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LPN To RN > Exam#1 > Flashcards

Exam#1 Flashcards

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NCLEX-RN® flashcards
1
Q

Stages of Professional Socialization

A

Stage 1: Excited (to start new role)
Stage 2: Overwhelmed/Doubt (if you can do the new role)
Stage 3: Let go of the LPN role
Stage 4: Accept the new role of the RN

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2
Q

Role

A

Set of expectations that will DEFINE the behavior society deems appropriate or inappropriate for the occupation

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3
Q

Care Provider

A

Most commonly recognized role, aims to ensure the best possible health for the patient

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4
Q

Counselor

A

provide pt/family with guidance and support/ identify emotional needs

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5
Q

Educator

A

knowledge provided to the patient/their family/ the community

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6
Q

Manager

A

supervises other members, planning, managing, and coordinating care.
Sound decision-making and problem-solving skills

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7
Q

Advocate

A

protect pt/family from harm, speak up against harmful or unnecessary forces
“take the patient’s side”/”stand up for the patient” right to autonomy and self-determination

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8
Q

Collaborator

A

Team dynamic; working toward common goal or end point.

Multidisciplinary meetings to ensure cooperation and compliance

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9
Q

Change Agent

A

Take a risk; possess courage to make change to implement EBP

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10
Q

Role Model

A

Code of ethics; present self in manner that best attributes the profession

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11
Q

Mentor

A

trusted advisor; promotes growth for others

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12
Q

Researcher

A

investigating possible solutions to nursing/patient problems; EBP awareness

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13
Q

Entrepreneur

A

function as a consultant, educator, and advisor

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14
Q

RN Roles

A

Legally responsible for initiating and carrying out the nursing process; Practices is autonomous; cares for most complex and highest acuity; delegates care; teaching and management; analyze and interprets data; determines nursing diagnosis; establishes patient-centered goals; evaluates patient progress; evaluates effectiveness of interventions

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15
Q

RN and LPN Roles

A

assists in developing of nursing care plan; gives direct person care to patients; admin medications and IV fluids; practice is directed; common health problems; practices collaboratively; collects data; identifies deviation from normal

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16
Q

3 types of RN education programs

A

Diploma, Associates degree, Baccalaureates degree

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17
Q

ANA

A

American Nurses Association; published Nursing scope and standards of Practice
Six standards of practice
Nine standards of professional performance

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18
Q

6 Standards of Practice

A

Assessment, Diagnosis, Outcome Identification, Planning; Implementation, Evaluation

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19
Q

9 Standards of Practice

A

Quality of Practice, Education, Professional Practice Evaluation, Collegiality, Collaboration, Ethics, Research, Resource Utilization, Leadership

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20
Q

3 primary ADN roles

A

Provider of care
Manager of care
Member of the profession

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21
Q

4 key elements for the future of Nursing:

A
  1. Practice to the full extent of education and training
  2. achieve higher levels of education
  3. Full partners with physicians and other health care professionals
  4. effective workforce planning and policy making, with better data collection and information infrastructure
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22
Q

Middle Ages

A

Religious Orders

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23
Q

Renaissance era

A

Protestant reformation in Europe, moved away from religious orders to SECULAR and STRUCTURED care
formal training programs began

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24
Q

Industrial Revolution

A

Women improved nursing education and patient care.

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25
Q

Nursing care in the Early 1980’s:

A

cost reduction and quality improvement issues surfaced, MANAGED care emerged.

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26
Q

Florence Nightingale

A

believed nursing care was to put the patient in the best conditions possible for healing; decreased Crimean War death; believed nursing is an art that requires organized, practical, and scientific training

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27
Q

Factors influencing Nursing TODAY:

A

Aging population, Known as “Graying of America”
Health maintenance and disease prevention
Outcomes-oriented patient-centered care*
Cost containment*
Quality Improvement
Patient Protection and Affordable Care Act

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28
Q

Outcomes-oriented patient-centered care

A

work with population and individuals to develop health related goals; achieve positive experiences with minimal complications

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29
Q

Types of Cost Containment groups:

A

DRG- Diagnosis-related groups (pre-Tx Dx billing)
PPO- Preferred provider organization (discounts w/ specific Dr’s)
HMO- Health maintenance organizations (prepaid fee)
Medicare (state program for ppl >65 or disability)
Medicaid (federal assistance for financial needs, below poverty)

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30
Q

Quality Improvement

A

continuous; uses clinical care pathways or care paths.
Joint Commission est. core measures for disease process
CMS (medicare/medicaid) est. Hospital Quality Initiatives for EBP
Leap Group collects/reports safety/quality data to the public & payers

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31
Q

Patient Protection and Affordable Care Act

A

Grants for Master & Doctoral studies; aims to increase nursing knowledge in quality standards, assessment, and improvement
1.5 billion in maternal/child programs

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32
Q

Law

A

mandates how we MUST behave toward each other

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33
Q

Ethics

A

How we SHOULD behave

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34
Q

Common Law

A

aka Case law, judge made decisions

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35
Q

Administrative Law

A

controls the administrative operations of government

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36
Q

Statutory Law

A

Constitutional Law & Enacted law- ie: nurse practice act

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37
Q

Legal Principles

A

Confidentiality and the right to privacy- HIPAA

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38
Q

Patient Rights

A

to be treated with dignity and respect, privacy, decision-making, confidentiality, access to health records, and the right to refuse treatment

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39
Q

Informed Consent

A

patients must fully understand what he or she has consented to for the consent to be valid

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40
Q

Assault

A

Deliberate THREAT to physically harm another

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41
Q

Battery

A

ACTUAL or intentional ACT of touching another WITHOUT consent

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42
Q

False Imprisonment

A

Verbal or physical forcing an individual to stay in a place against their wishes

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43
Q

Negligence

A

failure to use care as a reasonably prudent and careful person would under similar circumstances

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44
Q

Professional Negligence

A

omission or commission of an act that departs the standards of care

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45
Q

Accountability

A

willingness to assume responsibility and accept the consequences for your actions

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46
Q

Tort

A

legal wrong committed against a person or property

Unintentional tort- professional negligence

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47
Q

Malpractice

A

improper or unethical conduct or unreasonable lack of skill by a professional; four elements must be present: Duty of care, Breach of Duty, Injury, and Causation

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48
Q

Duty of Care

A

obligation to a recognized standard of care

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49
Q

Breach of Duty

A

a failure to adhere to an obligation and a deviation from standards of care

50
Q

Injury

A

Actual damages have occured

51
Q

Causation

A

injury was foreseeable, caused by a breach of duty, and the conduct was the cause of the injury

52
Q

Guidelines to prevent negligence and malpractice

A

Perform only skills within your scope, stay current in your field, delegate carefully and legally, admin drugs using the 6 rights, be aware of strengths and weaknesses, and advocating for your patients

53
Q

High Risk areas for Malpractice

A

Medication administration
ED
Mental Health
Specialty areas

54
Q

Most Common Malpractice Claims against nurses

A

Failure to: follow standards of care, use equipment in a responsible manner, communicate, document, assess and monitor, act as a patient advocate

55
Q

Failure to Rescue

A

lack of a timely and appropriate response to changes in a patient’s condition

56
Q

Root-Cause Analysis

A

designed to seek errors of process, rather than lay blame on individuals or groups

57
Q

Mandatory Reporting

A

Child abuse and neglect & elder abuse and neglect

Report to Child/Adult protective services

58
Q

Bioethics

A

applies ethical theories and principles to moral issues and problems in the practice of medicine

59
Q

Morals

A

what we believe to be right and wrong, based on religious beliefs, culture, social influences, and life experiences

60
Q

Values

A

beliefs and ideals, shaped by one’s culture

61
Q

Moral development

A

how an individual learns to handle moral and ethical dilemmas

62
Q

Autonomy

A

freedom to make own decisions, self determination

63
Q

Veracity

A

truth-telling

64
Q

Fidelity

A

practicing faithfully within legal boundaries; keeping promises

65
Q

Beneficence

A

promoting/doing good

66
Q

Nonmaleficence

A

Do NO harm

67
Q

confidentiality

A

protection of private health information, right to privacy

68
Q

Justice

A

fairness

69
Q

Culturally Competent Nursing care

A

integration of knowledge, attitudes, and skills- the ability to work within the cultural context of individual, family, or community

70
Q

Ethical Dilemmas exist when…

A

a conflict arises among health care professionals, patients, families, and health care organizations

71
Q

Moral Courage

A

deciding on a right course of action regardless of possible consequences

72
Q

Moral Distress

A

Situations in which an individual knows the right action to take BUT feels powerless to take that action

73
Q

8 steps to Ethical Decision-Making

A
  1. gather relevant information
  2. stating the practical problem
  3. Identify ethical issues and questions
  4. select ethical principles and theoretical frameworks to consider
  5. conducting an analysis and prepare a justification
  6. consider one or more counterarguments
  7. exploring the options for action
  8. selecting, completing, and evaluating the action
74
Q

Skill level of nurse:

A

Novice: beginner, lacks experience, does exactly as told
Advanced beginner: gains experience, level of most graduates
Competent nurse: 2-3 yrs in new role, organizational skills
Proficient nurse: much experienced, thinks holistically and critically
Expert nurse: great deal of experience, flexible and adaptable

75
Q

National Quality Forum

A

Created NEVER EVENTS in 6 areas: surgical, product/device, patient protection, care management, environmental, and criminal.

76
Q

Quality and Safety Education for Nurses (QSEN)

A

ensures that all nurses develop knowledge, skills, and attitudes for continuous quality and safety improvement

77
Q

Personal Accountability

A

maintain level of expertise, make honest assessment of weakness and strengths

78
Q

practice question #1: the nurse correctly understands the nine standards of professional performance?

A

collegiality

79
Q

practice question #2: florence Nightingale is known as:

A

the lady with the lamp

80
Q

practice question #3: DRGs, PPOs, HMOs, what nursing concept is the nurse describing?

A

Cost Containment

81
Q

practice question #4: a patient is trying to leave the hospital but the nurse restrained him to the bed, what action did the nurse commit?

A

False imprisionment

82
Q

practice question #5: a nurse wants to give immunizations to everyone because they provide the most good for the greatest amount of people, which ethical theory is the nurse using?

A

utilitarianism- actions judged on the greatest good

83
Q

practice questions #6: which organization is responsible for defining the standards of practice?

A

Individual state boards of nursing

i.e. Colorado

84
Q

Lydia E. Hall 1955

A

Introduced observation, administration of care, and validation.

85
Q

1958-1961 Orlando

A

3 step nursing process: assessment, planning, and evaluation.

86
Q

1973 the ANA added:

A

Diagnosis, to the nursing process

87
Q

1991 the ANA introduced:

A

outcome identification

88
Q

6 step nursing process:

A

assessment, diagnosis, outcome identification, planning, implementation, and evaluation.

89
Q

Assessment

A

objective and subjective data; complete head to toe
pain is subjective, but always what the patient says it is
can collect from primary (pt) and secondary (family) sources
validate all assessment info.

90
Q

Diagnosis

A

may be actual, potential, or wellness; written using PES format (Problem, etiology, and S/Sx)
Etiology is related to …. S/Sx is as evidenced by ….
collaborative problems for whole team dynamic
Dx arranged by priority, using Maslow’s hierarchy of needs
Safety is a priority

91
Q

Outcome Identification

A

immediate, intermediate, and long-term goals
MUST be specific, realistic, and measurable (SMART goals)
Nursing Outcome Classification (NOC)*

92
Q

Nursing Outcome Classification (NOC) has 31 classes and 7 domains, teh 7 domains are as follows:

A
  1. functional
  2. physiological
  3. psychological
  4. health knowledge and behavior
  5. perceived
  6. Family
  7. community
93
Q

Planning

A

goals and outcomes and planning interventions, regain a level of independence, establish outcome priority
Use linear or concept maps
Nursing Interventions Classifications (NIC)*

94
Q

Nursing Interventions Classifications (NIC) grouped into 30 classes and 7 domains, in 4 basic categories:

A

Basic; physiological; behavioral
Safety
Family; community
Health systems

95
Q

Implementation

A

Carrying out the plan of care; multidisciplinary approach

96
Q

Evaluation

A

process of examining the effectiveness of the plan; evaluation occurs simultaneously and continually
may require altering the care plan to meet the patient’s needs

97
Q

Critical thinking

A

purposeful and rational; accomplishes a specific goal

MUST understand and be incorporated into practice

98
Q

critical thinking; think RED

A

Recognize assumptions
Evaluate arguments
Draw conclusions

99
Q

purpose of critical thinking

A

to ensure that the decision-making process will lead to the best possible patient outcomes

100
Q

purpose of critical thought and reasoning

A

recognizes the question “what are you trying to accomplish”; define the purpose clearly and accurately
Point of view- explains or illustrates how the data can be understood
Critical thought is fluid and circular

101
Q

Attributes of a critical thinker….

A 
curiosity (attention to details)
pursuit of information (to know more)
rational thoughts
reflection (looking back)
creativity (thinking outside of the box)
intuition (listening with your 6th sense)
102
Q

The process of critical thought:

A

is rooted in discipline, exemplified by clarity, accuracy, specificity, relevance, logic, consistency, depth, and significance.

BE THE DR’s EYE and PATIENT ADVOCATE

103
Q

Verbal vs. nonverbal communication

A

verbal: spoken (10% of communication)
non-verbal: is processed through tone, pitch, intensity of how we speak, body language, facial expressions, personal appearance…. how we listen, use silence, use touch, and use space. (70-90% of communication)

104
Q

therapeutic communication:

A

occurs when a nurse engages in a helping relationship with a patient and family
Requires: empathy, genuineness, positive regard, self-awareness, and non-judgmental

105
Q

empathy

A

the ability to perceive the patient’s needs, feelings, and situation

106
Q

genuineness

A

the ability to meet person to person in a therapeutic relationship

107
Q

Positive Regard

A

implies respect and willingness to work with the patient and communicate that the person is worthy of caring about

108
Q

self-awareness

A

recognition of one’s own feelings

109
Q

non-judgmental

A

not judging one’s values or decisions

110
Q

Nurse-patient relatiionship

A

a planned and goal-directed process that focuses on the patient’s feelings, problems, and needs.
3 Phases*

111
Q

3 Phases of the nurse-patient relationship

A

Orientation/introductory phase- intro, set goals, orient pt/family to the facility
Working phase- longest phase, assess, interview, lasts until discharge
Termination phase- final phase, goals met, understanding verbalized, psych situation

112
Q

Health Literacy

A

an indivduals ability to gain understanding and use of information to promote and maintain health

113
Q

Culture

A

beliefs, values, and learning patterns of behavior to guide actions and decision-making

114
Q

Cultural Competence

A

ability to provide diverse cultural care; self-awareness of conflicting feelings
Aware of non-verbal communication, different for each culture

115
Q

Older adults

A

need special accommodations for changing systems… ie: hearing, vision, etc.

116
Q

collaborative communication

A

refers to interactions and functioning among patients and the healthcare team to provide safe, patient-centered, quality care
Assertive, aggressive, or passive-aggressive communication
Use of SBAR (situation, background, assessment, recommendations)

117
Q

practice question #7: what is subjective data?

A

the patient reports nausea.

118
Q

practice question #8: a nurse is developing an individual care plan for a patient, which of step of the nursing process is she using?

A

planning

119
Q

practice question #9: after gathering data from the assessment and identifying needs, the nurse develops a care plan. She is demonstrating which type of reasoning?

A

deductive

120
Q

practice question #10: a nurse is in the working phase with a patient and is using therapeutic communication, what statement will facilitate interactions?

A

It must be hard to tell me how you are feeling

121
Q

a nurse communicates using the SBAR, what section is the “A”

A

assessment

LPN To RN (4 decks)

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