PrepU Questions: Week 6-- EBP, Teaching, & Abuse

Although nurse practice acts may vary state by state, all recognize several basic principles supporting the legal parameters for all registered nurses. Select the activity that falls under the scope of nursing practice.

Appraising and enhancing an individual's health-seeking perspective

Which nursing action is applicable to the psychomotor domain of learning when conducting a teaching session for breastfeeding mothers?

Observing a mother expressing the breast milk

The nurse is developing a health-promotion program at a company in which many employees are women in their 20s and 30s. For this population, the nurse plans to include information about

Parenting issues

A nurse is caring for a slightly overweight client whose lipid panel revealed elevated cholesterol levels. The client was prescribed a statin by the health care provider. Which statement by the client would indicate a health literacy level that would enable the client to make appropriate health decisions to lower cholesterol levels?

"In addition to this cholesterol medication, I plan to reduce my consumption of red meat and other saturated fats and start walking again."

Which observation made by the nurse reflects the first fundamental technique used in physical examination?

"Patient appears older than stated age."

Which statement by the nurse shows an understanding of the focus of the quality assurance programs developed in the 1980s?

"The quality assurance programs focus on processes used to provide care and improving those processes." (In the 1980s, hospitals and other health care agencies implemented ongoing quality assurance programs that provided the foundation for the establishment of continuous quality improvement (CQI) programs in the 1990s)

Which of the following are the major roles of nurses working in institutional, community-oriented, or community-based settings? Select all that apply.

-Practitioner -Leader -Researcher

The nurse observes a serum albumin level of 2.50 g/dL in an older adult patient who lives at home alone. What does this level likely indicate?

A severe protein deficiency

Which guideline is most important for the nurse to keep in mind when planning to teach an exercise class to a group of older adults?

Allow ample time for psychomotor skills.

What primary nutritional nursing consideration should be included in the physical assessment of an older adult patient?

Altered metabolism and nutrient use secondary to an acute or chronic illness

The nurse must instruct a 35-year-old client with Down syndrome about the use of an albuterol rescue inhaler. Which documentation demonstrates appropriate individualization of the education plan for this client?

Assessed the client's understanding of illness; assessed motor skills and developmental stage; provided clarification

For which research activity is a phenomenological research method most appropriate?

Attempting to understand non-English speaking immigrants' experiences of being hospital clients

The nurse detects a heart murmur when performing a physical assessment on a patient. What process does the nurse use for this assessment?

Auscultation

Knowledge gained from someone with a great deal of perceived experience is which type of knowledge?

Authoritative knowledge

Which area for assessing the client profile should be addressed last?

Body image

A group of objects with relationships is which?

Concept

During a nutritional assessment, the nurse measures a woman's waist at 38.5 inches (98 cm). Based on this finding, which of the following is a priority intervention?

Educate the client regarding her increased risk for hypertension and diabetes.

Why should the nurse to be empathetic when caring for a client?

Empathy helps the nurse become effective while remaining detached.

A nurse who works in a pediatric practice assesses the developmental level of children of various ages to determine their psychosocial development. These assessments are based on the work of:

Erikson

When describing influences on health care delivery, a nurse cites information about current population demographics. Which of the following would be most accurate?

Fewer school-aged children

Which of the following is a diagnosis related to health education?

Ineffective health maintenance

A nurse is planning to conduct a nursing research study and is seeking federal funding. Which institution would be most helpful for the nurse to contact regarding acquiring funding?

National Institute of Nursing Research

If a nurse describes a study of people and the nursing profession including studies of education, policy development, ethics, and nursing history, then what is the nurse defining?

Nursing research

Nurses in an ICU noticed that their clients required fewer interventions for pain when the ICU was quiet. They then asked a researcher to design a study about the effects of noise on the pain levels of hospitalized clients. How does this demonstrate the ultimate goal of expanding the nursing body of knowledge?

Nursing research helps improve ways to promote and maintain health.

A nurse is preparing a presentation for a local community group addressing the influences on health care delivery. Which of the following would the nurse include in presentation when describing disease patterns?

Obesity along with conditions associated with it has become a major health concern.

The central figure in health care services is the:

Patient

A client is experiencing anorexia related to the adverse effects of cancer treatment. Using Maslow's hierarchy, the nurse identifies this as a reflection of which need?

Physiologic needs (Difficulties involving a loss of appetite would most likely indicate a nutritional problem, reflecting Maslow's physiologic needs.)

Which phase of the nursing process encompasses the establishment of expected outcomes?

Planning

Nursing students are reviewing the changing patterns of disease. The students demonstrate a need for additional review when they identify which condition as being on the rise?

Pneumonia

A group of nurses is planning to investigate the effectiveness of turning immobilized stroke clients more frequently in order to prevent skin breakdown. The team has begun by formulating a PICO question. Which element will the "O" in the team's PICO question refer to?

Preventing skin breakdown

The nurse using the assessment technique depicted in the accompanying image realizes that the following factor most strongly influences the success of the results:

Quick striking

Normal aging results in changes in cognition. Therefore, when teaching an elderly patient how to administer insulin, the nurse should:

Repeat the information frequently for reinforcement.

A nurse is teaching a client taking digoxin about checking the pulse rate daily. The client counts her radial pulse as 64 beats/min. The nurse counts at the same time and assesses the rate as 58 beats/min. When evaluating response to treatment, the nurse would chart that the client

Requires another opportunity for practice

A nurse evaluates whether a middle-age client with chronic back pain has been performing the different exercises and physiotherapy procedures recommended by the physician. What would the nurse most likely use to evaluate the client?

Return demonstration

The nurse is working at an institution that uses a collaborative practice model. Which of the following would most likely be reflected at this institution?

Shared accountability for care

Which tool is often used by case managers?

Standards of Care

An acute care nurse practitioner planning care for a client with rheumatoid arthritis reviews treatment guidelines developed by the American Nurses' Association (ANA). Which ANA document is the nurse accessing?

Standards of Professional Performance

A local college is having a career-day seminar for student nurses. Booths from various agencies and facilities have been set up. One of the students approaches the booth of a home care agency and asks the nurse there about what is required to become a home care nurse. Which of the following would the nurse incorporate into the response?

Strong clinical decision-making skills (A nurse working in home care needs advanced knowledge and skills in general nursing practice with an emphasis on community health and acute medical-surgical nursing. The home care nurse also needs high-level assessment, critical thinking, and decision-making skills in a setting where other health care professionals are not available to validate observations, conclusions, and decisions.)

A nurse is evaluating a client's motivation to make decisions that promote healthy behavior change, using the transtheoretical model of change. Which description best describes the decision making stage of this model?

The client constructs a plan to change behavior.

A nurse is educating a client with a new diagnosis of diabetes. Which example demonstrates cognitive learning by the client?

The client describes signs and symptoms of hypoglycemia.

The nurse is completing a physical examination of a group of clients. What client situation is the nurse most likely to use percussion during the assessment?

The client who presents with a respiratory rate of 22 and a productive cough and reports shortness of breath when climbing stairs. (The assessment technique of percussion is most beneficial with clients suspected of disease processes in the chest and abdomen.)

The nurse develops outcome criteria for a patient with chronic obstructive pulmonary disease. Which outcome criteria are appropriate for this patient?

The patient will have the ability to climb a flight of stairs without experiencing difficulty in breathing.

A parish nurse is preparing to provide a health promotion class to a group of adults in the parish. In preparing to meet the learning needs of this group, the nurse recognizes which as a characteristic of an adult learner?

Their readiness to learn is often related to a developmental task or social role.

During the initial physical examination, a client's pulse rate was 71 beats per minute (bpm). Four hours later on reassessment, the pulse rate was 40 bpm. How should the nurse proceed?

Thoroughly assess the client; then notify the physician.

Which aspect of the nursing research process addresses a client's understanding of the potential risks and benefits of the study?

Undergoing the informed consent process with the client

After teaching nursing students about the health-illness continuum, the instructor determines that teaching was successful when the students state which of the following?

"A person can be both healthy and ill at the same time."

A hospice nurse is discussing spirituality and faith with a client and the client's family member. The client asks the nurse what is the difference between spirituality and faith. How will the nurse describe faith?

"A trust and belief in a higher power or something you cannot see"

Which statement made by the nurse indicates that the nurse is performing a holistic health history versus a traditional health or medical history?

"How has the stroke affected your ability to perform your daily activities?"

While the nurse is caring for a hearing impaired client, and a family member of the client states, "What do you think is the best way to communicate?" What is the best response by the nurse?

"Use flash cards and writing pads."

While undergoing a health history and physical assessment, a patient states, "I'm really afraid this pain in my belly is cancer." Which response by the nurse would be MOST appropriate?

"You seem upset about the pain. Tell me what's happening."

A nurse is performing a physical assessment on the client. What questions will the nurse ask the client to best assess the client's self-concept? Select all that apply.

-"What concerns do you have about your body?" -"How do you feel about your life in general?"

When obtaining a health history from an older adult patient, what should the nurse remember to do? (Select all that apply.)

-Ask questions slowly, directly, and in a voice loud enough to be heard by those who are hearing impaired. -Clarify the frequency, severity, and history of signs and symptoms of the present illness. -Conduct the interview in a calm, unrushed manner using eye-to-eye contact.

A nurse is conducting a health history with a patient and has obtained the necessary biographical information. The nurse then collects data from the patient in the following categories. Place the categories in the proper sequence for data collection.

-Chief complaint (reason for seeking care) -Present health concern -Past health history -Family history -Review of systems

The nurse has educated the client on the pathophysiology of osteoarthritis and degenerative joint disease. This type of teaching best illustrates which learning theory?

Cognitive learning theory

When the nurse is percussing for measurement of the patient's liver span, what type of response should be heard?

Dull sound

The nurse is teaching a client with diabetes how to perform checks of blood glucose level. To optimize learning, it is best for the nurse to

Have the client return demonstrate.

Which diagnostic findings indicates nutritional balance?

High serum albumin

The definition of nursing has evolved over time since Florence Nightingale first attempted, in 1859, to explain nursing's scope of practice. In 2003, the American Nurses' Association, in its Social Policy Statement, included which of the following activities as a significant role of nursing?

Identifying human responses to illness

During a teaching session with a client with a new walker, the nurse provides frequent reinforcement to the client to get up from a chair that has arms by holding the top of the chair arm with one hand. Once standing and stable, the client can grasp either the other side of the walker or both sides of the walker. The nurse knows that this educational strategy is most effective with which type of disability?

Input disability

A student nurse is having difficulties finding appropriate journal articles to prepare for a research project. Which individual will be best for the student to approach for assistance with this process?

Librarian

The nurse is preparing to teach a client about a newly prescribed medication. The client lacks insurance. The medication costs approximately $100 per month. The client states, "I can't afford it." The nurse assesses a variable to successful education and health promotion for this client based on the Health Belief Model is

Resources (Resources address financial and social behaviors)

A nurse may attempt to help a client solve a situational crisis during what type of counseling session?

Short-term counseling

Which action would be incorporated in a teaching strategy for a hearing-impaired client?

Use of slow, directed, and deliberate speech

Future healthcare policy in the United States will be significantly affected by a population that is:

aging and becoming more culturally diverse.

One of the primary reasons for conducting nursing research is to:

generate knowledge to guide practice.

What percentage of people older than 65 years have one or more chronic disease(s)?

80%

A nurse is conducting a teaching session with a client about heart-healthy nutrition. Which teaching strategy would be appropriate to foster learning in the affective domain? Select all that apply.

-Role playing -Discussion -Printed materials

A nurse is reviewing a qualitative research study. Which aspects of this type of study would the nurse need to keep in mind? Select all that apply.

-Control or manipulation is rarely used. -Reality is not viewed as a fixed entity. -Intuition is used for analysis.

Place the following nursing actions in sequence in the nursing process.

-Determining what the patient wants to learn -Identifying learning needs and etiology -Establishing expected outcomes -Putting the teaching plan into action -Identifying alterations that need to be made to the teaching plan

A community health nurse goes on a first home visit to complete a home safety assessment. Which of the following components will be part of the nurse's home safety assessment? Select all that apply.

-Hard wood floors in the dining room -Motion light on the porch -ABC fire extinguisher in the kitchen pantry

Students are comparing and contrasting the roles and functions of nurse practitioners and clinical nurse specialists. The students demonstrate understanding of these roles when they identify which of the following as associated with nurse practitioners? Select all that apply.

-Prescribing of medications -Direct care provision -Collaboration with other disciplines

The nurse is practicing in a community-based setting. What outcomes may be achieved by the nurse's community interventions? (Select all that apply.)

-Promote wellness. -Reduce the spread of disease. -Improve the health status of the community.

When functioning in the practitioner role, with which of the following would the nurse be involved? Select all that apply.

-Providing direct care -Educating the patient and family -Coordinating with other disciplines

The nurse conducts a teaching session for a group of middle-aged women. Which exercise information will the nurse share with this group? Select all that apply.

-The importance of regular exercise to maintain health -The use of exercise to improve quality of life -The use of ambulation devices to improve exercise -How to perform deep breathing exercises

The nurse is discharging several clients from an acute surgical unit on the same day. The nurse will prioritize teaching based on how much time is required for each client. Place the clients in the order, from first to last, in which the nurse will carry out discharge teaching. Use all options.

1. client who is learning to draw up and inject insulin for the first time 2. client who indicates the live-in partner is a registered nurse 3. client who is being discharged to a long-term care facility 4. client who is being transferred to another unit in the hospital

To calculate the ideal body weight for a woman, the nurse allows

100 lb for 5 ft of height.

When calculating ideal body weight for women, the health care professional adds how many pounds for each inch of height over 5 feet?

5

A recommended approach to planning health teaching is applying the trans-theoretical model, which considers the stages of behavioral change. The stage in which the patient engages in calorie counting to reduce weight is called:

Action

The nurse is caring for a 70-year-old client with a fractured wrist. Which is the best method to determine whether the client has retained the information taught?

Ask the client to recall after approximately 15 minutes.

When preparing client teaching materials, how does the nurse best assess a client's preferred learning style?

Ask the client, "Do you learn best by observing, valuing, or doing?"

The nurse is documenting a teaching session with a client. Which nursing documentation is the most appropriate and detailed?

Family requested education on turning client. Explanation of use of draw sheet and body mechanics provided. Family coached through turning and repositioning client. Members state confidence and understanding.

A nurse is completing a family assessment during a routine home health visit. The parents have a child with special needs, along with six other children, and the older siblings help out with the younger. Which theory would best help the nurse understand this family's functioning?

General Systems Theory

The nurse is caring for a 33-year-old male client. Which clinical screening should the client have, based on his age?

Lipid panel (A lipid panel should be performed at age 20, then mutually determined by both the client and clinician.)

The home health nurse is planning teaching for a client with COPD and a history of noncompliance to the medication regimen. Which factor does the nurse recognize as having the most influence on enabling complete adherence to a health regimen?

Motivation

The nurse notes hyperresonance over inflated lung tissue when performing a physical assessment on a patient with emphysema. What process does the nurse use for this assessment?

Percussion

/When providing discharge instructions, the nurse recognizes that which client is most likely to comply with the therapeutic treatment regimen?

The client with pneumonia who requires 1 week of oral antibiotics

A nurse is teaching an older adult about a medication that the client will take at home. The nurse assesses which of the following factors as promoting adherence to the medication regimen?

The client's daughter is present and provides care to the client at home.

Changes in population demographics over the next 40 years will significantly affect the delivery of health care services. Select the one change that will have the most impact on the practice of nursing.

The number of adults over age 65 will double in size.