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PCC1: Campbell > Final Exam Review > Flashcards

Final Exam Review Flashcards

1
Q

What is the patient describing when they say, “I am in so much pain I cannot sleep?”

A

perception

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2
Q

What will the nurse remove once they have removed their goggles?

A

gown

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3
Q

What precaution is used for a microorganism that is transmitted by small, evaporated particles suspended in the air?

A

airborne

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4
Q

What does delegate mean?

A

entrust a task to another person

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5
Q

What does pallor mean?

A

decreased hematocrit

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6
Q

What does 20/30 mean in terms of eyesight?

A

the 20/20 person sees the same at 30 feet

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7
Q

How do you straighten the ear canal of an adult?

A

pull up and back

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8
Q

How do you straighten the ear canal of a child?

A

pull down and back

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9
Q

What mechanism can be utilized to promote venous return?

A

ambulation

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10
Q

Where do you begin lung auscultation?

A

above the clavicle

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11
Q

How often should an artificial eye be cleaned?

A

as needed

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12
Q

What are the six QSEN competencies?

A

PCC, team work and collaboration, EBP, quality improvement, safety, and informatics

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13
Q

Which QSEN competency focuses on providing individualized care and restores an emphasis on personal relationships?
(respect client’s preferences, values, and needs)

A

patient centered care

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14
Q

The nurse provides a bed bath and asks the client how they feel. Which step of the nursing process is this?

A

evaluation

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15
Q

What do nurses evaluate in ADPIE?

A

client outcomes

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16
Q

Which clinical judgement skill causes the nurse to collect, categorize, and clarify data?

A

interpretation

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17
Q

What organization evaluates clinical judgement abilities of new graduate nurses?

A

NCSBN (national council of state boards of nursing) aka NCLEX

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18
Q

Are responsibility, discipline, creativity, and curiosity are key components of the attitudes of critical thinking?

A

yes

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19
Q

What is an emic worldview?

A

intercultural encounter from an insider perspective

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20
Q

What are the standards of professional performance?

A

EDUCATION, ethics, culturally congruent practice, communication, collaboration, leadership, EBP and research, quality of practice, professional practice evaluation, resource utilization, and environmental health

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21
Q

What are the 5 components of the transcultural care model?

A

awareness, knowledge, skill, encounter, and desire

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22
Q

What should be provided toa client who does not speak English to maintain linguistic competency?

A

medically licensed interpreter

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23
Q

what is the ability to obtain,
process, and understand basic health information and services needed to make
appropriate health decisions called?

A

health literacy

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24
Q

What is a client without health insurance at risk for?

A

health disparities

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25
Q

What should a nurse use to build a therapeutic relationship with a client?

A

open-ended question

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26
Q

What is client describing when they state “my chest feels really tight”?

A

quality/character

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27
Q

What describes where pain is, such as deep, superficial, and radiating?

A

location

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28
Q

What is described with “burning, sharp, dull, crushing, looks like…?”

A

character/quality

29
Q

What is described with statements like “0/10 pain,” “soaked 5 sheets?”

A

quantity/ severity

30
Q

What is described as onset, duration, or frequency?

A

timing

31
Q

What is described as when/where symptoms started?

A

setting

32
Q

What is described as factors that make something better or worse?

A

aggravating/ relieving factors

33
Q

What is known as additional symptoms to the primary issue?

A

associated factors

34
Q

What is being described when a client described the effect their condition has on their daily activities?

A

client’s perception

35
Q

Which mode of transmission is person to person, object to person, or fecal to oral?

A

contact

36
Q

Which mode of transmission is spread through sneezing and travels less than 6ft?

A

droplet

37
Q

Which mode of transmission is spread through coughing and sneezing with small suspended particles that travel >6 ft?

A

airborne

38
Q

What PPE is needed for contact precautions?

A

gown and gloves

39
Q

What is required for droplet precautions?

A

surgical mask

40
Q

What PPE is required for airborne infection isolation precautions?

A

particulate respirator (N95) and negative pressure isolation room

41
Q

Which temperature alteration occur when pyrogens trigger the immune system, causing the hypothalamus to raise the set point?

A

pyrexia

42
Q

What are some objective categories to assess during a skin assessment?

A

texture, thickness, edema, turgor, color

43
Q

What should be washed first when giving a bath?

A

face (cleanest to dirtiest)

44
Q

What can be used to assess head for lice?

A

tongue depressor

45
Q

What is example of normal charting for a head?

A

normocephalic, no lumps, no lesions, no tenderness

46
Q

How often should an artificial eye be cleaned, and what should you use to clean it?

A

as needed with soap and water or saline

47
Q

What is clonus?

A

Very strong deep tendon reflex, +4

48
Q

What is the grade for a weak deep tendon reflex?

A

1

49
Q

What grade indicates a strong deep tendon reflex?

A

3

50
Q

What is the graded muscle strength for a client who cannot resist gravity?

A

2

51
Q

Muscle strength grade 5?

A

ROM full

52
Q

The nurse is assessing range of motion in a client who is able to actively achieve full range of motion against full resistance. How will the nurse grade this client’s muscle strength?

A

grade 5

53
Q

What is a full ROM against gravity with some resistance graded as?

A

4

54
Q

What is the graded muscle strength for a client who cannot resist gravity?

A

2

55
Q

What does a positive Romberg test indicate?

A

loss of balance

56
Q

How should the nurse manage the effects of immobility on the respiratory system?

A

teach the client to use an IS (incentive spirometer)

57
Q

How should the nurse manage the effects of immobility on blood flow to the skin?

A

turn the client every 2 hours

58
Q

How may immobility impact the cardiac system? How will the patient present?

A

-activity intolerance
-light headed, dizzy, increased HR, decreased BP

59
Q

Which interventions will the nurse implement to reduce the impact of immobility on a client’s integumentary system?

A

Turn the client every 1-2 hours, maintain a positive fluid balance, and teach the client to shift every 15 minutes

60
Q

The nurse is caring got four clients with immobility from different conditions. Which client should the nurse place in the side-lying position?

A

client with pressure ulcers

61
Q

How far should a client move a cane in front of them?

A

For maximum support when walking, the patient places the cane forward 6-10 inches

62
Q

Which leg should step first when using a cane?

A

The client moves the weaker leg forward to the cane so the body weight is divided between the cane and the stronger leg

63
Q

Which statement will the nurse include when teaching a client to use a walker?

A

” Your walker should be as tall as your wrist.”

64
Q

How should a client move with a walker?

A

When walking the client should step with the affected side, then move the walker, then step with the affected or stronger side.

65
Q

How will the nurse fit crutches to prevent nerve damage?

A

2-3 finger widths from axilla; 15-30 degree elbow angle

66
Q

What kind of breaths are regular wax and wean sleep apnea sounds?

A

Cheyne-Stokes Respirations

67
Q

What kind of breaths are irregular wax and wean sleep apnea sounds?

A

Biot Respirations

68
Q

What kind of respirations are characterized with prolonged expirations with dyspneic episodes?

A

COPD respirations

PCC1: Campbell (5 decks)

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