final exam

Question 1

social determinants of health

Answer 1

Social determinant of health defined - factors that impact health other than health services, including location, environment, genetics, income, relationships, and gender.
Neighborhood and built environment, health and healthcare, social and community context, education, economic stability, genetics

Question 2

effects on social determinants and examples

Answer 2

Health care disparities affect -> the avoidable differences that result from cumulative social disadvantages, including ehealth outcomes, health care assets, coverage and quality of care between groups of people, etc.
Examples: lack of public transportation, access to healthcare, exposure to environmental hazards, social support network, etc.
Poverty and unemployment are factors of socioeconomic status but is a social determinant of health

Question 3

palliative care

Answer 3

Services provided to clients to promote comfort while in the last stages of life. Services can be received during active treatment. A treatment approach that is focused on the management of symptoms of chronic or life-threatening illnesses while maintaining the highest level of quality of life possible for the client.
Palliative care has been shown to improve a client’s quality of life, reduce their time in the hospital, improve their satisfaction, and be given to those who are experiencing a severe medical illness and particularly those reaching the end of life.

Question 4

primary prevention

Answer 4

Primary - focuses on the act of intervening before the negative health effects occur. Working to decrease the risk for development of medical conditions by changing behaviors or minimizing exposures.

Question 5

examples of primary prevention

Answer 5

Vaccinations, changing risky behaviors such as tobacco use, banning harmful substances.
Teaching bicycle safety to school age children, discussing the prevention of sexually transmitted infections with a community group, distributing brochures about heart health at a center for older adults

Question 6

secondary prevention

Answer 6

is done to reduce the impact of the disease or injury, and to limit the disability. Early screenings to detect a disease process before it progresses to cause symptoms or complications.

Question 7

examples of secondary prevention

Answer 7

Blood pressure measurement to detect hypertension, blood cholesterol levels, cancer screening such as mammograms, Pap test, routine colonoscopies.
Scheduling a client for a screening for prostate cancer, checking all clients for depression at well client check ups

Question 8

tertiary prevention

Answer 8

Tertiary - focuses on controlling the chronic effect of a health issue that has already occurred, and/pr restoring the individual to a level of optimal functioning.

Question 9

examples of tertiary prevention

Answer 9

Self care, rehabilitation (OT and PT)
Implementing bladder retraining with a client who has a spinal cord injury, nutritional counseling for a client who has diabetes mellitus, leading a support group for clients who has post traumatic stress disorder

Question 10

quaternary prevention

Answer 10

a focus on protecting clients from the excessive use of medical interventions that can cause more harm than good

Question 11

what is a health record

Answer 11

a collection of health information and the data about an individual client’s health

Question 12

components of a health record

Answer 12

Includes: patient demographics, medical history, current medications, allergies (if any), physical examination findings, diagnostics and their results, progress notes, treatment plans, discharge summaries, immunization data.
- Treatment notes, progress notes, discharge summaries, admission paperwork, documentation of treatment

Question 13

the novice to expert stages of nursing

Answer 13

• Novice - a beginner with little or no experience
• Advanced beginner - can demonstrate basic skills but continues to need the support and guidance from a mentor
• Competent - individual can plan, make decisions, and perform job responsibly and efficiently
• Proficient - demonstrates advances decision making, knowledge, resourcefulness, flexibility, and problem solving
• Expert - role models deep knowledge and skills, teaches others, and multitasks effortlessly and fluently

Question 14

aromatherapy

Answer 14

the act of breathing in a scent of a natural plant extract

Question 15

lavender in aromatherapy

Answer 15

Lavender - inhalation of this and bergamot during radiation therapy as means to reduce anxiety; massaging lavender with tea tree oil is a sleep aid, inhalation of lavender and ginger in a 2:1 ratio can increase salivation

Question 16

steps to evidence based practices

Answer 16

Identify a problem: ask a question
Search credible sources of evidence: look for factual information
Evaluate findings: review the information
Implement recommendations: change the interventions
Review their effectiveness: do the new interventions improve results?
Disseminating the results: share the findings with others

Question 17

what is an incident report

Answer 17

This is a report that is a documentation of errors and the factors leading up to and including when an error occurs in the healthcare system
- Every system typically has a specific place for these and a specific way of doing them

Question 18

the most acceptable two client identifiers

Answer 18

full name and date of birht

Question 19

teach back method

Answer 19

Teach back is conducted by asking the client to repeat or demonstrate educational information back to you. This method allows the nurse to confirm that the client received the information correctly
Ex: teaching a client how to take their blood sugar. Then the nurse asked the client; can you tell me how you would take your blood sugar at home?

Question 20

lecture teaching method

Answer 20

Lecture - allows the client to gain comprehension and knowledge

Question 21

group instruction teaching method

Answer 21

Group instruction - involves teaching two or more clients who are obtaining the same learning material simultaneously

Question 22

individual instruction teaching method

Answer 22

Individual instruction - occurs when the education session engages only the learning and the teacher and is the most common form of client education
Allows for active engagement of feelings, attitudes, perceptions, and values (affective)

Question 23

question and answer method of teaching

Answer 23

Question and answer: allows teach-back, feedback, and evaluation

Question 24

the steps of the teaching process

Answer 24

Assessment, analysis, planning, implementation, and evaluation

Question 25

difference between ophthalmic and otic medication administration

Answer 25

Ophthalmic - the process of putting medication directly into the eye to treat a variety of eye conditions after applying medication apply pressure on the nasolacrimal duct Otic - the process of putting medication directly into the ear to treat a variety of conditions - Make sure it is at room temp, make sure to shake well before use, make sure to irrigate the ear if dirty or blocked

Question 26

pharmacodynamics

Answer 26

the study of how a drug works, its relationship to the drug concentrations, and how the body responds.

Question 27

trough blood level

Answer 27

Trough blood level - the lowest level of the drug when in the human’s body

Question 28

etic knowledge

Answer 28

an outsider's viewpoint of a culture

Question 29

emic knowledge

Answer 29

a cultural insider's viewpoint of a culture

Question 30

inclusion

Answer 30

An environment that embraces individual differences to allow individuals to bring their whole selves and identities to display their full capacity

Question 31

normal grief

Answer 31

Normal grief - also known as uncomplicated grief; caused by the death of a loved one or the ending of a relationship

Question 32

anticipatory grief

Answer 32

Anticipatory grief - grief that is experienced before the loss of someone or something

Question 33

prolonged grief disorder

Answer 33

Prolonged grief disorder (PGD) - previously known as complicated grief; experienced by clients who are unable to accept the death of a loved one

Question 34

disenfranchised grief

Answer 34

Disenfranchised grief - grief related to a relationship that does not coincide with what is considered by society to be recognized or justified as a loss - Ex: Death of a pet, miscarriage

Question 35

NURSE mnemonic

Answer 35

Name: identify what the client just stated, or the emotion expressed by the client Understand: demonstrate understanding by recognizing the client’s feelings and providing an opportunity for the client to discuss their feelings Respect: voice your respect for the client under these circumstances Support: inform the client that you are available for him or her Explore: ask open-ended questions to extend the conversation and provide a more detailed expression of the client’s feelings and beliefs

Question 36

general adaptive syndrome alarm stage

Answer 36

1st stage Alarm – when the central nervous system becomes aroused, and the body defense mechanisms are mobilized. Then hormones are released, and the body goes into fight of flight mode

Question 37

general adaptive syndrome resistance stage

Answer 37

2nd stage Resistance - the body resists and seeks to counter the stress. The parasympathetic nervous system attempts to return bodily functions back to a state of homeostasis. The body remains on alert while hormonal and other bodily functions return to normal and as the body repairs any damage caused by the threat.

Question 38

general adaptive syndrome exhaustion stage

Answer 38

3rd and final stage Exhaustion - the body can no longer defend itself against the stressor. In this stage, when the body’s capacity to withstand or adapt to the stressor becomes depleted and the individual’s resources are exhausted, prolonged exposure to stress may result in illness or disease.

Question 39

acute stress

Answer 39

Acute - the most common and frequent type of stress. Usually brief and can be positive or negative. It causes an immediate reaction and triggers the fight or flight response

Question 40

chronic stress

Answer 40

Chronic - a disabling condition that occurs when stress levels are heightened, constant, and prolonged.

Question 41

physiological stressors

Answer 41

Generally associated with injury or illness, such as things like exposure to extreme temperatures, trauma, injury, illness, or pain. - The body’s reaction is immediate and is necessary for survival.

Question 42

acute stress disorder

Answer 42

Acute stress disorder - an intense and dysfunctional reaction to a traumatic event that lasts less than a month - Ex: death of a loved one, threat of serious injury to themselves or others, exposure to war or other acts of violence.

Question 43

posttraumatic stress disorder

Answer 43

Posttraumatic stress disorder - A prolonged and heightened stress reaction to a traumatic event that lasts more than a month. Typically follows a traumatic event such as an accident, sexual abuse, or a naturally occurring disaster

Question 44

irritable bowel syndrome

Answer 44

Irritable bowel syndrome - a common GI condition manifested by symptoms of abdominal discomfort, cramping, bloating, diarrhea, and/or constipation.

Question 45

special considerations for nail care

Answer 45

Do not do nail care for someone who has diabetes, assess skin integrity, cut in a straight line, be cautious of bleeding disorders Clean cuticles and put lotion on them Woman with nail polish - take it off with nail polish remover with no acetone

Question 46

nociceptive pain

Answer 46

Nociceptive - pain that is felt in the tissue, an organ, a damaged part of the body, or a referred pain - Usually localized and described as throbbing or aching

Question 47

neuropathic pain

Answer 47

Neuropathic - nerve pain that arises from the somatosensory system, described as intense, burning, and shooting - Associated commonly with: spinal cord injuries, cancer pain

Question 48

acupuncture

Answer 48

A professional procedure using long, thin, sterile needles to penetrate the skin and stimulate, by hand and/or electrically, anatomical points in the body to improve short and long-term physical function

Question 49

body image

Answer 49

A person’s perceptions, feelings, and thoughts about their body and is usually conceptualized by perceptions related to body shape, size, and physical attractiveness

Question 50

hospice care

Answer 50

Care services for clients and families that focus on comfort and support; not curative when it is determined the client has less than six months to live - Generally provided in a home when treatment will no longer cure or control an illness

Question 51

postmortem care

Answer 51

Physical care provided after the client has died; includes washing the body, recording the time or death, documenting who was notified of the death, accounting for the client’s possessions, removing invasive devices, and placing identification tags on the body.

Question 52

nutritional supplements -> folic acid

Answer 52

Used when pregnant to prevent spina bifida in the developing fetus Important for early fetal development of the brain and spine

Question 53

vitamin C and iron coordinating with eachother

Answer 53

When taking Iron clients should also take vitamin C because it helps to absorb iron

Question 54

Donning PPE

Answer 54

hand hygiene gown mask eye goggles or face shield gloves

Question 55

doffing PPE

Answer 55

remove gloves face shield or eye goggles gown mask hand hygiene last

Question 56

Erikson's stages of psychosocial development

Answer 56

Infancy - trust versus mistrust Preschool - initiative versus guilt School age - industry versus inferiority Adolescence - identity versus role confusion Young adulthood - intimacy versus isolation Middle adulthood - generativity versus stagnation Maturity - integrity versus despair

Question 57

active listening

Answer 57

Focuses on the client’s verbal and nonverbal messages In this the nurse will show that they are paying attention and will then ask open ended questions to get the client to continue to talk

Question 58

NPO

Answer 58

- nothing by mouth

Question 59

regular diet

Answer 59

Regular diet - consists of healthy food coming from all of the food groups such as fruits, vegetables, grains, protein, and dairy sources

Question 60

soft diet

Answer 60

Soft diet - foods that are soft, easy to digest, low in fiber, and can be swallowed without difficulty

Question 61

pureed diet

Answer 61

Pureed diet - consists of foods that are soft and smooth and do not need to be chewed

Question 62

full liquid diet

Answer 62

Full liquid diet - a diet that contains only fluids, foods that are liquids, and foods that are liquids at room temperature, such as ice cream

Question 63

clear liquid diet

Answer 63

Clear liquid diet - contains only clear liquids, such as broth, gelatin, and water

Question 64

abbreviations

Answer 64

BID = twice a day AC = before meals HS = at bedtime PRN = as needed Q_H = every _ hours PC = after meals TID = three times a day QID = four times a day

Question 65

conversions

Answer 65

King Henry Died By Drinking Chocolate Milk - Kilo, hecto, Deka, Base (meter, liter, gram), deci, centi, milli

Question 66

how to move bigger or smaller with conversions

Answer 66

If going bigger the decimal moves the the left, if going smaller the decimal moves to the right

Question 67

PQRST

Answer 67

P - what were you doing when the pains started Q - describe what you pain feels like R - show me the location of your pain S - on a scale of 1-10 how is your pain T - when did the pain first begin? Have you experienced it before?

Question 68

the joint commission

Answer 68

Is an independent, non-profit organization that accredits healthcare organizations in more than nine different types of healthcare settings Accredits based on; their safety performance, policies, procedures, practices, and outcomes

Question 69

press ganey

Answer 69

This is a survey that is sent to clients who have recently received care at the participating facility. The survey covers things like communication with healthcare professionals, waiting times, care, and overall satisfaction

Question 70

what is health promotion

Answer 70

the process of enabling people to increase their control over and improve their health

Question 71

self-care practices

Answer 71

Is of the utmost importance that clinicians engage in self care and practices to maintain their emotional well being, and preventing burnout, moral distress, and or the lack of compassion - Burnout is a progressive loss of idealism, energy, and purpose experienced by people in the helping professions as a result of the conditions of their work (we are all susceptible to this)

Question 72

modifiable versus nonmodifiable risk factors

Answer 72

Modifiable - behaviors and actions that affect a client’s risk for developing a disease Non-modifiable - risk factors that cannot be changed like; age, gender, ethnicity, race, family history

Question 73

OARS

Answer 73

open-ended questions affirmations reflective listening summarizing

Question 74

PIE

Answer 74

problem intervention evaluation

Question 75

SOAP

Answer 75

Subjective - symptoms that the client describes (pain level, feelings) Objective - symptoms that are clinical impressions that the provider can see, hear, touch, smell, or measure (bp, fever, vomiting) Assessment - combines the subjective and objective information to help arrive at a nursing diagnosis Plan - the detailed steps to treat clients and the need for consultation or additional testing to address client needs

Question 76

EMTALA

Answer 76

Emergency Medical Treatment and Labor Act (EMTALA) - The act passed that says that a healthcare organization cannot pass off a client based on their inability to pay or lack of insurance - Ensures that any individual who comes in for care will at a minimum receive a medical screening examination and treatment is stabilized.

Question 77

Where should a patient hand-off report take place?

Answer 77

At the patient's bedside whenever possible to ensure ongoing communication between the staff and the client

Question 78

massage therapy

Answer 78

Is an ancient manual therapy of manipulating soft tissue for relief from pain and other conditions. - Includes: rhythmic pressure, friction, or kneading of: skin, muscles, tendons, ligaments, or the fascia - Can lead to adverse effects like: blood clots, nerve injuries, bone fractures

Question 79

PICOT

Answer 79

Population - who is the target population Intervention - what is the intervention being used Comparison - is there a control group or a comparison Outcome - what are the outcomes Time - what is the time frame or follow up time (not required)

Question 80

health literacy and low version

Answer 80

Health literacy - the ability to process and comprehend basic information necessary for the client to make appropriate health care decisions. All information should be presented at a 6th grade level

Question 81

contact transmission

Answer 81

Contact - occurs when microorganisms move form an infected person to another person (direct contact)

Question 82

droplet transmission

Answer 82

Droplet - occurs when airborne droplets from the respiratory tract of a client travels through the air and into the mucosa of the host or the other person (indirect contact)

Question 83

airborne transmission

Answer 83

Airborne - occurs when small particulates move into the airspace of another person

Question 84

stages of infection

Answer 84

Incubation - an infection enters the host and it begins to multiply, before symptoms appear Prodromal - when the client begins to have symptoms Acute illness - manifestations of the specific infectious disease process are obvious and may become severe (worst stage) Decline - the manifestations begin to wane as the degree of infectious disease decreases Convalescence - the client returns to a normal or “new normal” state of health

Question 85

droplet precautions

Answer 85

The infection preventions needed to protect a client who has something where the spread of pathogens can occur through close contact with respiratory secretions

Question 86

teratogenic medications

Answer 86

These are medication that are known to cause fetal defects, pregnancy loss, developmental disabilities, or prematurity Ex: cocaine, alcohol, lithium, NSAIDs, ACE inhibitors, gentamicin, tetracycline

Question 87

Self-concept congruence vs incongruence

Answer 87

Self-concept congruence - occurs when a person’s ideal self is consistent with their actual life experiences Self-concept incongruence - occurs when a person’s ideal self is not consistent with their actual life experiences

Question 88

identity self concept stressor

Answer 88

Identity - life events that threaten self-concept like; gender dysphoria, being laid off, losing one’s career, divorce, death or a spouse

Question 89

body image self concept stressor

Answer 89

Body image - societal attitudes about physical attributes, appearance, and performance that can impact a client’s self-perception of their body image

Question 90

role performance self concept stressor

Answer 90

Role performance - this refers to the individual's perception of how well they perform in roles. There are four type: role conflict, role ambiguity, role overload, role strain

Question 91

the four types of role performance

Answer 91

Conflict - faced with two or more expectations and are unable to meet them at the same time Ambiguity - refers to the lack of clarity in understanding the actions that are needed to be taken to achieve any proposed goals Overload - when roles and responsibilities placed are greater than the individual can effectively manage Strain - when they have difficulty meeting the responsibilities of a particular life role when incompatible needs are placed on them

Question 92

self-esteem as a self-concept stressor

Answer 92

Self-esteem - a person’s subjective sense of their own worth and value, essentially how much they believe they are capable and deserving of respect

Question 93

client advocacy

Answer 93

Being able to speak up for the clients’ needs when the client is unable to speak for themself and also being able to support the clients to helping them make choices for their own health - The nurse specifically needs to be able to communicate the client’s wishes or beliefs. They communicate with the healthcare providers and help with talking with families if needed. The nurse also helps to discuss the best options for that client specifically

Question 94

swanson's theory of caring

Answer 94

- The theory views caring as a process of five categories through which a person goes to achieve overall well being Maintaining belief: faith and recognizing it Knowing: how does it all fit in with the bigger picture Being with: being able to be with the client physically and emotionally Doing for: what skills and touch can you do (changing sheets?) Enabling: be able to enable them to do as much as they can for themselves

Question 95

cultural bias

Answer 95

Knowing our own bias can enhance our cultural awareness and in turn help us to take better care of clients

Question 96

health disparities

Answer 96

They involve health outcomes that may be greater or lesser among different socioeconomic populations - Vulnerable populations are the groups of people that are at higher risk for poor outcomes from barriers to social, economic, and environmental resources, including limitations or disability.

Question 97

Kubler-ross stages of grief

Answer 97

Denial - the client refuses to believe the truth and this helps to lessen the pain of the loss Anger - client is trying to adjust to the loss and is feeling severe emotional distress, often asking “why me?” and suggesting “it isn’t fair” Bargaining - usually involves bargaining with a higher power by making a promise to do something in exchange for a different, better outcome Depression - reality starts to set in, and the loss of the loved on or thing is deeply felt Acceptance - the client still feels the pain of the loss but realizes that all will be alright

Question 98

fight or flight response

Answer 98

When a situation is determined to be stressful, the hypothalamus secretes corticotropin releasing factor (CRF) which activates the sympathetic nervous system (SNS) to release norepinephrine, epinephrine, and dopamine also known as the “fight or flight” response which causes an increase in heart rate, blood pressure, cardiac output, dilation of bronchial airways, pupil dilation, and an increase in blood glucose levels.

Question 99

melatonin

Answer 99

The pineal gland manufacture melatonin which is a natural substance that tells the body when it is time to go to sleep

Question 100

end of life physiological signs

Answer 100

Physiological changes at the end of life follow a familiar pattern of signs and symptoms. The terminal phase of a client’s life is characteristically referred to as “actively dying” or “imminent death.” Dyspnea: shortness of breath. Retention of secretions in the respiratory tract, also known as “death rattle”. Cheyne-Stokes respirations: an irregular respiratory rate fluctuating between several quick breaths and periods of apnea Pain at the end of life: Experienced by nearly 60% of older adult hospice clients who have cancer. Occurs because of nerve injury, organs being stretched and compressed, and/or bone pain Temperature alterations at the end of life: Ability of the nervous system to regulate body temperature diminishes, causing clients to experience both increased and decreased temperature. Also caused by infection, cancer, and cancer therapy. Mottling occurs hours or days before death, with the upper and lower extremities becoming cool to the touch. Mottling occurs as a result of the heart’s inability to pump blood effectively, leading to decreased blood perfusion throughout the body. Vision and hearing at the end of life: clients may experience hallucinations or report hearing or seeing those who have already died

Question 101

functions of macros

Answer 101

Macronutrients include protein, carbohydrates, and fat. They are eaten in large amounts, are the primary building blocks of any diet, and provide the body with the energy needed to function

Question 102

what is beneficence

Answer 102

the principal that guides nurses to act in the clients best interests by promoting well-being and preventing harm

Question 103

integrity

Answer 103

when the nurse admits that they have administered the wrong medication

Question 104

drug calculations

Answer 104

desired/have

Question 105

what is nonmaleficence

Answer 105

the agreement to not do harm to patients

Question 106

autonomy

Answer 106

the ability to make your own decisions about what to do

Question 107

justice

Answer 107

giving fair equal treatment no matter who it is

Question 108

fidelity

Answer 108

the faithfulness towards a patient, cause, or belief

Question 109

veracity

Answer 109

truth telling; reporting errors that could harm patients, even is no harm has occurred