H&W - EXAM 1 (compilation of Weeks 1-3)

How many total standards are presented in the Scope and Standards of Practice?

18

A nurse offers pain medication to a client who is experiencing acute appendicitis. The nurse understands that this aspect of care delivery is an example of which ethical principle?​

Beneficence

What is the new NCLEX exam called and how many new question types are there?

Next Generation NCLEX, and 5 new questions

Select the potential unmet needs: Samara, a 22-year-old college student (preferred pronouns she, her), is finishing her senior year in nursing school. She works part-time as a waitress, but the diner's business has been slow and her paychecks have been small. Yesterday, Samara found out that she is pregnant and worries about telling her boyfriend.

paychecks have been small, worries about telling her boyfriend. Feedback: see photo

Wellness education

Interventions that teach people how to care for themselves in a healthy way.

CASE STUDY: If Amelia does not respond to this situation, which ethical principle could she be violating?​

Nonmaleficence

A nurse receives a medication prescription that seems incorrect based on the client's diagnosis and contacts the provider for clarification. The nurse understands that this action is an example of which ethical principle?​

nonmaleficence

Scope of nursing practice

see photo FEEDBACK: WHO: All registered nurses, including advanced practice nurses, are part of the "who" in nursing. Each has been educated, titled, and maintains an active license to practice nursing. WHAT: The unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that the person would perform unaided given the necessary strength, will, or knowledge. WHERE: Nursing occurs in any environment "where" there is a healthcare consumer (client) in need of care, information, or advocacy. ​ WHEN: Nursing occurs "when" there is a need for nursing knowledge, wisdom, caring, leadership, practice, or education... anytime, anywhere. ​ WHY: The "why" is characterized as nursing's response to the changing needs of society to achieve positive client outcomes in keeping with nursing's obligation to society. ​ HOW: The "how" of nursing practice is defined as the ways, means, methods, and behaviors that nurses use to practice professionally. ​

CASE STUDY: Recognizing cues (see photo)

see photo FEEDBACK: The location of the emergency department (ED), the client's cause and type of injury, and history do not represent an ethical issue. However, the provider's actions and statements as well as the charge nurse's statement represent an ethical situation that Amelia may need to handle. ​

History of the NPA

see photo FEEDBACK: As technology advanced and knowledge grew, many people began to provide healthcare services. The need for regulation of these providers was apparent.​ The regulation of nursing practice implies government intervention, but the U.S. Constitution does not include provisions to regulate nursing. Therefore, the responsibility for nursing regulations falls to the individual states.​ In 1903, North Carolina was the first state to enact a nurse practice act (NPA). Later that same year, New Jersey, New York, and Virginia passed similar laws. Despite this progress, these early acts did not define the practice of nursing; however, in 1938, New York was the first state to define a scope of practice for nurses. ​

For each nursing intervention, identify if the intervention is a direct or indirect care measure.

see photo FEEDBACK: Direct Care Measures—Interventions are those nurses provide through interaction with the client. Examples: The nurse administers medications, inserts an indwelling urinary catheter, and provides discharge instructions. ​ Indirect Care Measures—Interventions are performed away from the client but on their behalf. Examples: The nurse documents and collaborates with other members of the healthcare team.

Core values: Responsibility

​​The nurse agrees to provide the client with pain medication in 15 minutes. The nurse returns to the client's room at the designated time with the medication. FEEDBACK: Responsibility is the opportunity or ability to act independently and make decisions without authorization. It refers to the blameworthiness or praiseworthiness that one bears for one's conduct or the performance of duties. ​

secondary prevention

preventing the spread of disease, illness, or infection once it occurs

Why do nurses need a license?

To protect the public

Definition of Disease

Physical indicators and subjective experience

Affordable Care act programs

see photo

Nurses use the nursing process daily when caring for clients. What is the purpose of the nursing process?

A systematic universal approach to critical thinking in the nursing profession​

Which are standards of nursing practice?

1. assessment 2. diagnosis 3. outcomes identification 4. planning 5. implementation 6. evaluation

Illness prevention

Activities that protect people from actual or potential threats to health.

Which statement is true regarding healthcare value in the United States (U.S.) in 2020?​

Despite high spending, the U.S. has poor healthcare outcomes. ​ FEEDBACK: When compared to peer countries, the U.S. spends nearly twice as much on healthcare yet has the worst outcomes and lowest life expectancy.​ U.S. healthcare spending is much higher than our peer countries. Value is less than peer countries. Federal government spending for healthcare increased 36%, largely due to response to the COVID-19 pandemic.​

The major difference between Healthy People 2020 and 2030 is the ___focus on health equity, access to _____ , and ___.

Increased, social determinants of health, health literacy

CASE STUDY: After reviewing recommendations from Healthy People 2030, Jamal understands that it is important to administer naloxone to ____ opioid overdose. Increasing access to ____ can help reduce overdose deaths. ​

REVERSE, TREATMENT

Healthcare costs in the US are _____ annually. This is ____ similar peer countries.

increasing, in opposition to

What establishes and provides authority to the state board of nursing?

state government

standards of professional performance

see photo

CASE STUDY: Many students remain in after-school care once the school day ends. Which federally-funded program provides meals for students participating in after-school activities?​

Child and Adult care food program FEEDBACK: The Child and Adult Care Food Program (CACFP) is a federal program that provides reimbursements for nutritious meals and snacks to eligible children and adults over the age of 60 who are enrolled in participating daycare centers. The program also provides meals for children participating in after-school activities and residing in emergency shelters.​

CASE STUDY: Julia hypothesizes that her problem is ____?

Compassion fatigue

Standards of practice

Competent level of nursing practicedemonstrated by the critical thinkingmodel known as the nursing process. # of standards: 6

CASE STUDY: Moral distress vs ethical problem

Moral distress occurs when the nurse knows the correct action to take but feels powerless to take that action. Amelia likely believes the client needs pain medication, but both the provider and charge nurse seem to disagree. ​ An ethical problem is called a dilemma when two opposing courses of action can both be justified by ethical principles. ​

Errors in clinical judgement

More than 65% of nursing errors result from poor clinical decision-making and 50% of those errors involve novice nurses. In fact, only about 20% of employers believe they are hiring novice nurses who are effectively prepared to make clinical judgments on the first day of practice.​

CASE STUDY: SEE PHOTO

SEE PHOTO

Social Determinants of Health

Social determinants of health are social and economic conditions that affect the quality of life and health outcomes.

Match the S.M.A.R.T. term to its description

Specific: Be sure that the outcome addresses only one client behavior or response Measurable: Use a term in an outcome statement that allows for observation as to whether a change takes place Attainable: Work with the client to set an outcome that the client agrees to meet Relevant: set an outcome that the client can meet based on physiological, emotional, economic, and sociocultural resources Time-based: Include when an outcome should be met.

Contributing factors that apply to health

lifestyle choices genetic make up environment in which you live disease or disability psychological or mental health issues

Ethical principles

see photo

Match the type of tobacco product to its description. ​

see photo

Relate each step in the nursing process to the correct step(s) in the clinical judgment measurement model. Note that each row may have one or more than one answer.

see photo

TAPS vs CAGE assessment question

see photo

specify if the objective is core, developmental, or research.

see photo

The client's older brother asks the nurse to send a picture of the client's broken arm x-ray stating that the image is so "cool" and they want to share it with friends on Instagram. What is the best response by the nurse?

"No, protected health information of any kind should not be shared on social media."

Amelia decides to escalate her concerns to the manager. In doing so, she is demonstrating which professional core values? Select all that apply. ​

advocacy responsibility

What are the basic physiological needs according to maslow?

oxygenation food elimination water sleep FEEDBACK: Physiological needs are oxygenation, food, water, sleep, and elimination. These must be addressed first. Remember, physiological needs are a "matter of survival."​ Love, self-respect, and personal growth are higher-level needs. ​

After a class on the health promotion model, students make the following statements. Which statement does the faculty member need to clarify?

"Perceived self-efficacy is not related to the model." FEEDBACK: see photo

Health is a state of complete _____, ______, and _____ well-being and not merely the absence of disease or infirmity.

physical, mental, social

What is the primary focus of Provisions 1 through 3 of the code of ethics? Select all that apply.

*commitments of the nurse *Direct client care Feedback: see photo

Which complementary therapies can be used by a healthcare professional without any additional training? Select all that apply.

*progressive relaxation *guided meditation *guided imagery

CASE STUDY: Which legislative act should Anna review in her efforts to better understand childhood nutrition programs?​

Healthy Hunger-Free Kids Act FEEDBACK: see photo

CASE STUDY: What goal would most likely help Julia's condition?​

Improve self-care and decrease work hours​

Healthy people core objectives

Measurable objectives that are associated with 10-year targets.

CASE STUDY (see photo) If Mr. Taylor wants to stop pain medications and only use tai chi and meditation, he is practicing ____ therapy.

alternative

When attempting to resolve ethical issues, nurses should use the ______

code of ethics

Food insecurity is defined as a lack of _____ to enough food to maintain an active, healthy lifestyle due to a lack of ____. Conversely, hunger refers to a _____ of discomfort that may result from ______ . .​

consistent access available financial resources, personal physical sensation, food insecurity

Non-modifiable risk factors

gender at birth age family history ethnicity genetics personal history

A client presents to an immunization clinic to receive influenza and tetanus (Td) vaccines. Which need, according to Maslow's hierarchy, is being met?​

safety and security Feedback: see photo

Assessment Findings of substance abuse: Click to specify if the documentation in the medical record should or should not alert the healthcare professional to a possible opioid addiction. ​

see photo

CASE STUDY: A new nurse asks Larry to explain Provision 7 of the code of ethics. Match each component of Provision 7 to the example of a nurse demonstrating this behavior.

see photo

CASE STUDY: primary vs secondary prevention

see photo

Details in the Nurse Practice act

see photo

CASE STUDY: Which professional nursing standards is Larry demonstrating? Select all that apply.

14. scholarly inquiry 13. Leadership 12. Education 8. advocacy

Description of praparation stage scenario:

Communicator: Establishes therapeutic relationships upon which to build trust and honest, factual communication. Educator: Available to provide accurate information so that an individual can weigh the pros and cons of behavior. Supportive Advocate: Reaches out to encourage and offer help while protecting the individual's right to self-determination.

standards of professional performance

Competent level of behavior in the professional role. # of standards: 12

complementary vs alternative therapy

Complementary therapies (yoga) are used in conjunction (together) with traditional medical approaches (anti-hypertensive medication).​ Alternative therapies (meditation) are used instead of traditional medical approaches (anti-inflammatory medication). ​

Which Healthy People 2030 leading health indicator (LHI) is aimed at reducing healthcare costs?​

Increase the proportion of people with health insurance (AHS-01)​

CASE STUDY: Based on the nursing diagnosis of impaired gas exchange, which intervention is most appropriate for the client? ​

Initiate supplemental oxygen​

When providing care to Samara, which must the healthcare professional consider?​

Samara's need for love and belonging may supersede her other needs​. Feedback: Despite Maslow's needs being presented in a certain order on the pyramid, flexibility is needed based on external circumstances and individual differences (McLeod, 2020). The order of the needs is not rigid, but instead, it must be flexible. Samara's need for love and belonging may supersede her other needs, including basic physiological needs. ​ Financial security is a concern but is not the reason Samara is seeking assistance, indicating it is not her priority need at this time. ​Dropping out of school will likely produce more unmet needs.

Advocacy

The public health nurse recognizes an increase in the incidence of diabetes mellitus type 2 among school-aged children and works with local school nurses to improve lunch menus in the schools. FEEDBACK: Political, economic, social, cultural, environmental, behavioral, and biological factors can all promote health or harm it. Health promotion aims at making these conditions favorable through advocacy for health.

CASE STUDY: Which statement is correct about valerian and anxiety?​

There is not enough evidence to support the effectiveness or safety of valerian use to treat anxiety.

Which statement is correct about melatonin and insomnia?

There is not enough strong evidence to support the effectiveness or safety of melatonin for chronic insomnia.

CASE STUDY: See photo

While caring for clients, Sharon follows the nursing process. These standards of practice demonstrate that the nurse is critically thinking and using clinical reasoning. ​

Immunizations are an example of ______

illness prevention Feedback: Illness prevention includes activities such as immunization programs and blood pressure screenings that protect clients from actual or potential threats to health and wellness. ​ Health promotion activities include helping clients maintain or enhance their present health by encouraging healthy activities, such as regular exercise and good nutrition.​

What are environmental health risks?

living near a toxic waste occupational exposures pesticides in food high levels of pollution extreme temperatures FEEDBACK: The environment is the air we breathe, the water we drink, the food we eat, and the places where we live, work, and play. An environmental health risk is a substance that has the ability to cause an adverse health event. ​ Examples include living near a toxic waste disposal site (where we live), occupational exposure to chemicals (where we work), high levels of air pollution (the air we breathe), extreme temperatures (where we play), and pesticides in food (food we eat). ​ Lack of exercise, failure to eat fruits and vegetables daily, and reducing screen time for preschool-aged children are lifestyle choices that are modifiable. ​

CASE STUDY: Izaak is most likely demonstrating symptoms of an _____ use disorder.

opioid FEEDBACK: see photo

CASE STUDY: The healthcare professional should address Izaaks ____ and then his ____.

physical symptoms, addiction FEEDBACK: His physical symptoms pose the greatest risk to his immediate health. Once recovered, his addiction can be managed.​

Food assistance program eligibility

see photo

A nurse is experiencing an ethical dilemma with a client. Which information indicates the nurse has a correct understanding of the primary cause of ethical dilemmas?​

presence of conflicting values

CASE STUDY: Risk factors for food insecurity

recently lost her job single mother little savings little family support

The client tells the nurse they are afraid to speak up regarding a desire to stop chemotherapy treatment and end future care for fear of upsetting family members. Which principle in the nursing code of ethics ensures that the nurse will support the client's decision?

Advocacy FEEDBACK: see photo

Core values: Confidentiality

A healthcare provider who is not caring for the client calls and requests information about the client's neighbor. The nurse refuses to provide information. ​ FEEDBACK: Confidentiality is the nondisclosure of patient secrets or information without patient authorization. ​

Which statement is true about the Healthy People initiative?​

A program to promote, strengthen, and evaluate the nation's efforts to improve the health and well-being of all people. ​ FEEDBACK: see photo

Which organization is responsible for nursing's scope and standards of practice?

American Nurses Association

CASE STUDY: Larry is helping to orient a new graduate and wants to discuss the definition of nursing. Where could Larry find the most common definitions of nursing? Select all that apply.

American Nurses Association International Council of Nurses

CASE STUDY: Sharon Powers is a registered nurse leading a quality improvement initiative to prevent hospital-acquired pressure injuries. She attends a master's program in nursing leadership during the day and works as a charge nurse on the telemetry unit at night. Which standards of professional performance is Sharon displaying?

EDUCATION LEADERSHIP

CASE STUDY: Which action should Monice recommend that would be most appropriate for the community? ​

Employ a case manager that could assist clients with Medicaid enrollment​

CASE STUDY: The nursing process (SEE PHOTO)

FEEDBACK: Subjective data is information that the client tells the nurse.​ In this case, the subjective date includes: sore throat​ shortness of breath​ wife having the flu​ not sleeping well at night​ Objective data is information collected using our five senses.​ In this case, the objective date includes: hoarseness​ nasal congestion​ pulmonary congestion​ vital signs​

CASE STUDY: Jonathan decides to make additional lifestyle changes. For each change, indicate whether it would improve his health or decline his health.

Improve: Receives seasonal flu vaccine continues yoga class reports reduce stress Decline: Stays up all night to study drinking alcohol on weekends

Healthy people developmental objectives

Objectives that represent high-priority public health issues but do not yet have reliable baseline data.

CASE STUDY: After applying concepts from the Code of Ethics for Nurses to resolve this ethical dilemma, Nina understands that nursing care is shaped by client _____, ______, values, and ______ .

Preferences, needs, choices

CASE STUDY: Nina's colleagues politely express that the client is too young to make this type of decision. However, Nina knows that every client should be treated with respect despite personal attributes (age), health status, and situation. Nina worries that her colleagues are violating part of Provison 1 ______

Respect for human dignity

The American Nurses Association Code of Ethics is a contract between nurses and _____ and that contract is relevant in any situation. The code is ___ in any setting.

Society, non-negotiable

Core values: Accountability

The nurse arrives for the shift to discover that two nurses are out sick and have not been replaced. The nurse contacts the supervisor for additional help caring for clients. FEEDBACK: Accountability refers to being answerable to oneself and others for one's own choices, decisions, and actions as measured against a standard. ​

CASE STUDY: Click to select all the findings that require immediate follow-up by the nurse. (see photo)

coughing with wheezing no improvement in symptoms

Place Maslow's 5-tiered model in the correct ascending order starting from the most basic.

physiological safety and security love and belonging self esteem self actualization

History of the code of ethics

see photo

Levels of food security

see photo

Equity

The public health nurse recommends telehealth medical appointments be available for clients with limited transportation. FEEDBACK: Health promotion should focus on achieving equity in health. This means reducing differences in current health status and ensuring equal opportunities and resources to help all people achieve full health potential.

CASE STUDY: Which model of health is best used to assist a client who needs to stop smoking but may be resistant? ​

Transtheoretical model of change FEEDBACK: see photo

Which part of Provision 1 addresses lateral violence, nurse bullying, and incivility?

Relationships With Colleagues and Others FEEDBACK: see photo

The nurse is caring for a client experiencing shortness of breath, wheezing, and coughing due to an asthma attack. The client's respiratory rate is high. The nurse elevates the head of the bed, administers medication to relax the client's airway, and delivers supplemental oxygen. After these interventions, the client states, "I feel like I can breathe better now." Which nursing action(s) can the nurse use to evaluate the plan of care? Select all that apply.​

* Listen to the clients lungs * measure the clients respiratory rate

CASE STUDY: Which interventions performed on the client are indirect care measures? Select all that apply.

*Contact the healthcare provider to update on the client's condition. *Discuss the client's condition with the respiratory therapist. *Review chest x-ray results in the medical record.

When reviewing the core objectives related to social determinants of health, which are the goals for Healthy People 2030? Select all that apply.​

*Create neighborhoods that promote health and safety *Increase educational opportunities ​ *Increase social and community support​

Place the nursing actions in the correct order based on the clinical judgment model. ​

1. Recognize cues: The nurse identifies the assessment findings for a pregnant client.​ 2. Analyze cues: The nurse determines that the client is contracting and her cervix is dilating. ​ 3. Prioritize hypotheses: The nurse decides that the client's priority problem is labor. ​ 4. Generate solutions: The nurse plans to provide non-pharmacologic ways to reduce pain and promote comfort.​ 5. Take action: The nurse places the client in a rocking chair and leads a guided imagery.​ 6. Evaluate outcome: After providing intervention, the nurse assesses the client's pain as 4 out of 10. ​

What is the meaning of the term food desert? ​

A community with limited access to retailers that carry affordable and nutritious foods. ​

CASE STUDY: Which ethical principle is Nina demonstrating by encouraging the family to respect the client's wishes?

Advocacy

CASE STUDY: Akeem Omar is a healthcare professional at an acute care facility. Today, he is caring for four clients: ​ Highlight the client that requires immediate intervention by the healthcare professional.

Adult male client with severe anxiety who is taking valerian root supplements and antihistamines​. FEEDBACK: Valerian root supplements are commonly taken for anxiety but interfere with antihistamines. ​

A client suffers from an anxiety disorder and does not want to take medications. Which therapy teaches the client self-regulation and voluntary self-control over specific physiologic responses?

Biofeedback

Which part of Provision 7 encourages professional collaboration to promote change?

Contributions through nursing and health policy development

A client is admitted to the intensive care unit for treatment of a deep vein thrombosis. As part of treatment, the client is started on an anticoagulant called heparin. When reviewing the client's history of supplement use, which potential interaction should be reported to the healthcare provider? **On Previous Quiz**

Ginseng

CASE STUDY: The healthcare professional is planning a follow-up phone call with Jamal after the health fair. Based on Jamal's reported sleep habits, the professional will recommend relaxation and music therapy in the evening before bedtime. Which model of health is being used to assist Jamal? ​

Holistic health model Feedback: The holistic health model acknowledges that all dimensions of an individual contribute to health and wellness. A holistic view also includes emotional and spiritual well-being. Healthcare providers recognize the body's natural healing abilities and may recommend or incorporate complementary and alternative interventions.​

CASE STUDY: SEE PHOTO which cues alert Jane that she should be concerned?

Jane works in a high school and has seen 3 STI cases in a week.

CASE STUDY: Which food assistance program is providing free or reduced lunches for elementary children?​

National school lunch program

A nurse reports suspicious co-worker behavior to the nurse manager. What ethical principle is the nurse demonstrating?​

Nonmaleficence

scope of practice

Nurses provide services based on specific standards of practice and a code of ethics.​

Where are specific nursing practice rules found?

State nurse practice acts

CASE STUDY: Which desired outcome is appropriately written for the client?​

The client's oxygen saturation will increase above 90% within 1 hour of treatment.

Data trends for LHI reducing hunger:

The data for the leading health indicator "Reduce household food insecurity and hunger (NWS-01)" is at improving. Increasing nutrition assistance program benefits and addressing unemployment may help reduce food insecurity and hunger. ​

A nurse on a surgical unit is caring for a client who had surgery yesterday to repair a broken leg. The client is restless, grimacing, and groaning. The client's heart rate and blood pressure are elevated. The nurse notices that the client's pain medication has not yet been administered this morning. What part of this situation should the nurse reflect upon? ​

The delay in administration of the pain medication​

CASE STUDY: Which tobacco product is most common among adolescents?​ **On Previous Quiz**

electronic cigarettes

Valerian root ____ the central nervous system (CNS) effects of antihistamines. Akeem's client is at risk for developing severe ____ .

enhances, CNS depression Feedback: Valerian root enhances the CNS effects of antihistamines, barbiturates, and sleep medications. Valerian root promotes CNS depression. Antihistamines have CNS depression effects as well. When taken together, the client is at risk for severe CNS depression.

The goal is to increase the proportion of adults under 65 years with health insurance. Reducing _____ barriers will increase _____.

financial, insurance coverage.

CASE STUDY: Sara, a 28-year-old female, is currently pregnant. Before becoming pregnant, she lost 20 pounds by eating a healthy diet and exercising daily. Sara attends prenatal yoga and performs monthly breast self-exams. As a diabetic, she checks her blood sugar levels four times daily. ​

see photo

Which examples are perceived healthcare benefits of action?

1. An adult female undergoing a mammogram screening test. 2. A mother making an informed decision regarding her child receiving an immunization. 3. A sexually active teenager scheduling an appointment with a healthcare provider to discuss oral contraceptive use. FEEDBACK: see photo

Description of action stage scenario:

Coach: Provides training, prompting, leadership, and instruction. Caregiver: Implements a specific process to assist with antismoking medications, patches, and other support materials and aids as appropriate. Teacher: Provides practical strategies to deal with urges, withdrawal, and emotions​.

CASE STUDY: SEE PHOTO Based on Jamal's visit to the community health fair, click to specify if each of Jamal's behaviors is positive or negative. ​

Negative behavior: smoking for 41 years snacking late at night work-related stress positive: receives vaccines takes vitamins daily

Which are the dimensions of wellness?

Occupational Financial Social Physical Emotional Spiritual Environmental Intellectual

Definition of Wellness

Positive state of health that is continually changing

CASE STUDY: Match Jamal's statements with the appropriate stage within the transtheoretical model of change. ​

SEE PHOTO

CASE STUDY: Last night, Sara became very dizzy and almost passed out. Her partner took her to the Emergency Department where it was determined that Sara's blood sugar was dangerously low. She was admitted to the hospital for treatment of hypoglycemia and monitoring of her fetus. ​ What type of prevention is Sara receiving?​

Secondary Feedback: see photo

Primordial prevention

preventing exposure to risk factors that promote disease onset

A healthcare professional is planning a health promotion program on testicular self-examination. Using the health belief model, which statement made by a participant indicates perceived susceptibility to illness?​

"My brother had testicular cancer when he was a teenager, so I know my risk is elevated."​ Feedback: see photo

CASE STUDY: If prevention strategies are not implemented, which is the most concerning consequence? ​

Heart attack FEEDBACK: The major concern with Michael's family history and ethnicity is the development of cardiovascular disease leading to a heart attack. ​ Although career burnout may occur due to stress and extended working hours, this is not the most concerning consequence of Michael's family history. ​Diabetes mellitus type 2 does have a genetic component based on Michael's strong family history of cardiovascular concerns. However, this is not the most concerning consequence. ​Michael is not currently overweight; therefore, obesity is not the most concerning consequence of the family history. ​​

Your responsibility question

"Ignorance of the law is never an excuse" (Russell, 2017, p. 22). Understanding your state nurse practice act (NPA) is essential to safe practice. NPAs may evolve over time and reviews must be ongoing to keep up with changes or amendments. ​

CASE STUDY: see photo What cues alert Anna that she should be concerned about student nutrition?

*Most students receive free or reduced lunch​. *Many students only receive meals at school​. *The school serves low-income households​. *The local community is predominately migrant workers​.

The nurse uses findings and determines that that client's primary need is readiness for enhanced health management in what phase(s) of the clinical judgment measurement model? Select all that apply.

*Prioritize hypothesis *analyze cues

CASE STUDY: From Li's research, which goals should he plan for the presentation?

*Teach factors that increase risk for tobacco use and dependence​ *Provide resources for smoking cessation *Demonstrate peer pressure management strategies​ *Define stress management strategies *Explain the effects of smoking on health FEEDBACK: Adolescents need to be aware of modifiable and nonmodifiable risk factors to increase tobacco use and dependence, as well as the health effects of smoking. Li should discuss peer pressure and stress management strategies and provide resources for smoking cessation.

Place the steps of the clinical judgment process in the correct order. ​

1. recognize cues 2. analyze cues 3. prioritize hypotheses 4. generate solutions 5. take action 6. evaluate outcomes

A 16-year-old student tells the healthcare professional that they smoke e-cigarettes daily. Which is the best action by the professional?​

Educate that tobacco use in adolescents can have lifelong health effects FEEDBACK: Education is the best strategy for the healthcare professional to take. ​ Informing the parents will diminish the student's trust in the professional. Telling the student that vaping is not appropriate and that they should stop will not likely work. ​

CASE STUDY: The Affordable Care Act has three main objectives. Which objective would most benefit Monice's community?

Expand Medicaid to the working poor with income up to 138% of the federal poverty level

CASE STUDY: see photo

FEEDBACK: Cues that indicate that Tonya needs to research how to be licensed in her home state include: ​ *She just graduated from school.​ *She is unsure how to become licensed in her state.​ *She is interested in a multistate license. ​ All nurses need a license to practice, regardless of the setting of practice or the type of program they graduated from. ​

CASE STUDY: ANA publications A new nurse asks Larry to explain the differences between the code of ethics, practice standards, and professional performance standards. For each statement, identify which publication it represents.

FEEDBACK: The Standards of Practice describe a competence level of nursing practice demonstrated by the critical thinking model known as the nursing process. The nurse process forms the foundation of nursing decision making. There are 6 standards of practice: assessment, diagnosis, outcomes identification, planning, implementation, and evaluation. ​ The Standards of Professional Performance describe a competent level of behavior in the professional role. All nurses are expected to engage in professional role activities reflective of their education, experience, and position and are accountable to themselves, clients, peers, and society. There are 12 standards of professional performance: ethics, advocacy, respectful and equitable practice, communication, collaboration, leadership, education, scholarly inquiry, quality of practice, professional practice evaluation, resource stewardship, and environmental health. ​ The Code of Ethics incorporates 9 provisions that assist the nurse in managing ethical dilemmas and moral distress. ​

CASE STUDY: Li's presentation is well attended by both students and school administration. ​Which positive action by school administration would be most successful in reducing tobacco use among adolescents?​

Launch a poster media campaign highlighting dangers and treatment resources​

Legal vs ethical issues

Legal issues reference laws that are typically concrete. Ethics is broader than the law and refers to behavior and character.​

Description of maintenance stage scenario:

Mentor: Provides follow-up support, consultation, and referrals as needed. Researcher: Measures outcomes over time to build effective interventions. Innovator: Creates new solutions for unseen problems particular to each client's smoking recovery. ​

CASE STUDY: SEE PHOTO What cues alert Li that he should be concerned about adolescent tobacco use?​

Most tobacco use begins in adolescence. FEEDBACK: The majority of all tobacco use begins in childhood and adolescence. This cue is the alert that Li should be concerned about. ​ Tobacco use is more common in males, minority races, and people with lower incomes. ​

What is a leading health indicator?​

Objective that focuses on factors that are a major cause of morbidity or mortality​ feedback: see photo

CASE STUDY: The situation has escalated and the family is now demanding to speak with Nina's supervisor. Which solution to this dilemma might Nina suggest?

Request a care conference with the healthcare provider, client, and family.

The nurse has become aware of missing narcotics in the client care area. Which ethical principle obligates the nurse to report the missing medications?

Responsibility

What are some of nursing's core professional values?

Responsibility Accountability Confidentiality Advocacy FEEDBACK: Nurses study ethics to understand their responsibilities to act ethically and be accountable for their actions as guided by nursing professional standards. Nursing guidelines reflect our core values of advocacy, responsibility, accountability, and confidentiality. ​ Independence and competition are not the core values of nursing. ​

CASE STUDY: Larry is explaining the nursing scope of practice to a group of newly licensed nurses. Match each description to the component of the scope of practice.

SEE PHOTO

Definition of Health

State of complete physical, mental, and social well-being, not merely the absence of disease or illness

A nurse is caring for a client with several risk factors for developing cardiovascular disease, including obesity and family history. How should the nurse interpret these findings?​

The chances of having a myocardial infarction are increased.​ FEEDBACK: The presence of risk factors does not mean that a disease will develop, but risk factors increase the chances that the individual will experience a particular disease or dysfunction. ​ Control of risk factors does not guarantee that a disease will not develop. However, risk factor modification can assist clients in adopting activities to promote health and decrease risks of illness.​

Katie Costa, a registered nurse, is caring for a client who is dying. During admission, the client states they have an advanced directive requesting not to be resuscitated in the event of cardiac arrest. Katie receives a do not resuscitate (DNR) prescription from the healthcare provider and, soon after, the client goes into cardiac arrest. The family insists that the healthcare team do everything possible to save the client. The provider agrees with the family and tells Katie to begin CPR. ​ If katie speaks up, she is demonstrating what?

advocacy

What are external variables that influence a persons health?

family health practices cultural background social determinants of health

Clients with substance use disorders may exhibit suicidal ideation. Which best describes suicidal ideation?​

planning suicide FEEDBACK: Suicidal ideation is defined as thinking about or planning suicide.​ Attempting, whether successful or unsuccessful, is not suicidal ideation, it is self-harm and suggests a need for more advanced mental health care.

CASE STUDY: see photo Julia assesses her subjective and objective symptoms. What step in the clinical judgment model is she performing?

recognizing cues

Location of prevention strategies

see photo

Mediation

A local elementary school wants to implement a mask mandate to protect children from exposure to COVID-19 during an outbreak, but the school board is resistant. The public health nurse presents information during a school board meeting. FEEDBACK: Health promotion demands a coordinated action by governments, health and economic sectors, volunteer organizations, local communities, the health industry, and the media. Nurses have a responsibility to mediate between differing interests in society for the pursuit of health.

CASE STUDY: Julia thinks that her workload is affecting her health. Which cues support this finding? Select all that apply.​

*Difficulty sleeping​ *Fatigue​ *Gained 15 pounds​ *Feeling overwhelmed​

CASE STUDY: From Anna's research, which goals should she plan for improving student nutrition? Select all that apply.

*Discuss the School Breakfast Program with administration. ​ *Teach age-appropriate nutrition classes to students. ​ *Increase the amount of dark green, red, and orange vegetables served weekly.​ *Ensure healthy snacks that include fruit are provided during the school day. *Prepare information for families on how to receive federally-funded nutrition assistance.​

Which statements correctly describe the evaluation phase of the nursing process? Select

*Evaluation involves the use of assessment skills. *Evaluation requires the collection of objective and subjective data. *Evaluation is a continuous process.

Which client behaviors are suspicious of excessive substance use?

*Frequent injuries ​ *Self-inflicted trauma​ *History of attempted suicide​ *Concentration problems​ *Easily agitated​

CASE STUDY: Upon discharge, Akeem evaluates the client's learning. Which complementary therapy could the client safety use in addition to anti-anxiety medications? Select all that apply.

*Guided imagery *Progressive relaxation *Therapeutic touch *Meditation

Which of the following are included in complementary and alternative medicine (CAM) approaches to wellness and healing? Select all that apply.

*Herbs *Meditation *Therapeutic touch *Acupuncture *Aromatherapy

CASE STUDY: From Jane's research, which goals should she incorporate into her plan? Select all that apply.

*Improve student knowledge of STI prevention​ *Increase screening and testing for STIs​ *Reduce the number of STIs diagnosed weekly​ *Improve student knowledge of STIs​ *Refer students for STI treatment​

Which health effects are the result of tobacco use? Select all that apply. ​

*Increased aging appearance *Diabetes mellitus​ *Heart disease​ FEEDBACK: Smoking causes cancer, stroke, heart disease, and lung disease. It increases the risk for tuberculosis, certain eye diseases, diabetes mellitus type 2, and autoimmune dysfunction, including rheumatoid arthritis. Smoking increases peristalsis, leads to weight loss, and favors wrinkling of the skin.​ Smoking does not cause osteoarthritis or weight gain. ​

What are the primary causes of increased healthcare spending in the United States? Select all that apply. **ON PREVIOUS QUIZ**​

*Innovations in care​ *Advanced technology​ *New prescription drug development

CASE STUDY: Which results would indicate that Julia is improving after interventions? Select all that apply.​

*Losing 5 pounds in the past month​ *Verbalizing feeling more energetic *Sleeping at least 7 hours per night​

Which are common problems associated with the use of herbal supplements? Select all that apply.

*May contain pesticides *mount of ingredient varies by manufacturer *May interfere with prescribed medications *May contain carcinogenic properties

CASE STUDY: Based on Jamal's research, which goals should be incorporated into the clinic's plan for management of opioid overdose? Select all that apply.​

*Quick identification of symptoms of overdose​ *Compiling a list of community resources for substance use disorder ​ *Administration of naloxone as a reversal agent​ *Collaboration with a substance use treatment facility ​

CASE STUDY: What should Julia do to solve the problem? Select all that apply.​

*Speak with her manager about workload​ *Exercise regularly​ *Begin a stress reduction program​ *Spend time doing things she enjoys​

What are the major responsibilities of the state board of nursing (BON)? Select all that apply.

*Take disciplinary action against nursing licenses *Evaluate new graduate licensure applications *Issue licenses to new graduates and nurses relocating to the state *Renew registered nurse licenses

CASE STUDY: Which data would prove that community interventions were successful? Select all that apply.

*The number of clients receiving prenatal care increased *The number of clients who can't afford medication decreased *The number of clients receiving preventive healthcare increased *The number of emergency room visits decreased *The number of clients with an identified primary care provider increased

CASE STUDY: Select all the ethical dliemmas that nina is facing. Nina Brossard (preferred pronouns she, her) is a new graduate nurse assigned to care for a 21-year-old client diagnosed with leukemia. The client was diagnosed at age 10 and has undergone treatment and many invasive procedures over the past 10 years. Today, the client is refusing treatment, stating that they are tired of fighting cancer. The family is not in agreement with this decision and ask Nina to administer the intravenous treatment despite the client's statements.

*client is refusing treatment *family is not in agreement *ask Nina to administer the intravenous treatment

CASE STUDY: identify cues that Larry is demonstrating the behaviors of a professional registered nurse.

*clinical manager *researches best practices *implements a new time tracking policy *performing assessments *quickly assesses the client and moves them FEEDBACK: Larry is demonstrating professional nursing behaviors by performing clinical manager duties, researching best practices, implementing new policies, performing assessments, and quickly assessing and moving a critical client to a bed. ​ Wait time in the Emergency Department is not a nursing behavior but an outcome to measure. A client with chest pain is not a nursing behavior but a type of client that presents to an Emergency Department. ​

CASE STUDY: Click to select all the most common characteristics found in an uninsured population. ​ Monice Everett is a healthcare professional working in a community health department that serves an economically depressed rural community with many uninsured or underinsured people. The majority of residents are Hispanic females between the ages of 18 and 64. Most households experience an income below the federal poverty level.

*economically depressed *hispanic *ages of 18-64 *income below poverty

A nurse assesses a 42-year-old client at a health clinic. The client is married and lives in a condo with their spouse. The client reports having frequent voiding and pain when they pass urine. The nurse asks whether the client has to go to the bathroom frequently during the night and they respond, "Yes, usually twice or more." The client had an episode of diarrhea one week ago. They weigh 136 kilograms and report having difficulty cleansing their perineum after voiding or passing stool. Which data finding(s) indicates the nursing diagnosis of impaired urinary elimination? Select all that apply.

*frequent urination at night * painful urination

CASE STUDY: which are indicators of a substance use problem? Izaak walks into the urgent care clinic today requesting narcotic pain medication for a back injury. He has clearly been crying and reports his pain as 10 out of 10. When asked to describe how the injury occurred, he becomes agitated and has difficulty remembering the incident. ​ Izaak reports three previous visits to the emergency departmentfor the same injury and lists two different primary care providers on his intake form. Upon assessment, the healthcare professional notes several cuts on his right wrist that appear self-inflicted. Izaak denies suicidal ideation at this time.

*requesting narcotic pain medication *agitated *difficulty remembering the incident * 3 previous visits to the E.D. *Lists 2 different care providers *several cuts on his wrist

Which statement describes elements to consider when prioritizing hypotheses? Select all that apply.

* Priority setting establishes the order in which nursing interventions should occur. ​ * Prioritizing involves interpreting the relevant data to determine what is happening. ​ * Recognizing and analyzing symptoms helps the nurse prioritize interventions. ​

Which factors should be considered when choosing appropriate interventions for client care? Select all that apply.

* The desired outcome that will be used to judge the effectiveness of the plan * The appropriateness of the intervention compared to client condition * The assessment data that supports the intervention * The client's values and beliefs regarding the intervention

Which statement best describes the analyzing cues phase of the clinical judgment process? Select all that apply. ​

* The nurse determines which cues support the current situation *The nurse considers cues in context with the client's condition

In the following scenario, click to select all the components that qualify as objective assessment data. The nurse is caring for a 48-year-old client who states, "I feel like I can't breathe." Vital signs are respiratory rate 28 breaths per minute, heart rate 115 beats per minute, and blood pressure 152/95 mmHg. The client grabs their chest and says, "My chest hurts so bad, please help!" The client is sweating and pale. ​ The nurse asks the client to rate the pain on a scale from 0-10. The client replies, "10, it hurts so badly!" The nurse asks the client to describe what the pain feels like and the client reports that their pain feels like pressure.

* respiratory rate * heart rate * bp * seating and pale

What are FDA enforcement action efforts to prevent e-cigarette use in adolescents? Select all that apply.​ **ON PREVIOUS QUIZ**

*Ban production of unauthorized flavored products that appeal to children *Launch retailer education efforts *Bar retailers who are caught selling to minors from future sales​ *Develop resources aimed at youths about the dangers of e-cigarette use *Hold retailers accountable for sales to minors​

Which are smoking cessation treatments?

*Behavior modification therapy​ *Nicotine patches​ *Buproprion hydrochloride *Varenicline tartrate *Counseling

How are Healthy People 2030 objectives categorized? Select all that apply. ​ **ON PREVIOUS QUIZ**

*By population​ *By health condition *By the setting *By social determinants of health *By health behavior

CASE STUDY: What are the consequences of being uninsured or underinsured?

*Clients may use costly emergency services more often *Clients are less likely to have a primary care provider *Clients may not receive preventative services *Clients may not be able to afford medications to treat diseases

Which important cancer prevention screenings are currently being tracked? Select all that apply.

*Colonoscopy for colorectal cancer​ *Mammograms for breast cancer​ *Radiologic exams for lung cancer​ *Pap smear tests for cervical cancer​

What is the purpose of the National Council of State Boards of Nursing (NCSBN)? Select all that apply.

*Develop and administer the nursing licensure exam *support nursing regulators in protection of the public *collaboration of all state boards of nursing

Which factors increase the risk of tobacco use in adolescents? Select all that apply. ​

*Diagnosed with depression *Belonging to a minority racial group *Highly stressful situation​s

CASE STUDY: After hearing the nurse manager and Amelia's concerns, the healthcare provider prescribes a low dose narcotic pain medication for the client. Although confronting the healthcare provider and the charge nurse was difficult, Amelia knows that _____ for quality client care is the ___ thing to do in​ ___situation.​

Advocating, right, every

External factors impacting health Which external variables influence this client's current health practices?

Difficulty paying bills Support from social networks Family practice of not routinely seeing a healthcare provider Feedback: External factors impacting health practices include family beliefs, family practices, and socioeconomic variables. The way that clients' families use healthcare services generally affects their current health practices. History of preventive care behaviors (or lack of them) can also influence how clients think about their current health practices. A person may seek support from social networks (friends, family, and spiritual advisors). Economic variables may affect a client's level of health by increasing the risk for disease and influencing how or at what point the client enters the healthcare system. A client's age, degree of psychological stress, and denying the need for help are internal factors.

Substance use disorder is associated with several destructive social conditions. For which conditions should the nurse assess?

Financial problems marital issues intimate partner violence child abuse FEEDBACK: Although substance use disorders are associated with seizures and respiratory arrest, these are not social conditions. ​

What are internal variables that influence a persons health?

Growth & Development Intellectual Background Emotional/spiritual factors Perception of functioning

Examples of need by level

Physiological: Shelter safety and security: Health and well-being love and belonging: intimacy self-esteem: independence self--actualization: personal growth Another example in photo

Unmet needs vs. maslows level (see photo)

Safety & security = small paychecks self - esteem = struggling in school physiological = evection notice love & belonging = rejection by boyfriend

CASE STUDY: In planning future care for Michael, click to specify if each strategy is primary, secondary, or tertiary prevention. ​

See photo

CASE STUDY: Based on client actions as a result of participating in the community health fair, which findings indicate the health promotion activities were effective? Select all that apply.​

Did not develop influenza this season​ Brought spouse to pharmacy to receive shingles vaccine Reduced number of cigarettes smoked per day Reports sleeping 6-7 hours nightly​

CASE STUDY: The healthcare professional considers which prevention strategies may be most effective for Michael. From the list provided, identify which strategies may be effective or unnecessary. ​

Diet alterations stress reduction physical activity unnecessary: weight loss and medication

Healthcare professionals often use Maslow's hierarchy of needs when planning and implementing client care. How does Maslow's theory provide structure for client care?

Establishes priorities of care​ FEEDBACK: Maslow's hierarchy of needs is used by healthcare professionals to establish priorities of care. It provides a basis for healthcare professionals to care for clients of all ages in all settings.​ Maslow's theory does not help with an accurate diagnosis, selecting appropriate laboratory testing, or communicating client needs.

Health promotion

Activities that help individuals maintain or enhance their present level of health.

At which point in care does a nurse assess health risks?

During each client encounter

Using the transtheoretical model of change, place the steps needed to make a lifestyle change in the correct order.

Precontemplation: The client becomes angry when the healthcare provider suggests losing 40 pounds. Contemplation: The client recognizes the need to lose weight when struggling to play catch with the son. Preparation: The client joins a gym and hires a personal trainer. ​ Action: The client works out 4 days per week with their spouse. Maintenance: Six months after beginning the workout regimen, the client has lost 20 pounds. ​

Health Belief Model

see photo

Identifying levels of prevention

see photo

CASE STUDY: Evaluating outcomes

see photo FEEDBACK: Statements that indicate Jordan's situation is improving include:​ No longer coughing and wheezing shows improvement in the acute condition.​ Getting a fish tank helps the children cope with the loss of the pet and will not produce allergens.​ Statements that indicate Jordan's situation is declining include:​ No longer taking inhaler medications which are needed regularly to prevent asthma attacks. ​ Keeping the pet represents a serious risk to Jordan's health. ​

Definition of Illness

Functional or structural disturbance

CASE STUDY: Which findings from Michael's physical examination require preventive strategies? Select all that apply​. (See photo)

Grandfather's history occupation parent's history FEEDBACK: Health promotion is the process of helping people gain control of and improve their health. An individual takes responsibility for health and wellness by making positive lifestyle choices and avoiding negative ones. Michael has already been exposed to several risk factors for the development of cardiovascular disease, including family history and a stressful occupation. Additionally, high blood pressure is more common in African American males than Caucasian, Asian, or Hispanic adults (CDC, 2020). Therefore, a heightened response is required. ​ Michael's vital signs and BMI are within normal limits and do not require preventive measures at this time. ​

what factors contribute to wellness?

financial state physical state mental state environmental state social state

tertiary prevention

managing a chronic condition to lessen long-term complications

primary prevention

reducing the incidence of disease or injury

CASE STUDY: The nurse should first address the client's ____ followed by the client's ____.

symptoms, environment

modifiable risk factors

tobacco use diet sleep pattern wearing seat belt exercise lifestyle substance misuse stress

CASE STUDY: Requirements for assistance

The Supplemental Nutrition Assistance Program (SNAP) provides nutrition benefits to supplement the food budgets of low-income families so they can purchase healthy food. Tosha would likely qualify for this program. ​ The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is available to low-income women who are pregnant, postpartum, and breastfeeding as well as their infants and children up to age 5 years. Tosha should qualify for this program. ​ The National School Lunch Program (NSLP) and the School Breakfast Program (SBP) provide nutritionally balanced, low-cost, or free breakfasts and lunches to eligible students each school day. Tosha's oldest daughter would likely qualify for this program. ​ The Child and Adult Care Food Program (CACFP) is a federal program that provides reimbursements for nutritious meals and snacks to eligible children and adults over the age of 60 who are enrolled in participating daycare centers. Since Tosha is not over the age of 60 and her daughters do not attend daycare, they would not qualify for this program. ​

CASE STUDY: The healthcare professional recommends relaxation for Mr. Taylor. Which type of relaxation would be most appropriate?

PASSIVE

CASE STUDY: Click to specify the assessment findings that indicate the client's condition is improving or declining. ​

SEE PHOTO FEEDBACK: Evaluation is the fifth step in the nursing process that determines whether a client's condition is improving after nursing interventions are delivered. The client's respiratory rate and temperature have decreased, showing signs of improvement. The client's statement of improved ability to breathe indicates that interventions are working. ​ The client's oxygen saturation is declining, indicating he is not improving. ​

CASE STUDY: At the health fair, Jamal stated that he could never quit smoking. Considering the transtheoretical model of change, which response by the healthcare professional is most appropriate? ​

"What do you think is the greatest challenge to stopping smoking?​" FEEDBACK: The client's statement indicates that he is in the precontemplation stage and does not intend to make a behavior change. In this stage, the client is not interested in information about his behavior and may be defensive when confronted with the information. Asking an open-ended question about smoking may encourage the client to identify a reason to begin a behavioral change. Discussing health risks, making demands, and requesting changes are unlikely to succeed until the client is motivated toward change.

CASE STUDY: Allergy testing reveals that Jordan is allergic to both hay and pet dander. It is determined that the pet must be re-homed to protect Jordan from future problems. Both Jordan and his sister are very sad to lose their pet.​ What advice should the nurse offer to Jordan's caregivers? Select all that apply.​ ​

*Consider a hypoallergenic pet (e.g., fish, reptile) *Sponsor an animal at the local zoo *Continue to take medications as prescribed *Suggest a virtual pet FEEDBACK: Moving the pet outside may not prevent asthma symptoms because allergens can remain in the clothes and be transferred to the carpet and furniture. ​

Self-actualization is the highest level of need and refers to a person's realized potential. Select the behaviors that lead to self-actualization.

*Taking accountability and responsibility *Identifying weaknesses and working to overcome them *Boldly assuming unpopular views *Trying new experiences FEEDBACK: Self-actualization is the highest level of need and refers to a person's realized potential. This level represents a person's desire to accomplish all that is possible and become the best version of oneself.​ Behaviors that lead to self-actualization include trying new experiences, taking accountability and responsibility for actions, identifying weaknesses and working to overcome them, and boldly assuming unpopular views. ​ Following traditional paths and being unconcerned about the welfare of humanity do not lead to self-actualization. ​

What are the 5 stages of transtheoretical model of change in order?

1. precontemplation 2. contemplation 3. preparation 4. action 5. maintenance Feedback: As much as people want to live healthy lifestyles, change can be difficult to start and maintain. Breaking change into steps that can be identified and managed is one way healthcare professionals can help patients make healthier, long-lasting choices.

By leading health promotion activities, in which areas do nurses improve healthcare outcomes? Select all that apply.

Bioterrorism Emerging infections Aging population Natural disasters FEEDBACK: As a collective workforce, nurses are engaged in health promotion at multiple levels: providing care in a variety of situations (emerging infections, bioterrorism events, natural disasters); addressing the changing health needs of an aging population; and working on institutional and legislative policies that promote all aspects of health, including the decreasing (not increasing) costs of healthcare.

Case study: Which variables are affecting Jonathans Health? See photo

Childhood experiences Feelings about Health Career Choice Financial struggles Degree of stress FEEDBACK: Variables affecting Jonathan's health include knowledge from his professional program and work experience, his childhood experiences, his degree of life stress, his financial struggles, and his personal feelings about his health. ​ Jonathan's gender is not a variable that impacts health. ​ The scenario does not state Jonathan's cultural background, so we cannot determine if this variable is impacting his health. ​

Description of contemplation stage scenario:

Counselor: Guides in problem solving, supports self-determination, and shows that change is possible and necessary. Educator: Reinforces education about the evidence of smoking effects, success with abstinence, and available options to support smoking cessation. Critical Thinker: Uses a specific process to support change with the client​.

CASE STUDY: The following year, Michael returns to the clinic for a physical exam. Which findings indicate preventive measures were effective? Select all that apply.​

Daily walking/cycling Normal BMI Reports a low-fat, low-cholesterol diet

Description of precontemplation stage scenario:

Guide: Helps the smoker through unfamiliar circumstances and guides plan development with evidence-based science. Motivator/Change Agent: Creates motivation through honest involvement, active listening, and encouragement. Coordinator: Links available resources and creates a supportive network for success.

Models of health provide various ways of understanding ____ and ____ concepts.

Health, wellness FEEDBACK: Models of health provide various ways of understanding health and wellness (not diet, illness, exercise, or activity) concepts by guiding you to think about:​ different ways of understanding health and wellness relationships between health and wellness individual beliefs and subjective experiences of health and wellness ​

Health belief model

Nurses acknowledge that multiple factors influence a client's health perceptions, health beliefs, and likelihood of taking preventative health action. FEEDBACK: This model explores the relationship between what individuals believe (self-perception), modifying factors, and how they behave - likelihood to take action to avoid illness and those who do fail to take preventative action.

Transtheoretical model

Nurses recognize that people are at different stages of readiness to adopt healthful behaviors. FEEDBACK: This model proposes that health-related behavior moves through five stages; precontemplation, contemplation, preparation, action and maintenance. This model identifies "stages of change."

Holistic health model

Nurses using this model recognize the natural healing abilities of the body, acknowledge, and incorporate complementary and alternative interventions into the plan of care. FEEDBACK: This model acknowledges multi-dimensional components of an individual, inclusive of emotional and spiritual well-being that contribute to physical health and wellness.

CASE STUDY: The nurse recognizes that Jordan's issues stem from a/n ______ risk factor. ​

environmental FEEDBACK: An environmental risk factor is a substance that has the ability to cause an adverse health event. The likely trigger of Jordan's symptoms is the introduction of a pet into the household.​

A nurse recommends iron-fortified infant formula to a new mother. This is an example of ____ health promotion. ​ A client attends yoga daily that ends with a meditation session. This is an example of _____ health promotion. ​

passive, active FEEDBACK: With passive health promotion strategies, individuals gain from the activities of others without acting themselves. Iron-fortified infant formula is passive health promotion. With active health promotion strategies, individuals become personally involved in health promotion. Attending yoga and meditation sessions daily is active health promotion. ​

A healthcare professional is conducting a home care visit with an older adult couple. While in the home, the professional weighs each individual and reviews the food diary. The professional checks vital signs and encourages the couple to increase daily fluids and activity levels to help with their voiced concern about constipation. The professional is addressing which level of need according to Maslow's hierarchy of needs?​

physiological

An adolescent is sent to the principal's office for not paying attention in class. The student states they didn't eat breakfast. These concerns represent ______ needs. Additionally, the student discloses that the family slept in their car last night and they were fearful of being robbed. These concerns represent _____ needs. The school staff notices that the adolescent's clothes have an unpleasant odor and the student admits to being bullied in homeroom. These concerns represent _____ needs. Due to these unmet needs, the student is unable to concentrate and fails to complete assignments. These concerns represent ____ needs. ​

physiological, safety, belonging, cognitive

CASE STUDY: Based on Michael's physical examination, which type of prevention should the healthcare professional implement now?​ (see photo)

primary

Health promotion model: Case scenario

see photo Feedback: The health promotion model (HPM) is directed at increasing a person's level of well-being, focusing on individual characteristics and experiences, behavior-specific knowledge and effects, and behavioral outcomes. Individual characteristics are prior attempts at weight loss (prior related behavior) and the family history of obesity (biological factors). Behavior-specific knowledge includes understanding that exercising and eating healthily are perceived benefits for disease management (perceived benefit of action) and family support (interpersonal influences). The client's concerns about arthritis limiting exercise is a perceived barrier. ​

"Working back to health after an illness is always an important step to recovery. I had a heart attack last month and got out of the hospital about a week ago. I am on my way to my first cardiac rehabilitation visit at the hospital gym. I am practicing ______ prevention."

tertiary FEEDBACK: This action is a way of rehabilitating or coming back from an illness towards restorative health. This is part of the recovery period, which is where tertiary prevention takes place to reduce or reverse damage caused by a condition.

An individual can have _____ in the presence of illness.

wellness FEEDBACK: Wellness is in a continual state of change and adaptation across the lifespan, even in the presence of illness. Healthcare professionals learn how wellness is individualized to support optimal health across the continuum in the presence or absence of illness. Optimal function is not found when illness is present.

Maslow's hierarchy of needs

Nurses recognize that an individual's physiological needs are the highest order and priority need. FEEDBACK: This model explains the interrelationships of basic human needs. The higher order needs can only be met when the ones beneath have been met satisfactorily: self-actualization, self-esteem needs, love and belonging needs, safety and security needs (physical and psychological), and physiological needs.

Healthy people research objectives

Objectives that represent public health issues with a high health or economic burden or significant disparities between population groups but are not yet associated with evidence-based interventions.

What is the purpose of the nurse licensure compact (NLC)?

Allows nurses to practice in multiple states

CASE STUDY:

Amelia approaches the nurse manager to discuss the situation. Together, they discuss Amelia's concern with ​the healthcare provider. In this situation, Amelia first talked with the healthcare provider , then the ​charge nurse , and finally the nurse manager. She followed the proper chain of command. ​

Which organization is responsible for nursing's code of ethics?

American Nurses Association

CASE STUDY: The family requests to review the client's medical records stating, "We are the parents and we have a right to know what is happening." What is the best action for Nina to take?

Ask the client if the family has permission to view the medical records.

The data for the leading health indicator "Reduce current tobacco use in adolescents - TU-04" is ____. Increasing _____ and mass media campaigns are the most beneficial strategies to meet the goal. ​

At baseline, prices FEEDBACK: Currently, the data shows this objective's data at baseline. ​ Population-level interventions to reduce tobacco use include price increases, mass media campaigns, and smoke-free policies.​

A major goal of Healthy People 2030 is to increase the number of people with medical insurance. What is the target goal for this objective?​

Increase the number of persons under 65 with medical insurance from 89% to 92%

Nurses apply clinical judgment daily when caring for clients. What is the purpose of the clinical judgment process?​

Measures the nurse's ability to problem solve and make decisions​

CASE STUDY: What is the most commonly reported reason for being uninsured?

Not affordable

Core values: Advocacy

The client does not want to receive a blood transfusion that has been prescribed, so the nurse contacts the healthcare provider. FEEDBACK: Advocacy is the act or process of supporting a cause or proposal. ​

CASE STUDY: Akeem understands that including herbal supplements when assessing current medication use is essential. What is the rationale for assessing a client's use of herbs?

The nurse must determine if any drug, food, or herbal supplements could interact.

What are the steps of the nursing process in order?

The steps in the nursing process are: 1. assessment 2. diagnosis/analysis 3. planning and outcome identification 4. implementation 5. evaluation

The nurse is caring for a client supported on a ventilator who has been unresponsive since arrival via ambulance a week ago. The client has not been identified and no family members have been found. The nurse is concerned about the plan of care regarding maintenance or withdrawal of life support measures. Place the steps the nurse will use to help resolve this ethical dilemma in the correct order.

There are seven steps when attempting to resolve an ethical dilemma: ​ 1. Ask the question. Is this an ethical dilemma? ​ 2. Gather as much information as possible that is relevant to the case. ​​ 3. Examine and determine your values about the issues. ​​ 4. Verbalize the problem.​​ 5. Consider possible courses of action.​​ 6. Negotiate the outcome.​​ 7. Evaluate the action.

What information is found in any given nurse practice act?

Though the specific details of a nurse practice act (NPA) vary from state to state, all NPAs include:​ *definitions​ *authority, power, and composition of a board of nursing (BON)​ *educational program standards​ *standards and scope of nursing practice​ *types of titles and licenses​ *protection of titles​ requirements for licensure​ *grounds for disciplinary action, other violations, and possible remedies ​

Which best describes integrative healthcare?

Traditional and complementary therapies coordinated by a multidisciplinary team.

Steven Wilcox, a registered nurse, is caring for a client who has been diagnosed with terminal cancer. Both the client and their family are from a culture that considers talking openly about death and dying to be unacceptable. The family has requested the client not be told about the diagnosis as they believe this will bring about death sooner and doing so is disrespectful. Steven believes that lying is a violation of the client's autonomy and a betrayal of trust. ​ What ethical principle is Steven attempting to uphold in this situation? ​

Veracity Veracity refers to telling the truth. Steven is attempting to be truthful with the client. ​

CASE STUDY: see photo which nursing diagnosis needs immediate planning and intervention?

impaired gas exchange FEEDNACK: The client reports shortness of breath with nasal and pulmonary congestion, as well as low oxygen saturation. This is the client's immediate need. Airway and breathing are life-sustaining processes that must be corrected. ​ The client did not receive the influenza vaccination, which may have prevented this infection (ineffective health management), but this is not the current priority. ​ The client is not sleeping well (disturbed sleep pattern), which is causing fatigue, but this is not a life-threatening concern. Resolving the client's other symptoms will likely resolve this problem.

A client presents to the Emergency Department with difficulty breathing and a history of asthma. They are placed on oxygen and given a breathing treatment. This scenario represents _____ prevention. ​ A client suffers a spinal cord injury during a motor vehicle accident. They are admitted to a rehabilitation facility to learn how to perform activities of daily living while using a wheelchair. This scenario represents ______ prevention. ​

secondary, tertiary FEEDBACK: Secondary prevention focuses on preventing the spread of disease, illness, or infection once it occurs. The goal is detection of a disease or injury and includes activities that are directed at diagnosis, prompt intervention, and prevention of worsening condition. A client seeking treatment for an asthma exacerbation is secondary prevention. ​ Tertiary prevention involves helping a client manage a chronic condition to lessen long-term complications and return to optimal functioning. In addition to restoration of quality of life, it prevents symptoms from becoming more terminal, leading to disability or death. This includes activities directed at rehabilitation rather than diagnosis and treatment. ​

CASE STUDY: What recommendations could be made to assist Jonathan in improving his health? Select which recommendations are essential versus nonessential.

Essential: Consider vaccinations Explore stress reduction strategies Nonessential: quit job eat more fast food to save money reduce exercise time to have time to study FEEDBACK: Essential recommendations for Jonathan to consider are vaccination based on age recommendations (vaccination will help protect Jonathan against several acute illnesses) and exploring stress reduction strategies (emotional factors, such as stress, can impact health and lead to illness). ​ Though Jonathan may need to reprioritize activities and work on time management skills, it would not be beneficial to quit his job, eat more fast food, or reduce exercise time. These are healthy behaviors that are contributing positively to Jonathan's state of wellness.

A healthcare professional is caring for an elderly client with dementia who is not eating, not communicating, and refuses to see family members. The client has a high fall risk and does not trust the staff. ​ Which is the highest priority need?

High fall risk FEEDBACK: According to Maslow, in all cases, an emergent physiological need takes precedence over a higher-level need. Nutrition is a physiological need and should be addressed first. The next priority need is the fall risk as this represents a safety need. ​ Not communicating and refusing to see family members are love and belonging needs, which are lower-level needs than physiologic and safety needs. ​

CASE STUDY: For each variable affecting Jonathan's health, identify if the variable is internal or external.

Internal: Career choice degree of stress feelings about health External: childhood experiences financial struggles FEEDBACK: Many variables influence a person's health beliefs which, in turn, influence health practices that positively or negatively affect their level of health. When healthcare professionals understand these internal and external variables, we can better plan and individualize client care. Internal variables affecting health include developmental stage, intellectual background (career choice and professional program), perception of functioning (feelings about health), emotional (degree of stress), and spiritual factors. External variables influencing health include family practices (childhood experiences), psychosocial and socioeconomic (financial struggles) factors, and cultural background.

Health promotion model

Nurses recognize individuals have unique personal characteristics and experiences that affect subsequent actions and understand behavior-specific variables influence motivation to adopt healthy behaviors. FEEDBACK: This model is directed at increasing a person's level of well-being; focusing on individual characteristics and experiences, behavior-specific cognition and affect, and behavioral outcomes.

A client has several risk factors for cardiovascular disease, including:​ Father died of a heart attack at 53 years old​, Mother has high cholesterol​. The blood pressure reading today is elevated​. However, the client's cholesterol level is within the normal range. The healthcare provider decides to prescribe cholesterol-lowering medication and recommends a low-fat diet. This represents ____ prevention. ​

Primary FEEDBACK: The client has several risk factors for developing cardiovascular disease, but the condition is not diagnosed. Prescribing cholesterol-lowering medication and recommending a low-fat diet are considered primary prevention. ​ If the client had an elevated cholesterol level or was overweight, these could be considered secondary prevention strategies. ​

The nurse is working in a vaccination clinic providing influenza immunizations and health education about preventing the spread of respiratory diseases. This scenario represents ______ prevention. ​ A pregnant client participates in a prenatal nutrition program to ensure delivery of a healthy newborn. This scenario represents ______ prevention. ​

Primary, primordial FEEDBACK: Primary prevention promotes the general health of the individual, family, or community by focusing on activities the client can do to avoid disease or injury before it happens. This includes eliminating risk factors from the surrounding environment and making lifestyle changes before problems arise. Health education programs and immunizations are examples of primary prevention. Primordial prevention involves risk factor prevention. Strategies are often aimed at children to decrease as much risk exposure as possible. Activities focus on social and environmental conditions that promote disease onset. The pregnant client eating healthily to prevent risk factors from developing prenatally in her newborn is an example of primordial prevention.

CASE STUDY: What are the benefits of health education?​

Promote lifestyle changes inform of healthy behavior improve wellness mngmnt develop health habits FEEDBACK: Health education assists clients in understanding their health and how to better manage wellness. Education promotes lifestyle changes and assists clients in developing health-oriented habits. ​ Health education does not solve health-related problems. It is up to the client to implement the knowledge gained from health education to promote health and wellness.

What are some ways that healthcare professionals assist clients to achieve optimal health?

Provide preventative care​ Provide health education​ Understand the dimensions of wellness​ Identify actual and potential risk factors​ Encourage healthy behaviors​ FEEDBACK: Healthcare professionals are in a unique position to assist patients in achieving and maintaining optimal levels of health and wellness. Healthcare professionals understand the challenges of today's healthcare system and embrace the opportunity to use wellness activities to promote health and to prevent illness. Healthcare professionals can encourage healthy behaviors, provide health education, identify actual and potential risks to health, understand the dimensions of wellness, and provide preventative care.

which unmet need has the highest priority according to Maslow?

physiological

Risk factors for diabetes mellitus: Non vs modifiable

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primary vs secondary prevention

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