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N314 > Exam #2 > Flashcards

Exam #2 Flashcards

1
Q

The nurse is aware that preschoolers often display a developmental characteristic that makes them treat dolls or stuffed animals as if they have thoughts and feelings. This is an example of:

  1. Logical reasoning.
  2. Egocentrism.
  3. Concrete thinking.
  4. Animism.
A
  1. Animism.
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2
Q

An 18-month-old child is noted by the parents to be “angry” about any change in routine. This child’s temperament is most likely to be described as:

  1. Slow to warm up.
  2. Difficult.
  3. Hyperactive.
  4. Easy.
A
  1. Difficult.
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3
Q

Nine-year-old Brian has a difficult time making friends at school and being chosen to play on the team. He also has trouble completing his homework and, as a result, receives little positive feedback from his parents or teacher. According to Erikson’s theory, failure at this stage of development results in:

  1. A sense of guilt.
  2. A poor sense of self.
  3. Feelings of inferiority.
  4. Mistrust.
A
  1. Feelings of inferiority.
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4
Q

The nurse teaches parents how to have their children learn impulse control and cooperative behaviors. This would be during which of Erikson’s stages of development?

  1. Trust versus mistrust
  2. Initiative versus guilt
  3. Industry versus inferiority
  4. Autonomy versus sense of shame and doubt
A
  1. Initiative versus guilt
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5
Q

When Ryan was 3 months old, he had a toy train; when his view of the train was blocked, he did not search for it. Now that he is 9 months old, he looks for it, reflecting the presence of:

  1. Object permanence.
  2. Sensorimotor play.
  3. Schemata.
  4. Magical thinking
A
  1. Object permanence.
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6
Q

When preparing a 4-year-old child for a procedure, which method is developmentally most appropriate for the nurse to use?

  1. Allowing the child to watch another child undergoing the same procedure
  2. Showing the child pictures of what he or she will experience
  3. Talking to the child in simple terms about what will happen
  4. Preparing the child through play with a doll and toy medical equipment
A
  1. Preparing the child through play with a doll and toy medical equipment
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7
Q

Which of the following are examples of the conventional reasoning form of cognitive development? (Select all that apply.)

  1. A 35-year-old woman is speaking with you about her recent diagnosis of a chronic illness. She is concerned about her treatment options in relation to her ability to continue to care for her family. As she considers the options and alternatives, she incorporates information, her values, and emotions to decide which plan will be the best fit for her.
  2. A young father is considering whether or not to return to school for a graduate degree. He considers the impact the time commitment may have on the needs of his wife and infant son.
  3. A teenage girl is encouraged by her peers to engage in shoplifting. She decides not to join her peers in this activity because she is afraid of getting caught in the act.
  4. A single mother of two children is unhappy with her employer. She has been unable to secure alternate employment but decides to quit her current job.
A
  1. A 35-year-old woman is speaking with you about her recent diagnosis of a chronic illness. She is concerned about her treatment options in relation to her ability to continue to care for her family. As she considers the options and alternatives, she incorporates information, her values, and emotions to decide which plan will be the best fit for her.
  2. A young father is considering whether or not to return to school for a graduate degree. He considers the impact the time commitment may have on the needs of his wife and infant son.
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8
Q

Place the following stages of Freud’s psychosexual development in the proper order by age progression.

  1. Oedipal
  2. Latency
  3. Oral
  4. Genital
  5. Anal
A

3, 5, 2, 1, 4

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9
Q

According to Piaget’s cognitive theory, a 12-year-old child is most likely to engage in which of the following activities?

  1. Using building blocks to determine how houses are constructed
  2. Writing a story about a clown who wants to leave the circus
  3. Drawing pictures of a family using stick figures
  4. Writing an essay about patriotism
A
  1. Writing a story about a clown who wants to leave the circus
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10
Q

Allison, age 15 years, calls her best friend Laura and is crying. She has a date with John, someone she has been hoping to date for months, but now she has a pimple on her forehead. Laura firmly believes that John and everyone else will notice the blemish right away. This is an example of the:

  1. Imaginary audience.
  2. False-belief syndrome.
  3. Personal fable.
  4. Personal absorption syndrome.
A
  1. Imaginary audience.
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11
Q

Elizabeth, who is having unprotected sex with her boyfriend, comments to her friends, “Did you hear about Kathy? You know, she fools around so much; I heard she was pregnant. That would never happen to me!” This is an example of adolescent:

  1. Imaginary audience.
  2. False-belief syndrome.
  3. Personal fable.
  4. Sense of invulnerability.
A
  1. Sense of invulnerability.
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12
Q

Which of the following activities are examples of the use of activity theory in older adults? (Select all that apply.)

  1. Teaching an older adult how to use e-mail to communicate with a grandchild who lives in another state
  2. Introducing golf as a new hobby
  3. Leading a group walk of older adults each morning
  4. Engaging an older adult in a community project with a short-term goal
  5. Directing a community play at the local theater
A
  1. Teaching an older adult how to use e-mail to communicate with a grandchild who lives in another state
  2. Introducing golf as a new hobby
  3. Engaging an older adult in a community project with a short-term goal
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13
Q

Dave reports being happy and satisfied with his life. What do we know about him?

  1. He is in one of the later developmental periods, concerned with reviewing his life.
  2. He is atypical, since most people in any of the developmental stages report significant dissatisfaction with their lives.
  3. He is in one of the earlier developmental periods, concerned with establishing a career and satisfying long-term relationships.
  4. It is difficult to determine Dave’s developmental stage since most people report overall satisfaction with their lives in all stages.
A
  1. It is difficult to determine Dave’s developmental stage since most people report overall satisfaction with their lives in all stages.
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14
Q

You are working in a clinic that provides services for homeless people. The current local regulations prohibit providing a service that you believe is needed by your patients. You adhere to the regulations but at the same time are involved in influencing authorities to change the regulation. This action represents ___________ stage of moral development.

A

Social contract orientation.

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15
Q

You are caring for a recently retired man who appears withdrawn and says he is “bored with life.” Applying the work of Havinghurst, you would help this individual find meaning in life by:

  1. Encouraging him to explore new roles.
  2. Encouraging relocation to a new city.
  3. Explaining the need to simplify life.
  4. Encouraging him to adopt a new pet.
A
  1. Encouraging him to explore new roles.
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16
Q

What are are the innate or basic human needs according to the Self Determination Theory?

A

R - Relatedness
A - Autonomy
C - competence, perceived

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17
Q

What is A-motivation

A

Behavior is not personally important; don’t believe they have the ability to carry out the behavior; and/or don’t believe the behavior will produce the desired outcome

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18
Q

What is intrinsic motivation?

A

Behavior is engaged for the enjoyment,
Interest, fun inherent in the activity itself
(More likely to maintain behaviors over the long term if only focused here.)

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19
Q

What is integrated motivation?

A

Behavior is in harmony with other big picture
values, life goals, and behaviors
(More likely to maintain behaviors over the long term if only focused here.)

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20
Q

What is identified motivation?

A

Value the behavior (e.g., because it improves health)

More likely to maintain behaviors over the long term if only focused here.

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21
Q

What is introjected motivation?

A

Internal pressures to do the behavior in order
To avoid feeling bad (e.g., guilt, anxiety, Shame) or to feel better about oneself (e.g.,
pride) and maintain self-worth

(Less likely to maintain behaviors over the long term if only focused here.)

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22
Q

What is external motivation?

A

Direct rewards or punishment/pressures for
doing the behavior

(Less likely to maintain behaviors over the long term if only focused here.)

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23
Q

What is IPN?

A

Intervention project nursing

The Intervention Project for Nurses (IPN) was established in 1983 through passage of legislation. … For non-nursing healthcare practitioners, DOH contracts with the Professional Resource Network (PRN) to provide similar services.

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24
Q

Relatedness refers to:

A

Relatedness refers to:

  1. The need to feel close,

connected to, &

valued by important others;

The sense that one is
significant, lovable, & worthy of care

If met, this need provides a foundation of self-worth

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25
Q

Autonomy refers to:

A

Autonomy refers to:

The idea that people need to feel engaged willingly in their behavior &

feel a sense of ownership over their actions.

The opposite:

feeling controlled or pressured to behave in a certain way.

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26
Q

Competence refers to:

A

Competence refers to:

the need to feel capable &

effective

 &

develop a sense of mastery over one’s behaviors.

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27
Q

Psychologists-Scientists studied children in classrooms

Asked, “What made students’ engage in learning vs. disengaging or checking out’?”

A

Students engaged in learning more often when they had:
> Positive relationships
> Autonomy (volition) &
> Perceived competence  > Motivation

Psychologists Developed self-determination theory

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28
Q

Compared to other sources, is the SDT definition of motivation similar or different?

A

Quantity Vs

Type / Quality

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29
Q

There are 2 inter-related, but different micro-concepts of autonomy?
Psychological autonomy
Moral autonomy

A

Psychological autonomy
Moral autonomy

ANA Code of Ethics
Has had 9 provisions

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30
Q

Rationale for Autonomy &1st Provision Ethics for Nurses

A

The nurse, in all professional relationships, practices with compassion and respect for inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems.

The nurse’s primary commitment is to the patient, whether an individual, family, group, or community.
The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient.

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31
Q

Clarify: Perceived competence vs. Self-efficacy

A

Some nurse-scholars & psychologists use one term/concept, Some the other
What is similar?
What is different?

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32
Q

. Psychologists & Authors

A

Bandura defined:

Perceived self-efficacy
belief that one can exercise control over one’s habits to reach particular goals

Deci & Ryan defined:

Perceived Competence
belief in one’s confidence and competence to change, that is, to engage in behaviors to reach one’s goals

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33
Q

Rationale for P. Competence / Self-efficacy; Research has shown that:

A

The > perceived self-efficacy,
higher the goals people set for selves,
the firmer their commitment to them.

Self-efficacy beliefs shape outcomes people expect their efforts to produce.
Those with > efficacy expect their efforts  good outcomes
Those with < efficacy expect their efforts  poor outcomes

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34
Q

Apply type of motivation to practice

A

Assess clients’ goals for health
Link these to clients’ condition skillfully, ex., If…., then…. (Yet without threatening clients)
This can
Eliciting their own motives, not ours
Develop discrepancy btw where they are to where they want to be
Both can increase autonomous motivation

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35
Q

How would you apply relatedness in practice?

A

Express empathy to..
Reflect clients’ comments to..
Affirm client’s experience
Ask open-end questions in a sensitive manner

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36
Q

What does OARS stand for?

A

Open Questions, Affirmation, Reflective Listening, and Summary Reflections

37
Q

How can we apply the concept autonomy with clients?

A

Assess their preferences, choices w/ open-end questions
Ask permission before any advice
Roll with any resistance
Avoid arguing

38
Q

How can we boost clients’ perceived competence?

A

Reflect for yourselfs…how people in general

a) Learn new skills and
b) The Role of perceived competence

What would be helpful? Or unhelpful ?

39
Q

. How to boost Perceived Competence

A 
Interpersonal environment –
Feedback that is skillful in 
Timing 
Amount
Type - specific vs. general
Choosing difficulty of the task carefully &amp;
Identifying level of preparation for the task – 
Expected to do behavior w/ or w/o info?
40
Q

How can nurses boost clients’ perceived competence w/ new behavior?

A

Assist in setting realistic goal for behavior or task
Assess clients’ current knowledge & skill level
Identify together what task difficulty to start with (choice)
Share information on how to begin behavior, execute task

41
Q

How can nurses boost clients’ perceived competence w/ new behavior?

A

Let them see ; Observation
Role modeling by experts
Vicariously, by watching peers
Make space to Practice, in positive environment
Choose feedback carefully
focus on strengths, progress
specific, focused
Respect autonomy/choice (timing, amount of feedback)
Together, problem-solve ways to overcome their barriers, respecting individual choice and situation

42
Q

In what health care situations would perc’d competence be important?

A

In what kind of situations would perceived competence be especially important?

Learning skills for primary prevention
New diet,
New exercise routine from PT,
Stress mangement
Self-mgmt/Disease Control/Secondary prevention
d) chronic medical condition
e) physical condition e.g., wound care, catheter

43
Q

When our practice is based on SDT, are we culturally sensitive?

A

Assessing provides basis for > cultural congruence
2. Asking about Goal setting &
3. Eliciting client’ preferences
allows for their choices – what to plan & when to act –in ways consistent with their preferences based on gender, beliefs, culture, & current situation

44
Q

What micro-concept should you use when giving feedback?

A

relatedness

45
Q

What should you consider how you foster others

A

perceived competence

46
Q

Focus on __________, not traits.

A

Behavior

47
Q

What is Self Management?

A

“Self-management is the ability of individuals and/or their caregivers to engage in the daily tasks required to maintain health and well-being or to manage the physical, psychological, behavioral, and emotional sequelae of a chronic disease based on their knowledge of the condition, its consequences, and the plan of care co-developed with their health care team.”

48
Q

90% of the nations 3.5 trillion in annual health care expenditures are for people with __________.

A

chronic and mental health conditions.

49
Q

As of 2014, _____percent of American adults had at least one chronic condition, and ___percent had more than one chronic condition.

A

60 and 42

50
Q

______ and ______ were the most common chronic conditions in 2014.

A

Hypertension and high cholesterol

51
Q

Difference between self-care and self management.

A

Self care using ones own volition to improve their health and Self management is the approach one takes to manage the complexities of chronic disease.

52
Q

Self-Management
Patients with chronic disease must _____________ engage in health care practices and make decisions about health behaviors that influence the course and progression of their disease.

A

continuously and over time

53
Q

Partnerships in Self-Management

A

Patients
Caregivers
Health care providers
The health care system

54
Q

Attributes of Self-Management

A 
Self-efficacy
Patient engagement
Health education
Patient-provider relationship
Disease management
55
Q

What is health education?

A

any combination of learning experiences designed to help individuals, families, communities or systems improve their health, by increasing their knowledge or influencing their attitudes.”

56
Q

Disease management

A system of coordinated health care interventions and communications for patients with chronic conditions that require significant self-management efforts

The primary goal of disease management is to ___________________ costs by mitigating future complications of chronic conditions through [self-management].

A

improve population health and reduce health care

57
Q

What determines human behavior

A

Cognitive factors, behavioral factors, Environmental factors

58
Q

Cognitive factors

A

knowledge, expectations, and attitudes

59
Q

Behavioral factors

A

skills, practice, self efficiency

60
Q

Environmental factors

A

social norms, access in community, influence on others (ability to change own environment)

61
Q

Thoughts create

A

feelings

62
Q

Feelings create

A

behavior

63
Q

Behavior reinforces

A

thoughts

64
Q

Self management programs

A

In-person groups, internet groups, disease specific groups, generic groups.

65
Q

______________ have better attendance and retention rates
Hospitals are not convenient
Health Care settings don’t have a “friendly feeling”

Peer led classes have outcomes equal/better than those led by health professionals
Peer led: people do more/teaches self-management skills
Professionally led: experts give information, people do less

A

Workshops in the community

66
Q

What is self management nursing care

A 
Health Enhancement and Wellness
Pre-Disease/Disease Prevention
Disease/ New Diagnosis
Acute Event Management
Transitions in Care
67
Q

Making a self action plan

A

Anticipated barriersHelp the patient imagine what might get in the way of their plan.

Potential solutions for barriersHave the patient come up with ideas that might help them overcome the barriers.

Follow-up planWhen, where and how will you check in with the patient about their experience with the plan.

Confidence ratingOn a scale of 1-10 (with 1 being no confidence that the plan can be completed to 10 being absolutely certain that they can complete the plan), have the patient rate their confidence level.

68
Q

Creating a successful action plan

A

Begin with something the patient wants to do
Make the goal reasonable
something the patient can reasonably expect to be able to accomplish this week
Strive for a change that is behavior-specific
losing weight is not a behavior; not eating in the evenings while watching television is a behavior
Ensure that the plan answers these questions: what; how much; when; how often?
Start when the patient has a confidence level of 7 or greater

69
Q

Ways to Support Self-Management

A 
Trust
Positive reinforcement
Communication
Shared responsibility
Partnership
Active management

Compliance is NOT the same as Self-Management!

70
Q

Define “family”

A

The family is a basic structural unit within a community

71
Q

Summarize the makeup of the family structure?

A

Traditional roles

Decision-maker

Caregiver

Deviant

Dependent

Victim

72
Q

Describe family development stages and identify factors and risks that shape development

A

Families change and develop over time
Based on age of family members and social norms

Families have predictable stressors and changes
Based on changes in family development and family structure

Families experience disequilibrium when they transition from one stage to another stage

Married couple – Childbearing families with infants – Families with preschool children – families with school-aged children – families with adolescents – families launching young adults – middle-aged parents – Aging parents

73
Q

Differentiate common assessment procedures used to examine family health across the life span

A

Calgary Family Assessment Model (CFAM)
Genogram
Ecomap

74
Q

Illustrate the purpose, goals and methods, including the nursing process, of promoting evidence-based health promotion strategies for families

A 
Assess
Diagnose
Plan
Intervention
Patient and family teaching
Referrals for appropriate resources
Mental health
Social work
Nutritional support
Caregiver support
Evaluation
75
Q

Discuss the impact of chronic illness on family dynamics

A

Change in roles

Additional role responsibilities

Support systems

Dealing with concurrent stresses

76
Q

Describe growth and development and the significance to nursing

A

“The sequence of physical, psychosocial, and cognitive developmental changes that take place over the human lifespan”

77
Q

Discuss risk factors that impact development

A

Prenatal, birth, individual, family, situational, social determinants, toxic stress, health status.

78
Q

Describe the scope and domains of development

A

Spans birth to death

Development stages are identified by age and characteristics

Developmental tasks are competencies mastered at developmental stage

Delayed—Expected–Advanced

physical/Physiological, motor, cognitive, communication, social/emotional, adaptive

79
Q

Apply selected theories of growth and development across the lifespan

A 
Goals of chronic care
Maintain or improve self-care capacity
Manage disease effectively
Boost the body’s healing abilities
Prevent complications
Delay deterioration and decline
Achieve highest possible Quality of life
Die with comfort and dignity
80
Q

Discuss how development is impacted by chronic health conditions

A

Age of onset

Coping mechanisms
Adaptive
Maladaptive

Health education
Consider developmental level
Long-term impact

81
Q

Physical/Physiological development

A

Growth and changes in Body tissues and organ systems
Changes body functions and proportions
Occurs in a bilateral and symmetrical way
Cephalocaudal
Proximodistal

82
Q

Motoric Development

A

Gross
Use of large muscles to move about environment
Fine
Use of small muscles in an increasingly coordinated and precise manner
Contingent on cognitive and neurologic development

83
Q

Social/Emotional development

A

Self-understanding

Understanding others

Understanding social interactions

84
Q

Cognitive Development

A

Includes
Working memory capacity
Cognitive self-regulation
Processing and use of information about the environment

Development of critical thinking skills and executive functioning
Learning
Forming concepts
Understanding 
Problem solving
Reasoning
Remembering 
Abstract thought
85
Q

Moral and spiritual development

A

Cognitive + Advanced social/emotional development.

86
Q

Communication development

A

Language

Set of rules shared by a group of people that allows communication of thoughts, ideas and emotions

Speech
Spoken expression of language
Articulation
Voice
Fluency

Communication Requires receptive and expressive skills

87
Q

Adaptive development

A

Acquisition of a range of skills that enable independence at home and in the community
Activities of daily living
Functional behaviors

88
Q

Attributes and criteria of Expected Development

A

Developmental level
Individual’s stage of development or ability to independently achieve an outcome

Developmental milestone
Ability or specific skill that most individuals can accomplish in a certain age range
Physical/physiological, Motor, social, emotional, cognitive and communication skills

89
Q

Abnormal development terms

A

Developmentally delayed

Developmental milestones not accomplished within a specific age range or critical time period

Developmental regression
Loss of developmental milestones

Developmental arrest
Plateau of developmental change

N314 (3 decks)

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