Foundations Exam 3 (ian's study guide)
According to Piaget's cognitive theory, a 12-year-old child is most likely to engage in which of the following activities?
writing a story about a clown who wants to leave the circus
Is it time for some coffee?
yes
The nurse teaches parents how to have their children learn impulse control and cooperative behaviors. This would be during which of Erikson's stages of development?
Initiative versus guilt
Dave reports being happy and satisfied with his life. What do we know about Dave?
It is difficult to determine Dave's developmental stage since most people report overall satisfaction with their lives in all stages.
can you resolve ethical dilemmas by "taking a vote"?
No...it's not about what people "want"
What page should I look on to formulate appropriate nursing diagnoses for impaired body alignment?
Potter and Perry pg 1144 nursing care plan
When preparing a 4-year-old child for a procedure, which method is developmentally most appropriate for the nurse to use?
Preparing the child through play with a doll and toy medical equipment
Teaching an older adult how to use e-mail to communicate with a grandchild who lives in another state is an example of ____________, which aids cognitive performance by using new approaches.
Selective optimization with compensation
explain how health care reform is an ethical issue?
Since health care reform focuses on the public good, discussions about it inevitably involve reference to all aspects of ethical discourse. Reference to ethical principles helps to shape the discussion, even when individual values differ. Access to care is an issue of justice.
how does exercise effect the pulmonary system?
increased resp. rate and depth followed by a quicker return to resting rate, improved alveolar ventilation, decreased work of breathing, improved diaphragmatic excursion
The nurse recognizes that a common conflict experienced by the older adult is the conflict between:
independence and dependence
Other common nursing diagnosis for impaired body alignment and mobility:
ineffective air clearance, ineffective coping, risk for injury, risk for impaired skin integrity, insomnia,and social isolation
fidelity
keep promises/stay with them (moniter) imagine the patient like a spouse don't abandon them and follow through on promises made.
which side is weak after a right hemisphere stroke?
left side (and vise versa)
What instructions is crucial for the nurse to give to both family members and the patient who is about to be started on a patient-controlled analgesia (PCA) of morphine?
only the patient pushes the button
opioid naive
someone who has not been taking opioids. (opioid tolerant is the term for someone who has been taking opioids for more than 1 week)
5 functions of skeletal system
support, protect, movement, mineral storage, hematopoiesis
what about a sandwich?
yes
maximum daily dose of ibuprofen
3200mg
When meeting the unique preoperative teaching needs of an older adult, the nurse plans a teaching program based on the principle that learning:
Requires continued reinforcement
Maximum daily dose of acetaminophen?
4g (4000mg)
The home care nurse is instructing a nursing assistant about interventions to facilitate location of items for patients with vision impairment. Which strategy is not effective in enhancing a patient's impaired vision? A. Use of fluorescent lighting B. Use of warm incandescent lighting C. Use of colors with sharp contrast and intensity D. Use of yellow or amber lenses to decrease glare
A
When assessing a 45-year-old patient's sensory status, which of the following assessment findings does the nurse consider a normal part of aging? A. Presbyopia and the need for glasses for reading B. Reduced sensitivity to odors C. Impaired balance and coordination D. Reduced taste discrimination
A
The nurse is having difficulty understanding a client's decision to have hospice care rather than an extensive surgical procedure. Which ethical principle does the client's behavior illustrate?
Autonomy
The medical record of an older adult reveals a stroke affecting the right hemisphere of the brain. Which of these assessment findings should the nurse expect to find? (Select all that apply.) A. Visual spatial alterations such as loss of half of a visual field B. Loss of sensation and motor function on the right side of the body C. Inattention and neglect, especially to the left side D. Cloudy or opaque areas in part of the lens or the entire lens
A,C
The nurse is aware that preschoolers often display a developmental characteristic that makes them treat dolls or stuffed animals as if they have thoughts and feelings. This is an example of
Animism
Which of the following signs or symptoms in an opioid-naïve patient is of greatest concern to the nurse when assessing the patient 1 hour after administering an opioid? A. Oxygen saturation of 95% B. Difficulty arousing the patient C. Respiratory rate of 10 breaths/min D. Pain intensity rating of 5 on a scale of 0 to 10
B
beneficence
Benefit/ best interest of patient
A 72-year-old patient with bilateral hearing loss wears a hearing aid in her left ear. Which of the following approaches best facilitate communication with her? A. Speak directly into the patient's left ear. B. Approach the patient from behind and speak frequently. C. Face the patient when speaking; speak slower and in a normal volume. D. Face the patient when speaking; use a louder than normal tone of voice.
C
The nurse notices that a patient has received oxycodone/acetaminophen (Percocet) (5/325) two tablets PO every 3 hours for the past 3 days. What concerns the nurse the most? A. The patient's level of pain B. The potential for addiction C. The amount of daily acetaminophen D. The risk for gastrointestinal bleeding
C
A child in the hospital starts to have a grand mal seizure while playing in the playroom. What is your most important nursing intervention during this situation?
Clear the area around the child to protect the child from injury.
An older adult who was in a car accident and fractured his femur has been immobilized for 5 days. Which nursing diagnosis is related to patient safety when the nurse assists this patient out of bed for the first time? A. Chronic pain B. Impaired skin integrity C. Risk for ineffective cerebral tissue perfusion D. Risk for activity intolerance
D
Why is "quality" difficult to define in regard to "quality of life"
Definitions of quality depend on individual experience and value integrated into community standards, but value refers to elements beyond monetary value.
An 85-year-old client is alert and able to participate in care. The nurse understands that, according to Erikson, a person's adjustment to the period of senescence will depend largely on adjustment to which developmental stage?
Generativity versus stagnation
You are working in a clinic that provides services for homeless people. The current local regulations prohibit providing a service that you believe is needed by your patients. You adhere to the regulations but at the same time are involved in influencing authorities to change the regulation. This action represents which stage of moral development?
Social contract orientation
You are admitting Mr. Jones, a 64-year-old patient who had a right hemisphere stroke and a recent fall. The wife stated that he smokes two packs of cigarettes a day, uses a cane to walk at home, and has a history of high blood pressure, which is controlled by an antihypertensive and a diuretic. Currently he exhibits left sided neglect and problems with spatial and perceptual abilities and is impulsive. He has moderate left-sided weakness that requires the assistance of two and the use of a gait belt to transfer to a chair. He currently has an intravenous (IV) line and a urinary catheter in place. What factors increase his fall risk at this time?
Takes antihypertensive and diuretics History of recent fall Neglect, spatial and perceptual abilities, impulsive Requires assistance with activity, unsteady gait IV line, urinary catheter Smoking is not a risk factor for falls. Because the patient used the cane at home, it is not a current risk factor for falls. Risk is determined by his current status.
Resolution of an ethical dilemma involves discussion with the patient, the patient's family, and participants from all health care disciplines. Which of the following describes the role of the nurse in the resolution of ethical dilemmas?
To articulate his or her unique point of view, including knowledge based on clinical and psychosocial observations
articulating a patients point of view would be an example of what?
advocating for the patient
nonmaleficense
avoidance of harm or hurt/ least harm possible
what is proprioception
awareness of the position of the body and its parts
A parent calls the pediatrician's office frantic about the bottle of cleaner that her 2-year-old son drank. Which of the following is the most important instruction the nurse gives to this parent?
call the poison control center
You are caring for a recently retired man who appears withdrawn and says he is "bored with life." Applying the work of Havinghurst, you would help this individual find meaning in life by:
encouraging to explore new roles
What is syncope?
fainting episode
Patients who abuse substances overreact to discomforts.
false
Nine-year-old Brian has a difficult time making friends at school and being chosen to play on the team. He also has trouble completing his homework and, as a result, receives little positive feedback from his parents or teacher. According to Erikson's theory, failure at this stage of development results in:
feelings of inferiority.
Ethical dilemmas often arise over a conflict of opinion. What is the critical first step in negotiating the difference of opinion?
gather all relevant information regarding the clinical, social, and spiritual aspects of the dilemma.
Utilitarianism
greatest good for the greatest number of people
The two most common nursing diagnoses for impaired body alignment and mobility
impaired physical mobility risk for disuse syndrome
how does exercise effect the musculoskeletal system?
improved muscle tone, increased joint mobility, improved muscle tolerance to physical exercise, possible increase in muscle mass, reduced bone loss
psychosocial factors of exercise?
improved tolerance to stress reports of "feeling better" reports of decrease in illness
How does exercise effect the cardiovascular system?
increase cardiac output, improved mycardial contraction, decreased resting HR, improved venous return
how does exercise effect the metabolic system?
increased BMR, increased use of glucose and fatty acids, increased triglyeride breakdown, increased GI motility, increased production of body heat
A 35-year-old woman is speaking with you about her recent diagnosis of a chronic illness. She is concerned about her treatment options in relation to her ability to continue to care for her family. As she considers the options and alternatives, she incorporates information, her values, and emotions to decide which plan will be the best fit for her. She is using which form of cognitive development?
postformal thought
Autonomy
power to the patient
What are elastic stockings used for?
promote venous return to the heart
ethics of care suggests that ethical dilemmas can best be solved by attention to what?
relationships
The nurse's first action after discovering an electrical fire in a patient's room is to:
remove all patients from immediate danger (Thank RACE) R is rescue and remove
A patient on week-long bed rest is now performing isometric exercises. What nursing diagnosis best addresses the safety of this patient?
risk for activity intolerance
The nursing assessment on a 78-year-old woman reveals shuffling gait, decreased balance, and instability. On the basis of the patient's data, what nursing diagnoses indicates an understanding of the assessment findings?
risk for falls
