development 2. Family function 3. Family structure 4. Economic stability

4

Which of the following statements is most descriptive of the psychosocial development of school-age children? 1. Boys and girls play equally with each other. 2. Peer influence is not yet an important factor to the child. 3. They like to play games with rigid rules. 4. Children frequently have "best friends."

4

A nurse prepares to contact a patient's physician about a change in the patient's condition. Put the following statements in the correct order using SBAR (Situation, Background, Assessment, and Recommendation) communication. 1. "She is a 53-year-old female who was admitted 2 days ago with pneumonia and was started on Levaquin at 5 PM yesterday. She complains of a poor appetite." 2. "The patient reported feeling very nauseated after her dose of Levaquin an hour ago." 3. "Would you like to make a change in antibiotics, or could we give her a nutritional supplement before her medication?" 4. "The patient started complaining of nausea yesterday evening and has vomited several times during the night."

4S, 1B, 2A, 3R

Sequence the skills in the expected order of gross-motor development in an infant beginning with the earliest skill: 1. Move from prone to sitting unassisted 2. Sit down from standing position 3. Sit upright without support 4. Roll from abdomen to back 5. Can turn from side to back

5, 4, 3, 1, 2

School aged and adolescent

6-18 years puberty around 12yrs perfect writing skills and further education absorption develops logical thinking independent daily activities sexuality and stress

Infants sleep about _____ hrs a day

9-11

A patient comes from a close-knit family. The patient's family functions as context. You will need to evaluate: A. attainment of patient needs. B. family attainment of developmental tasks. C. individual family members caring about one another. D. family satisfaction with its new level of functioning.

A

During a teaching session, the nurse tells a patient with a recent neck injury that damage to the nerves is comparable to a water hose that has been pinched off. During this teaching session, the nurse is using the process of: A. analogy. B. discovery. C. role playing. D. demonstration.

A

Helping relationships serve as the foundation of clinical nursing practice. Contracts for a therapeutic helping relationship are formed during the: A. orientation stage. B. working stage. C. termination stage. D. preinteraction stage.

A

You are caring for a 5-year-old who is hospitalized for stabilization of asthma. To render age-specific care, an action you can take would be to: A. allow the child to handle medical equipment. B. respond immediately to the child's every need. C. tell the child to be good. D. rationalize the child's complaint as part of the developmental stage.

A

postconventional reasoning

A type of reasoning in which a child bases decisions on his or her conscience.

conventional reasoning

A type of reasoning in which a child looks for approval from peers and society.

A nurse is teaching a 27-year-old gentleman how to adjust his insulin dosages on the basis of his blood sugar results. This type of activity addresses learning in the cognitive domain at the level of ___________.

Application

A pregnant teenager asks the clinic nurse why she should not smoke during the first trimester. The nurse's best response should be: A. the distribution of body hair can be altered. B. the organ systems are beginning to develop. C. development of fingers and toes can be affected. D. the sex of the baby is determined in the first 3 months.

B

While admitting a patient, during the initial interview, a family member tells you, "My mom really means that she does not understand her medical diagnosis." The communication form used by the family member is: A. focusing. B. clarifying. C. summarizing. D. paraphrasing.

B

You are in the process of admitting an ethnically diverse patient. To plan culturally competent care, you will conduct a cultural assessment that includes: A. biocultural history. B. ethnohistory. C. negotiation. D. ethnocentrism.

B