Exam 2014 Flashcards
- Which one of the following is NOT a Core skill required for self-management?
a. Having problem solving skills
b. Ability to make and manage decisions
c. Ability to utilise resources
d. Having good health care partnerships
e. Taking action after extensive planning
Problem solving Decision making Finding and utilising resources Forming partnerships with their health care providers Taking action
- Identify the statement that is MOST CORRECT for the surgical intervention of obesity.
a. Adjustable gastric banding is a malabsorptive procedure.
b. The Biliopancreatic diversion is the preferred procedure in WA
c. Adjustable gastric banding is a restrictive type of procedure.
d. The Restrictive surgical intervention is not preferred in WA.
c. Adjustable gastric banding is a restrictive type of procedure.
Circle the statement that BEST DESCRIBES self-management support for chronic conditions:
a. To empower oneself to take up support that is provided.
b. For a patient to effectively manage their own self-care with the assistance of family members and community.
c. This is what health care providers, carers, organisations and systems do to support and empower the person with a chronic condition “to actively
participate in their own health care”.
d. Self-management support empowers people with chronic conditions to seek support.
c. This is what health care providers, carers, organisations and systems do to
support and empower the person with a chronic condition “to actively
participate in their own health care”.
- Which of the following factors influence psychosocial attitudes and behaviours in
chronic illness? There may be more than one answer.
a. Culture and language
b. Religious beliefs
c. Peer or family factors
d. Psychological factors
all
The following are principles for psychosocial care. Identify those that are NOT principles. a. Partnership b. Compliance c. Team centeredness d. Collaborative decision making e. Holistic care f. Empowerment
b. Compliance
c. Team centeredness
All the following are important for a culturally competent approach to care EXCEPT:
a. Understand your own beliefs and values
b. Recognise and respect others beliefs
c. Explore the differences to enhance healthcare and to minimise barriers
d. Have standard actions that clients must adhere to
d. Have standard actions that clients must adhere to
- Identify the correct statement that relates to the model of care matrix?
a. Axis 1 represents the activities and services that should be provided.
b. Axis 2 represents the stages of a condition, injury or event.
c. Axis 3 represents the levels of the health care system.
d. Axis 4 represents the staff involved.
c. Axis 3 represents the levels of the health care system.
The trend for chronic illness is highest within the population of Aboriginal or Torres Straits Islanders. Circle the statement below that is INACCURATE.
a. Lung cancer is ten times higher
b. Diabetes is fourteen times higher
c. Chronic kidney disease is eight times higher
d. Heart Disease is five times highest
e. Disability is twice as high
a. Lung cancer is ten times higher
- Which statements are TRUE for motivational interviewing?
a. The clinician’s role is to identify goals, and to use reflection and summarising with an individual
b. The clinician’s role is to question in depth the goals of the individual
c. The clinicians role is to engage the patient and develop rapport
d. The clinicians role is to scope out all the needs of the patient prior to planning
b. The clinician’s role is to question in depth the goals of the individual
c. The clinicians role is to engage the patient and develop rapport
d. The clinicians role is to scope out all the needs of the patient prior to planning Encourage the person to talk
- Which statements represent CORRECTLY how one may acquire self-efficacy?
a. “You are an idiot to think you can do it”
b. “I did that well”
c. “I was unable to do it”
d. “I have learnt to manage stress”
b. “I did that well”
d. “I have learnt to manage stress”
- Perceptions and beliefs of pain vary. Which statements are CORRECT?
a. Adaptive coping with pain increases ones mood.
b. Adaptive coping ability does not put effort into function in spite of the pain
c. Adaptive coping ability distracts self from the pain
d. Adaptive coping with pain causes greater incidence of depression
a. Adaptive coping with pain increases ones mood.
c. Adaptive coping ability distracts self from the pain
- Which statement BEST explains the Patterson’s shifting Perspectives model.
a. Patients see their illness behind them and take risks.
b. Patients see their illness in front of them and this lowers their self-esteem.
c. Increased activity and interaction occur if illness is in front of them
d. Patients see their illness behind them or in front of them.
d. Patients see their illness behind them or in front of them.
- Which of the following statements is INCORRECT about Advance Health Directives?
a. An Advance Health Directive provides your consent for, or refusal to future treatment.
b. An Advance health directive does not include medical, surgical and dental treatment and other health care
c. You must have one witness to sign the consent form
d. Advance Health Directives must be registered
b. An Advance health directive does not include medical, surgical and dental treatment and other health care
Which one of the below statements CORRECTLY identifies why the Carers Recognition
Act 2004 was developed?
a. To support the patient/client in the WA health and hospital system
b. To identify a patient who may need a paid support worker once they leave the hospital
c. To promote greater inclusion of the family/friend/carer when accessing health and disability services.
d. To support the patient/client within the Western Australian community
c. To promote greater inclusion of the family/friend/carer when accessing health and disability services.
- Which one of the below statements is NOT a cultural determinant for coping with pain?
a. Individuals usually have a higher threshold for pain
b. individuals are less likely to report their pain
c. Individuals understand that pain is related to disease only
d. Individuals fear that medicines will speed up death
e. individuals mistrust main stream medicine
c. Individuals understand that pain is related to disease only
- Perceptions and beliefs of pain vary. Which statements are CORRECT?
a. Adaptive coping with pain increases ones mood.
b. Adaptive coping ability does not put effort into function in spite ofthe pain
c. Adaptive coping ability distracts self from the pain
d. Adaptive coping with pain causes greater incidence of depression
a. Adaptive coping with pain increases ones mood.
c. Adaptive coping ability distracts self from the pain
- Which statement about the principles for psychosocial care is NOT correct?
a. Partnership in psychosocial care is where health professionals use a blend of nursing skills and knowledge to assist patients
b. Collaborative decision making is where the health professionals recognise that at times patients are not compliant with their treatment
c. Self management is where individuals seek new information and learn new skills
d. Holistic care requires the nurse to communicate with the patient in every- day language.
c. Self management is where individuals seek new information and learn new skills ?????
- Identify which statement is the key point of the Carers Charter.
a. Respect the patient and maintain their dignity
b. Include the carer in any decision making that may impact on their caring role
c. Tell the carer everything that is happening to their family member/friend
d. To enable the carer to report on the patient’s health status.
b. Include the carer in any decision making that may impact on their caring role
- What statements are CORRECT about the additional signs and symptoms for diabetes?
a. Type 1 diabetics have weight loss
b. Type 2 diabetics have weight loss
c. Itching skin and tingling lips is a symptom diabetics may experience with high or low BGL’s
d. Leg cramps are one of the additional symptoms a patient with diabetes may experience
a. Type 1 diabetics have weight loss
- Screening patients who have diabetes is done regularly. Which of the below statements are NOT correct.
a. HbA1c (average BGL for last 2-3 months) is screened every 6 months
b. Review of SBGM (Self-blood glucose monitoring) is done every month
c. Weight/Height (BMI) is screened every 3 months
d. Blood lipid profile is screened every 3 months
a. HbA1c (average BGL for last 2-3 months) is screened every 6 months (should be every 3 months)
b. Review of SBGM (Self-blood glucose monitoring) is done every month (should be every 3 months)
d. Blood lipid profile is screened every 3 months (should be every 6 months)
- Which statement is INCORRECT about Metformin.
a. Metformin is a Nonsulfonylurea and increases sensitivity of tissues to insulin
b. Metformin reduces intestinal uptake and hepatic production of glucose
c. Metformin can cause GIT symptoms
d. Metformin increases insulin release from the beta cells in the pancreas.
d. Metformin increases insulin release from the beta cells in the pancreas.
- Identify the statement that is CORRECT for the medication of Insulin
a. Humalog is rapid acting insulin. It has a duration of 1-2 hours only
b. Humalog is rapid acting insulin. It will peak at 1-2 hours
c. Novomix 30 is a combination of insulin and protamine. It lasts for 36 hours
d. Novomix 30 is a combination of insulin and protamine. It will peak at 8 hours
b. Humalog is rapid acting insulin. It will peak at 1-2 hours
- Cirde the LEAST likely symptom that a COPD patient with have?
a. Breathlessness
b. Hallucinations
c. Large amounts of sputum
d. Weight loss
b. Hallucinations
- Which of the following statements are TRUE of ventilation support for COPD?
a. May need BiPap for COPD exacerbation with C02 retention
b. May need CPap for COPD exacerbation with C02 retention
c. Bloating stomach is a side effect of using non-invasive ventilator support
d. There are no side effects to using non-invasive ventilator support
a. May need BiPap for COPD exacerbation with C02 retention
b. May need CPap for COPD exacerbation with C02 retention
- Which of the following statement is TRUE for the management of COPD?
a. Dyspnoea is managed by lowering the head of the bed
b. Acetylcystiene may be used as a mucolytic
c. Corticosteroids such as Nefidipine are given
d. Oxygen therapy is given to keep the concentration above 95%
b. Acetylcystiene may be used as a mucolytic
- Which of the below statements are ACCURATE for systolic and diastolic heart failure?
a. In diastole heart failure the ventricle walls are thicker
b. In diastole heart failure the ventricle is dilated
c. In systole heart failure the ejection fraction is preserved
d. In systole heart failure the ejection fraction is reduced
d. In systole heart failure the ejection fraction is reduced
Circle the INCORRECT assessment for heart failure?
a. Chest x-ray and echocardiogram
b. GFR and homocysteine levels
c. Creatinine levels
d. Heart sounds or heart murmur
c. Creatinine levels
- Identify which statement shows the CORRECT signs and symptoms within the Prodromal phases of Schizophrenia
a. Symptoms not responsive to medication, General loss of interest, Failure to initiate interest and engagement, Lack of motivation, Have little confidence of
their mind,
b. General loss of interest in activity, Withdraws from social interaction, Work or school difficulties, Develop odd beliefs, Start talking to themselves, Develop odd
ritualistic behaviours
c. Hallucinations, Delusions, Highly anxious, Depressed, Can’t think through
activities, don’t trust others
d. Appear depressed, have hallucinations, symptoms not responsive to medication.
b. General loss of interest in activity, Withdraws from social interaction, Work or school difficulties, Develop odd beliefs, Start talking to themselves, Develop odd
ritualistic behaviours
- Which of the statements below is NOT associated with a major depressive episode?
a. Is known as double depression
b. Can have symptoms of feeling worthless or guilty on a daily basis
c. Is defined as having a depressed mood or loss of interest plus 4 other symptoms for a 2 week period
d. Average onset is 20 years of age
d. Average onset is 20 years of age
- Circle the INCORRECT statement about the Beyond Blue guidelines for Suicide intervention.
a. let the individual who is at risk know that you are concerned
b. Take action within 48 hours if not improved
c. Take care of yourself when with individuals who are at risk
d. Ask them if they are thinking about suicide
b. Take action within 48 hours if not improved
- Circle the INCORRECT statement about the psychological symptoms experienced by
patients with chronic kidney disease.
a. The biggest psychological impact upon the patient is depression
b. The biggest psychological stress is not associated with the disease but with the medications and their side effects
c. Patients with CKD are impacted psychologically because of the increased need to see health professionals
b. The biggest psychological stress is not associated with the disease but with the medications and their side effects
- When screening patients who have renal failure the GFR is assessed. Which of the
below GFR show that a patient is in stage 3 kidney disease?
a. GFR? 60
b. GFR? 15-29
c. GFR? 25-50
d. GFR? 30-59
d. GFR? 30-59
- Circle one or more of the following statements about Squamous cell carcinoma that
are CORRECT.
a. Squamous cell carcinoma is the most common form of skin cancer
b. It accounts for 2/3rds of all skin cancers
c. Found most commonly in females
d. It presents as a non-healing lesion, scaly spot or pinkish-red growth
a. Squamous cell carcinoma is the most common form of skin cancer
d. It presents as a non-healing lesion, scaly spot or pinkish-red growth
- Diagnosis of Melanoma is done using a staging classification. Circle the MOST CORRECT answer that states what is being assessed.
a. primary tumour depth
b. lymph node involvement
c. the location of metastases
d. All ofthe above
d. All ofthe above
- Circle which statement is TRUE for Marjolin’s Ulcer?
a. It is a rare skin cancer, however it is not aggressive.
b. It is a common skin cancer, is aggressive and occurs in wounds that are 5 years old
c. It is a non-aggressive transformation of a chronic wound, it is rare and is not malignant
d. It is an aggressive transformation of a chronic wound, it is rare and is malignant
d. It is an aggressive transformation of a chronic wound, it is rare and is malignant
- One of the following statements about Squamous cell carcinoma is not correct. Circle the INCORRECT statement.
a. Squamous cell carcinoma occurs on the keratinizing cells of the epidermis
b. It is of greater concern than BCC as it is an invasive cancer
c. It presents as thick roughened skin
d. It does not appear on the mucous membranes
d. It does not appear on the mucous membranes
- The age of a patient will affect the action of drug metabolism. Circle one or more of the CORRECT statements.
a. Gastric emptying time is decreased
b. Oesophageal motility time is decreased
c. Metabolism is decreased
d. Drug receptors have increased receptor sensitivity
e. Excretion of drugs is increased
b. Oesophageal motility time is decreased
c. Metabolism is decreased
d. Drug receptors have increased receptor sensitivity
- All of the following may be used in the treatment of dysthymic disorder EXCEPT:
a. Lithium
b. Anti psychotics
c. Oestrogen
d. Phenergan
d. Phenergan
- Most of the following drugs are routinely monitored for drug interactions. Identify which combination of drugs is NOT routinely monitored for their drug interactions.
a. Metformin/Naproxen/Prednisolone- Increased risk of Gl upsets
b. Heparin/Metformin/Frusemide
c. Warfarin/Naproxen/Prednisolone- Increased risk of Gl bleed
d. Metformin/Giiclazide/Prednisolone- BGL lowering effects of anti-diabetic medications may be diminished by prednisolone
b. Heparin/Metformin/Frusemide
- ALL of the following statements relate to osteoporosis. Which statements are NOT CORRECT.
a. Heparin will cause loss of bone density.
b. Glucocorticoids will not cause loss of bone density.
c. High alcohol consumption will cause loss of bone density.
d. Antacids that contain aluminium will not cause loss of bone density.
b. Glucocorticoids will not cause loss of bone density.
d. Antacids that contain aluminium will not cause loss of bone density.
- Identify the six socioeconomic factors for chronic illness.
Risk taking behaviours Low income Poor housing Exposure to violence LOTE - poor communication Sense of “no control”
What is the NORMAL RANGE for a BMI’?
18.5 to 24.9
- Outline the management or treatment for obesity.
Primary care strategies – prevention and promotion
General practice role – detection, management, support for self management
Surgical interventions
Health services - equipment and facility issues and initiatives
Identify what are the aims of the models of care for chronic illness?
Prevention and Promotion
Early Detection
Integration & continuity of Care
Self Management
The assessment of pain is usually undertaken with a PQRST method. What four other assessments should be made for a person with chronic illness?
Serious physical factors
Psychiatric symptoms
Psychological factors: beliefs /judgements /emotional responses /pain behaviour/ values
Relationship between work and health
System and contextual variables that may present obstacles to overcoming pain and disability
In the management of chronic pain with Aboriginals and Torres Strait Islanders, what issues are there with its management?
Uses assessment tool to measure pain
Appreciate variations in response to pain
Appreciate variations in communication
Accept that communication about pain may not be acceptable within some cultures
Appreciate variance about the meaning of pain
Define what catastrophizing is.
Catastrophizing is a common cognitive distortion that has been extensively studied in psychology.
Part 1: Predicting a negative outcome.
Part 2: Jumping to the conclusion that if the negative outcome did in fact happen, it would be a catastrophe.
What are the four models used to assist individuals to make lifestyle changes?
Transtheoretical Model
Motivational Interviewing
Social cognitive behaviour therapy
5As
Explain how you would deconstruct stigmatisation.
Identifying labels is the first step
Identifying areas where society excludes interaction, communication or learning
Identify reflexive thinking to develop awareness
- What is the definition for Quality of Life
individuals perceptions of their position in life in the context of the culture and value system where they live, and in relation to their goals, expectations, standards and concerns. It is a broad ranging concept, incorporating in a complex way a person’s physical health, psychological state, level of independence, social relationships, personal beliefs and relationship to salient features of the environment.
Identify 4 known risk factors for schizophrenia.
Causes
Genetic disposition Exposure to intrauterine infection Birth trauma Head injury in childhood Communication patterns in the family Environmental stress Drug use
The 5A’s acronym is used by nurses to remember the process of intervening and engaging patients to stop smoking. Please state what the acronym means.
Ask Advise Assess Assist Arrange
Identify the three tests used to screen for Chronic Kidney Disease and state why
these are important
BP, GFR and urine dipstick
List the three conditions of Chronic Obstructive Pulmonary disorder?
a
Identify 3 common myths or beliefs about schizophrenia.
Most sufferers experience one or few brief episodes
Schizophrenia is the same as “having a split personality”
Schizophrenic patients are dangerous
Early treatment does not make a difference to their wellbeing
Onset is usually slow
Identify and briefly describe the three treatment options for end stage kidney disease.
Kidney Transplantation
Haemodialysis
Peritoneal Dialysis
Describe the recommended diet for a patient with chronic renal failure.
Limiting fluids
Eating a low-protein diet
Limiting salt, potassium, phosphorous, and other electrolytes
Getting enough calories if you are losing weight
What are the types of depression
Mild episodes Moderate episodes Severe Episodes Melancholia Major depression with psychotic features Atypical depression Postpartum depression Seasonal affective disorder
six of the nine principles of nursing care and support the nurse can undertake to assist a patient to manage their depression
MedicationECT St. John’s wort Omega 3 fatty acids Rapport & Meaning Education Ongoing assessment Thinking Patterns Promoting Sleep Promoting activity & exercise Recognize withdrawn behaviour Suicidal thoughts assessment Self soothing and pleasant events
What are the Corbin and Strauss Illness trajectory model levels
pre-trajectory- trajectory, crisis, acute, stable, unstable, downward, dying
