NR222 exam 2
A community center is presenting a nurse-led program on the Patient Protection and Affordable Care Act. Which statement made by a participant indicates a need for further teaching?
"As long as my son is a full-time student in College, I will be able to keep him on my health insurance until he is 26 years old."
A patient is fearful of upcoming surgery and a possible cancer diagnosis. He discusses his love for the Bible with his nurse, who recommends a favorite Bible verse. Another nurse tells the patient's nurse that there is no place in nursing for spiritual caring. The patient's nurse replies:
"Spiritual, mind, and body connections can affect health."
A nurse is attending a continuing education program about growth and development. Why is it necessary that nurses are well educated about this content? (Select all that apply)
-Can deliver anticipatory guidance to families -Have a better understanding of genetics and genomics -Can provide more effective health education
Which of the following nursing activities is provided in a secondary health care environment?
-Changing the postoperative dressing for a patient on a medical-surgical unit. -Doing endotracheal suctioning for a patient on a ventilator in the medical intensive care unit.
Which of the following is a strategy for creating work environments that enable nurses to demonstrate more caring behaviors?
-Increasing the number of nurses who work each shift to decrease the nurse-patient ratio -Providing nursing staff an opportunity to discuss practice changes they can implement to enhance opportunities for patient caring
Which of the following statements related to theory-based nursing practice are correct?
-Nursing theory differentiates nursing from other disciplines. -Integrating theory into practice promotes coordinated care delivery. -Nursing knowledge is generated by theory. -Evidence-based practice results from theory-testing research.
Which of the following are characteristics of managed care systems?
-Provider receives a predetermined payment for each patient in the program. -System tries to reduce costs while keeping patients healthy. -Focus of care is on prevention and early intervention.
Which of the following are examples of the nurse participating in primary care activities?
-Providing prenatal teaching on nutrition to a pregnant woman during the first trimester -Assessing the nutritional status of older adults who come to the community center for lunch. -Teaching a class to parents at the local grade school about the importance of immunizations.
A nurse demonstrated caring by helping family members to:
-become active participants in care -Have uninterrupted time for family and patient to be together. -Have opportunities for the family to discuss their concerns.
Match the following description to the appropriate middle-range theory.
-benner skills acquisition-the nurse processes through five stages of expertise -AACN's synergy model- Matching nurse competencies to patient needs -Misher's uncertainty in illness-The nurse assists the patient to process and find -Kolcaba's theory of comfort-The nurse strives to relieve patients' distress.
Nurses have developed theories in response to:
-changes in health care -prior nursing theories -changes in nursing practice -research findings -theories from other disciplines
What are some ethical standards that nurses can utilize for interpersonal communications? (select all that apply)
-communication information accurately -be sensitive to gender and cultural context -communicate verbal and nonverbal messages in a congruent manner
Theory is essential to nursing practice because it:
-contributes to nursing knowledge -predicts patient behaviors in situations -provides a means of assessing patient vital signs -explains relationships between concepts
Health concerns in arab americans :
-diabetes melitus, coronary artery disease, mental health, teenage smoking
a nurse is discussion restorative health care with a newly licensed nurse. which of the following examples should the nurse include in the teaching?
-home health care -rehabilitation facilities -skilled nursing facilities
a nurse is explaining the various levels of health care services to a group of newly licensed nurses. which of the following examples of care or care settings should the nurse classify as tertiary care?
-intensive care unit -oncology treatment center -burn center
Match the following descriptions to the appropriate grand theorist.
-king-Based on 14 activities, the nurse should assist patients with meeting needs until they are able to do so independently -Henderson- Based on 14 activities, the nurse should assist patients with meeting needs until they are able to do so independently. -Orem-Based on the belief that people who participate in self-care activities are more likely to improve their health outcomes. -Neuman-Based on the theory that focuses on wellness and prevention of disease
The nurse utilizes strategies associated with client-centered communication by doing which of the following? (select all that apply
-not being"too busy" to talk -developing mutual understanding -using a conversational interviewing style -tuning in to the client's preferences and style
A nurse is caring for a patient who recently lost a leg in a motor vehicle accident. The nurse best assists the patient to cope with this situation by applying which of the following theories?
-roy
a nurse is in the process of establishing a therapeutic relationship with a person. which of the following techniques should be used by the nurse:
-showing interest in the persons concerns -define the parameters of the relationship with the person
Nurses have a responsibility to ensure health literacy when providing health education. What are some strategies that nurses can use to promote health literacy? (select all that apply)
-speak clearly and distincly -face the person when speaking -conclude with a summary of key points
Arab americans
-they use fold remedies -male dominant family structure/present oriented
The nursing staff is developing a quality program. Which of the following are nursing-sensitive indicators from the National Database of Nursing Quality Indicators (NDNQI) that the nurses can use to measure patient safety and quality for the unit?
-use physical restraints -pain assessment,intervention, and reassessment -RN education and certification
Asian american
-value education -family is very important social institution. respect elders -passivity to avoid conflict -use folk medicine & alternative treatment modalities
A nurse is using the Plan-Do-Study-Act (PDSA) strategy to do a quality improvement project to decrease patient falls on a nursing unit. What is the correct sequence for PDSA? 1. Bedside change of shift report is piloted on two medical-surgical units 2. Patient satisfaction levels after implementation of the bedside report are compared to patient satisfaction levels before the change 3. The nursing council develops a strategy for bedside change of shift report 4. After modifications are made in the shift report elements, bedside shift report is implemented on all nursing units
3, 1, 2, 4
While working in a rehabilitation facility, it is important to obtain nursing histories and develop a therapeutic nurse-patient relationship. Which of the following lists in correct order the phases of Peplau's theory as applied in this setting. The nurse: 1. Ensures that the patient has access to appropriate community resources for long-term care.2. Collaborates with the patient to identify specific patient needs3. Collects essential information from the patient's health record.4. Works with the patient to develop a plan for resolving patient issues.
3, 2, 4, 1
An example of a nurse caring behavior that families of acutely ill patients perceive as important to patients' well-being is:
Asking permission before performing a procedure on a patient.
Technological advances in health care:
D. do not replace sound personal judgement
The nurse is teaching a class to students of pediatric nursing on comparing the concepts of growth and development. Which statement most accurately represents these concepts?
Development is a gradual change that includes advances in skills.
E in S.O.L.E.R
Establish and maintain intermittent eye contact
Of the five caring processes described by Swanson, which describes "knowing the patie
Establishing an understanding of a specific patient
L in S.O.L.E.R
Lean toward the patient
Which of the following statements is true regarding Magnet status recognition for a hospital?
Magnet is a special designation for hospitals that achieve excellence in nursing practice
A nurse is providing restorative care to a patient following an extended hospitalization for an acute illness. Which of the following is an appropriate goal for restorative care?
Patient will be able to walk 200 feet without shortness of breath
The components of the nursing metaparadigm include:
Person, health, environment, and nursing
A nurse is using data collected from the unit to monitor the incidence of falls after the unit implemented a new fall protocol. The nurse is working in which area?
Quality improvement
A group of staff nurses notice an increased incidence of medication errors on their unit. After further investigation it is determined that the nurses are not consistently identifying the patient correctly. A change is needed quickly. What type of quality improvement method would be most appropriate?
Rapid-improvement event
R in S.O.L.E.R
Relax
-Stress heardy characteristics=
See stress as a challenge instead of a threat
A nurse is caring for an older adult who needs to enter an assisted living facility following discharge from the hospital. Which of the following is an example of listening that displays caring?
The nurse listens to the patient's story while sitting on the side of the bed and then summarizes the story.
A patient tells a nurse that she is enrolled in a preferred provider organization (PPO) but does not understand what this is. What is the nurse's best explanation of a PPO?
This health plan gives you with a list of physicians and hospitals from which you can choose
A nurse hears a colleague tell a nursing student that she never touches a patient unless she is performing a procedure or doing an assessment. The nurse tells the student that from a caring perspective:
Touch forms a connection between nurse and patient.
Which of the following scenarios best describes a nurse using metacommunication
Understanding that an individual needs a break before proceeding
Using Maslow's hierarchy of needs, identify the priority for a patient who is experiencing chest pain and difficulty breathing.
air,water,and nutrition
The nurse incorporates cultural considerations into the health teaching plan by
assessing a person's beliefs
Personalistic practitioners=
believe ecternal agent (Sorcerer) or nonhuman (Ghost) causes health and illness. Emphasis on humans' relationship w/ others living & dead. Ex: voodoo priest,shamen
Cultural imposition
caused by a lack of knowledge about a group. When someone imposes their values and behaviors onto someone else.
while admitting a patient, during the inital 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:
clarifying
a nurse manager is developing strategies to care for the increasing number of clients who have obesity. which of the following actions should the nurse include as a primary health care strategy?
collaborating with providers to perform obesity screenings during routine office visits
Transcultural nursing
comparative study of cultures to understand their similarities and differences.
Tanner stages=
development of breasts and pubes in girls and gonads and pubes in boys
a nurse is discussing the purpose of regulatory agencies during a staff meeting. Which of the following tasks should the nurse identify as the responsibility of state licensing boards?
ensuring that health care providers comply with regulation
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:
feeling of inferiority
muslim (arab american)
halal food (meat(slaughtered during prayer ritual), fish, fresh fruit, vegetables, eggs, milk, cheese)
The communication of health information in a manner which is clear and understandable to the client is known as
health literacy
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:
imaginary audience
emic worldview
inside, native, perspective. How one perceives and catagorizes the world, rules for behavior & what it means for them.
public(levels of communication)
interaction with an audience
transpersonal(levels of communication)
interaction within a person's spiritual domain
small group(levels of communication)
interactions with a small number of people
Enuresis=
involuntary urination. especially for children during the night.
Which of the following types of theory influence the "evidence" in current "evidence-based practice (EBP)"?
middle-range theory
A nurse ensures that each patient's room is clean, well ventilated, and free from clutter, excessive noise, and extremes in temperature. Which theorist's work is the nurse practicing in this example?
nightingale
Haram (arab american)
non-permitted foods (non-halal meat, animals w/ fangs, pork, gelatin, alcohol) -female circumcision
Intrapersonal(levels of communication)
occurs within an individual
interpersonal(levels of communication)
one-to-one interaction between two people
The nurse is caring for a patient admitted to the neurological unit with the diagnosis of a stroke and right-sided weakness. The nurse assumes responsibility for bathing and feeding the patient until the patient is able to begin performing these activities. The nurse in this situation is applying the theory developed by:
orem
Nurses on a nursing unit are discussing the processes that led up to a near-miss error on the clinical unit. They are outlining strategies that will prevent this in the future. This is an example of nurses working on what issue in the health care system?
patient safety
A nurse is presenting information to a management class of nursing students on the topic of financial reimbursement for achievement of established, measurable patient outcomes. The nurse is presenting information to the class on which topic?
pay for performance
-Devout muslims=(arab american)
pray 5x a day & some cleans before prayer (religion can also be Christian or judaism)
culturally competent care
process of acquiring knowledge, skills, and attitudes to provide culturally congruent care.
assimilation
process of adapting to and adopting a new culture
Which of the following categories of shared theories would be most appropriate for a patient who is grieving the loss of a spouse?
psychosocial
-cognitive restructuring=
recognizing that negative thinking often causes emotional destress
Race=
shared biological attributes of a group. Ex: skin
Ethnicity
shared language, geographical origin, customs, food, dress
you are invited to attend the weekly unit patient care conference. The staff discusses patient care issues. This type of communication is :
small group
enculturation
socialization into primary culture as child
Latino/hispanic americans health concerns:
stomach cancer, diabetes mellitus, cardiovascular disease, HIV
morbidity=
the condition of being diseased/ the proportion of sickness or of a specific disease in a geographical location
etic worldview
the outsider's perspective. realize that members of a culture are so immursed to see anything else.
Culture
thoughts, communications, actions, customs, beliefs, values. -Can be racial, ethnic, religious or social group
Japanese traditions
tradition says food should be consumed as close to its original natural state as possible.
an older-adult is wearing a hearing aid. which techniques should the nurse use to facilitate communication
turn off the Television
A patient is aphasic, and the nurse notices that the patients hands shake intermittently. Which nursing action is most appropriate to facilitate communication?
use pen and paper
cultural group share
values/ thinking and acting different from those outside of the group. Ex: hisidic jews
Latino/hispanic americans
-largest minority group in U.S -highest uninsured in U.S -family is more important than individual needs -spirituality is important -disease has supernatural or psychological causes -uses folk remedies w/ western medicine
a nurse is explaining the various types of health care coverage clients might have to a group of nursing students.which of the following health care financing mechanisms are federally funded ?
-medicare -medicaid
culturally congruent care
fits persons values and meanings. requires knowledge & skill in delivering care.
Asian american health concerns
hesitant to seek early diagnosis, high TB rate, mental health problems, low rate of obesity & hypertension
Islamic (arab american)
male circumcision
A nurse is preparing to begin intravenous fluid therapy for a patient. Which category of theory would be most helpful to the nurse at this time?
practice theory
Which activity performed by a nurse is related to maintaining competency in nursing practice?
Attending a review course in preparation for a certification examination
A patient who needs nursing and rehabilitation following a stroke would most benefit from receiving care at a:
B.restorative care center
The nurses on a medical unit have seen an increase in the number of pressure ulcers that develop in their patients. They decide to initiate a quality improvement project using the Plan-Do-Study-Act (PDSA) model. Which of the following is an example of "Do" from that model?
Based on findings from patients who developed ulcers, implementing an evidence-based skin care protocol.
Taoism(asian american)
Chinese medicine "achieving harmony"
Ethnocentrism
Holds own way of life as superior. Cause of bias and prejudices
O in S.O.L.E.R
Observe an open posture
acculturation
assimilation to dominant culture
S in S.O.L.E.R
Sit facing the patient
