Exam 1 Flashcards

0
Q

What is the message?

A

The actual physiologic product of the source

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1
Q

What/who is an encoder?

A

The sender or encoder of he message is a person or group who initiates he communication process

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2
Q

What are the phases of the helping relationship?

A

There are three phases, the orientation phase, the working phase, and the termination phase.

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3
Q

Describe the orientation phase

A

In the orientation phase

  • the patient will be able to call nurse by name
  • Patient will accurately describe the roles of participants in the relationship
  • The patient to nurse will establish an agreement about…..
  • Goals of the relationship
  • Location, frequency, and length of the contacts
  • The duration of the relationship
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4
Q

Describe the working phase

A

In the working phase…

  • The patient will actively participate in the relationship
  • The patient will participate in activities that work toward achieving mutually acceptable goals
  • The patient will express feelings and concerns to the nurse
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5
Q

Describe the termination phase

A

In the termination phase

  • The patient will participate in identifying the goals accomplished or the progress made towards goals
  • The patient will verbalize feelings about the termination of the relationship
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6
Q

What is rapport?

A

A feeling of mutual trust experienced by people in a satisfactory relationship, facilitate open communication.

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7
Q

What is the definition of semantics?

A

The study of the meaning of words is called semantics

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8
Q

What is a cliché?

A

A cliché is a stereotyped, tried, or pat answer.

Ex:
“Everything will be alright”
“Your doctor knows best”
“Everybody is afraid of surgery why should you be any different”

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9
Q

What is a horizontal violence?

A

Horizontal violence is anger and aggressive behavior between nurses, or nurse to nurse hostility.

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10
Q

Describe the five steps of the nursing process

A
  1. Assesses the patient to determine need for nursing care
  2. Determine nursing diagnosis for actual potential health problem
  3. Identify expected outcomes and plan care
  4. Implement the care
  5. Evaluate the results
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11
Q

What are the seven steps of scientific problem-solving?

A
  1. Problem identification
  2. Data collection
  3. Hypothesis formation
  4. Plan of action
  5. Hypothesis testing
  6. Interpretation of results
  7. Evaluation
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12
Q

What is intuitive problem solving?

A

A direct understanding of the situation based on a background of experience, knowledge, skill that makes expert decision-making possible.

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13
Q

What is assessing?

A

Assessing is a systematic and continues collection, validation, analysis, and communication of patient data, or information.

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14
Q

What is a focused assessment?

A
In a focused assessment, the nurse gathers data about a specific problem that has already been identified.
Ex:
What are your symptoms?
When did they start?
What makes her symptoms better or worse?
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15
Q

What is an emergency assessment?

A

When I physiologic or physiological crisis presents, the nurse informs emergency assessment to identify life-threatening problems.

Ex:
A nursing home resident choking in the dining room, bleeding patient brought to the emergency room.

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16
Q

What is a time- lapsed assessment?

A

The time-lapsed assessment Is scheduled to compare a patient’s current status to baseline data obtained earlier.

Ex:
Most patients in residential settings and those receiving nursing care over long periods of time are scheduled periodic time lapse assessments to reassess health status

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17
Q

What is the definition of a nursing diagnosis?

A

A nursing diagnosis is a clinical judgement about individual, family, or community responses to actual or potential health problems or life processes. Nursing diagnosis provides the basis for selection of nursing interventions to achieve outcomes for which the nurse is accountable…nanda

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18
Q

What is a medical diagnosis?

A

Traumatic or disease condition or syndrome validated by medical diagnostic studies

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19
Q

What is a cue?

A

The term cue is often used to denote significant data or data that influence this analysis.

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20
Q

What is a data cluster?

A

A data cluster is a grouping of patient data or cues that points to the existence of a patient health problem. Nursing diagnosis should always be derived from clusters of significant data rather than from a single cue.

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21
Q

What is an actual nursing diagnosis?

A

Actual nursing diagnoses represent a problem that has been validated by the presence of major defining characteristics. This type of nursing diagnosis has 4 components : label, definition, defining characteristics and related factor

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22
Q

What is risk nursing diagnosis?

A

Risk nursing diagnosis are clinical judgements that an individual , family, or community is more vulnerable to develop the problem than others in the same or similar situations

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23
Q

What are possible nursing diagnosis?

A

Possible nursing diagnosis are statements describing a suspected problem for which additional data are needed. Additional data are used to confirm or rule out the suspected problem.

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24
Q

What is the wellness diagnosis?

A

Wellness diagnosis are clinical judgments about an individual, group, or community in transition from a specific level of wellness to a high-level wellness. Two cues must be present for a valid wellness diagnosis:

  • a desire for a higher level of wellness
  • an effective present status or function
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25
Q

What are syndrome nursing diagnosis?

A

Syndrome nursing diagnosis comprise a cluster of actual or risk nursing diagnoses that are predicted to be present because of a certain event or situation for example posttrauma syndrome

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26
Q

What is etiology?

A

The etiology identifies the physiologic, psychological, sociologic, spiritual, and environmental factors believed to be related to the problem is either caused or contributing factor. Because etiology identifies the factory cementing unhealthy patient state and prevent the desired change, the etiology directs nursing intervention.

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27
Q

The purpose of diagnosing is to identify…

A
  1. How individual, group, or community response to an actual or potential health and life process
  2. Factors that contribute to our cause health problems (etiologies)
  3. Strength the patient can drawn to prevent resolve problems
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28
Q

True or false
When nurses diagnose medical problem, there just as accountable as physicians for detecting, identifying, managing the signs and symptoms of disease

A

False

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29
Q

Which was the first date to identify diagnose and it’s part of the legal domain of professional nursing?

A

New York

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30
Q

Which group is responsible for the promotion and organization of activities to continue the development, classification, and scientific testing of nursing diagnosis?

A

North America nursing diagnosis Association

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31
Q

Altered health maintenance is an example of which of the following types of problems?

A

Nursing problem, because it describes a problem like to be treated by nurses within the scope of independent nursing practice

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32
Q

To determine the significance of a blood pressure reading of 148/100, it is first necessary for the nurse to do which of the following?

A

Compare this reading to a standard or a norm

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33
Q

When the initial nursing assessment revealed that the patient had not had a bowel movement for 2 days, the student wrote the diagnostic label constipation. Which of the following comments is she most likely to hear from her instructor?

A

Nursing diagnosis should always be derived from clusters of significant data rather than from single cues

34
Q

The clinical judgment that an individual, family, community is more horrible to develop the problem than others in the same or similar situation is what type of nursing diagnosis?

A

A risk diagnosis

35
Q

What is initial planning?

A

Initial planning is developing a nurse who performs admission nursing history and physical assessment.

36
Q

What are standardized care plans?

A

Standardize care plans are prepared plans of care that identify the nursing diagnoses, outcomes, and related nursing interventions, do a specific population health problem.

37
Q

What is ongoing planning?

A

I’m going planning is carried out by any nurse to interact with the patient. Its cheap purpose is to keep the plan up to date to facilitate the resolution of health problems, manage risk factors, and promote function.

38
Q

Mr. Price tells the nurse he fears becoming hooked on drugs and waits until his pain becomes unbearable before requesting his PRN analgesic. The nurse plans to be more attentive to him and to asses his needs for pain management more closely. Which of the following consequences of informal planning ought to be the major concern for this nurse?

A

The lack of a coordinated plan known by everyone will result in uneven pain management

39
Q

When helping mr. Price turn in bed, the nurses notices that his heels are reddened and plans to place him on precautions for skin breakdown. This is an example of what type of planning?

A

Ongoing planning

40
Q

Where are nursing outcomes derived from?

A

The problem statement of the nursing diagnosis

41
Q

What is an optional element in a measurable outcome?

A

Conditions

42
Q

What is delegation?

A

Delegation is the transfer of responsibility for the performance of an activity to another individual while retaining accountability for the outcome

43
Q

Who was Florence nightingale and what did she do?

A

1860
She was the 1 st nursing theorist who was responsible for HEALTH RESTORATION and MAINTENANCE , she organized the first nurse training school

44
Q

What was Clara Barton involved in?

A

The civil war : creating the American Red Cross?

45
Q

Name some nursing theorist and their theories

A
Gordon: fun patterns
Watson: caring
Benner : novice to expert
Roy: adaptation
Leiniger: transcultural
46
Q

What are the ANA standards of nursing?

A
  1. Assessment
  2. Diagnosis
  3. Outcome identification
  4. Planning
  5. Implementation
  6. Evaluation
47
Q

What are four aims of nursing that can be identified in the definition of nursing?

A
  1. Promote health
  2. Prevent illness
  3. Restore health
  4. Facilitate coping with disability or death
48
Q

What phrase best describes the science of nursing?

A

The science of nursing is the knowledge base for care

49
Q

Which nursing history is credited with establishing nursing education?

A

Florence nightingale

50
Q

Which of the following phrases describes one of the purposes of the ANAs nursing social policy statement?

A

The nursing social policy statement describes the values and social responsibility of nursing

51
Q

The school nurse is teaching a class of junior high students about effects of smoking. This educational program will meet which of the aims of nursing?

A

Preventing illness

52
Q

Which nursing organization was the first international organization of professional women?

A

ICN, founded in 1899

53
Q

What is the purpose of the ANAs scope and standards of practice?

A

To define activities are special and unique to nursing

54
Q

What type of authority regulates the practice of nursing

A

State nurse practice acts

55
Q

The nursing student is nervous and concerned about the work she’s about to do at the clinical facility. T o allay anxiety and be successful in the provision of care is important for her to do what?

A

Engage in self talk plan her day and decrease her fear

56
Q

During nursing staff meeting the nurses determine that they will make sure all vital signs are reported and charted within 15 minutes following assessment. This is an example of what?

A

Ascertaining that the staff complete the task on time and that all members agree the task is important is a characteristic of group identity

57
Q

A nursing student is preparing to administer morning Careton patient. What is the most important question of the nursing student should ask the patient?

A

A. Would you prefer a shower or bath
B. May I help you with a bed bath now or later this morning?
C. I will be giving you your bath do you prefer soap or shower gel

B

58
Q

Interpersonal vs. Intrapersonal

A

Interpersonal

  • face to face interaction between nurse and another person
  • most frequent
  • problem solving

Intrapersonal

  • inner thought
  • mental rehearsal : test out
59
Q

Definition of referent?

A

One who encodes and one who decodes the message

60
Q

Definition of channels?

A

Motivates one to communicate with each other

61
Q

What are the four types of nursing assessments?

A

Initial comprehensive
Focused
Emergency
Time lapsed

62
Q

What is an initial comprehensive assessment?

A
  • ## performed shortly after admittance to hospital-performed by the nurse to collect data on all aspects of patient health
63
Q

What is a focused assessment?

A
  • May be performed during initial assessment auras routine ongoing data collection
  • perform to gather data on a specific problem
64
Q

What is an emergency assessment?

A
  • performed with a psychologic or psychological crisis present
  • performed to identify life threatening problems
65
Q

What is a time lapsed assessment?

A
  • performed to compare patient’s current status to baseline data obtained earlier
  • perform by the nurse to collect data about current health status of patients
66
Q

Medical vs. Nursing assessments

A

Medical assessments
- target data pointing to pathological conditions

Nursing assessments
-focus on the patients response to health problems

67
Q

What is objective data?

A

Observable and measurable data that can be seen, heard, or felt by someone other than the person experiencing them
Ex: elevated temp,skin moisture, vomiting

68
Q

What is subjective data?

A

Information received only by the affected person

Ex: pain experience, feeling dizzy, feeling anxious

69
Q

Gordon’s functional health patterns

A

Functional health patterns provide information for Manursing perspective rather than a medical one

Functional health patterns referred to positive and negative behaviors a person uses to interact with the environment or to maintain health

No one pattern can be understood without knowledge of other pattern

70
Q

What Is the difference between nurses and doctors?

A
  • Doctors are licensed to diagnose and treat a medical disease or condition
  • nurses are licensed to diagnose and treat a patient’s response to a disease or condition, patient education, comfort in counseling
71
Q

What is scientific problem solving?

A

Scientific problem-solving of the systematic, seven step, problem-solving process that involves

  1. problem identification,
  2. data collection,
  3. hypothesis formation,
  4. Plan of action,
  5. hypothesis testing,
  6. interputation of results and,
  7. evaluation
72
Q

What is Intuitive problem solving?

A

Into problem-solving is that’s a direct understanding of the situation based on background and experience, knowledge, and skill that makes expert decision-making possible

73
Q

The best description of critical thinking indicators is which of the following?

A

Evidence-based descriptions of behaviors that demonstrate the knowledge, characteristics, and skills to promote critical thinking and clinical practices

74
Q

The nursing process ensures the nurses our patient centered rather than task centered. Broader than simply approaching the patient to take vital signs, the nurse thinks how is Miss Barklay today? Our nursing actions helping her to achieve her goals? This demonstrates which characteristic of the nursing process?

A

Interpersonal

75
Q

True or false
The state board examinations for professional nursing practice now use the nursing process rather than medical specialties is organizing concept

A

True

76
Q

The patient complains about feeling nauseated after lunch. This is an example of what type of data?

A. Subjective
B. Objective
C. Overt

A

Answer: a. Subjective

77
Q

When you receive the shift report, you learn that your patient has no special skincare needs. You’re surprised about to observe red areas over bony prominences. What action is appropriate?

A. Correct the initial assessment
B. Redo the initial assessment and document current findings
C. Conduct an emergency assessment
D. Perform and document a focused assessment on skin integrity

A

Answer: D. Perform and document a focused assessment on skin integrity

78
Q

Although the nursing process is presented as an orderly progression of steps, in reality there is great interaction and overlapping among the five steps. Which of the following describes his characteristic of nursing process?

A

Systematic

79
Q

The following are all classic elements of evaluation. Which item below places them in the correct sequence?

A
  1. Identifying evaluative criteria and standards
  2. Collecting data to determine whether going to criteria and standards are met
  3. Interpreting and summarizing findings
  4. Documenting your judgment
  5. Terminating, continuing, or modifying the plan
80
Q

When you nurses oriented to the subacute unit, she’s told each nurses expected to observe her patients at least every hour, and Morestre condition warrants extra monitoring. This expectation is thus termed:

A. Standard
B. Criteria
C. Custom

A

Answer: a. Standard

81
Q

One of the outcomes Janon the nurse plan is that Jan appreciate their values a healthy body sufficiently to try new behaviors. Which of the following best describes type of outcome?

A

Affective, affective outcomes pertain to changes in patient values beliefs and attitudes

82
Q

What does an evaluative statement contain?

A

A date
The words “outcome met! partially met or outcome not met”
And the patient data and behaviors that support this decision

83
Q

Different types of quality

A

Quality improvement: internally driven, focuses on patient care rather than organizational structure, focuses on processes rather than individuals. It’s Outcome is improving quality rather than assuring quality.

Quality by inspection: focuses on finding a deficient worker and removing them

Quality as opportunity: focuses on finding opportunities for improvement and fosters an environment that thrives on teamwork