Nur 222 Exam 2
a client stated, "I don't know what the pills are for or why I am taking them, so I don't want them." Which is an example of therapeutic communication technique of giving information? 1) you must take your medication to get better 2) the doctor wouldn't prescribe these pills if they were harmful 3) do you feel this way about all your medication? 4) let me tell you about your medication
4) let me tell you about your medication
A nurse meets the following goals: helps a patient maintain health and helps a patient with an illness. Which factors assist the nurse in achieving these goals? (Select all that apply.) A.Understands the challenges of today's health care system. B.Identifies actual and potential risk factors. C.Has coined the term "illness behavior." D.Minimizes the effects of illnesses. E.Experiences compassion fatigue.
A, B, D
What are the 5 A's of smoking cessation?
Ask Advise Assess Assist Arrange
after a natural disaster occurred, an emergency worker referred a family for crisis intervention services. one family member refused to attend the services, stating, 'no way I'm not crazy'. What is the nurse's best response? a. 'many times, disasters can create mental health problems, so you really should participate with your family.' b. 'seeking this kind of help does not mean that you have a mental illness; it is a short term problem-solving technique' c. ' don't worry now. the psychiatrists are well trained to help.' d. ' this will help your family communicate better'
B
The nurse is admitting a patient with uncontrolled diabetes mellitus. It is the fourth time the patient is being admitted in the last 6 months for high blood glucose levels. During the admission process, the nurse asks the patient about employment status and displays a nonjudgmental attitude. What is the rationale for the nurse's actions? A.External variables have little effect on compliance B.A person's compliance is affected by economic status. C.Employment status is an internal variable that impacts compliance. D.Noncompliant patients thrive on the disapproval of authority figures.
B.A person's compliance is affected by economic status.
Which areas should the nurse assess to determine the effects of external variables on a patient's illness? (Select all that apply.) A.Patient's perception of the illness B.Patient's coping skills C.Socioeconomic status D.Cultural background E.Social support
C,E
The nurse is caring for a patient who has been trying to quit smoking. The patient has been smoke free for 2 weeks but had two cigarettes last night and at least two this morning. What should the nurse anticipate? A.The patient does not want to and will never quit smoking. B.The patient must pick up the attempt right where the patient left off. C.The patient will return to the contemplation or precontemplation phase. D.The patient will need to adopt a new lifestyle for change to be effective.
C.The patient will return to the contemplation or precontemplation phase.
A nurse is following the goals of Healthy People 2020 to provide care. Which action should the nurse take? A.Allow people to continue current behaviors to reduce the stress of change. B.Focus only on health changes that will lead to better local communities. C.Create social and physical environments that promote good health. D.Focus on illness treatment to provide fast recuperation.
Create social and physical environments that promote good health.
secondary prevention
Efforts to limit the effects of an injury or illness that you cannot completely prevent.
2. Which of the following actions best exemplifies the nurse's role in promoting health? A.Encouraging a group to engage in regular physical activity B.Facilitating a support group for patients affected by stroke C.Administering medication to a patient with high blood pressure
Encouraging a group to engage in regular physical activity
What is something you NEVER want to do regarding therapeutic communication
Give your opinion!!!!
particles in tobacco smoke
Nicotine Nitrosamines Lead Cadmium Polonium-210
"Does it hurt when you raise your arm?" Therapeutic or non-therapeutic
Non-Therapeutic
"Is the bandage too tight" Therapeutic or Non-Therapeutic
Non-Therapeutic
"That's right, I agree" Therapeutic or Non-Therapeutic
Non-Therapeutic
"why did you do that?" Therapeutic or non-therapeutic
Non-therapeutic
A nurse is using Maslow's hierarchy to prioritize care for an anxious patient that is not eating and will not see family members. Which area should the nurse address first? A.Anxiety B.Not eating C.Mental health D.Not seeing family members
Not eating - Physical Need
What types of questions are preferred in nursing care? Closed-ended or open-ended
Open-ended
A client comes to you wanting to lose weight and eat healthier. She removed unhealthy snacks in the house. What stage of change is she in? A.Action B.Maintenance C.Preparation D.Contemplation
Preparation
1. A nurse is administering immunizations at a health fair. The nurse correctly identifies the action as: A.Primary prevention B.Secondary prevention C.Tertiary prevention
Primary Prevention
A nurse is using the World Health Organization definition of health to provide care. Which area will the nurse focus on while providing care? A.Focusing on helping patients be disease free B.Providing care that involves the whole person C.Assuring that care is strictly personal in nature D.Directing focus only on the pathological state
Providing care that involves the whole person
"So far we have talked about...." Therapeutic or non-therapeutic
Therapeutic
"Tell me what is worrying you most right now" Therapeutic or Non-therapeutic
Therapeutic (minus the "tell me")
What word should you avoid using in nursing and what is the reason?
Why because it is seen as using judgement
how does physical dependence on nicotine develop? a. nicotine binds to receptors in the brain and other organ systems b. peer pressure makes it hard to quit using tobacco c. the mental habit of using tobacco is hard to break d. the craving for tobacco is too strong
a
the nurse plans post-operative care for a patient who smokes a pack of cigarettes a day. which goal should the nurse include in the plan of care for this patient? a. improve quality of sleep b. enhance apetite c. decrease gastrointestinal discomfort d. prevent sore throat
a. improve quality of sleep
the nurse is assessing a recently married patient who is stressed because of responsibilities towards family and work. the patient tells the nurse that being single was better than being married. which kind of situation or crisis does the patient have? a. situational crisis b. developmental crisis c. post-traumatic stress disorder d. general adaptation syndrome
a. situational crisis
tertiary prevention
actions taken to contain damage once a disease or disability has progressed beyond its early stages
advise smoking cessation
advise the patient strongly to quit
primary intervention
an intervention that occurs before the onset of the disease
arrange smoking cessation
arrange follow-up counseling
what does ask mean in smoking cessation
ask about the patient's tobacco use
assess smoking cessation
assess the patient's readiness to quit
assist smoking cessation
assist with quitting
what is the first stage of GAS? a. resistance b. alarm c. exhaustion d. appraisal
b. alarm
the patient complains of racing thoughts. the nurse asks the patient if something upsetting happened, and the patient's response is not focused on the question. the nurse assesses the level of anxiety as: a. mild b. moderate c. severe d. panic
b. moderate
which of the following statements about the epidemiology of tobacco use is not true? a. cigarette taxes are related to smoking prevalence b. people of hispanic origin have the highest smoking rates c. those with GED diploma have the highest prevalence of adult cigarette smoking d. the biggest opponent to tobacco control efforts is the tobacco industry itself
b. people of hispanic origin have the highest smoking rates
the nurse is preparing an evidence-based educational pamphlet on the harms of tobacco use. Which of the following could be accurately included? a. nicotine inhalation is a precursor to lung cancer b. tobacco smoke produces more than 4800 different compounds c. only 5-10 of the compounds in tobacco smoke have been proven to cause cancer d. exposure to secondhand smoke is not as dangerous to health as smoking cigarettes
b. tobacco smoke produces more than 4800 different compounds
what are the two aspects of treating smoking cessation
behavioral and physical
the US Surgeon General's report found that which of the following is true? a. every form of tobacco is not addicting b. addiction to nicotine is unlike addiction to any other drug c. nicotine is the drug in tobacco that causes addiction d. nicotine contributes to lung disease in smokers
c
which symptom is most likely to be associated with smoking cessation? a. sleepiness b. decreased appetite c. anxiety d. weight loss
c. anxiety
When did most current adult smokers start smoking? a. in their 20's b. in their 30's c. in their teenage years d. in their elder years
c. in their teenage years
in a natural disaster relief facility, the nurse observes that an older-adult male has a recovery plan, while a 25-year old male is still overwhelmed by the disaster situation. a nurse is planning care for both patients. which factors will the nurse consider about the different coping reactions? a. restorative care factors b. strong financial resource factors c. maturational and situational factors d. immaturity and intelligence factors
c. maturational and situational factors
which of the following is true about electronic cigarettes a. they are safer than cigarettes b. use has remained steady among adolescents c. they are used as an aid to cessation d. they involve combustion of tobacco similar to cigarettes
c. they are used as an aid to cessation
what are gases that are in tobacco smoke
carbon monoxide, formaldehyde, hydrogen cyanide, ammonia, benzene
what are different forms of tobacco
cigarettes, smokeless tobacco, electronic cigarettes, pipes, cigars, clove cigarettes, bidis, hookahs
A female patient has been overweight for most of her life. She has tried dieting in the past and has lost weight, only to regain it when she stopped dieting. The patient is visiting the weight loss clinic/health club because she has decided to do it. She states that she will join right after the holidays, in 3 months. Which stage is the patient displaying? A.Precontemplation B.Contemplation C.Preparation D.Action
contemplation because they see the need to make a change, even if they have not taken any steps towards that goal
A nurse is educating a current smoker on the negative health effects of smoking. Which of the following statements should the nurse include in the teaching? a. smoking causes reduced fertility in women b. smoking can cause impaired immune function, leading to an increased susceptibility to illness c. smoking can result in multiple cancers, pulmonary diseases, and cardiovascular diseases d. all of the above
d. all of the above
a nurse is counseling a patient about the health benefits that occur within the first year of smoking. Which of the following should he include? a. the risk of coronary artery disease is similar to that of people who have never smoked. b. lung cancer death rate drops to half of that of a continuing smoker c. risk of kidney cancer decreases d. excess risk of coronary heart disease decreases to half of that of a continuing smoker
d. excess risk of coronary heart disease decreases to half of that of a continuing smoker
which ego-defense mechanism does the nurse suspect in the patient who breaks objects when he experiences high levels of stress? a. denial b. regression c. identification d. displacement
displacement
motivational interviewing
encourages patients to share their thoughts, beliefs, fears, and concerns with the aim of changing their behavior
what are withdrawal symptoms associated with nicotine?
irritability, chest tightness, constipation, depressed mood, hunger, cough, dry throat, dizziness, tobacco craving, insomnia
what a person perceives....
is their life experience
unconditional regard
learn to value and care for client simply because their humanity warrants your care
"I know you feel that way, but I'm sure your doctor has your best interests in mind." Therapeutic or non-therapeutic
non-therapeutic
"If I were you, I would try to see the positive in the situation" therapeutic or non-therapeutic
non-therapeutic
"you shouldn't feel that way" therapeutic or non-therapeutic
non-therapeutic
the helping relationship
orientation - working phase - termination phase
forms of nonverbal communication
personal appearance, posture and gait, facial expressions, eye contact, gestures, sounds, territoriality and personal space
3. Which of the following is an example of a secondary illness prevention? A.Counseling about diabetes prevention B.Administering insulin C.Screening for type II diabetes
screening for type II diabetes
non-therapeutic communication techniques
self-disclosure, inattentive listening, using medical jargon, giving personal opinion, prying, changing subject
A nurse is communicating with a client. The client moves closer and invades the nurse's personal space. Which is the appropriate intervention? 1) nurse ignores behavior because it shows that the client is progressing 2) The nurse expresses a sense of discomfort and limits behaviors 3) the nurse understands that clients require various amounts of personal space and accepts the behavior 4) the nurse confronts and informs the client that the client will be secluded if this behavior continues
the nurse expresses a sense of discomfort and limits behaviors
"Rather than talking about what your husband thinks, I would like to hear how you are feeling right now" therapeutic or non-therapeutic
therapeutic
"please tell me what the doctor told you about this medication" therapeutic or non-therapeutic
therapeutic
"you seem upset?" therapeutic or non-therapeutic
therapeutic
elements of professional communication
use of names, courtesy, trustworthiness, autonomy and responsibility, assertiveness
techniques of therapeutic communication
using silence, offering self, restating, clarifying, acknowledging, reflecting, giving information, summarizing
forms of verbal communication
vocabulary, denotative and connotative meaning, pacing, inotation, clarity and brevity, timing and relevance
when should you use motivational interviewing
with patient's that seem like they may not be ready for a behavioral change
how is your message conveyed
words -10%, tone of voice -40%, body language- 50%
lateral violence
workplace bullying between cowokers