Nurs 200 Midterm Chaminade University

What is the GPA that must be maintained in the CUH Nursing Program?

2.5

Skim the assigned reading for ___ minutes prior to studying

5

Which is the current version of the American Psychological Association Manual (APA)?

7th edition

Formulation of a problem statement

A clear and unambiguous expression of the relationship between two or more variables and the population to be studied.

Self-knowledge:

A cognitive perception of one's cognitive, affective, and physical abilities/traits

Definition:

A definition that describes the characteristics of the human response under consideration

Proposed research question or hypothesis

A detailed statement of the expected causal effects or proposed relationships between/among operationally defined variables

Defense mechanisms:

A form of temporary removal from the stress

Instructional concept maps:

A graphical tool for organizing and representing knowledge used in nursing education

Values inquiry

A method of examining social issues and the values that motivate human choices

Ethnographic Interview:

A more structured way to elicit respondents' culturally based meaning of health and illness that may lead to deeper understanding of a culture.

Self:

A person's unique dimensions, potentials, and purposes.

Tort

A private wrong-doing subject to action in a civil court.

Health and Wellness Promotion

A process of enabling people to increase control over and to improve their health. Health promotion activities are often associated with lifestyle choices targeted at increasing the level of wellness.

Race:

A set of categories created by society based on physical appearance or place of origin.

Chronic stress:

A sustained response or repeated event that eventually impedes coping.

Crime:

A violation punishable by the state through the criminal justice system.

While taking a patient history, the nurse asks the patient how he feels about himself. What step of the nursing process does this represent? A. Assessment B. Outcome planning C. Health promotion D. Evaluation

A. Assessment Rationale: Asking questions during a patient history is a part of the assessment phase of the nursing process. Outcome identification is done with the help of the patient after assessment and formulation of nursing diagnoses. Health promotion is a method of care plan implementation. Evaluation is done to measure the attainment of goals.

Select the statement that best reflects a nursing diagnosis: A.Constipation related to decreased activity and fluids as manifested by small, hard, formed stool every 3 days B.Potential activity intolerance C.Adjustment impaired, possibly due to recent skateboard injury resulting in quadriplegia D.Abnormal bleeding due to hemophilia

A. Constipation related to decreased activity and fluids as manifested by small, hard, formed stool every 3 days Rationale: Answer A contains all necessary components of a nursing diagnosis: diagnostic label, related factors and defining characteristics. In answer B, the term "potential" is used rather than "risk." In answer C, cues are included without validation, and answer D is a medical diagnosis.

The statement, "This is the only acceptable alternative to approaching this problem" is an example of which characteristic of culture? A. Culture is ethnocentric. B. Culture is dynamic. C. Culture is pervasive and holistic. D. Culture is diverse.

A. Culture is ethnocentric. Rationale: Ethnocentrism is a cultural characteristic in which cultural beliefs are held as truths and are the only correct standard by which to view the world.

The nurse overheard a parent telling a 9-year-old child that the reason he received an injection was because he was disobedient and rode his bike in the street. The nurse knows that this is particularly distressing to the child because he probably is in the following stage of spiritual development: A. Mythic-Literal Faith B. Individuative-Reflective Faith C. Intuitive-Projective D. Synthetic-Conventional

A. Mythic-Literal Faith Rationale: Children between the ages of 7 to 12 usually are in the Mythic-Literal Faith stage, which includes a strong belief in the relationship of a painful event being their fault and a punishment. The parent's statement reinforced this relationship, which has implications for future interpretations of painful events.

The nurse is reviewing the nursing diagnoses of a patient and begins to formulate a priority list. Which phase of the nursing process is the nurse performing? A.Outcome identification B.Diagnosis C.Evaluation D.Planning

A. Outcome identification Rationale: The phase of outcome identification includes the steps of establishing priorities, patient goals, and outcome criteria.

The nurse taps on a pregnant woman's abdomen with her middle fingertip and listens to the resulting sound. If the patient asks you what the nurse is doing, you would respond that the nurse is using: A.Percussion B.Auscultation C.Palpation D.Inspection

A. Percussion Rationale: Percussion is the use of tapping with the finger to produce a percussive note that can denote presence of fluid, air, or solid mass. Palpation does not include the sense of hearing nor does inspection. The use of auscultation in assessment does not include eliciting sounds, just listening for ones that are presence.

The component of therapeutic communication in which unnecessary labeling of the patient is avoided is: A. Positive regard B. Empathy C. Self-awareness D. Self-reflection

A. Positive regard Rationale: Viewing patients as their disease (e.g., "the diabetic in room 354") can interfere with the ability to see the person behind the label, making it difficult to view the patient with respect.

The research approach that uses the least amount of control over study variables is: A.Qualitative B.Quantitative C.Mixed methods D.Randomized trial

A. Qualitative Rationale: Quantitative studies involve data collection under controlled conditions. A clinical trial is a highly controlled quantitative study. Mixed methods research uses both qualitative and quantitative methods, thus still may involve some control over variables in the design.

Technical skills:

Ability to use equipment, machines, and supplies to render nursing care

Resistance:

Adaptability to adversity

Which of the following are true statements about professionalism from the student handbook? a) Class attendance is voluntary b) Travel arrangements for a recess should not include any day on which a lecture, lab or clinical is scheduled c) Students must contact the course coordinator, clinical coordinator and/or clinical coordinator and/or clinical adjunct of facility preceptor to inform them about any absences or tardiness prior to the date of the absence d) All newly admitted students will be assigned a professional advisor upon admission to the BSN program

All except (a) class attendance is mandatory

To avoid plagiarism, what needs to be cited in your Service Learning paper? Select all that apply a) Direct quotes b) Paraphrase of ideas c) Personal communication d) Author's personal ideas

All except (c) I think?

Secondary Source of Data

All other sources of data, including diagnostic tests

Assessment

Allows comparison of objective and subjective assessment data gathered by all team members to determine current health status and progress toward goals.

Sensory and physical state:

Alteration in physical state (fatigue, alteration in cognition) or sensory challenges may be an inhibiting factor on learning.

Professional Nursing Organizations

American Nurses Association (ANA): Sets the standards of practice for nurses and makes decisions about the functions, activities, and goals of the nursing profession. Sigma Theta Tau International (STTI), Honor Society of Nursing: Provides leadership and scholarship in practice, education, and research to enhance the health of all people. National Student Nurses' Association (NSNA): An autonomous organization that is financed and administered by students that serves as the voice of nursing students.

Spiritual well-being:

An affirmation of life, peace, harmony, and a sense of interconnectedness with God, self, community, and environment that nurtures and celebrates wholeness.

Subcultures:

An ethnic, regional, economic, or social group exhibiting characteristic patterns of behavior sufficient to distinguish it from others in a culture.

Cue clustering:

Analyzing individual cues and fitting them into a particular meaningful cluster that describes a specific patient problem

Values clarification methods

Approaches that assist healthcare providers or patients to understand what they hold as important in order to identify preferences in decision-making.

Intentional torts Examples

Assault and battery Defamation of character FraudoInvasion of privacy False imprisonment

Stereotype:

Assigning people to specific categories or behaviors because of their culture, race, or ethnicity.

Therapeutic use of self

Assists person to: Grow in the ability to face reality Discover potential solutions to problems Good communication skills, trust, and empathy are needed

Structure evaluation

Attributes of the setting or surroundings

Clinical surveillance tools

Automated surveillance tools that scan electronic health record data and produce a real-time patient's risk score for designated high-risk conditions.

Care planning

Availability of all assessment data allows nurses to more accurately develop nursing diagnoses, patient goals, outcome criteria, interventions, and evaluation criteria for the patient plan of care.

Personal Identity:

Awareness that one is a distinct individual separate from others

Strong Personal Identity

Awareness that one is a distinct individual separate from others

Which of the following is a nontherapeutic response? A. Summarizing B. Being moralistic C. Seeking clarification D. Giving information

B. Being moralisticRationale: Being moralistic is a nontherapeutic response. Being moralistic means seeing a situation as good or bad, or right or wrong. It is a judgmental approach.

Which of the following is the best method for assessing a patient's cultural beliefs and values? A. Speaking with a key informant B. Conducting an open-ended interview with the patient C. Conducting a literature review D. Reading a synopsis of the patient's culture on the Internet

B. Conducting an open-ended interview with the patient Rationale: Open-ended interviewing elicits responses from the interviewee that are as free from influence by the interviewer's comments as possible.

The nursing student is reviewing assessment findings to organize existing cues into a pattern. This is known as which phase of the nursing process? A.Assessment B.Diagnosis C.Planning D.Outcome identification

B. Diagnosis Rationale: Formulation of nursing diagnoses occurs when assessment findings are organized and compared to identify existing patterns. Planning and outcome identification cannot occur until diagnoses are identified.

Which of the following descriptors used by NANDA-I means "not consistent with a standard"? A.Depleted B.Disproportionate C.Disabled D.Disorganized

B. Disproportionate Rationale: The descriptor disproportionate used by NANDA-I means "not consistent with a standard or norm" and is the only definition in the choices offered that refers to comparing assessment findings with a standard.

A high school student reports that he is "stressed out" and does not want to attend school. He mentions that his family moved into the neighborhood 2 weeks ago and although he has made some friends, the class schedule and courses are very different from that of his previous school. The type of stress most likely the reason for his symptoms is: A. Physiologic stress B. Environmental stress C. Psychological stress D. Sociocultural stress

B. Environmental stress Rationale: The most likely stress is environmental, as the school environment is different from what he previously experienced, and there is no mention of family issues or peer pressure.

The use of successive checks prior to high-risk procedures is known as: A.Mistake proofing B.Redundancy C.Time-out D.Standardized reporting

B. Redundancy Rationale: Redundancy is the use of built-in "double-checking" or of successive checks prior to performance of high-risk procedures or administration of high-risk medications. An example is that of checking a high-risk medication dosage calculation by two nurses.

All of the statements about the patient record are true except: A. The patient record communicates the plan of care to all providers. B. The patient record cannot be used in quality assurance due to the principle of confidentiality. C. The patient record can be used in court to prove or disprove injuries to a patient. D. The patient record is the basis for decisions regarding reimbursement to the healthcare provider.

B. The patient record cannot be used in quality assurance due to the principle of confidentiality. Rationale: HIPAA allows de-identified aggregate data from patient records to be used in healthcare quality assurance programs.

Which of the following types of assessment is done to evaluate changes in the patient's functional health from baseline? A.Focus assessment B.Time-lapse assessment C.Emergency assessment D.Initial assessment

B. Time-lapse assessment Rationale: Time-lapse assessment determines the status of problems already identified. They usually are performed when substantial periods of time have elapsed between assessments.

Which of the following terms defines unlawful touching of the body? A.Assault B.Battery C.Libel D.Slander

B.Battery Rationale: Battery is touching another person without his or her consent (unlawful touching). Assault is the threat of touching another person without his or her consent. Defamation of character is false communication that results in injury to a person's reputation by means of print (libel) or spoken word (slander).

The social interaction in which attitudes, beliefs, and behaviors are most likely influenced by peer group relationships is: A.Family interaction B.School interactions C.Religious interactions D.Workplace and service interaction

B.School interactions Rationale: Interactions in school teach cultural values through both observed peer and supervisory adult behaviors.

Studies show that artificial nails contain which of the following contaminates?

Bacteria

Collaborating

Based on positive professional relationships, which are built on trust and respect for the unique contribution of each healthcare team member

Assessment of learning needs:

Baseline knowledge, cultural and language needs, and priorities

Role Performance:

Behavior in fulfilling ascribed or assumed roles in social positions

Fidelity

Being faithful to one's commitments or promises.

Personal values

Beliefs a person considers highly important and are learned through interactions with social systems

Professional values

Beliefs endorsed by professional groups (like nursing associations, dental associations, or medical associations) that support generalizable standards of conduct that are to be upheld in all professional situations

A patient becomes agitated in the hallway and begins to cry, stating, "I'm not afraid of any of you and I'm not going to take it anymore." After spending time with the patient, the nurse repeats back to him that, "You are concerned that someone is going to try to make you do something that you do not want to do." Which component of the L.E.A.P. approach is the nurse using? A. Listening B. Empathizing C. Affirming D. Partnering

C. Affirming Rationale: The nurse is restating the patient's feelings and concerns in an effort to confirm that his "message" was correctly received and that his feelings are being affirmed.

Which of the following is mostly likely to be used for documenting the care of patients who have frequently occurring conditions with predictable outcomes? A. PIE charting B. SOAP notes C. Critical pathways D. FOCUS DAR notes

C. Critical pathways Rationale: Critical pathways are used to guide the care of patients who have commonly occurring and generally predictable conditions. The PIE charting system, SOAP notes, and FOCUS DAR notes are not used for this purpose.

During a review of a low-fat cardiac diet by the nurse, Mr. Jones has nodded his head several times in feedback. Later in the day when the nurse checks his dietary choices, it was found that he selected several foods on the menu that were the highest in fat. The type of communication that Mr. Jones exhibited was: A. Congruent metacommunication B. Therapeutic communication C. Incongruent metacommunication D. Elemental communication

C. Incongruent metacommunication Rationale: Incongruent metacommunication occurs when the relationships among written, verbal, nonverbal, and/or metacommunication are contradictory and give a "mixed message." In this case, during the education session, Mr. Jones agreed that he understood and agreed with the information that he was receiving, but his nonverbal behavior was contradictory to this message.

The nurse is reviewing the taxonomy of the Nursing Intervention Classification (NIC) System to develop a patient plan of care. This activity is related to which phase of the nursing process? A.Outcome identification B.Diagnosis C.Planning D.Implementation

C. Planning Rationale: Although the implementation phase of the nursing process uses the interventions documented in the patient plan of care, the NIC system is used primarily in the planning phase.

Which of the following is the first step the research process? A.Formulation of a problem statement B.Literature review C.Problem area identification D.Development of a study design

C. Problem area identification Rationale: The first step in any research process is to identify the problem area. The problem statement is formulated only after this is completed. The literature review and design development come after these initial steps.

The nursing instructor asks you whether the blood pressure of your assigned patient has decreased since admission. This question is related to which of the following activities of the evaluation phase? A. Setting priorities B. Performing nursing interventions C. Reviewing patient goals and outcomes D. Recording nursing actions

C. Reviewing patient goals and outcomes Rationale: Reviewing patient outcomes (in this case a reduction in blood pressure) is a part of the evaluation phase of nursing. Setting priorities, performing nursing interventions, and recording nursing actions are a part of the implementation phase of nursing.

The nursing instructor asks you whether the blood pressure of your assigned patient has decreased since admission. This question is related to which of the following activities of the evaluation phase? A.Setting priorities B.Performing nursing interventions C.Reviewing patient goals and outcomes D.Recording nursing actions

C. Reviewing patient goals and outcomes Rationale: Reviewing patient outcomes (in this case a reduction in blood pressure) is a part of the evaluation phase of nursing. Setting priorities, performing nursing interventions, and recording nursing actions are a part of the implementation phase of nursing.

What does the acronym SBAR stand for? A. Situation, Barriers, Assessment, Reporting B. Situation, Background, Acuity, Recommendation C. Situation, Background, Assessment, Recommendation D. Situation, Briefing, Alignment, Reporting

C. Situation, Background, Assessment, Recommendation Rationale: SBAR is a communication template that prompts the communicator to remember four important points of the situation—what the current situation is, the background of the situation, what the final assessment of the situation (or problem) is, and what might be potential solutions (recommendations).

A committee of nurses who are employed by the hospital are making inspection rounds of the patient care units to determine whether there is an adequate number and appropriate placement of hand sanitizing equipment. This type of evaluation is termed: A. Process evaluation B. Outcome evaluation C. Structure evaluation D. Unit evaluation

C. Structure evaluation Rationale: Structure evaluation focuses on the attributes of the setting or surroundings where healthcare is provided. Process evaluation focuses on nursing performance. Outcome evaluation focuses on patient outcomes.

A committee of nurses who are employed by the hospital are making inspection rounds of the patient care units to determine whether there is an adequate number and appropriate placement of hand sanitizing equipment. This type of evaluation is termed: A.Process evaluation B.Outcome evaluation C.Structure evaluation D.Unit evaluation

C. Structure evaluation Rationale: Structure evaluation focuses on the attributes of the setting or surroundings where healthcare is provided. Process evaluation focuses on nursing performance. Outcome evaluation focuses on patient outcomes.

Organizations to which healthcare institutions report quality and safety issues include: A.The Institute for Healthcare Improvement (IHI) B.The Institute for Medicine (IOM) C.The Centers for Medicare and Medicaid Services (CMS) D.The QSEN Institute

C.The Centers for Medicare and Medicaid Services (CMS) Rationale: The Centers for Medicare and Medicaid Services (CMS) is the only institute to which healthcare organizations need to report quality and safety data, as reimbursement depends on these data. The other institutions listed make recommendations and develop standards related to healthcare quality and safety.

The Johari Window

Can assist in the development of self-awareness by making an individual's word portrait in four areas: The Open Pane: The "mask" exhibited to others The Blind Pane: Qualities not recognized by the individual, but are noticed and known by others The Hidden Pane: Qualities known only to the individual The Unknown Pane: Qualities unknown or not yet discovered by oneself or others

Compliance:

Can be affected by factors such pain, anxiety, financial constraints, social isolation, and loss of independence.

Legal document

Can be used in court to prove or disprove injuries a patient incurred unintentionally or to implicate or absolve a healthcare professional with regard to improper care.

Dissemination of results

Can occur by podium or poster presentations at research meetings or in print through research and clinical journals.

Instructional patient plans of care:

Care plans that allow students to demonstrate their knowledge of a variety of patient problems and apply the nursing process

Nursing Responsibilities

Caregiver Patient advocate Educator Decision maker Manager and coordinator Communicator

APA level one heading

Centered, Boldface, Uppercase and Lowercase Headings

Chaminade's accreditation

Chaminade University of Honolulu is accredited by the Commission on Collegiate Nursing Education (CCNE)

Which of the following hands-on strategies are most important for an INTUITIVE learner ?

Checking your work

Where would you check out a course reserve book like Medical Terminology for this class?

Circulation desk

Communication:

Clear, accurate, and up-to-date patient documentation is a cornerstone for safe care delivery providing flow of information between providers of care.

Nursing Interventions

Cognitive: Educational, delegation, and supervisory Interpersonal: Coordinating, supportive, and psychosocial Technical: Maintenance Surveillance Psychomotor

Types of nursing interventions

Cognitive: Educational, delegation, and supervisory Interpersonal: Coordinating, supportive, and psychosocial Technical: Maintenance Surveillance Psychomotor

Care bundles

Combination of patient care elements into "bundles" that are consistently used as a whole Example: Central line-associated bloodstream infection bundle that contains basic elements of: Hand hygiene Maximal barrier precautions during line insertion Preparation of skin with chlorhexidine Optimal catheter site selection Daily review of line necessity

On the first day of clinical, it is most important for a student to

Come prepared and on time

Value Conflicts

Common areas of conflict often result from conflict among family members or among healthcare providers and patients.

Meta communication:

Communication about the communication

Most of the learning during a lecture takes place while doing which of the following tasks?

Competing assigned material before class

Family Conflicts

Conflicts between family members arise from differences in developmental stages, experiences, and personal values

Self-evaluation:

Conscious assessment of the self

Taxonomy:

Contained within the NANDA-I Taxonomy I under the level of nursing diagnosis. Taxonomy II was adopted in 2002 based on the functional health patterns assessment framework.

Plan of care:

Contains nursing diagnoses, goals, outcome criteria, interventions, and evaluation. Standardized plans of care may be used, but must always be individualized.

Education

Contains valuable educational information that allows students to relate patient signs and symptoms, interventions, and outcomes.

Nonverbal communication:

Conveys information through gestures, facial expressions, posture, space, appearance, body movement, touch, voice tone and volume, and rate of speech

Culture is dynamic:

Culture change occurs as people come into contact with new beliefs and ideas.

Culture is pervasive and holistic:

Culture links a wide variety of behaviors and events uniquely and holistically.

Culture is relative:

Cultures relate different meaning to the same given situations.

A nursing student is asked by the nursing instructor to develop a plan of care for his or her assigned patient. The most appropriate type of patient plan of care to be developed would be the: A.Individual plan of care B.Standardized plan of care C.Generic plan of care D.Instructional plan of care

D. Instructional plan of care Rationale: The instructional plan of care is the most appropriate for a nursing student to develop, as it allows the instructor to follow the student's critical thinking processes in the development of the plan.

Which of the following activities is the best example of a cognitive intervention? A. Maintaining equipment B. Coordinating activities C. Providing care D. Providing feedback

D. Providing feedback Rationale: Providing feedback is a cognitive skill. Maintaining equipment is a technical intervention. Coordinating activities and caregiving are examples of interpersonal interventions.

Which of the following activities is the best example of a cognitive intervention? A.Maintaining equipment B.Coordinating activities C.Providing care D.Providing feedback

D. Providing feedback Rationale: Providing feedback is a cognitive skill. Maintaining equipment is a technical intervention. Coordinating activities and caregiving are examples of interpersonal interventions.

Which of the following is the main purpose of validating a nursing diagnosis? A.To derive the meaning of the cues B.To identify individual cues C.To synthesize cue clusters D.To legitimize the nursing diagnosis

D. To legitimize the nursing diagnosis Rationale: After selecting a nursing diagnosis, the nurse should validate it with the patient. Validation legitimizes the diagnosis and helps to discover its significance for the patient.

Which of these four elements would not support the presence of malpractice? A.Duty to the plaintiff B.Failure to meet the standard of care by commission or omission C.Failure to meet the standard of care produced the injury in a natural and continuous sequence D.Potential for physical, emotional, financial, or other injury to the patient

D.Potential for physical, emotional, financial, or other injury to the patient Rationale: Causation between the standard of care not being met and the injury must be proven for the courts to find negligence; potential harm is not admissible as evidence of malpractice.

Problem-focused coping:

Deals directly with the challenge

Self-expectations:

Defines the self that a person wants to be

Teaching Methods

Demonstration Discussion and verbal teaching Written information Role-playing Lectures Teaching aids and resources: Audiovisual aids, Internet, interpreters, translators, equipment, and models

Related factors:

Describe the conditions, circumstances, or etiologies that contribute to the problem

Time-lapse assessment:

Determining change from previous findings

=Emergency assessment

Determining presence of life-threatening conditions

Admission assessment:

Determining reference baseline

Focus assessment:

Determining status of a specific problem

Planning:

Development of nursing strategies designed to ameliorate patient problems; used to direct nursing activities. Activities include: Planning nursing interventions Writing the patient plan of care

Emotion-focused coping:

Directed at dealing with emotions

Physical observations

Disfigured or missing body part or dysfunction

Psychomotor:

Domain of performance of new skills and procedures.

Communicating

Encompasses effective written and spoken mode as well as the ability to document accurately by electronic means. It also means the ability to translate medical terms to patients and to other healthcare professionals

Communication Techniques

Encouraging elaboration Seeking clarification Giving information Looking at alternatives Using silence Summarizing

Risk factors:

Environmental factors and physiological, psychological, genetic, or chemical elements that increase the vulnerability of an individual, family, or community to an unhealthful event

Ethics

Ethics is a branch of philosophy with an emphasis on morality. Morality is the set of beliefs about the standards of right and wrong that help a person determine the correct or permissible action in a given situation.

Peer review

Evaluation and judgment of a nurse's performance by other nurses A mechanism for evaluating and monitoring nursing care provided

TeamSTEPPS

Evidence-based toolbox of communication techniques developed by the Department of Defense and AHRQ that includes: SBAR: Standardized report consisting of Situation, Background, Assessment, and Recommendation Huddles: Held at the beginning of a shift to highlight important issues that will need attention Debriefing: Used after an event, especially an unexpected one, to explore what went well and what could have been performed better

Quality

Excellence or superiority of something; often viewed as a continuum

Standards of care

Expected level of performance or practice as established by guidelines, authority, or custom; each nurse practice act provides one set of guidelines for the standard that nursing care should meet.

Working:

Exploring and developing solutions that are enacted and evaluated in subsequent interactions.

Spiritual need:

Expression of a person's inner being that seeks meaning in the dynamic relationship among self, others, and a supreme being.

FOCUS

F: Education for formation in faith. O: Education in family (o'hana) spirit. C: Education for change and adaptation. U: United in integral, quality education. S: Education for service, justice and peace.

FICA:

F: Explores the questions of faith. I: Explores how important faith is to the individual. C: Explores activity within communities of faith. A: Explores any concerns of the individual about their faith

After completing a test, it is best to spend at least an hour immediately after the test reviewing information that you were unsure about

False

Auditory learners will benefit most from graphic organizers

False

Highlighting and writing in a textbook makes it more difficult to remember the reading material because there is so much extra writing in the book

False

It is a poor use of time to try to connect the material you are currently reading about in an assignment to info you have already learned

False

It is best to try and memorize a list of terms in one session as opposed to over multi days

False

It is better to study with distractions because the real world is full of distractions

False

It is important to try to record all of the information an instructor presents during a lecture

False

It is preferable to study in a warm room, rather than in a cool room.

False

Jewelry is only restricted in certain clinical settings.

False

Most students complete the assigned reading before lecture

False

Outlining notes during lecture will help students better retain information

False

Passwords may be shared with other members of the health care team.

False

Reviewing feedback given on a test will help you retain information in your short-term memory, but not your long-term memory

False

Students should only take notes on material they understand; taking notes on materials they do not understand could cause the notes to be confusing

False

Studies have shown that less than half of university professors use lecture format as their primary instructional method

False

When first starting clinical, students meet the health care professional they work with on their first day.

False

Working while in school lowers academic performance

False

the best time to study is in the morning

False

Sociocultural stressors

Family, financial, career concerns

Psychological stressors

Feelings of loss of personal control or powerlessness, (e.g., from death of a loved one)

Barriers to Motivation for Performing Health Maintenance BehaviorsHealth Maintenance Behaviors

Financial problems Inconvenience Lack of social support Anxiety Fear Negative self-concept

1950s−1960s (Historical Nursing Research)

First nursing research journal published; federally funded Nurse Scientist Training Program provided support for doctoral study in allied fields; research focused on nurses' activities and functions; conceptual frameworks for nursing evolved.

Coping with Alterations in Health Status

Focuses on enhancing coping of individuals and families who experience new and/or frightening procedures or must adjust to live with chronic illness or disability

Restoration of Optimal Health and Function after Illness

Focuses on limiting disability or restoring function

Prevention or Early Diagnosis of Illness

Focuses on teaching patients the knowledge and skills for early detection or prevention of disease and disability.

Outcome identification:

Formulation of goals and measurable outcomes that provide the basis for evaluating nursing diagnoses. Activities include: Establishing priorities Establishing patient goals and outcome criteria

Practical Nursing Programs

Graduates eligible to take the National Council Licensure Exam-Practical Nursing (NCLEX-PN) to become a licensed practical nurse (LPN) or licensed vocational nurse (LVN).

Registered Nurse Programs

Graduates eligible to take the National Council Licensure Examination-RN (NCLEX-RN). Programs include diploma nursing programs, associate degree programs, baccalaureate degree programs, and graduate entry programs

Minority:

Group of people within a society whose members have different ethnic, racial, national, religious, sexual, political, linguistic, or other characteristics from most of that society.

Holism:

Health and well-being exist when mind, body, and soul are balanced and are working in harmony with each other and the universe.

Core Values of Chaminade BSN

Holism Caring Community Service Diversity Integrity Commitment

Self-perception:

How a person explains behavior based on self-observation

Body Image:

How individuals picture and feel about their body.

Social self:

How individuals see themselves in relation to social situations

Self-Esteem:

How people feel about themselves. Influenced by: Power Meaning Competence Virtue

Ha`aha`a

Humility, humble, tolerant

The Quality and Safety Education for Nurses (QSEN)

Identifies key quality and safety competencies for nurses: Patient-centered care Teamwork and collaboration Evidence-based practice Quality improvement Safety Informatics

Standardized vocabulary

Important for use in the electronic health record, as consistency of terminology makes retrieval of individual and aggregate data possible. The ANA has approved the following as appropriate for nursing practice: Omaha, Nursing Interventions Classification (NIC), Nursing Outcomes Classification (NOC), Home Health Care Classification (HHCC), NANDA-I, and Ozbolt's Patient Care Data Set (PCDS).

Florence Nightingale

Improved health laws, reformed hospitals, reorganized military medical services, and established nursing as a profession. Published Notes on Nursing and started the Nightingale Training School for Nurses.

What are parenthetical citations?

In-text Citations

Vulnerability:

Inability to adapt to adversity; usually follows one or more adverse events, leading to decreased resistance and resilience

Circle of confidentiality:

Includes all the people who have responsibility for the patient; it also, with the patient's permission, includes the family.

Listening

Includes being responsive to both verbal information and nonverbal cues that patients send

Types of Clinical Plans of Care

Individual plan of care Standardized plan of care Generic plan of care Computerized plan of care

Organized and timely

Information should be documented chronologically and include patient response to interventions. Timely documentation decreases the chance of forgetting important information. All medications and procedures should be documented upon completion.

Physical examination techniques

Inspection Palpation Percussion Auscultation

Orientation:

Introductions and an agreement made between nurse and patient about their mutual roles and responsibilities.

Clinical Reasoning

Involves critical thinking, which integrates knowledge that until this point had been theoretical, to an actual patient scenario.

Quality improvement:

Involves measuring the extent to which standards have been achieved.

Types of Nursing Entries

Kardex Admission Entries Narrative notes Charting by Exception Progress Notes SOAP and SOAPIER notes PIE and APIE notes FOCUS DAR notes

Proactive Steps in Legal Protection

Keeping current with advances in practice Keeping current with changes in the local nurse practice act Becoming involved in development of institutional policies, procedures, protocols, and standardized nursing plans of care Maintain professional liability insurance. Maintain appropriate, accurate, complete, and contemporaneous documentation: Avoid documenting events before they occur. Assess and record patient conditions in accordance with the institutional policy. Document objective data only. Avoid pasting copied information from one electronic health record to another.

Confidential

Keeping information private is a legal and an ethical requirement. Applies to written and computerized medical records and any other information pertaining to the patient's health status or care. The Health Insurance Portability and Accountability Act (HIPAA) regulates all areas of information management, including security of records. Students must de-identify any patient information in written assignments to be HIPAA compliant.

Which of the following multi intelligences best describes an athlete ?

Kinesthetic learner

Culture is shared unequally by its members:

Knowing a cultural norm does not enable one to predict a person's response.

Na'au

Knowledge

Spiritual support (Nurse needs to be):

Knowledgeable about spiritual and religious expressions Nonjudgmental Empowering

Behavioral manifestations:

Lack of eye contact Hand-wringing

Ka'i

Leadership

Culture is learned:

Learned through sustained contact between groups and repeated observations of and participation in the group.

Maslow Hierarchy of Human Needs

Listed from least importance to most Physiologic needs: The need for oxygen, food, water, elimination, activity, rest, temperature maintenance, and sexuality. Safety needs: The need to be physically safe and free from fear and anxiety resulting from lack of security and protection. Love needs: The feeling of belonging and being loved to avoid loneliness and isolation. Esteem needs: Composed of esteem derived from others (respect) and self-esteem. Self-actualization needs: The need to maximize one's potential.

Auscultation:

Listening to body sounds with a stethoscope

What multi intelligence's best describes a statistician ?

Logical intelligence

Data analysis

Manipulation of data either statistically or through qualitative methods to determine study outcomes.

Quality assurance

Medical record audits can be performed to determine whether certain standards of care were met and documented and often lead to changes in care provision. Ongoing quality assurance programs that include audits of patient records are a part of accreditation requirements.

1970s−1980s (Historical Nursing Research)

More nursing research journals published; establishment of National Center for Nursing Research (NCNR) at NIH; professional organizations begin to establish nursing research priorities; both biological and behavioral health research that will become the scientific basis for clinical nursing practice

Assessment of learning readiness (inhibiting and facilitating factors):

Motivation, compliance, sensory and physical state, literacy level, and health literacy level

Culture is not easily described by its members:

Much of culture is implicit—a combination of habit and assumptions about the world.

Critical pathways:

Multidisciplinary tools that identify expected progression of patients toward discharge. Often used for patients requiring complex care or for frequently encountered situations.

1990s−present (Historical Nursing Research)

NCNR elevated to status of Institute (NINR) in 1993; heightened emphasis on evidence-based practice; the concept of translational research is born; in 2016 published a new set of nursing research priorities

Environmental stressors

Natural disasters, relocation, hospitalization

A'o

Need to acquire, communicate & pass on knowledge

Unintentional torts Examples

Negligence

Process evaluation

Nurse's performance

Research

Nursing and healthcare research is often carried out using patient records. Accurate documentation helps assure that research outcomes are valid and reliable

Two types of peer review:

Nursing audits Individual peer review

Instructional Patient Plans of Care Components

Nursing diagnoses/problem list Patient goals Patient outcome criteria Nursing interventions Scientific rationale Evaluation

Accurate

Nursing documentation should only contain observations that nurses have seen, heard, smelled, or felt. Observations or statements by other healthcare professionals need to be identified as such. All information that was charted remains in the patient record; erasure is not permissible. Proofreading should be done to assure correct spelling and correct use of medical terms

Good Samaritan laws

Offers legal immunity for healthcare professionals who assist in an emergency and render reasonable care under such circumstances

Culture is ethnocentric:

One views his/her own culture as the only correct standard by which to view people of other cultures.

Components of an ethnographic interview:

Open-ended general question. Selection of key terms for clarification. Accurate and complete documentation

Types of interviews include:o Explanatory Model:

Open-ended interviews of individual patients that ask questions about their explanation of health and illness.

Progressive allostatic load:

Overexpression of stress response mediators (e.g., sympathetic activity, glucocorticoid release, etc.) leading to cellular damage and pathology.

Concise and complete

Partial sentences and phrases should be used in narratives. The patient's name and terms referring to the patient can be eliminated in narrative charting. Only abbreviations that are commonly accepted and approved by the institution should be used.

Outcome evaluation

Patient and patient's function

HIPAA regulations are designed to protect

Patient's privacy

Legally Sensitive Areas of Nursing Practice

Payment for Enhanced Care Services and Technology Use Use of Online Communication Technologies Controlled substances Death and dying Assisted suicide Terminal sedation Advance directives Resuscitation

Clinical plans of care:

Plan organized in a practical, concise format for daily use

Adenocarcinoma

Prefix: Adeno = related to glands Root: Carci = cancerous Suffix: Oma= tumor Cancerous tumor that originates in glandular cells.

Craniotomy

Prefix: Crani = head/skull Root: NONE Suffix: Otomy = cut into An incision or hole cut into the skull- usually for brain surgery or to relieve pressure

Pancytopenia

Prefix: Pan = all Root: Cyto = cell Suffix: Penia = deficiency Low blood counts, often occurring after chemotherapy or significant blood loss

Quadriplegia

Prefix: Quadri = four Root: NONE Suffix: Plegia = paralysis Paralysis affecting all four extremities What about paraplegia? Paralysis of the legs What about hemiplegia? Paralysis of one side of the body

Intellectual skills:

Problem solving, decision-making, and teaching skills

Motivation:

Provides incentive to learn and starts with the patient's recognition of the need to know and perform the behavior.

Reimbursement

Provides the basis for decisions regarding care and subsequent reimbursement to the agency. Federal, state, and private payers usually require specific criteria to be met to cover specific health-related expenses, including diagnostic-related group (DRG) classification and appropriate related interventions.

Implementation Phase Activities

Reassessing Setting priorities Performing nursing interventions Recording nursing actions

Implementation Phase Activities

Reassessing Setting priorities Performing nursing interventions Recording nursing actions

Congruent relationship:

Relationships among written, verbal, nonverbal, and/or meta communication are aligned to give the same "message."

Incongruent relationship:

Relationships among written, verbal, nonverbal, and/or meta communication are contradictory and give a "mixed message."

Open-ended interviews:

Require that respondents use their own words to answer.

Nontherapeutic Responses

Rescue feelings False reassurance Giving advice Changing the subject Being moralistic Nonprofessional involvement

Theoretical framework

Research is preferably guided by a nursing model or theory to assist in identification and systematic study of the logical relationships between or among variables.

1900s−1940s (Historical Nursing Research)

Research on education, methods of teaching, and methods of evaluating how nurses learn.

'Olu'olu

Resiliency, flexibility, kindness

Principles of Healthcare Ethics

Respect for persons: Individuals are treated as autonomous agents and persons who have limited autonomy are protected. Beneficence: To do or promote good to help others. Nonmaleficence: To avoid doing harm, to remove from harm, and to prevent harm. Justice: Making fair decisions about resource allocations for societies or groups.

Acute stress:

Results from daily life encounters that lead to the "fight-or-flight" response

Self-awareness and self-reflection:

Results in being aware of one's own personality, values, cultural background, and style of communication; taking responsibility for one's actions as a professional; and being separate from, but connected to, others.

Termination:

Review of health changes and how the patient has dealt with physical and emotional responses; includes discharge planning.

Outcome Evaluation Phase Activities

Reviewing patient goals and outcome criteria Collecting data Measuring goal attainment Recording judgments or measurements of goal attainment Revising or modifying the patient's plan of care

Culture is ritualistic:

Rituals are common and observable expressions of culture that may help restore a sense of control, competence, and familiarity in times and places of stress and uncertainty.

TeamSTEPPS Communication Tools and Strategies

SBAR Call-out Check-back Handoff I PASS THE BATON CUS (I am concerned; I am uncomfortable; this is a Safety Issue)

Ethnicity:

Self-conscious, past-oriented form of identity based on a notion of shared cultural and perhaps ancestral heritage.

Elements of the Communication Process

Sender Encoding Communication channel Receiver Decoding Feedback

Kuleana

Share responsibility

SBAR

Situation: What is happening at the present time?o Background: What are the circumstances leading up to this situation? Assessment: What is the problem? Recommendations: What should be done to correct the problem?

Handheld devices

Smartphone and tablets allow bedside access to such supports as drug information, assessment tools, conversion tables, immunization guidelines, language translation, and access to evidence to support clinical decisions.

Palpation:

Specialized use of touch that augments the inspection process

diagnostic validation:

Stage 1: Interpreted cue clusters are compared with norms for the patient and for patients in general. Stage 2: The formulated nursing diagnosis is evaluated for its nursing research base.

Early research (Historical Nursing Research)

Statistical records of Florence Nightingale.

Distress:

Stress that activates physiologic stress pathways and emotional stimuli (e.g., dread or fear) that is judged as threatening.

Eustress:

Stress that activates physiologic stress pathways, but includes pleasurable stimuli (e.g., exhilaration and well-being) and is judged as nonthreatening.

Percussion:

Striking the body surface with one or both hands to produce a percussive note

Types of Evaluation

Structure evaluation: Attributes of the setting or surroundings Process evaluation: Nurse's performance Outcome evaluation: Patient and patient's function

Which of the following is true about Chaminade SON's electronic and social media guidelines?

Students must use their student.chaminade.edu for all their communication

Interventions

Supportive Interventions Psychosocial Interventions Technical Interventions Maintenance Interventions Psychomotor Interventions

Cue interpretation:

Synthesizing the derived cue clusters to derive the meaning and implications of the human response of a patient

Review of scientific literature

Systematic and exhaustive process of selecting published materials that have the most relevance to the potential research which highlights gaps in knowledge and prevents duplication of a well-studied subject.

Flow sheets:

Tables with vertical and horizontal columns allowing for documentation of routine assessments and procedures.

Advocacy:

Taking the patient's side is the basis for communication with patients.

Empathy:

The ability to look at things from another's perspective.

Health literacy level:

The ability to obtain, process, and understand basic health information and follow instructions for treatment.

Literacy level:

The ability to read and write; the ability to use language, numbers, and images to understand the written and spoken word.

Resilience:

The ability to recover from an adverse event

Implementation:

The action phase of the nursing process in which nursing care is provided as per the patient plan of care and nursing actions are recorded

Implementation:

The action phase of the nursing process in which nursing care is provided as per the patient plan of care and nursing actions are recorded.

Privacy

The appropriate use of patient information.

Safety

The avoidance or prevention of adverse outcomes for patients

Physiologic Mediators of Allostasis

The central nervous system Neuroendocrine regulation Autonomic regulation Immune regulation

Homeostasis:

The constant process of maintaining physiologic parameters of the human body to allow survival

Culture is diverse:

The cultural diversity of a population increases the plurality of ideas and options for behavior, adding to the texture and complexity of the society and increasing the potential for well-being, achievement, tension, and conflict.

Community Based Healthcare

The design, delivery, and evaluation of healthcare services developed in partnership with communities. Found where people are—where they work, recreate, go to school and church—and is developed within the context of a given community.

Nursing licensure

The legal ability to practice as a nurse as defined in a region's nurse practice act.

Self-concept:

The mental image a person has of oneself which is influenced by experiences and expectations.

Standards of practice

The minimum acceptable guidelines for providing and evaluating nursing care. The ANA designates professional nursing responsibilities such as assessment, diagnosis, outcome identification, planning, implementation, and evaluation.

Diagnostic label:

The name of the nursing diagnosis as listed in the NANDA-I taxonomy. Describes the essence of the problem using as few words as possible and represents a pattern of related patient cues.

Stress:

The nonspecific response of the body to any demand for change; an actual or potential threat to homeostasis.

Veracity

The obligation to be honest with patients and give accurate, unbiased, and understandable information.

Defining characteristics:

The observable cues or inferences that cluster as manifestations of an actual illness or wellness health state, or nursing diagnosis

Data Management Research design:

The overall plan for controlling variables and for the collection and analysis of data

Primary Source of Data

The patient

Coping

The process of applying thoughts and actions to deal with stressful events.

Allostasis:

The process of maintaining or reestablishing homeostasis when responding to stress. Sustained allostatic states lead to allostatic load, which, in turn, can lead to illness.

Problem area identification

The process of narrowing an area of interest into a researchable question.

Confidentiality

The professional duty and legal obligation to keep information about a patient private.

Spiritual quest:

The spiritual journey to answer life's philosophic questions and seek a higher level of consciousness or a deeper awareness of spiritual life

Stressor:

The stimulus initiating the stress response.

Leininger's theory (transcultural nursing/Culture care theory)

The theory states that nurses cannot separate world-views, social structure factors, and cultural beliefs or practices from health, wellness, illness, or care when working with cultures because these factors are closely linked and interrelated

Evaluation:

The thorough, systematic review of the effectiveness of nursing interventions and a determination of patient goal achievement.

Pono

To be just and seek harmony in all that one does

Malama

To care for one another, to cherish

Purpose of the Implementation Phase

To provide the technical and therapeutic nursing care required to help the patient achieve an optimal level of health

Translation to practice

Translational research, or inquiry implementation into practice, is the bridge between theory and practice.

An important factor to remember about preparing for an assignment is to follow all facility policies and procedures.

True

Client condition is protected under HIPAA.

True

If a clinical site feels that a student is unprepared to care for a client/patient, the clinical site can ask the student to leave the clinical site.

True

It is important to study under conditions similar to those in which you will be tested.

True

Kolb's model categorizes learners based on how they take in and process info.

True

Kolb's model divides people into either reflective or active learners

True

Mnemonic devices can help with memorization

True

Most allied health programs have specific colors that students must wear while in the clinical setting.

True

Research indicates that academic performance is positively correlated with the quality of notes a student takes in class

True

Retaking a test is a good way to retain information in your long-term memory

True

Sitting in front of class forces you to be a more active listener

True

The note-taking process should begin before arriving at class

True

The organization of your notes is related to how well you remember what you have read.

True

Universal precautions are designed to keep the students and clients safe.

True

VISUAL learners often prefer to learn from a textbook

True

Your goal is to understand the material not memorize it

True

Positive regard:

Underlying assumption is that the person is worthwhile and has value and dignity; avoids unnecessary labeling.

Lewin Change Theory

Unfreezing: Recognition of the need for change and the dissolution of previously held patterns of behavior. Movement: Shift of behavior toward a new and more healthful pattern. Refreezing: Long-term solidification of the new pattern of behavior.

Redundancy

Use of built-in "double-checking" or successive checks prior to high-risk procedures. Example: Checking a unit of blood by two nurses prior to administration

Communication

Use of clear, accurate, and concise communication. Example: Use of standardized reports at end of shift.

Checklists

Use of lists that validate critical points in a procedure. Example: "Time out" checklist in operating room validating correct patient, operative site, and procedure.

Mistake-proofing

Use of mechanisms or devices that make it difficult to perform an error. Example: Tubing connections that are not interchangeable between enteral and intravenous connections.

Racism:

Use of skin color as the primary indicator of social value.

Interviewing

Used to collect subjective data for the nursing history and requires effective communication.

Mixed methods

Uses both quantitative and qualitative approaches.

Objective

Using direct quotes of patient statements can help maintain objectivity, especially when documenting psychosocial and mental health issues. Actual patient behavior should be described rather than making interpretations.

Prefix

Usually is a modifier (color, quality, size, speed, number, position- may also refer to a body part)

Suffix

Usually refers to a procedure or disease process

Root word

Usually refers to the body part, organ or system

Interpersonal skills:

Verbal and nonverbal communication skills

Inspection:

Visual inspection performed in a methodical and deliberate manner

Which if the following multi intelligence's best describes an artist?

Visual intelligence

Descriptors:

Words that describe changes in condition, state of the patient, or some qualification of the specific nursing diagnosis.

Hana Ka Lima

Work diligently together

Evaluation of Learning

Written tests and questionnaires Oral tests"Teach-Back" method Return demonstration Check-off lists Simulation

Which of the following statements is appropriate for writing an APA studentpaper? a) No running head b) A first level heading is flushed left bold, title case heading c) Use of any type of font and size is permitted d) 3 inches of margins on all sides

a) No running head

A nurse is caring for a patient with leg ulcers. The nurse assesses that these are related to venous stasis, but when asked, the patient reports that there is someone "shooting lasers through the floor" in the apartment. In order to progress with wound treatment, what must the nurse understand about resolving value conflicts? Select all that apply: a) It is necessary to establish common ground about therapy goals. b) Further exploration of the patient's belief system may be needed to identify beliefs related to care. c) The nurse may need to answer patient questions related to care. d) The nurse may need to examine personal values related to mental health and care.

a, b, c, d. All of the statements should be considered in resolving value conflicts and establishing a therapeutic relationship between the nurse and patient.

A nurse is working in an organization that prescribes and supports Plan B ("the morning after pill") as a form of contraception. In analyzing the nurse's role and moral values, the nurse should consider which of the following? Select all that apply: a) Is the nurse affirming the patient's desires? b) Is the nurse upholding the ethics of the profession? c) What are the nurse's beliefs/biases related to this medication? d) What are the consequences and alternatives of giving or not giving this medication?

a, b, c, d. All questions posed should be considered in evaluating values in relation to the professional nursing role.

Which focuses would be considered priorities by the nurse engaged in active nursing research? Select all that apply: a) Evaluating the perceived well-being of patients b) Identifying ethical frameworks used when questioning participants regarding issues considered confidential c) Identifying means by which side effects associated with antipsychotic medication therapy can be minimized d) Evaluating the effectiveness of a newly designed tool to assess cognitive impairment in nonverbal patients e) Analyzing various cost saving strategies related to intensifying motivation of college students to act as participants in research projects

a, b, c, d. Each of these examples matches identified priorities for nursing research: promoting health and well-being, ensuring ethical principles are followed in research, meeting care needs of vulnerable populations, and developing tools to measure nursing care. Analyzing various cost saving strategies related to intensifying motivation of college students to act as participants in research projects is not identified as a nursing research priority.

A nurse is evaluating the medical center's approach to mobilizing secretions in patients with tracheotomies. Which would be the benefit to using EBP? Select all that apply: a) EBP is evaluated based on outcome studies. b) Practitioner knowledge and personal experience are insufficient. c) EBP integrates clinical expertise with external evidence. d) Hospitals can utilize experts in their facility. e) Provide cost-saving, quality care.

a, b, c, e. Evidence-based practice (EBP) is based on outcome studies, recognizes that pathophysiologic reasoning and personal experience are not sufficient, and involves the incorporation of individual clinical expertise with the best available external evidence from systematic research. The goal of EBP is to provide the highest quality individualized care based on thorough assessment, history taking, sound research evidence, clinical proficiency, and information from the patient on values and care preferences to ensure favorable outcomes. EBP standardizes practice and methods based on research, thus discouraging facilities to follow a single practitioner's recommendations.

A nurse is developing patient goals for a patient following abdominal surgery. Which of the following are appropriate goals? Select all that apply: a) "Ambulates in the hall prior to discharge" b) "Demonstrates deep breathing and splinting of incision" c) "Reports pain level less than 4/10 with movement" d) "Incentive spirometry every 2 hours"

a, b, c. Statements A through C appropriately identify outcomes for the described patient scenario. Statement D is a nursing intervention but does not identify an outcome.

The nurse has admitted a single mother with nausea and vomiting for the last 3 days and upper left quadrant abdominal pain. Which of the statements below indicate that the nurse is using the functional health patterns model of assessment? Select all that apply: a) "Please describe your appetite over the last week." b) "What kind of help have you had from your family since this started?" c) "Have you been able to sleep or rest lately as usual?" d) "Have you had symptoms like this in the past?" e) "Your blood pressure is 94/48; heart rate is 122."

a, b, c. These three statements assess the functional health patterns of nutrition-metabolism, coping-stress tolerance, and sleep-rest. Statement D ("Have you had symptoms like this in the past?") focuses on past symptoms in relation to the current admission adhering to a medical model or review of body systems. Vital signs are objective data collected in adherence to a head-to-toe model to first gauge the current state of health.

Marcy is aware that nursing responsibilities are related to standards of professional performance. Which are included in these standards? Select all that apply. a) Collaboration b) Performances appraisal c) Outcomes identification d) Quality of practice

a, b, d. Collaboration, performance appraisal, and quality of care are all elements of professional performance. Other elements include education, collegiality, ethics, research, and use of resources. Standards of care designate professional nursing responsibilities such as assessment, diagnosis, outcome identification, planning, implementation, and evaluation.

What are important factors in setting nursing priorities? Select all that apply: a) Patient condition b) Reassessment data c) Modification of the plan of care d) Feedback from the family and healthcare team

a, b, d. Patient condition; new information from reassessment; time and resource availability for nursing interventions; feedback from the patient, family, and healthcare staff; and the nurse's experience are all elements of priority setting. Modification of the plan of care may occur after setting priorities if these differ from those outlined previously in the plan of care.

The nurse is establishing a plan of care for a patient with dyspnea and pneumonia. Which of the following is an appropriate addition to the plan of care for this patient? a) Impaired mobility related to dyspnea as evidenced by shortness of breath with position change b) Patient reports no shortness of breath after ambulating to bathroom by time of dischargeAmbulates frequently c) Clinical pathway for pneumonia including anticipated length of stay d) No shortness of breath with incentive spirometry therapy

a, b, d. Plans of care should include nursing diagnosis, patient goal, patient outcome criteria, nursing interventions, scientific rationale, and evaluation. A critical or clinical pathway may be included depending on the diagnosis and the organization. The nursing diagnosis, patient outcome criteria, and pathway are correct. "Encourage ambulation frequently" is not a correct nursing intervention because it lacks a time frame and information on how the action will be carried out. "No shortness of breath with incentive spirometry therapy" is not a correct patient goal because it does not include behavioral verbs.

An antibiotic is ordered that the patient has had an allergic reaction to in the past. Which would be an appropriate nursing action as determined by the professional nursing role? Select all that apply. a) Identify that the antibiotic is inappropriate. b) Document the allergy and call the physician. c) Administer the drug as ordered. d) Complain to other nurses about the physician's poor judgment.

a, b. The nurse should use his or her knowledge of the sciences to make safe judgments on the patient's behalf. The nurse should also communicate the patient's needs in written and oral form. Administering the drug does not utilize professional judgment and is not appropriate for this patient; the nurse is not advocating for the well-being of the patient. Complaining to peers does not exhibit collegiality with the healthcare team.

Outcome identification serves which of the following purposes? Select all that apply: a) Providing individualized care b) Identifying potential health problems c) Planning care that is realistic and measurable d) Eliminating the need for the involvement of support people

a, c. Outcome identification individualizes care to the patient and plans care that is realistic and measurable. The nursing process identifies potential health problems, but this is not a characteristic unique to outcome identification. Outcome identification allows for support people to be involved rather than prevents it.

Evaluation of nursing quality may be directly done by which of the following? Select all that apply: a) Peer review b) Management audit c) The ANA d) The Joint Commission

a, d. Peer review is evaluation and judgment of a nurse's performance by other nurses. The Joint Commission performs external review and establishes standards to ensure that nurses and institutions function within specified criteria. The Joint Commission also requires continuous monitoring by departments of nursing. Management audit is not a standard evaluation mechanism in nursing. The American Nurses Association develops standards of behaviors for evaluating nursing care and performance but does not directly perform evaluation of nurses.

A nurse is conducting an admission assessment on a confused patient brought in by his son. Which of the following would be included in primary sources for information? Select all that apply: a) Physical assessment b) Health history per the patient's son c) Clinical notes in the computer system from a past admission d) Patient's report of physical symptoms

a, d. Primary sources of information are attained from the patients themselves (i.e., physical assessment and patient report of symptoms). Secondary sources include family members and the health record.

Which statement made by a nursing student using websites as informational resources demonstrates an understanding of appropriate site selection criteria? a) "I was familiar with both the authors since they have authored a textbook I'm currently using." b) "This website is recommended by many people in my class as a reliable source." c) "The website is easy to use and well designed for quick access to articles." d) "I'm new to using websites, so I used the first one listed when I searched."

a. Websites can prove to be excellent informational resources, but they need to be rigorously evaluated for authenticity, accuracy, objectivity, and currency. Being familiar with authors and their previous work is an effective way to judge the appropriateness of a website. Recommendations by others and good physical design may be viewed as positive characteristics, but neither is considered a rigorous test for critiquing a website. Being the first site listed in the search results is not indicative of a reliable website.

What nursing action best demonstrates an activity focused on the safety goal of reducing the risk of healthcare-associated infections (HAIs)? a) Providing an in-service on the appropriate technique to be used when providing indwelling catheter care b) Monitoring all visitors for presence of possible infections and restricting visitation when appropriate c) Formulating an institutional policy requiring all employees to be vaccinated yearly against the flu d) Assessing all patients for history of infections within the previous 12 months

a. A common source of HAIs is an indwelling catheter. Educating staff on evidence-based practice techniques to ensure effective indwelling catheter care would demonstrate efforts to reduce such risks. Although the other options all focus on the spread of and risk for infection, none are directly associated with the reduction of healthcare-associated infections.

A patient is admitted with renal failure and oliguria. Which should be done first in formulating a nursing diagnosis? a) Synthesize data including urine output, color of urine, and potassium levels. b) Compare data with physiologic norms and norms for this patient. c) Assign diagnosis of Impaired Urinary Elimination. d) Validate diagnosis using research of the health problem and management.

a. Data synthesis or cue clustering should be done first after attaining subjective and objective data. Comparing data with norms or cluster interpretation should follow cue clustering. Assigning a nursing diagnosis should be done next. Validation of a diagnosis is done using research and/or experience with similar patient problems. This would be done after assigning a diagnosis and prior to formulating the complete diagnostic statement.

The unlicensed assistive personnel (UAP) comes out of the patient's room and reports to the nurse that the patient is "really breathing hard and can hardly say an understandable word." Which instruction should the nurse give to the UAP? a) Stand by and help the nurse at the patient's bedside. b) Put a face mask on the patient with 10 L of oxygen. c) Trend the patient's respiratory rates. d) Transfer the patient to a chair in the room.

a. Delegating responsibility to another staff member does not take away the responsibility of the outcome from the primary nurse. The only answer that is appropriate for a patient who is in distress is for the UAP to assist in actions that will not put the patient at risk for injury. All other answers require a registered nurse to be with the patient to complete the nursing intervention when the patient is in distress.

The nurse is showing a patient who recently received a prescription for insulin injection how to perform a subcutaneous injection. The nurse asks the patient to demonstrate back the process of administering the medication. What type of nursing intervention is the nurse practicing? a) Educational b) Maintenance c) Psychosocial d) Supervisory

a. Educational teaching requires demonstrating and is evaluated by a return demonstration. Maintenance interventions are hygiene, skin care, and activities of daily living. Psychosocial interventions are encouraging and supporting the patient through the disease process. Supervisory interventions require the collaborative efforts of other healthcare providers.

A patient reports frustration that she has been unable to sleep while in the hospital and that she is exhausted. The nurse also notes that the patient has an unreliable social support network, has poor confidence in her ability to care for herself after discharge, and is at risk for a fall. Which of these issues would take priority according to Maslow's hierarchy of human needs? a) Sleep b) Fall risk c) Social support d) Doubt related to self-care

a. Sleep is part of the foundation of Maslow's hierarchy, included in physiologic need. Safety (fall risk), love and belonging (family, friends, social support), and self-esteem (lack of confidence in self-care abilities) are later considerations according to this model.

A nurse is found to have performed procedures outside her scope of practice. Identify which element is true related to nursing scope of practice. a) Scope of practice is defined by each state's nurse practice act. b) The ANA sets requirements for licensure. c) Scope of practice is defined by CNEA-accredited school curricula. d) Reciprocity explains the relationship between scope of practice and state licensure.

a. The nurse practice act of each state defines the practice of nursing within that area. The board of nursing in each state sets requirements for licensure. Scope of practice is established at the state level in the nurse practice act, not by schools of nursing or Commission for Nursing Education Accreditation. Reciprocity involves meeting licensure requirements in a state other than the state where there is current licensure. As long as the nurse maintains licensure, the licensure exam does not need to be retaken.

Your nurse manager informs you he is using the tool "Asking Why 5 Times" to investigate medication error in which you were involved. What was the nurse manager doing? a) Conducting root cause analysis b) Applying concepts of just culture c) Assessing outcomes for CMS d) Using bundles of care

a. The tool "Asking Why 5 Times" is used in root cause analysis. Just culture refers to a process of error review that focuses on system issues as well as individual responsibility. CMS outcomes include mortality and infection rates and come from tracking patient data. Bundles of care are grouped interventions that improve outcomes.

Which nursing action demonstrates the role nurses play in addressing collaborative problems arising from delegated medically prescribed interventions? a) Recognizing that a patient is having an allergic reaction to a prescribed medication and holding the next scheduled dose b) Noting in the plan of care for an immobile patient that repositioning must occur every 2 hours c) Requesting a dietary consult for a patient newly diagnosed with type 2 diabetes d) Raising the head of the bed of a patient reporting difficulty breathing

a. When a provider delegates actions (provider-prescribed interventions) that require nurses to use their own judgment, nurses are addressing collaborative problems. For example, although providers must prescribe medications, they rely on the judgment of nurses to hold a dose of that medication when appropriate. Initiating a turn and positioning schedule, requesting a dietary consult, and placing a patient in respiratory distress in a high Fowler position are all independent nursing actions that do not require collaboration.

What is not an example of academic dishonesty? a) Stealing records or exams b) Group work assigned by the instructor c) Plagiarism d) Cheating

b) Group work assigned by the instructor

Which is not a core value of Chaminade University's School of Nursing? a) Integrity b) Individualism c) Caring d) Holism

b) Individualism

Students in clinical sites must always wear the following EXCEPT a) Name badge b) Jewelry c) Lab coat d) comfortable clothing

b) Jewelry

Which of the following are ethical and legal issues related to the research process that are evaluated by IRBs? Select all that apply: a) Blinded participation b) Privacy and dignity c) Balance between benefits and risk d) Protection from mental and physical suffering e) Cost of the research to the organization

b, c, d. Institutional review boards evaluate these elements as well as the ability to withdraw from the investigation at any time, self-determination, anonymity, confidentiality, and fair treatment. Study subjects must be informed of the risks and benefits of a study and voluntarily consent. Blinded participation is a technique used by researchers to increase the validity of the results, but use of blinded participation is not evaluated by the IRB.

Which of the following are true related to nursing diagnoses? Select all that apply: a) Describes a disease or pathology of body systems b) Describes human response to a health problem c) Actual or potential physiologic complications related to disease or treatment d) Include descriptors and risk factors e) Relates contributing factors or relationships to identified health problem f) There are not associated legal ramifications

b, d, e. Nursing diagnoses describe human responses and include descriptors and risk factors for health problems. Nursing diagnoses also identify relationships between health problems and contributing factors. A medical diagnosis describes a disease or pathology. Collaborative health problems include actual and potential complications addressed by both the medical and nursing teams. Nursing diagnoses may have legal implications based on licensure-defined scope of practice and appropriate treatment for the patient independent from those prescribed by physicians.

Which of the following are true about the introductory phase of interviewing? Select all that apply: a) The introductory phase is the first phase of the interviewing process. b) Introduce yourself by name and position. c) Focus on goals and move to the next topic after data are collected. d) Observe behavior and patient's self-perceptions.

b, d. Introduction of self, including position, and observing behavior and self-perceptions are both elements of the introductory phase. The introductory phase is the second phase following the preparatory phase. Focus on goals and goal attainment are included in the maintenance phase.

The nurse is caring for a team of patients during the shift. Which assessment reflects a time-lapsed assessment type of collecting data? a) Auscultating the patient's abdominal sound after administering an anticonstipation medication b) Checking the patient's blood pressure a month after educating patient on lifestyle changes c) Scheduling a follow-up appointment with the orthopedic clinic 2 weeks after the patient was initially seen for an injury sustained during football practice d) Monitoring the patient's blood sugar level every hour after a day of insulin administration

b. A time-lapsed assessment is done several weeks after the initial assessment. Answers a and c are focused assessments, and d is an emergency assessment during an ongoing intervention for a life-threatening situation.

A novice nurse has made what is considered a human error while performing as a medication nurse on a busy long-term care nursing unit. What intervention implemented by the unit's nurse manager would be most appropriate in this situation to help prevent similar errors in the future? a) The incident is recorded in the nurse's permanent employee file. b)The nurse is asked to identify and discuss the factors that contributed to the making of the error. c) The nurse manager provides a verbal warning to the nurse and explains that another error will result in disciplinary action. d) The nurse is told by the nurse manager that everyone makes mistakes occasionally but to be more careful in the future.

b. As human beings, healthcare personnel will make errors. A one-time medication error is typically a human error that will happen in the complex healthcare world. A nurse who makes a human error should be asked to review his or her practice to see what he or she could learn from it. The opportunity to learn from the experience should not be overlooked. A pattern of human errors requires further evaluation and possible discipline by the nurse manager.

A nurse receives a patient at handoff who is experiencing acute changes in neurologic status. Which nursing action should be done first? a) Call the physician. b) Perform a neurologic assessment. c) Administer an antihypertensive medication stat. d) Move the patient back to bed.

b. Assessment should be the first step in the nursing process. Calling the physician, an intervention, is necessary, but only after performing an assessment. Administering medications would also be an intervention, as would moving the patient back to bed.

A nurse fails to observe and document a patient's change in neurologic status, ultimately resulting in the patient's death from a stroke. Which type of malpractice is most relevant? a) Fraud b) Breach of duty c) Negligence by commission d) Battery

b. Breach of duty is the failure to conform to the standard of practice, thus creating a risk for a person that a reasonable person would have foreseen. The nurse may be accused of breach of duty whenever reasonably accepted standards of nursing care are not met, such as failure to observe and monitor a patient's condition. Fraud is purposeful misrepresentation of self or an act that may cause harm to a person or property, such as qualifications. Negligence by commission is doing something that a reasonably prudent person would not do; this example is negligence by omission. A nurse may be sued for battery if he or she fails to obtain consent for a procedure or allows the patient to refuse a therapy.

A patient is scheduled to receive metoprolol for blood pressure control at 09:00. The order reads: "for SBP greater than 90, 25 mg PO daily." Prior to administration, the nurse rechecks the blood pressure and finds it to be 90/50 with a heart rate of 68. This is an example of using what type of nursing skill? a) The nursing process b) Critical thinking c) The Nurse Practice Act d) Medical simulation

b. Critical thinking is needed in situations that bring nursing judgment into play: those situations that are not addressed clearly by physician orders or by a changing patient condition. The nursing process is the broad description of the theoretical structure of preparation and action of patient care. The nurse practice act details the practice ethics for a registered nurse (RN). Medical simulation is a method of developing critical thinking skills via creating acute or changing patient scenarios in the safe practice environment of a learning laboratory.

The nurse tells the patient that pain medication is prescribed to be administered every 4 hours when needed and promises the patient that a pain assessment will be performed. The nurse assesses the patient's level of pain and the need for pain relief every hour. Which ethical responsibility to the patient is the nurse practicing? a) Beneficence b) Fidelity c) Justice d) Nonmaleficence

b. Fidelity is keeping one's promise. The nurse promises the patient that the prescribed medication would be administered when needed and makes sure to assess the patient every hour just in case the patient needs pain relief. Beneficence means doing or promoting good to help others. Justice involves making decisions about resource allocations for people. Nonmaleficence means the nurse avoids doing harm to the patient, removes the patient from harm, and prevents harm from happening to the patient.

A nursing student is asking the preceptor the importance of formulating a nursing diagnosis. What statement by the preceptor is the best answer to the graduate nurse's question? a) "It guides the nurses to manage their time wisely." b) "It keeps the patient safe by focusing attention on the patient's actual or potential problems." c) "It is required by the hospital for risk assessment." d) "It assures the hospital that nothing bad will happen to the patient during hospitalization."

b. Nursing diagnosis will provide the opportunity for communicating client care and focusing attention on the client's actual or potential health needs. Answers a and c do not help the patient's needs, and answer d is not possible because there are several variables that influence whether patients become injured during their hospitalization.

A new nurse is caring for four patients for the first time. One patient is admitted with respiratory distress, reports no shortness of breath, SpO2 is 95% on 2LNC, and RR is 18. The other patient is admitted for a laparoscopic prostatectomy, complains of 6/10 pain, and has new onset of hematuria in the Foley catheter. The third is an IV drug user with abscess and pain 3/10 and wants to go outside to smoke. The final patient is an elderly confused patient admitted with a urinary tract infection and is determined to be a fall risk. Which patient should be the nurse's priority? a) Patient 1 b) Patient 2 c) Patient 3 d) Patient 4

b. Patient 2 should be seen first for the new-onset hematuria. Although Patient 1 is admitted for respiratory distress, there is no current oxygenation need or change in condition. Patient 3 may have immediate needs related to nicotine withdrawal but is not the most acute patient. Patient 4 should be seen shortly because he is a fall risk and has had a change in mental status but is not the most acute patient of the four.

A nurse is developing medication safety protocols for the hospital and is looking at the appropriate delivery of crushed medications via gastric tubes. This is an example of what type of evaluation? a) Structure evaluation b) Process evaluation c) Outcome evaluation d) Functional evaluation

b. Process evaluation focuses on nurse performance and whether the nursing care provided was appropriate and competent. Structure evaluation focuses on the attributes of the setting where healthcare is provided. Outcome evaluation focuses on the patient and patient's function and can only take place once standards have been developed. Functional evaluation is not a type of evaluation.

A nurse is conducting a focus assessment of a hospitalized patient who is a fall risk. Which of the following would be most appropriate? a) "Do you have many stairs that you need to navigate at home?" b) "Are you more unsteady on your feet when you are out of bed today?" c) "Are you feeling any pain in your abdomen?" d) "What is your usual or baseline diet at home?"

b. Statement B ("Are you more unsteady on your feet when you are out of bed today?") targets an existing problem that has already been identified and attempts to determine changes in the status of the problem. The other statements do not address the current problem and are beyond the scope of the focus assessment.

You have been asked to participate in a committee writing a policy for the care of a patient with an indwelling catheter. What is most important to include? a) Information retrieved from a website directed toward the lay public b) The nationally recognized catheter-associated urinary tract infection prevention bundle c) The policy from a well-respected nearby hospital d) Information from a nursing textbook that is more than 10 years old

b. The nationally recognized bundle of care is the most important to include. Although information from another hospital might be helpful, if it doesn't include the bundle, it is not sufficient. Websites directed toward the public likely don't have enough information for a policy. Typically, references for professional work should be dated within the last 5 years.

The Nurse is caring for a patient who had abdominal surgery yesterday. Which nursing action reflects an initial assessment step of the nursing process? a) Monitoring the patient's pain level 30 minutes after medication administration b) Listening to breath sounds at the beginning of the shift c) Reflecting on the patient's pain response after getting out of bed d) Checking the patient's blood pressure 30 minutes after the administration of an antihypertensive medication

b. The nurse is collecting baseline information, which is the gathering of data on the patient prior to any intervention by the nurse. Answers a, c, and d are evaluative assessments or reassessment performed during or after an intervention.

The nurse is developing nursing diagnoses for a patient with chronic pain related to bone cancer. Which of the following would be most correct? a) Constipation related to impaired mobility as evidenced by daily, soft bowel movements b) Activity Intolerance related to chronic pain as evidenced by patient stating pain 10/10 with movement c) Effective Management of Therapeutic Regimen as evidenced by normal cell counts d) Ineffective Coping related to terminal cancer diagnosis

b. The nursing diagnosis correctly incorporates the three parts of diagnostic label, related factors, and defining characteristics. Statement A lacks sufficient evidence (daily bowel movements) to identify constipation as a current problem. Statement C lacks related factors. Statement D lacks defining characteristics and does not give sufficient evidence for ineffective coping as a current problem.

The nurse is writing a planned outcome on the computer for a patient who is diagnosed with chronic kidney disease and is on a renal diet. What is the most important aspect in developing this step of the nursing process? a) The nurse's understanding of patient care b) The patient's feelings regarding a renal diet c) The nurse's ability to manage feeding time during the day's schedule d) The patient's knowledge in choosing which food items in a renal diet

b. The patient is the biggest stakeholder during this step of the nursing process. If the patient does not want a renal diet, the goal is not attainable. Answers a and c are relevant but not as important, and d is not important since the cafeteria staff has a list of food choices for every diet available to patients in the hospital.

A nurse is reviewing a care plan for a patient diagnosed with chronic obstructive pulmonary disease (COPD) who is experiencing a moderate shortness of breath. Which planned outcome is correctly written for this patient? a) Patient will ambulate in the hallway once during the evening shift. b) Patient will ambulate safely with one-person assist once during the day shift. c) Patient will ambulate in the hallway twice during the day shift. d) Patient will ambulate with one-person assist twice during the evening shift.

b. This planned outcome has all the components such as who, what action, under which condition, how well, and when to perform the action. Statement A is lacking the criteria "how well," and no specific condition. Statement C might not be reasonable due to patient's state, and the specific circumstances are not mentioned. Statement D is lacking the criteria and might not be reasonable given possible staffing limitations.

A nurse is formulating a nursing diagnosis for a hospitalized patient with acute mental status changes and urinary tract infection (UTI). Which nursing diagnoses are appropriate? Select all that apply: a) Total Incontinence related to UTI as evidenced by patient's spontaneous urination and inability to recognize urge b) Acute Confusion related to UTI as evidenced by patient's statement that she is at home c) Situational Low Self-Esteem related to incontinence as evidenced by patient crying d) Ineffective Health Maintenance related to acute mental status changes as evidenced by UTI

b. This statement correctly establishes a nursing diagnosis appropriate to the patient problem, relates to contributing factors, and describes evidence that is congruent. Statement A is incorrect because it assumes the patient is incontinent, which can, but does not necessarily, occur with confusion and UTI. Statement C does not provide evidence that is sufficient, particularly for a patient experiencing acute mental status changes. Statement D incorrectly defines contributing factors because the acute mental status changes are a result of the urinary tract infection, not vice versa.

Discrimination

based on Sexual orientation and Gender Identity

A nurse is admitting a patient with congestive heart failure. Which of the following describe appropriate aspects of assessment? a) Define patient goals for increasing ability for self-care. b) Evaluate current therapeutic regimen at home. c) Identify activities that exacerbate symptoms. d) Apply oxygen therapy via nasal cannula.

c. "Identifying activities that exacerbate symptoms" is an example of data collection or assessment. Defining patient goals is an example of outcome identification. Evaluation of current home regimen is an evaluation rather than an assessment. Applying oxygen is an example of implementation.

Which description of value-based purchasing is most accurate? a) Ensuring "never events" never occur b) Conducting a thorough investigation to analyze the root cause of all errors c) Adjusting reimbursement based on measurement of processes, outcomes, and patient satisfaction d) Determining the actual cost of care to calculate reimbursement

c. CMS adjusts hospital reimbursement based on adherence to guidelines for processes and outcomes of care and patient satisfaction. Although ensuring "never events" never occur is a goal of healthcare, it is not the basis for value-based purchasing (VBP). Conducting root cause analysis of errors and determining cost of care are not related to VBP.

The nurse is caring for a patient who had a surgical repair to a fractured tibia. The nurse uses a gait belt while ambulating the patient for the first time. Which ethical responsibility is the nurse promoting? a) Beneficence b) Justice c) Nonmaleficence d) Veracity

c. Nonmaleficence means the nurse is avoiding doing harm to patient, removing the patient from harm, and preventing harm from happening to the patient. It is a strong proactive duty for all healthcare professionals. In this case, the nurse is taking precautions to prevent the patient from falling by using a belt to hold the patient during ambulation. Beneficence means doing or promoting good to help others, such as giving medication prescribed for pain as needed when the patient needs pain relief. Justice involves making decisions about resource allocations for people. On a patient level, nurses ensure that they are providing equitable time, service, and care to each person with dignity and respect. Veracity is when the nurse tells patients the truth about their care so patients can make their own choices.

A nurse is conducting a research study of postoperative pain medications. What should be done first? a) Develop a theoretical framework. b) Define a hypothesis. c) Review the literature. d) Gather participants.

c. Review of existing literature is the first step of conducting research, followed by developing a theoretical framework, formulating a problem statement or hypothesis, proceeding with the study, and disseminating findings.

A patient with esophageal cancer is no longer able to consume foods by mouth and is now fed via a gastric feeding tube. The patient is withdrawn and states, "My family used to have big dinners with friends, family, lots of laughter, and loud conversation." Which of the patient's values are apparent and best describe the behavior? Select all that apply: a) Independence and individuality b) Family role c) Socialization d) Human nature

c. Socialization during mealtime is the value that is described by the patient's statement and subsequent withdrawal related to not being able to eat. Independence and individuality are not reflected by the statement or setting. The patient's role within the family may be affected but is not the best answer for this setting. Human nature describes the way in which people interpret the world around them; it is not relevant in this scenario.

In conducting an assessment of a patient with gastrointestinal bleeding, the nurse uses which of the following pieces of subjective data? Select all that apply: a) Hematocrit 20% b) Appearance of stool c) Spouse's statement of symptoms d) Health record description of signs

c. Subjective data contain symptoms that are supplied by the patient or family and are obtained via interview. Laboratory studies, direct observation, and descriptions in the health record of signs are examples of objective data.

Which intervention demonstrates the nurse's fulfillment of a standard of nursing practice? a) Preparing to give an end-of-shift report b) Acting as a preceptor for a senior nursing student c)Assessing a newly admitted patient for potential fall risks d) Requesting an interpreter when providing education to a non-English-speaking patient

c. The ANA's standards include two lists: standards of practice and standards of professional performance. Measurement criteria are printed in the ANA book Nursing: Scope and Standards of Practice (2015). The standards of practice list designates professional nursing responsibilities such as assessment, diagnosis, outcome identification, planning, implementation, and evaluation. Standards of professional performance include culturally congruent practice such as requesting an interpreter; collaboration such as providing an end-of-shift report; and leadership when acting as a preceptor for a nursing student.

Which of the following statements is an accurate nursing diagnosis? a) Poor Parenting Abilities related to lack of sleep b) Disturbed Body Image, Possibly related to recent childbirth c) Risk for Ineffective Breastfeeding related to poor infant latch d) Sleep Deprivation, Potential related to frequent infant feeding schedule

c. This nursing diagnosis includes the appropriate term "risk" and identifies a risk factor for Ineffective Breast-Feeding. Statement A lacks the correct diagnostic label as accepted by NANDA-I. Statement B reverses the diagnostic label, and cues in the "related to" statement lack validation. Statement D reverses the diagnostic label and uses "potential" instead of the accepted term "risk for."

Nursing students interact with which of the following health care staff members? a) Allied Health professionals b) Physicians c) Pharmacists d) All of the above

d) All of the above

Students need to be familiar with a) indications. b) normal dosage forms. c) routes of administration. d) All of the above

d) All of the above

Which of the following hygiene practices are recommended? a) Avoid wearing offensive perfume. b) Keep nails clean and short. c) Bathe or shower with soap. d) All of the above

d) All of the above

According to Patricia Benner's From Novice to Expert, there are five distinct levels of proficiency. Micah is a nurse with 3 years of experience who is now able to analyze his patient's heart failure as conceptually related to the renal failure and anemia that are present rather than as separate issues. Which level most appropriately describes his proficiency? a) Competent b) Expert c) Novice d) Advanced beginner

d. Advanced beginner is identified as being the first 5 years after graduation from nursing school and is described as seeing situations in parts to seeing them more conceptually, or as a whole. Competency occurs 5 to 10 years after graduation, and the nurse is no longer outside the situation observing but is directly involved. The expert nurse has an enormous background of experience, has intuitive grasp of each situation, and accurately targets the problem without unnecessary consideration of a large range of alternative diagnoses and solutions. The novice nurse moves from relying on abstract principles to using concrete experiences.

A nurse is revising a plan of care for a patient with dysphagia (difficulty swallowing) related to an esophageal mass. The patient's goal was to eat more than 50% of a blenderized diet, but he is reporting 8/10 pain and shortness of breath when eating. Which phase of the nursing process is impacted when the nurse develops an intermediate goal of pain less than 4/10 while eating? a) Assessment b) Outcomes/planning c) Implementation d) Evaluation

d. Evaluation commonly refers to rating, grading, and judging. In the evaluation phase, nurses discover why the patient plan of care was a success or failure. Assessment involves confirming a proposed nursing diagnosis with the patient using objective and subjective data. The planning phase involves identifying goals and intervention strategies that will reduce identified problems and preparing an initial patient plan of care, which directs the activities of the nursing staff in the provision of patient care. Implementation is the actual initiation of the plan, evaluation of response to the plan, and recording of nursing actions and patient response to these actions.

A nurse in the transplant ICU is caring for a teenager following a liver transplant as a result of a Tylenol overdose. The patient also superseded another ICU patient (reformed alcoholic) who subsequently died without the transplant. The patient does not want treatment and states: "I just want to die." The nurse questions the principles of healthcare ethics in this case. Which principle would be most in question? a) Beneficence b) Nonmaleficence c) Autonomy d) Justice

d. Justice would be in question because the patient is not willing to receive medical therapies to support the transplanted liver after another patient died waiting to receive the same organ. Beneficence would be in question because this describes whether it is in the best interest of the patient; a transplant would be the only course of treatment for severe overdose of Tylenol and would be in the patient's best interest. Nonmaleficence is the principle to not do harm. Autonomy is the patient's ability to consent and participate in his or her own care. This patient was not able to consent related to her physical and mental health state at the time of admission.

Which statement is true about latent errors? a) They are errors whose effects are not known for a long time. b) Latent errors cause minimal effects to patients. c) Latent errors are traceable to a particular individual. d) They are errors that are due to system issues.

d. Latent errors are those due to systems issues; active errors are those attributable to an individual. The effects of latent errors may be apparent immediately and may certainly cause significant harm to patients.

Which statement about patient safety is correct? a) Physicians have sole responsibility for patient safety. b) Safe patient care is the same as quality care. c) High scores on HCAHPS surveys indicate patient safety. d) Nurses play an important role in keeping patients safe.

d. Nurses are uniquely prepared to help keep patients safe, and their presence at the bedside 24 hours every day puts them in a position to monitor for and intervene as needed for safety. Nurses work collaboratively with physicians to achieve patient safety. Safe care is not necessarily of the highest quality. Although patient satisfaction with care is important, it does not mean care is necessarily safe.

Nursing research includes systematic inquiry into which of the following? a) Clinical practice b) Education c) Administration d) All of the above

d. Nursing research includes clinical practice problems, modes of patient care, nursing education, and administration.

The nurse is caring for a group of patients on a medical/surgical unit. Which assessment finding by the nurse reflects objective data? a) Feelings of exhaustion b) Pain level from 0 to 10 c) Reports of watery stools d) A 2-inch head laceration

d. Objective findings are measured or observed by the nurse. The other answer choices are subjective because they are example of cues provided by the client to the nurse.

A nurse is caring for a patient with anorexia. Which of the following would be an example of interpersonal nursing interventions? a) Provide basic dental hygiene. b) Educate on minimal dietary requirements. c) Supervise patient's oral intake. d) Provide opportunity to examine values.

d. Providing an opportunity for the patient to examine personal values is an example of an interpersonal intervention. Providing education and supervision are cognitive interventions.

The nurse is formulating a nursing diagnoses for several patients. Which nursing diagnosis is correctly written? a) Impaired swallowing as evidenced by choking on thin liquids and refusing to eat meals b) Infection related to prolonged antibiotic administration as evidenced by experiences of watery stools and abdominal pain c) Risk for autonomic dysreflexia as evidenced by both bowel and bladder incontinence d) Risk for fall related to newly diagnosed high blood pressure and a prescription for an antihypertensive medication

d. Risk diagnosis has two parts, the problem and the cluster of cues, and the nurse can intervene on this diagnosis. Answer a, impaired swallowing, is an actual diagnosis, and it needs a related factor. Answer b, infection, needs to be written as a risk diagnosis; otherwise it is a medical diagnosis. Answer c is a risk diagnosis, and it needs a related factor rather than a defining characteristic.

A nurse is developing outcome criteria for a patient following abdominal surgery. Which of the following is most appropriate? a) "Patient ambulates by time of discharge." b) "Identify two techniques to safely rise out of bed." c) "Patient reports pain less than 6/10." d) "Patient ambulates safely in hall twice on postop day 2."

d. Statement includes all elements of specific, measurable, realistic outcome criteria. Statement A lacks circumstances and criteria. Statement B lacks subject and criteria. Statement C lacks specific time.

The nurse develops a care plan for a patient who was admitted for uncontrolled hypertension. Prior to calling the practitioner for medication, the nurse checked the patient's blood pressure level using a manual machine. Which nursing skill is the nurse using for the assessment? a) Collaborative b) Initiative c) Intellectual d) Technical

d. The nurse has the technical ability to use equipment, machines, and supplies in a particular specialty, this time using a manual blood pressure machine instead of an manual one. Collaborative and initiative are not implementation skills. Intellectual skills include problem solving, decision-making, and teaching.

The nurse is caring for a patient after gastric bypass surgery. The goal is for the patient to be able to feed herself appropriately. The patient correctly states, "I should only drink 30 cc of juice an hour." The patient struggles to demonstrate measuring and monitoring of intake frequency, as she is having frequent vomiting. How would the nurse evaluate the attainment of this goal? a) Goal completely met b) Goal partially met c) Goal completely unmet d) Modification of plan of care needed

d. The plan of care must be modified because it is not a priority for the patient to feed herself when she is unable to tolerate oral intake. The goal would be completely met if the patient could state the appropriate parameters and measure and monitor her intake.

Bundling findings to improve care is now a nursing standard in the care of patients with heart failure and has been shown to reduce readmission rates. This is one example of which of the following research aspects? a) Qualitative and quantitative data collection b) Disseminating research results c) Classifying nursing phenomena d) Translation of research to practice

d. Translation of research forms the foundation for evidence-based protocols and interventions that increase the quality of nursing care and improve patient outcomes. Qualitative and quantitative data collection are methods used in nursing research. Disseminating research results can be done in various ways but does not necessarily include evaluating effects on patient outcomes. Classifying nursing phenomena is a priority for nursing research but is not described by bundle implementation.

A day 1 postoperative patient has the following abnormal assessment findings: pain 7/10, diminished lung sounds, hypoactive bowel sounds, and a saturated bloody abdominal dressing and bedsheets. Which would be the nursing priority? a) Pain b) Lung sounds c) Bowel sounds d) Wound care

d. Wound care should be the priority based on the life-threatening situation of a hemorrhage. Pain may be the patient's first priority but would be less important than extensive bleeding. Diminished lung sounds and hypoactive bowel sounds, although abnormal, are not unusual in a recent postoperative patient and could be addressed once the patient is stable.

Lokahi

harmony, unity

Watson theory of human caring

humans cannot be treated as objects and humans cannot be separated from self, other, nature, and the larger workforce

Scope of practice

is the legislation describing what nurses are legally authorized to do. The Nurse Practice Act of each state defines the practice of nursing within the state.

Jean Watson

nurse theorist and nursing professor who is best known for her theory of human caring

Madeline Leininger

nursing professor and developer of the concept of transcultural nursing

Cues include:

objective signs and subjective symptoms

most appropriate hands on strategy for a REFLECTIVE learner

taking time to THINK about your notes

Ageism:

the stereotyping, prejudice, and discrimination against people on the basis of their age