EXAM#4 (CHPTS. 7, 12, 22, 23, 26, & 27)

Question 1

What is a case control study?

Answer 1

A study that compares two groups of people: those with the disease or condition under study (cases) and a very similar group of people who do not have the disease or condition (controls).

Question 2

THERORISTS

Answer 2

FREUD — Psychosexual focus
ERICKSON — Stages of psychosocial development
MASLOW — Based on human needs
PIAGET — Development of cognition
KOHLBERG — Moral development

Question 3

Difference between a teratogen, maturation, development, and growth

Answer 3

Teratogen: any agent that causes an abnormality following fetal exposure during pregnancy r/t defects

Maturation: the biological plan for the predictable milestones for growth and development. Physical growth and motor development are a function of maturation.

Development: an interaction of biological, sociological, and psychological forces. Development occurs gradually and refers to changes in skill and capacity to function. These changes are qualitative in nature and difficult to measure in exact units.

Growth: is the measurable aspect of a person’s increase in physical dimensions. Measurable growth indicators include changes in height, weight, teeth and bone, and sexual characteristics.

Question 4

Psychomotor learning

Answer 4

Occurs when patients acquire skills that require the integration of knowledge and physical skills.
— Examples of psychomotor learning are learning how to administer insulin injections, use inhalers, and swipe a magnet across a vagal nerve stimulator (VNS)

Question 5

Difference b/w affective learning and cognitive learning

Answer 5

Affective: includes a patient’s feelings, attitudes, opinions, and values. Research shows that you need to include the affective domain in teaching because it includes a patient’s personal attitudes, beliefs, behaviors, and emotions (Miller and Stoeckel, 2016). Learning objectives in the affective domain include influencing attitudes and motivating the learner.

Cognitive: includes what a patient needs to know and understand. All intellectual behaviors are in the cognitive domain, including:
* Acquisition of knowledge
* Comprehension (ability to understand)
* Application (using abstract ideas in concrete situations)
* Analysis (relating ideas in an organized way)
* Synthesis (recognizing parts of information as a whole)
* Evaluation (judging the worth of a body of information)

Question 6

Nursing-sensitive outcome

Answer 6

— focuses on how patients and their health care problems are affected by nursing interventions
— look at the effects of interventions within the scope of nursing practice.
_______________
Examples of nursing-sensitive outcomes include:
* Symptoms (e.g., pain, fatigue, nausea).
* Functional status (e.g., activity tolerance, ability to perform activities of daily living).
* Safety (e.g., incidence of falls, infections, pressure injuries).
* Psychological distress (e.g., anxiety, depression).

Question 7

What is a hypothesis?

Answer 7

— Predictions made about the relationship among study variables

Examples
— Characteristics or traits that vary among subjects).

Question 8

QSEN competency skills for EBP

Answer 8

— Patient Values
— Clinical Expertise
— Values
_________________
Other QSEN skills: teamwork, collaboration, safety, quality

Question 9

What type of journal could be used to review the latest information regarding hospital acquired infections?

Answer 9

PEER-REVIEWED
Reputable primary sources made by experts

Question 10

Baby in the 2nd trimester

Answer 10

most organ systems are complete and able to function. The fetus weighs approximately 0.7 kg (1 1/2 lb) and is approximately 30 cm (12 inches) long.

NOTE:
On average, a pregnant woman needs 15% to 20% more kilocalories than she needs when not pregnant. This is equal to approximately 340 kcal/day extra beginning in the second trimester and 450 kcal/day extra during the third trimester

Question 11

Know Erikson’s Psychosocial Development stages

Question 12

Compassion fatigue

Question 13

What are the milestones for a 1 year old?

Question 14

What does exercise release?

Answer 14

Endorphins (hormone)

Question 15

Definition of homeostasis

Question 16

For evidence-based practice (EBP) when providing care, what should a nurse do first?

Answer 16

Ask clinical question

Question 17

Preschool aged children

Answer 17

Ages 3-5 years
— ID shapes and colors
— “I’m hungry NOW!”
A 3-year-old can recognize people, objects, and events by their outward appearance. For example, 3-year-olds prefer having two nickels over a dime because it appears to be more. The continued egocentricity of early thinking makes it difficult to suggest acceptable alternatives to preschoolers. When they are hungry, they expect others also to be hungry, and they think they must eat now!

Question 18

Spiritual Belief of Erickson’s middle-aged person

Answer 18

Middle-age person will review value systems during crisis

Question 19

Reducing fear in school aged children

Answer 19

— Gently encourage your child to do things they’re anxious about, but don’t push them to face situations they don’t want to face.
— Wait until your child actually gets anxious before you step in to help.
— Praise your child for doing something they’re anxious about. Avoid criticising your child for being afraid or worried

Question 20

Know Kubler-Ross’ 5 responses to loss

Answer 20

1. Denial — act as though nothing has changed. They cannot believe or understand that a loss has occurred
2. Anger — a person resists the loss, is angry about the situation, and sometimes becomes angry with God
3. Bargaining — the individual begins to accept the reality and inevitability of loss and looks to the future
4. Depression — the person feels overwhelmingly lonely or sad and withdraws from interactions with others
5. Acceptance — the individual begins to accept the reality and inevitability of loss and looks to the future

Question 21

Regression

Question 22

Reactions according to General Adaptation Syndrome (GAS)

Answer 22

a three-stage set of physiological processes that prepare, or adapt, the body for danger so that an individual is more likely to survive when faced with a threat

(1) initial alarm, (2) resistance as a person attempts to compensate for changes induced by the alarm stage, and (3) a state of exhaustion if the person cannot adapt successfully during the stage of resistance or if stress remains unrelieved.

Question 23

Know PICO(T)

Answer 23

Purpose: how much time does it take to demonstrate an outcome (e.g., the time it takes for the intervention to achieve an outcome or how long participants are observed)?

P = patient population or area of interest
—ID your patients (family, clinical staff) by age, gender, ethnicity, disease, and experience or health problem
I = intervention of interest
— Which intervention do you want to use in practice (e.g., a treatment, diagnostic test, educational approach)?
C = comparison of interest
— What is the usual standard of care or current intervention that you now use in practice?
O = outcome
— What result do you wish to achieve or observe as a result of an intervention (e.g., change in patient/family caregiver behavior, physical finding, patient perception)?
T = time
— How much time does it take to demonstrate an outcome (e.g., the time it takes for the intervention to achieve an outcome or how long participants are observed)?

Question 24

For nausea, what beverage could be offered?

Answer 24

Ginger ale

Question 25

Know the differences b/w actual loss, perceived loss, situational loss, maturational loss, reminiscence, grief and mourning

Answer 25

Actual: when they can no longer touch, hear, see, or have near them valued people or objects. Examples include the loss of a body part, pet, friend, life partner, or job.
Perceived loss: is uniquely experienced by a grieving person and is often less obvious to others. A perceived loss is very real to the person who has had the loss.
Situational: occurs as a result of an unpredictable life event. A situational loss often involves multiple losses. For example, a divorce begins with the loss of a life companion but often leads to financial strain, changes in living arrangements, less contact with one’s children, and loss of friends who were part of the couple’s married life.
Maturational: as they go through a lifetime of normal developmental processes.

Question 26

Know types of ego defense mechanisms

Answer 26

Compensation
— Making up for a deficiency in one aspect of self-image by strongly emphasizing a feature considered an asset. (Example: A person who is a poor communicator relies on organizational skills.)

Conversion
— Unconsciously repressing an anxiety-producing emotional conflict and transforming it into nonorganic symptoms (e.g., difficulty sleeping, loss of appetite).

Denial
—Avoiding emotional conflicts by refusing to consciously acknowledge anything that causes intolerable emotional pain. (Example: A person refuses to discuss or acknowledge a personal loss.)

Displacement
— Transferring emotions, ideas, or wishes from a stressful situation to a less anxiety-producing substitute. (Example: A person transfers anger over a job conflict to a malfunctioning computer.)

Identification
— Patterning behavior after that of another person and assuming that person’s qualities, characteristics, and actions.

Dissociation
— Experiencing a subjective sense of numbing and a reduced awareness of one’s surroundings.

Regression
— Coping with a stressor through actions and behaviors associated with an earlier developmental period.

Question 27

What is the next step in EBP after implementing a practice change?

Question 28

What are maladaptive coping strategies + examples?

Question 29

What studies have the best evidence?

Answer 29

Evidence-based practice
— The best scientific evidence comes from well-designed, systematically conducted research studies found in scientific, peer-reviewed journals.

Question 30

Example of a loss of a ‘known environment

Answer 30

Loss occurs through maturational or situational events and with injury or illness. Loneliness in an unfamiliar setting threatens self-esteem and makes grieving difficult.
_____________
_Examples: moving from a neighborhood, hospitalization, a new job, moving to a long-term care facility

Question 31

What is the definition of a maladaptive coping strategies + examples?

Question 32

Actions for postmortem care

Answer 32

care of body after death
— Because a body undergoes many physical changes after death, provide postmortem care as soon as possible to prevent tissue damage or disfigurement of body parts.
______________
Example
— Immediately after death, elevate the head of the bed to 30 degrees or place the patient’s head on pillows to prevent pooling of blood, which can discolor the face.

Question 33

General Adaptation Syndrome

Answer 33

a three-stage set of physiological processes that prepare, or adapt, the body for danger so that an individual is more likely to survive when faced with a threat

Question 34

Signs of Impending Death

Answer 34

• Minimal intake of food or water
• Increased sleeping and decreased consciousness
• Disorientation and restlessness
• Decreased urinary output and/or incontinence
• Cool hands and feet
• Noisy breathing
• Irregular breathing patterns with long pauses
• At the time of death, you will note:
• Absence of breathing and heartbeat
• Bowel and bladder release
• Unresponsiveness
• Eyes fixed on a certain spot
• Dilated pupils

Question 35

Know Worden’s 4 Tasks of Mourning

Answer 35

Describe how individuals help themselves through mourning and ask others for help. Although the time needed varies from person to person, moving through Worden’s tasks typically takes at least 1 year.
— Task I: Accept the reality of the loss.
— Task II: Work through the pain of grief
— Task III: Adjust to the environment in which the deceased is missing
— Task IV: Emotionally relocate the deceased and move on with life

Question 36

Early childhood/toddler major development theories of childhood

Answer 36

Age — 18 months to 3 years
___________________________________
Developmental stage —
Freud (Psychosexual devel.) —
Erickson (Psychosocial) —
Piaget (logical, cognitive, and moral) —
Kohl berg (moral reasoning) —

Question 37

Infancy major development theories

Answer 37

Age — birth to 18 months
___________________________________
Freud (Psychosexual devel.) — Oral stage
Erickson (Psychosocial) — Trust vs. mistrust; ability to trust others
Piaget (logical, cognitive, and moral) — sensorimotor period; Progress from reflex activity to simple repetitive actions
Kohl berg (moral reasoning) — N/A

Question 38

Preschool major development theories

Answer 38

Age — 3-5 years
___________________________________
Freud (Psychosexual devel.) — Phallic stage
Erickson (Psychosocial) — Initiative vs. guilt | Highly imaginative
Piaget (logical, cognitive, and moral) — Use of symbols; egocentric
Kohl berg (moral reasoning) — Preconventional level | Premoral | Instrumental orientation

Question 39

Childhood major development theories

Answer 39

Age — 6-12 years
___________________________________
Freud (Psychosexual devel.) — Latent stage
Erickson (Psychosocial) — Industry vs. inferiority | Engaged in tasks and activities
Piaget (logical, cognitive, and moral) — Concrete operations period | Logical thinking
Kohl berg (moral reasoning) — Conventional level | Good-boy, nice-girl orientation

Question 40

Adolescence major development theories

Answer 40

**Age — 12-19 years **
___________________________________
Freud (Psychosexual devel.) — Genital stage
Erickson (Psychosocial) — Identity vs. role confusion | Sexual maturity, “Who am I?”
Piaget (logical, cognitive, and moral) — Formal operations period | Abstract thinking
Kohl berg (moral reasoning) — Postconventional level | Social contract orientation

Question 41

Young adulthood major development theories

Answer 41

Age —
___________________________________
Freud (Psychosexual devel.) — N/A
Erickson (Psychosocial) — Intimacy vs. isolation | Affiliation and love
Piaget (logical, cognitive, and moral) — N/A
Kohl berg (moral reasoning) — N/A

Question 42

Adulthood major development theories

Answer 42

Age —
___________________________________
Freud (Psychosexual devel.) — N/A
Erickson (Psychosocial) — Generativity vs. stagnation | Production and care
Piaget (logical, cognitive, and moral) — N/A
Kohl berg (moral reasoning) — N/A

Answer 43

Age —
___________________________________
Freud (Psychosexual devel.) — N/A
Erickson (Psychosocial) — Ego integrity vs. despair | Renunciation and wisdom
Piaget (logical, cognitive, and moral) — N/A
Kohl berg (moral reasoning) — N/A

Question 44

Definition of appraisal regarding nursing

Answer 44

Many EBP committees use critical appraisal guides or useful checklists for evaluating studies (Spruce et al., 2016). A guide lists questions about essential elements of research (e.g., purpose, sample size, setting, method of study).

Question 45

Know Bowlby’s 4 Phases of Mourning

Answer 45

1. shock-numbness
2. yearning-searching
3. disorganization-despair
4. reorganization

Question 46

Signs/Symptoms of compassion fatigue

Answer 46

a combination of secondary traumatic stress and burnout experienced by professional and la

— feelings of helplessness and powerlessness in the face of patient suffering.
— reduced feelings of empathy and sensitivity.
— feeling overwhelmed and exhausted by work demands.
— feeling detached, numb and emotionally disconnected.
— loss of interest in activities you used to enjoy.

Question 47

Distinguish the difference b/w intensity, scope, duration and predictability

Question 48

Know Erickson’s developmental stages compared to the spiritual beliefs

Answer 48

8 Stages of development; individuals need to accomplish particular tasks before successfully completing a stage

Trust vs Mistrust — Infancy (birth to 18 months)
Autonomy vs. Shame & Doubt — early childhood/toddler (18 months to 3 years)
Initiative vs. Guilt — Preschool (3-5 years)
Industry vs Inferiority — Childhood (6-12 years)
Identity vs. Role Confusion — Adolescence (12-19 years)
Intimacy vs. Isolation — Young adulthood (20-35 years)
Generativity vs. Stagnation — Adulthood (35-65 years)
Ego Integrity vs. Despair — Maturity (65 to death)

Question 49

Full term neonate’s length, weight and head circumference

Answer 49

The average full-term neonate weighs 3.4 kg (about 7 1/2lb), is 50 cm (20 inches) in length, and has a head circumference of 35 cm (14 inches). Neonates lose up to 10% of their birth weight in the first few days of life, primarily through fluid losses by respirations, urination, defecation, and low fluid intake. They usually regain the weight by the end of the second week of life.

Question 50

Stages of General Adaptation Syndrome (GAS)

Answer 50

a three-stage set of physiological processes that prepare, or adapt, the body for danger so that an individual is more likely to survive when faced with a threat

Question 51

Know Freud’s Psychosexual Development stages

Answer 51

psychoanalytic model of personality development is grounded in the belief that two internal biological forces drive the psychological change in a child: sexual (libido) and instinctive forces. The theory describes a series of five stages, each associated with a pleasurable zone serving as the focus of gratification.
Oral — infancy
Anal — early childhood/toddler
Phallic — preschool
Latent — childhood
Genital — adolescence

Question 52

Adulthood major development theories

Answer 52

**Age — **
___________________________________
Developmental stage — N/A
Freud (Psychosexual devel.) — N/A
Erickson (Psychosocial) —
Piaget (logical, cognitive, and moral) —
Kohl berg (moral reasoning) —

Question 53

Adulthood major development theories

Answer 53

Age —
___________________________________
Developmental stage — N/A
Freud (Psychosexual devel.) — N/A
Erickson (Psychosocial) —
Piaget (logical, cognitive, and moral) —
Kohl berg (moral reasoning) —