N112 Exam

The nurse completes the admission process of a client to an acute care facility. Which statement by the nurse demonstrate the communication technique of focusing? A) "you've been having a great deal of fatigue for the last 3 months." B) "you are hoping to figure out the cause of your extreme fatigue during this hospital stay." C) " you are frustrated because you are too tired to perform normal activities." D) "you are unsure of what helps or prevents your fatigue"

"You are hoping to figure out the cause of your extreme fatigue during this hospital stay" focuses on the main problem that the client has been reporting and the goal for this admission. The other statements demonstrate the communication technique of clarifying

Chronic illness may be characterized by periods of remission. Remission is best described as: A) the presence of a disease w/ the absence of symptoms B) the reappearance of symptoms of a dz C) the response of a person to a dz D) a pathologic change in the structure of fx of the body or mind.

A

A nurse is helping a client on hospice make an informed decision about his own health & life. Which nursing role has this nurse performed? A) communicator B) caregiver C) advocate D) counselor

As part of one of the four essential competencies to provide safe and knowledgeable care, nurses must be ethically and legally skilled. An ethically and legally skilled nurse would assist the client above by being an advocate. An advocate would believe and support a client in the client's right to make informed decisions about his own health and life. The other three roles listed are important nursing roles, but do not address the hospice client making an informed health care decision.

Diff types of communication

Assertive - ability to stand up for oneself & others using open, honest, & direct communication. Aggressive - asserting one's rights in a negative manner that violates the rights of others.

Why are health promotion & illness prevention a key responsibility of nurses? A) chronic illnesses can cause pain & suffering B) tx of chronic illnesses is very expensive C) chronic illnesses ar the leading health problem in the world. D) people do not like being sick & feel bad

Because chronic illnesses are the leading health problems in the world, health promotion & illness prevention activities are vital to nursing care. By endorsing health promotion & illness prevention, the nurse can assist the client to achieve optimal health even with a chronic illness. It is true that treating chronic illnesses can be expensive, they do cause pain & suffering and people do not like to be sick, but these are not the most important reasons for promoting health & preventing illnesses.

Positive regard

Conveying genuine care to clients w/o passing any negative judgement on them.

An experienced nurse has been working with a client with heart failure. The client's lungs were clear to auscultation during the morning assessment; however, the afternoon assessment revealed bibasilar crackles and tachypnea. The nurse calls to give SBAR report to the covering health care provider. In the final step of the report the nurse should: A) provide detailed finings of the head-to-toe assessment B) detail the client's PMH & active med orders C) discuss the client's situation & request a CXR to assess lung dx D) recommend 40mg of furosemide be administered b/c the client had improvement w/ past admin.

D - SBAR stands for Situation, Background, Assessment, & Recommendations. S & B provide objective data, A & R allow for presentation of subjective data.

Deductive reasoning vs inductive reasoning

Deductive reasoning involves looking at an idea as a whole and then considering more specific ideas. Inductive reasoning is derived from consideration of specific properties to conclusions about a general idea.

Congruence

Feelings that match the expressions of the client

Who is considered to be the first nursing theorist who conceptualized nursing in terms of manipulating the environment?

Florence nightingale conceptualized the nurse's role as manipulating the environment to facilitate and encourage the reparative process. This would be accomplished by attending to ventilation, warmth, light, diet, cleanliness, and noise.

Health promotion vs health protection

Health promotion - behavior of a person who is motivated by a personal desire to increase well-being & health potential. Health protection (illness/dz prevention) - behavior motivated by a desire to avoid or detect dz or to maintain fx-ing w/ing the constraints of an illness or disability.

A nurse has been caring for a client who has a MI 2 days ago. During the morning assessment, the nurse asks the client how the client feels. Which scenario warrants further investigation? A) the client looks at the nurse & states, "i am not feeling my best" B) the client stares at the floor & states, "i feel fine" C) the client is sitting in a chair & states, " i feel a lot better than i did yesterday" D) the client smiles at the nurse & states, "i cannot wait to go home"

It often helps nurses to understand subtle & hidden meaning in what the client is saying verbally. The nurse should investigate further because of the incongruence between the client's verbal & nonverbal communication. In the other three scenarios, the nurse-client communication is effective & no further investigation is warranted.

Three forms of communication channels

Kinesthetic - use of touch to convey emotional support for the client Verbal - uses words to relay info Visual - use of gestures or actions to communicate. Body language — broad term for nonverbal communication (touch, eye contact, facial expressions, posture, gait, gestures, general physician appearance, grooming, sound, and silence)

A nurse is caring for a client admitted to the hospital for dehydration. The physical findings consistent with this diagnosis that the client's general appearance can nonverbally communicate to the nurse include: A) slow heart rate & prolonged capillary refill B) pallor & diaphoresis C) cold intolerance & brittle nails D) easy wrinkling of the skin & sunken eyes

Most illnesses cause at least some alterations in general physical appearance. Observing for changes in appearance is an important nursing responsibility for detecting illness or evaluating the effectiveness of care and therapy. For example, a person with an insufficient intake of fluids has dry skin that wrinkles easily, eyes that might be sunken and dull in appearance, and poor muscle tone. On the other hand, a person in good health tends to radiate this healthy status through general appearance. Although prolonged capillary refill is consistent with dehydration, slow heart rate is not. Pallor may be associated with dehydration but diaphoresis is not associated with this condition. Cold intolerance and brittle nails are consistent physiologic changes seen in clients with hypothyroidism.

ANA Cabinet on Nursing Research vs National Institute of Nursing Research

NINR - place nursing securely in the sphere of scientific investigation & to support research & training in client care, health promotion, & dz prevention, as well as the mitigation of effects of acute & chronic disabilities. They fund & support nursing research & is instrumental in the support & dissemination of seminal work in nursing. The ANA cabinet on Nursing research was responsible for establishing priorities for nursing research

One of the primary reasons for conducting nursing research is to: A) quantify outcomes related to clients B) prevent further dz & death C) generate knowledge to guide practice D) determine outcomes for clients

One of the major reasons for conducting nursing research is to generate knowledge to guide practice. The other answers pertain to other aspects of nursing practice but not to nursing research.

Authoritative knowledge

Passed from an expert

Traditional knowledge

Passed from one generation to another.

Remission

Presence of a dz, but the person does not experience the symptoms

The nurse is caring for a client who is a victim of sexual assault. Which action would the nurse take to develop a trusting rapport with the client? A) Use strategic pauses to allow the client to provide info that will be used to help officials in their investigation. B) practice active listening by allowing the client to express fears & concerns then restating in the nurse's own words to demonstrate understanding. C) exhibit a professional demeanor while examining the client & obtaining specimens, asking questions that are not intrusive D) approach the client w/ empathy & understanding & allow the client to share feelings w/o being judged.

Rapport is a feeling of mutual trust between nurse & client. Kindness is the quality of being friendly, generous, & considerate. Active listening & the use of silence are communication techniques, but they do not necessarily develop mutual trust between the nurse & client.

Exacerbation

Reappearance of symptoms of a dz

Reflective quesiont

Repeating what the person has said or describing the person's feelings

Illness

Response of a person to a dz

What are the characteristics of chronic condition? Vs acute

Slow onset Prolonged course Does not resolve spontaneously Are rarely curable Require lifelong management Acute conditions have rapid onset & short course & resolve spontaneously or are curable.

Empathy vs sympathy

Sympathy differs from empathy b/c it shifts the emphasis from the client to the nurse as the nurse shares feelings & personal concerns & projects them onto the client, limiting the ability to focus objectively on the client's needs.

Illness prevention vs health promotion

The education on lifestyle choices is part of health promotion activity, which focuses on protecting the person's health. The goal of the prevention of illness is to detect and prevent the illness. High-level wellness focuses on maximizing the person's highest potential for functioning. Reversal of self-care deficits would involve therapeutic interventions that are directed at contributing factors.

Which nursing actions are characteristic of the nurse's role as communicator? A) assessing, implementing, and evaluating individual teaching plans to meet learning needs B) establishing & maintaining helping relationships w/ clients of all ages in a variety of settings C) Facilitating clients' problem-solving & decision-making skills D) effecting change w/in a group

The nurse acting in the role of communicator uses effective interpersonal and therapeutic communication skills to establish and maintain helping relationships with clients of all ages in a wide variety of health care settings. The nurse in the role of the teacher/educator uses communication skills to assess learning needs, implement, and evaluate individualized teaching plans to meet those learning needs of patients and their families. The nurse in the role of counselor uses therapeutic interpersonal communication skills to provide information, make appropriate referrals, and facilitate the patient's problem-solving and decision-making skills. The nurse in the role of leader is assertive and self-confident in the practice of nursing when providing care, effecting change, and functioning with groups.

Therapeutic speech vs nonassertive speech

Therapeutic speech - used when communicating w/ a client that has a specific purpose or goal. Nonassertive speech is opp. Of assertive.

A nurse is discussing dietary issues with a Latino client in the clinic. The client states, "My grandmother always told me that I needed to include beans in my diet so that my muscles would grow." The information that the client is expressing is known as what?

Traditional knowledge is known as knowledge that is passed down from one generation to the next. A grandmother passing information is an example of traditional knowledge. Authoritative knowledge is information that is gleaned from an expert based on their perceived experience. Scientific knowledge is derived through the scientific method. Philosophy is the study of wisdom and one perceptions of life.

Which advancement in the nursing profession occurred immediately after WWII? A) advanced nursing education was established b) national standards for nursing were developed C) care of clients in the hospital setting declined D) govt funding supported minority nurses

after the end of WWII, schools of nursings were based on educational objectives & were increasingly developed in university & college settings, leading to degrees in nursing for men, women, & minorities. National standards for nursing were already developed at this time. Following the war, care of clients in hospitals increased, not decreased. Govt funding did not increase to support minority nurses at this time.

Disease

pathologic change in the structure or function of the body or mind