Healthcare Participant Flashcards
1
Q
What are health care disparities?
A
Preventable differences in health outcomes and access to care that are linked to social, economic, and environmental disadvantages.
2
Q
What are the three major types of health disparities?
A
Access disparities – limited or no access to quality healthcare
Outcome disparities – higher rates of disease or death in certain populations
Treatment disparities – unequal or biased delivery of care
(Access to healthcare, higher death and disease rates, unequal treatment or biases)
3
Q
What factors contribute to poor care in vulnerable populations?
A
Social determinants of health (the non-medical factors that influence a person’s health and well-being.)
Low health literacy
Cultural barriers
Systemic bias and discrimination
Lack of insurance or transportation
Understaffed or underfunded healthcare systems
4
Q
Name five populations considered vulnerable to health disparities.
A
Low-income individuals
Racial and ethnic minorities
Immigrants (especially undocumented)
LGBTQ+ individuals
People with disabilities
5
Q
Why do rural residents (like those in New Mexico) face greater health disparities?
A
Fewer healthcare facilities
Limited transportation
Shortage of providers
Geographic isolation
6
Q
What are key risks faced by immigrants in accessing care?
A
Language barriers
Fear of deportation
Lack of familiarity with the U.S. healthcare system
Poverty and unstable housing
7
Q
How does low health literacy contribute to disparities?
A
Increases medication errors
Lowers use of preventive services
Leads to poor chronic disease management
Results in more frequent hospitalizations
8
Q
What is the PRAPARE tool used for in nursing practice?
A
To assess social determinants of health by collecting data on patients’ assets, risks, and experiences that impact health.
9
Q
How can nurses ensure culturally appropriate education for low-literacy patients?
A
Use plain language
Provide materials in the patient’s preferred language
Use visual aids and the teach-back method
Avoid medical jargon
10
Q
What is an example of a treatment disparity in pain management?
A
Minority patients often receive less pain medication or delayed pain management due to provider bias.
11
Q
How does stigma affect veterans and mental health care?
A
Military culture promotes stoicism; veterans may avoid care due to fear of being judged or misunderstood.
12
Q
What initiative sets national goals to reduce health disparities every 10 years?
A
Healthy People 2030
13
Q
What federal standards guide culturally and linguistically appropriate services in healthcare?
A
CLAS Standards (Culturally and Linguistically Appropriate Services)
14
Q
What communication strategies can nurses use to reduce care disparities?
A
Use professional interpreters
Speak slowly and clearly
Confirm understanding with teach-back
Avoid using family as translators
15
Q
What specific actions can nurses take to reduce disparities in care delivery?
A
Perform thorough cultural and SDOH assessments
Advocate for inclusive policies
Educate using culturally adapted materials
Refer patients to community resources
16
Q
What are the three levels of prevention in healthcare?
A
Primary Prevention – prevents disease before it occurs
Secondary Prevention – detects and treats disease early
Tertiary Prevention – manages disease after diagnosis to prevent complications
17
Q
What is the goal of primary prevention?
A
To promote health and prevent the onset of disease by reducing exposure to risk factors.
18
Q
What are common nursing interventions used in primary prevention?
A
Providing health education
Administering vaccines (e.g., flu, HPV)
Promoting healthy lifestyle habits (e.g., nutrition, exercise)
19
Q
What are specific examples of primary prevention?
A
Immunizations
Teaching safe sex practices
Smoking cessation programs
Stress management workshops
20
Q
What is the focus of secondary prevention?
A
Early detection and prompt intervention to limit disease progression or prevent complications.
21
Q
What are common nursing roles in secondary prevention?
A
Conducting screenings
Monitoring risk factors
Providing early interventions and referrals
22
Q
What are examples of secondary prevention activities?
A
Mammograms for breast cancer
Blood pressure checks for hypertension
Diabetes screenings
Depression screening in adolescents
23
Q
What is the main goal of tertiary prevention?
A
To reduce disability, prevent further complications, and improve quality of life after diagnosis.
24
Q
What are common tertiary prevention strategies nurses use?
A
Providing chronic disease education
Coordinating long-term care
Supporting rehabilitation and therapy
25
What are some specific examples of tertiary prevention?
Stroke rehabilitation
COPD self-management education
Support groups for chronic illness or addiction
Pain management and mobility training
26
How do levels of prevention differ from levels of care?
Levels of prevention refer to when and how disease is addressed (e.g., prevention, screening, management).
Levels of care refer to where care is provided (e.g., clinic, hospital, home).
27
What does BADL stand for?
Basic Activities of Daily Living – essential self-care tasks required for day-to-day physical functioning.
28
What does IADL stand for?
Instrumental Activities of Daily Living – more complex skills needed to live independently in the community.
29
What are the key differences between BADLs and IADLs in terms of complexity?
BADLs require basic physical ability.
IADLs require higher-level cognitive and physical function.
30
Which type of activity typically declines first in cognitive impairment or dementia?
IADLs – such as managing finances or medications.
31
Which type of activity often declines first in physical frailty or end-stage illness?
BADLs – such as bathing and toileting.
32
What are the six main examples of BADLs?
Bathing
Dressing
Toileting
Feeding/Eating
Continence
Transferring (e.g., bed to chair)
33
What are the common examples of IADLs?
Managing money
Using transportation
Shopping for groceries
Preparing meals
Taking medications
Doing laundry
Housekeeping
Using the phone
34
What clinical tool is used to assess BADLs?
Katz Index of Independence in ADLs
35
What clinical tool is used to assess IADLs?
Lawton IADL Scale
36
Who typically uses the Katz Index and Lawton Scale in practice?
Nurses, occupational therapists, and social workers use these tools for care planning and discharge decisions.
37
What is the main purpose of assessing BADLs?
To determine if a patient can perform basic self-care or requires personal assistance.
38
What is the main purpose of assessing IADLs?
To evaluate if a person can live independently or needs community/home-based support.
39
What is the main purpose of a functional assessment in nursing?
To evaluate a person’s ability to perform essential daily tasks and guide care planning for independence, safety, and rehabilitation.
40
What populations commonly require functional assessments?
Older adults (frailty, cognitive decline, chronic conditions)
## Footnote
Children (developmental concerns)
All ages when there are changes in ability to perform daily activities.
41
What does the Katz Index of Independence in ADLs measure?
Basic self-care tasks such as bathing, dressing, toileting, feeding, continence, and transferring.
42
Which population is the Katz Index primarily used for?
Older adults, post-stroke patients, or those recovering from surgery.
43
What does the Lawton IADL Scale assess?
Instrumental activities of daily living, such as managing finances, using the phone, shopping, meal prep, and medication management.
44
Who is the Lawton IADL Scale most appropriate for?
Older adults, especially those with early cognitive decline or dementia.
45
What is the Barthel Index used to assess?
Mobility and physical function related to basic ADLs.
46
What is the Functional Independence Measure (FIM) used for?
Evaluating physical and cognitive disabilities to track functional independence—used across all age groups, especially in rehab.
47
Which tool is used to assess instrumental ADLs specifically in older adults?
FAQ (Functional Activities Questionnaire)
48
What does the MMSE (Mini-Mental State Exam) screen for?
Cognitive impairment, often used in older adults.
49
What functional assessment tool is used for children with developmental delays?
NGAGED
50
What tool is used to assess functional status in nursing home residents?
Minimum Data Set (MDS)
51
What tool measures frailty and risk of decline in older adults?
Edmonton Frailty Tool
52
What kind of tools are performance-based assessments?
Tools where the nurse observes the patient completing tasks for an objective measure of function.
53
What are self-report tools, and what is a limitation of them?
Patients rate their own ability, which is quick but may be biased or inaccurate.
54
What is the primary goal of evidence-based practice in nursing?
To integrate the best available evidence, clinical expertise, and patient preferences to provide safe, high-quality care and improve patient outcomes.
55
How does EBP improve patient outcomes?
It leads to better safety, reduced complications, fewer errors, and more effective interventions based on proven research.
56
How does EBP help reduce health disparities?
By identifying gaps in care and guiding the use of tailored interventions that meet the needs of underserved or at-risk populations.
57
How does EBP support clinical decision-making?
It provides a scientific foundation for decisions while allowing care to be personalized to the patient’s values, culture, and situation.
58
What is one way EBP promotes health equity?
It supports standardized, unbiased care and reduces disparities in diagnosis and treatment.
59
What types of nursing outcomes does EBP help measure and improve?
Nursing-sensitive outcomes like fall rates, pressure ulcers, infection rates, and pain management effectiveness.
60
What national benchmark database is linked to EBP in nursing?
The National Database of Nursing Quality Indicators (NDNQI).
61
How does EBP enhance holistic and culturally appropriate care?
It combines scientific evidence with cultural competence, compassion, and patient-centered communication.
62
How does EBP support professional development in nursing?
It encourages lifelong learning, critical thinking, and evidence-informed advocacy.
63
What role does EBP play in healthcare policy and advocacy?
It equips nurses to support and advocate for data-driven, equitable, and effective policies and practices.
64
What is the main focus of public health nursing?
Promoting health and preventing disease at the population level by assessing needs, shaping policy, and ensuring access to care.
65
What are the three core public health functions?
Assessment – Monitoring health status
Policy Development – Creating supportive health policies
Assurance – Ensuring services are accessible and effective.
66
What are common roles of a public health nurse?
Community outreach
Health education
Case management
Immunizations and screenings
Disease surveillance
Policy advocacy.
67
What is the focus of community health nursing?
Addressing the specific needs of local populations, especially underserved groups, by promoting health equity and community collaboration.
68
What are key roles of a community health nurse?
Conducting health assessments
Designing tailored health programs
Partnering with communities
Providing culturally and linguistically appropriate care
Acting as a liaison between communities and healthcare systems.
69
What are the nursing roles in home health care?
Promote recovery at home
Educate patients and families
Monitor and manage health equipment
Prevent complications after illness or surgery.
70
What is the focus of hospice nursing in the community?
Providing holistic, palliative, end-of-life care that supports both patients and families.
71
What roles do school nurses play in population health?
Track immunizations and health screenings
Manage chronic conditions (e.g., asthma, diabetes)
Provide acute care
Promote health education
Operate school-based clinics.
72
What is the role of an occupational health nurse?
Prevent workplace injuries
Implement wellness and safety programs
Assess environmental hazards
Educate employees on health risks.
73
What does an environmental health nurse do?
Advocate for safe air, water, and housing
Educate on environmental risks
Promote policies to reduce exposure to toxins.
74
What are the responsibilities of a global health nurse?
Promote health equity worldwide
Participate in global partnerships
Provide culturally competent care internationally
Respond to global health threats like pandemics.
75
What is the focus of case management in community nursing?
Coordinating care for patients with complex needs, especially across transitions like hospital discharge.
76
What are the key duties of a community nurse case manager?
Assess patient/caregiver needs
Coordinate services and referrals
Create long-term care plans
Prevent hospital readmissions.
77
What is the definition of population health?
Population health refers to the health outcomes of a defined group of people, including the distribution of those outcomes and the determinants that influence them.
78
What are the key focuses of population health?
Prevention and wellness
Reducing health disparities
Improving outcomes across populations
Addressing social determinants of health
79
What are some key attributes of population health?
Encompasses both acute and chronic conditions
Involves collaboration across sectors
Considers factors like income, education, healthcare access, environment, and community context
80
What is the definition of health equity?
Health equity is the state in which everyone has a fair and just opportunity to achieve their highest level of health, by addressing avoidable inequalities and eliminating health disparities.
81
What are the essential components of health equity?
Valuing all individuals equally
Addressing social, economic, and environmental disadvantages
Ensuring fair access to healthcare and resources
82
How is health equity related to social justice?
Health equity is a core principle of social justice, requiring system-level changes to remove barriers and promote fairness in healthcare delivery.
83
What dietary practice is common in Judaism?
Avoid pork and shellfish.
Do not mix meat and dairy.
Food must be kosher (prepared under religious guidelines).
84
What should nurses consider for Jewish patients regarding diet?
Provide kosher meals.
Avoid gelatin-based meds.
Respect Sabbath restrictions for meals or procedures.
85
What foods are prohibited in Islam?
Pork and pork products.
Alcohol.
Any food not certified halal.
Gelatin and meat not slaughtered according to halal laws.
86
What religious observance in Islam affects diet and medication timing?
Ramadan – a month-long fast from sunrise to sunset, requiring med adjustments and hydration planning.
87
What is a typical Hindu dietary practice?
Avoid beef (sacred).
Many are vegetarian or lacto-vegetarian (no eggs, meat, or fish).
88
How should nurses accommodate Hindu dietary needs?
Offer vegetarian meals without beef or pork.
Allow fasting, if requested.
Respect individual and regional variation.
89
What are typical Buddhist dietary preferences?
Many follow a vegetarian diet.
Some may eat fish or seafood depending on sect.
Motivated by beliefs in nonviolence and karma.
90
What foods or substances do Mormons (LDS) avoid?
Alcohol, coffee, tea, and recreational drugs.
Some also avoid caffeinated drinks.
91
What accommodations should be made for Mormon patients?
Provide non-caffeinated options.
Ensure medications do not contain alcohol.
92
What are common dietary restrictions for Seventh-Day Adventists?
Often vegetarian.
Avoid pork, shellfish, and caffeine.
93
What should nurses do when admitting patients with potential religious dietary needs?
Ask directly about religious or cultural dietary restrictions.
Document preferences in the care plan.
Coordinate with dietary and spiritual care teams.
94
What is meant by 'family as context' in nursing care?
The patient is the primary focus, and the family is assessed only in terms of how they influence or support the patient’s health.
95
What is the nursing goal when treating the family as context?
To evaluate how the family affects the individual’s care, such as their support system, home environment, or caregiving ability.
96
What is an example of treating the family as context?
Asking the parent of a child with asthma about home triggers like smoking or pets.
97
What is meant by 'family as patient'?
The entire family is the unit of care, with attention given to all family members’ health, support needs, and functioning.
98
What is the nursing focus when treating the family as patient?
To provide health education, support, and interventions to all family members, especially when one member’s illness impacts the whole family.
99
What is an example of treating the family as patient?
Providing emotional and logistical support to the parents and siblings of a child with cancer.
100
What does it mean to view the family as a system?
Recognizing the family as an interconnected whole, where changes in one member affect all others through relationships and communication.
101
What is the nursing goal in the 'family as system' model?
To provide holistic, family-wide care by understanding and supporting the mutual influences among family members.
102
What is an example of the family as a system?
Involving both spouses in care decisions for one partner’s chronic illness, acknowledging shifts in roles and emotional dynamics.
103
What is the purpose of the Denver II Developmental Screening Tool?
To screen children from birth to 6 years old for potential developmental delays—not to diagnose.
104
Is the Denver II a diagnostic tool?
No—it is a screening tool used to identify children who may need further evaluation.
105
What are the four domains assessed by the Denver II tool?
Personal-Social, Fine Motor-Adaptive, Language, Gross Motor.
106
What does the Personal-Social domain assess?
A child’s ability to interact with others and perform tasks independently (e.g., playing, feeding self).
107
What does the Fine Motor-Adaptive domain assess?
Hand-eye coordination and object manipulation (e.g., stacking blocks, drawing shapes).
108
What does the Language domain assess?
Both receptive (understanding) and expressive (speaking) communication skills.
109
What does the Gross Motor domain assess?
Large muscle activities like sitting, walking, running, and jumping.
110
How is the Denver II test administered?
Through a combination of direct observation and caregiver interview by a trained examiner.
111
How are tasks scored on the Denver II?
Passed, Failed, Refused, No Opportunity (child hasn’t had the chance to try it).
112
What happens if a child does not meet expected milestones on the Denver II?
The child may be referred to specialists or early intervention programs for further assessment and support.
113
Who commonly uses the Denver II tool?
Pediatricians, Public health nurses, Early childhood educators.
114
When is the Denver II typically used?
During well-child visits or routine early childhood developmental screenings.
115
What are determinants of health?
Factors that influence a person’s health status, including both medical and non-medical elements like genetics, behavior, environment, and social conditions.
116
What are social determinants of health (SDOH)?
Conditions in which people live, work, learn, and age that affect a wide range of health risks and outcomes.
117
What are the five key domains of social determinants of health?
Economic Stability, Education Access and Quality, Health Care Access and Quality, Neighborhood and Built Environment, Social and Community Context.
118
What are examples of factors under Economic Stability?
Income, Employment, Food insecurity, Housing instability.
119
What influences are included under Education Access and Quality?
Early childhood education, Literacy, High school and college graduation rates.
120
What does Health Care Access and Quality include?
Insurance status, Proximity and availability of providers, Health literacy.
121
What factors are included in the Neighborhood and Built Environment domain?
Safe housing, Transportation access, Exposure to pollution, Availability of healthy food.
122
What influences are part of the Social and Community Context?
Discrimination, Social support, Community engagement and cohesion.
123
What are examples of avoidable health determinants?
Poverty, Unsafe housing, Low educational attainment, Food insecurity.
124
What are examples of unavoidable health determinants?
Genetics, Age, Family history of illness.
125
Why are many health disparities considered unethical?
Because they are avoidable, unjust, and often result from social inequities that can be addressed with targeted interventions.
126
What is biased clinical decision making?
When a healthcare provider’s decisions are influenced by personal, societal, or systemic biases, leading to unequal or inaccurate care.
127
What are some common causes of clinical bias?
Patient characteristics (race, SES, gender), provider factors (experience, specialty), system pressures (time limits, stress, unfamiliarity).
128
What is implicit bias in healthcare?
Unconscious attitudes or stereotypes that affect a provider’s perceptions and actions without intentional awareness.
129
What is stereotyping in clinical settings?
Applying generalized group traits to individual patients, which can result in misdiagnosis or inadequate treatment.
130
How do mental shortcuts (heuristics) lead to bias?
Providers may rely on quick judgments during stressful or uncertain situations, leading to assumptions rather than thorough assessments.
131
What are some consequences of biased clinical decision making?
Delayed diagnosis, inappropriate treatment, health disparities, patient mistrust, under- or over-treatment.
132
What is the impact of discrimination in healthcare?
Patients may receive less effective care, feel dismissed, or be reluctant to seek help, especially in marginalized populations.
133
How can misinformation contribute to bias?
Providers may base care on false beliefs or outdated data, such as myths about pain tolerance by race or gender.
134
What are strategies to reduce bias in clinical practice?
Implicit bias training, use of standardized care protocols, practicing cultural humility, encouraging diverse staff and inclusive communication.
135
Why is reducing bias important for health equity?
Because bias perpetuates unjust disparities; reducing it promotes fair treatment, trust, and better outcomes for all patients.
136
What is a mass casualty incident (MCI)?
An event involving multiple casualties that overwhelms the local healthcare system’s ability to respond effectively.
137
What are common causes of MCIs?
Human-made: Terrorism, shootings, explosions
Natural disasters: Earthquakes, wildfires, hurricanes
138
What is the purpose of MCI triage?
To prioritize treatment when resources are limited, aiming to save the greatest number of lives.
139
What does a red triage tag indicate in an MCI?
The patient needs immediate attention for life-threatening injuries.
140
What does a yellow triage tag represent?
The patient has serious injuries but can wait for care (delayed treatment).
141
What does a green triage tag mean?
The person has minor injuries and is considered 'walking wounded.'
142
What does a black triage tag indicate?
The individual is deceased or unsalvageable due to the severity of injuries.
143
What must healthcare workers know during an MCI?
The facility’s emergency plan
Their specific role
How to respond during drills
How to handle surge capacity
144
What organizations assist overwhelmed local systems during MCIs?
FEMA (Federal Emergency Management Agency)
NDMS (National Disaster Medical System)
CERTs (Community Emergency Response Teams)
145
What are key priorities during MCI management?
Clear interagency communication
Defined roles and responsibilities
Rapid triage and treatment
Decontamination if hazardous materials are involved
146
How does the Western (biomedical) model define illness?
Illness is seen as a result of biological dysfunction, such as pathogens, genetics, or physical abnormalities.
147
What is the Western definition of health?
Health is typically viewed as the absence of disease.
148
What type of treatments are emphasized in Western healthcare?
Cure-oriented treatments
## Footnote
Use of medications, surgery, and diagnostics; Focus on measurable outcomes.
149
What is the typical role of the provider in Western healthcare?
Providers are seen as experts or authorities who guide patients based on evidence-based protocols.
150
How is the patient typically expected to behave in Western care?
Patients are expected to openly describe symptoms and actively participate in decision-making.
151
How does the Non-Western model define health?
Health is seen as balance and harmony between the mind, body, spirit, and community.
152
What are common causes of illness in Non-Western perspectives?
Spiritual or supernatural causes
## Footnote
Social disharmony; Energy imbalances or natural forces.
153
What kinds of treatments are used in Non-Western models?
Spiritual healing
## Footnote
Herbal remedies; Rituals and energy-based practices; Community or family support.
154
What is an example of a Non-Western medical system?
Ayurvedic medicine from India, which focuses on balancing five elements (earth, water, fire, air, ether).
155
How might Non-Western cultures express emotional distress?
Through somatic symptoms like stomach pain or fatigue, rather than directly discussing emotions.
156
What are “cultural idioms of distress”?
Culture-specific ways of expressing illness, such as:
## Footnote
Ataque de nervios (Latin America); Neurasthenia (China).
157
What is a key difference in decision-making between Western and Non-Western cultures?
Western: Emphasizes individual autonomy
## Footnote
Non-Western: Involves family or community decision-making.
158
What should nurses do to respect both models of care?
Practice cultural humility
## Footnote
Validate and respect diverse health beliefs; Adapt communication and care to align with the patient’s cultural values.
159
What is the primary goal of global health?
To improve health equity and outcomes worldwide through international collaboration.
160
How has globalization impacted the spread of disease?
Increased international travel and urban crowding have led to faster global spread of diseases like COVID-19, Ebola, Zika, and SARS.
161
What are some global health priorities affected by globalization?
Equitable vaccine access, climate change and pollution, clean water and sanitation, prevention of non-communicable diseases (e.g., heart disease, diabetes).
162
How does globalization contribute to the rise of non-communicable diseases (NCDs)?
Through the spread of globalized behaviors such as poor diet, sedentary lifestyle, and tobacco use.
163
What are some healthcare inequities worsened by globalization?
Unequal access to care and medications, healthcare worker shortages, cost barriers in both developed and developing nations.
164
What role do international organizations play in global health?
Agencies like the WHO and FEMA help coordinate emergency responses, distribute supplies, and promote health equity.
165
How has technology been influenced by globalization in healthcare?
There’s been a rise in telehealth, remote monitoring, and digital health education, enhancing international communication but exposing the digital divide.
166
What must nurses understand in a globalized health environment?
How global trends affect local health, the importance of culturally competent care, the need to advocate for health equity globally, how to respond to international health threats.
167
What defines a public health emergency?
An urgent situation requiring immediate public health action to prevent widespread illness, injury, or death, potentially overwhelming local resources.
168
What is a local public health emergency?
An event manageable by local resources, such as a small outbreak or minor flood, often addressed by local health departments.
169
What is a state or regional public health emergency?
A situation that exceeds local capacity and requires assistance from neighboring jurisdictions or state government (e.g., wildfires, regional chemical spills).
170
What characterizes a national-level public health emergency?
Involves multiple states or national infrastructure, triggering a federal response (e.g., COVID-19, Hurricane Katrina, 9/11 attacks).
171
What is a Public Health Emergency of International Concern (PHEIC)?
A global threat recognized by WHO requiring international coordination, such as Ebola, SARS, or COVID-19.
172
What factors determine the magnitude of a public health emergency?
Number of people affected
Rate of spread or escalation
Availability of healthcare resources
Infrastructure damage
Disruption to public services
173
What tool helps communities evaluate and plan for large-scale emergencies?
THIRA – Threat and Hazard Identification and Risk Assessment
174
What is the Stakeholder Preparedness Review (SPR)?
A tool used to assess readiness based on FEMA’s 32 core capabilities, reviewed every two years to improve response planning.
175
What are key indicators of magnitude for infectious outbreaks?
Case count
Geographic spread
Need for vaccines or treatment resources
176
How is the magnitude of a natural disaster assessed?
Death toll
Extent of damage to infrastructure
Number of displaced individuals
177
What makes bioterrorism a high-magnitude emergency?
The use of agents like anthrax or smallpox, and their potential for widespread exposure and panic.
178
What is the purpose of the QSEN initiative?
To prepare nurses with the knowledge, skills, and attitudes (KSAs) needed to improve quality and safety in healthcare systems.
179
What is the QSEN competency for recognizing the patient as a partner in care?
Patient-Centered Care – Respect the patient's preferences, values, and active participation in decisions.
180
What QSEN competency emphasizes interprofessional communication and respect?
Teamwork and Collaboration – Work effectively with healthcare teams, using open communication and shared decisions.
181
Which QSEN competency involves using current research and clinical expertise in care?
Evidence-Based Practice (EBP) – Combine evidence, clinician judgment, and patient values.
182
Which competency focuses on using data to improve care processes?
Quality Improvement (QI) – Continuously assess outcomes and implement changes to improve performance.
183
What QSEN competency focuses on reducing harm to patients and providers?
Safety – Prevent errors and minimize risks by improving both individual and system performance.
184
Which QSEN domain requires nurses to use technology effectively?
Informatics – Leverage digital tools to communicate, manage knowledge, and enhance decision-making.
185
What is the central conflict of Erikson's stage in infancy (birth–1 year)?
Trust vs. Mistrust – The infant learns to trust caregivers, which forms the foundation for hope and spiritual comfort through attachment.
186
How does spiritual development manifest in infancy?
Through trust and comfort in nurturing relationships, forming the basis for spiritual attachment and safety.
187
What is Erikson’s psychosocial stage in toddlerhood (1–3 years)?
Autonomy vs. Shame/Doubt – The child seeks independence; success develops willpower and self-trust.
188
How is spirituality expressed during toddlerhood?
Through curiosity and exploration, which helps build early self-concept and identity, including spiritual self-awareness.
189
What is Erikson’s stage in early childhood (3–6 years)?
Initiative vs. Guilt – Children assert themselves more; successful resolution leads to a sense of purpose.
190
What spiritual behaviors are common in preschoolers?
Asking existential questions and developing moral reasoning related to right and wrong, and basic beliefs about life and death.
191
What is the psychosocial task of school-age children (6–12 years) in Erikson’s model?
Industry vs. Inferiority – Developing a sense of competence through achievement and social interaction.
192
What characterizes spiritual development in school-age children?
Formation of concrete religious beliefs and an understanding of right, wrong, and divine authority.
193
What is Erikson’s psychosocial stage during adolescence (12–18 years)?
Identity vs. Role Confusion – Focused on developing a sense of self, beliefs, and future direction.
194
How is spirituality explored during adolescence?
Adolescents question beliefs and seek identity and personal meaning, leading to evolving spiritual values.
195
What is Erikson’s conflict for young adults (18–40 years)?
Intimacy vs. Isolation – Focus on building deep relationships; success leads to the virtue of love.
196
How does spirituality deepen in young adulthood?
By finding meaning in relationships, life goals, and personal values, often integrating spirituality with lifestyle.
197
What is the psychosocial task of middle adulthood (40–65 years)?
Generativity vs. Stagnation – Involves contributing to society and mentoring; success results in care.
198
How is spirituality often expressed in middle adulthood?
As a coping strategy, a source of meaning during life transitions, and a guide for legacy and purpose.
199
What is Erikson’s final psychosocial stage (65+ years)?
Ego Integrity vs. Despair – Reflecting on life to find meaning and satisfaction leads to wisdom.
200
How does spiritual development appear in older adults?
Through life review, peace-seeking, and preparation for end-of-life, often involving deeper connection to spirituality or faith.
201
What causes Down Syndrome?
It is caused by Trisomy 21, an extra copy of chromosome 21.
202
What are common physical features of Down Syndrome?
Flat facial profile
Upward slanting eyes
Protruding tongue
Short stature
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What is the cognitive impact of Down Syndrome?
Mild to moderate intellectual disability
Developmental delays
Risk for early-onset Alzheimer’s disease
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What are major medical concerns for children with Down Syndrome?
Congenital heart defects
Vision and hearing impairments
Increased risk of leukemia
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What interventions improve outcomes for individuals with Down Syndrome?
Early intervention therapies
Inclusive education
Ongoing medical care
Strong family and community support
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What is the average life expectancy for someone with Down Syndrome?
Around 60 years, with appropriate medical and supportive care.
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What is developmental delay?
A significant lag in physical, cognitive, behavioral, emotional, or social development compared to expected milestones.
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What developmental domains can be affected by developmental delay?
Gross and fine motor skills, language and speech, cognitive abilities, social-emotional development, and adaptive/self-help skills.
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What are early warning signs of developmental delay?
Poor eye contact, delayed or absent speech, difficulty walking or coordinating movements, frequent tantrums, and lack of social interaction.
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Why is consistency important in managing behavior in children with developmental delays?
Consistent routines provide predictability and security, which help reduce anxiety and improve behavior.
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What are examples of behavior management strategies for children with developmental delays?
Positive reinforcement, redirection, clear communication, calm environments, structured routines, and individualized approaches.
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How does positive reinforcement help with behavior management?
It encourages repetition of desired behaviors through praise, rewards, or other incentives.
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What is redirection and why is it useful in behavior management?
Shifting the child’s attention from inappropriate to acceptable behavior; helps de-escalate situations without punishment.
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How can nurses support children with developmental delays behaviorally?
By assessing milestones, educating caregivers, maintaining calm settings, and coordinating with therapists and specialists.
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Why are children with developmental delays at increased risk for injury?
They may have limited hazard awareness, poor communication, and impaired judgment or mobility.
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What are common safety risks for children with developmental delays?
Falls, choking, burns, drowning, wandering/elopement, and medication errors.
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What environmental safety measures can help prevent injury?
Safety locks, stair gates, alarms, secured furniture, and removal of small or hazardous objects.
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How can communication tools enhance safety for nonverbal children?
Picture boards or assistive tech help them express needs, reducing frustration and risk of unsafe behaviors.
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What inpatient safety precautions are used for children with developmental delays?
Close monitoring, elopement precautions, sensory-safe environments, de-escalation strategies, and minimizing restraints.
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How should nurses approach medication safety for these children?
Verify all medications with caregivers, use visuals for explanation, and monitor closely for behavior-based adverse reactions.
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What should nurses teach families about home safety?
Home adaptations (e.g., locks, alarms), emergency planning, and the importance of supervision and routine.
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What role does the nurse play in promoting safety for children with developmental delays?
Assess risks, communicate individualized plans, coordinate care, and educate families and the healthcare team.
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What is the purpose of a patient-centered interview?
To gather subjective data, understand the patient’s experiences, and establish a therapeutic relationship built on empathy and trust.
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What is the first phase of a patient-centered interview and what does it involve?
The orientation phase; it involves greeting the patient, introducing yourself and your role, explaining the interview purpose, ensuring privacy, and beginning to build trust.
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What key actions help establish trust in the orientation phase?
A warm greeting, clear explanation of your role and the interview process, ensuring a private and comfortable environment.
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What is the second phase of the patient-centered interview and what is its purpose?
The working phase; it focuses on gathering detailed health information using open-ended questions and active listening.
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What techniques are used during the working phase to gather information?
Open-ended questions, reflection, clarification, summarizing, observing nonverbal cues, and possibly including input from family or support persons.
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What kind of questions should the nurse use during the working phase and why?
Open-ended questions, because they encourage storytelling, uncover patient concerns, and lead to richer, more complete data.
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What is the third and final phase of the patient-centered interview and what happens in it?
The termination phase; the nurse summarizes the conversation, allows the patient to ask questions, explains next steps, and thanks the patient.
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Why is summarizing important in the termination phase?
It ensures mutual understanding, validates the patient’s input, and helps transition to the next phase of care.
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What communication tools are commonly used throughout the interview?
Open-ended questions, silence, clarification, restating, reflection, and reading nonverbal cues like eye contact and posture.
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Why is active listening essential during the patient-centered interview?
It fosters trust, demonstrates empathy, reduces miscommunication, and ensures the nurse fully understands the patient’s perspective.
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What are advance directives?
Legal documents that communicate a patient’s healthcare preferences in case they become unable to make decisions themselves.
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What is the primary purpose of advance directives in healthcare?
To ensure care is aligned with the patient's values, cultural beliefs, spiritual practices, and end-of-life preferences.
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How do advance directives support person-centered care?
They respect the patient's autonomy by honoring their decisions regarding treatment and care preferences.
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What are the nursing responsibilities regarding advance directives?
Nurses must uphold and honor advance directives, ensure all team members are informed, and involve healthcare proxies when needed.
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What is a healthcare proxy?
A person legally designated to make medical decisions on behalf of the patient if the patient is incapacitated.
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What should nurses do when a healthcare proxy is identified?
Include the proxy in discussions, ensure their understanding of the patient’s wishes, and involve them in decision-making.
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What are the common types of advance directive documents?
Living will, durable power of attorney for healthcare, and Do Not Resuscitate (DNR) orders.
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What is the purpose of a living will?
To specify what types of medical treatments a patient wants or does not want in certain medical situations.
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What is a durable power of attorney for healthcare?
A legal document that designates a healthcare proxy to make decisions if the patient cannot do so.
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What is a Do Not Resuscitate (DNR) order?
A directive instructing healthcare providers not to perform CPR if the patient’s breathing or heart stops.
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In what clinical situations are advance directives especially important?
During terminal illness, emergencies, major surgeries, or in palliative/hospice care settings.
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How should nurses approach communication about advance directives?
Use clear, simple language, educate the patient and family, and be sensitive to cultural or spiritual beliefs around end-of-life decisions.
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At what age does a baby typically lift their head briefly when prone?
Around 1 month old.
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When can a baby hold their head up 90° in prone and when supported?
Around 2–3 months old.
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At what age should head lag disappear when pulling to a sit?
By 4 months.
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When do most babies begin to sit independently and roll over both ways?
Around 6 months.
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When does a baby typically begin pulling to stand and cruising along furniture?
Around 9 months.
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At what age can a child usually stand alone and take first steps?
Around 12 months.
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What gross motor skills are expected by 18 months?
Walks independently, climbs stairs with help, may run stiffly.
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What gross motor milestones are typical by 24 months?
Runs well, climbs onto furniture, kicks a ball, jumps in place.
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What fine motor skill appears around 2 months?
Regards hands and bats at hanging objects.
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When does a baby start reaching with both hands to grasp objects?
Around 4 months.
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When does hand-to-hand object transfer typically develop?
Around 6 months.
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At what age does the pincer grasp begin to develop?
Around 9 months.
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What fine motor skills are seen at 12 months?
Intentional object release and banging two objects together.
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What are typical fine motor milestones by 18 months?
Stacks 2–3 blocks, turns 2–3 pages in a book.
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What fine motor skills should be present by 24 months?
Builds a tower of 4–6 blocks, turns pages one at a time, begins scribbling.
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Why is early identification of developmental delays important for families to understand?
Early recognition allows for timely intervention, which can significantly improve outcomes in development and learning.
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What should families understand about functional vs. chronological age?
Interventions should be based on the child’s functional abilities, not just their actual age.
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What communication strategies should nurses use when teaching families?
Use clear, plain language, visuals, modeling, and culturally sensitive communication.
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Why is involving families in planning important?
It ensures care is personalized, promotes family engagement, and supports consistency across home and clinical settings.
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Why is it helpful to focus on a child’s strengths during family teaching?
Emphasizing strengths builds confidence, encourages participation, and fosters a positive outlook.
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What is a key focus for preschool children with developmental delays?
Promoting language, motor skills, emotional regulation, and play-based learning.
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What strategies can help preschoolers manage transitions and expectations?
Visual schedules and social stories.
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How can families encourage social development in preschoolers?
Through structured play, turn-taking, and expressive activities like drawing or storytelling.
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What is an important educational support for preschool-aged children with delays?
Early intervention services and special education programs through public preschool.
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What areas of development are most important for school-age children with delays?
Academic skills, peer relationships, and independence in self-care.
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How can families support academic success for children with delays?
By working with schools on accommodations, attending IEP meetings, and promoting adaptive tools.
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What should families watch for in school-age children socially?
Signs of bullying or exclusion, and help children develop advocacy and communication skills.
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How can families reinforce daily living skills at this age?
Practice routines like toothbrushing, dressing, and organizing school materials.
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What developmental goals are important for adolescents with developmental delays?
Developing independence, identity, social-emotional skills, and planning for adulthood.
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What should families teach teens with delays about relationships and safety?
Information about consent, sexuality, personal boundaries, and appropriate social behavior.
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How can families prepare teens for adulthood?
Collaborate with schools on transition planning, promote life skills, and explore future education or employment.
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What legal or planning topics might be necessary during adolescence?
Guardianship, healthcare decision-making, and developing self-advocacy skills.
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What mental health support should be considered for teens with delays?
Encourage open dialogue, coping strategies, and access to counseling or mental health services as needed.
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What is a core diagnostic feature of Autism Spectrum Disorder related to communication?
Impaired social communication, which can range from nonverbal presentation to atypical verbal patterns.
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What is echolalia and how is it seen in children with autism?
Echolalia is the repetition of words or phrases spoken by others, often used as a form of communication in autism.
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How might a child with autism speak differently in tone or pitch?
They may speak in a monotone voice or use unusual intonation patterns.
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Why do children with autism often struggle with jokes or sarcasm?
They tend to interpret language literally and may not understand figurative speech.
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What is an example of pronoun confusion in autism?
Using 'you' instead of 'I' when referring to themselves.
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How can a child with autism have strong vocabulary yet struggle socially?
They may have advanced vocabulary in areas of interest but find it difficult to initiate or sustain reciprocal conversations.
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What are common nonverbal communication challenges in autism?
Limited eye contact, inappropriate facial expressions, minimal gestures, and trouble interpreting others' body language.
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What are repetitive behaviors in autism often used for?
Self-regulation and coping, especially in response to stress or overstimulation.
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How can sensory sensitivity affect children with autism?
They may be hypersensitive or hyposensitive to sensory input like light, noise, or texture, affecting their behavior and comfort.
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What sensory tools can help children with autism cope?
Noise-canceling headphones, weighted blankets, fidget toys, and other calming items.
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Why is routine important for children with autism?
Predictable routines reduce anxiety and help them feel secure.
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How can visual supports help children with autism manage transitions?
Tools like visual schedules, timers, and calendars provide structure and help prepare for change.
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What emotional regulation strategies are helpful for children with autism?
Social stories, modeling calming behaviors, deep breathing, and occupational therapy techniques.
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What are key nursing strategies to support coping in autistic children?
Maintain structure, minimize sensory overload, use visual communication aids, and respect coping behaviors unless harmful.
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What is the gold standard for overcoming language barriers in healthcare?
The use of qualified medical interpreters (in-person, phone, or video).
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Why should nurses avoid using children or family members as interpreters?
It poses risks of miscommunication, breaches confidentiality, and may be inappropriate for sensitive topics.
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What federal standards require the provision of free language assistance services?
CLAS Standards (Culturally and Linguistically Appropriate Services) and ACA Section 1557.
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What do CLAS standards promote regarding language access?
Respectful, effective communication across languages using trained interpreters and translated materials.
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How should a nurse speak when using a medical interpreter?
Directly to the patient using first-person language (e.g., “How are you feeling?”).
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Where should the interpreter be positioned during communication?
Slightly behind or to the side of the patient to maintain direct nurse-patient eye contact.
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What communication techniques should nurses use when language barriers exist?
Short, simple phrases; avoid idioms, slang, humor, and medical jargon.
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What tools can support patient understanding when language barriers exist?
Visual aids such as diagrams, models, pictures, and translated written materials.
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What method should nurses use to verify patient understanding?
The teach-back method (e.g., “Can you explain how you’ll take this medication?”).
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At what reading level should written materials be provided to patients with LEP?
At a 6th–8th grade reading level.
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What cultural considerations should be kept in mind during cross-language communication?
Eye contact norms, gender roles (may need same-gender interpreter), and decision-making customs.
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What documentation should be included when an interpreter is used?
Type of interpreter used (e.g., phone, in-person), date/time, and interpreter ID if required.
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What laws mandate access to language services in healthcare settings?
Title VI of the Civil Rights Act and Section 1557 of the Affordable Care Act.
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What is the nurse’s role in overcoming language barriers?
Advocate for interpreter use, identify communication barriers, educate the care team, and ensure clear patient understanding.
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What is the key mindset a nurse should adopt when taking an ethnic history?
Cultural humility—approach with openness, avoid assumptions, and respect individual differences.
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Why is trust important in taking an ethnic history?
Trust encourages honest sharing of cultural beliefs, health practices, and identity, improving care planning.
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How should a nurse initiate questions about ethnic background?
Use a conversational tone with open-ended questions, rather than rigid or checklist-style questioning.
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What should be included when assessing a patient's cultural identity?
Ethnic/racial background, preferred language, immigration history, and cultural or community affiliation.
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What are some health-related traditions to ask about when taking an ethnic history?
Beliefs about illness causes, traditional healers, complementary therapies, and attitudes toward disability or death.
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What should nurses assess regarding family roles in cultural history-taking?
Family decision-making patterns, caregiving expectations, and influence of elders or extended family.
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What communication aspects should be explored during an ethnic history?
Verbal/nonverbal preferences, eye contact norms, preferred language, and interpreter needs.
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Why is it important to ask about spirituality or religion in ethnic history-taking?
Religious beliefs may influence healing, treatment choices, dietary practices, and end-of-life decisions.
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What dietary aspects should be included in a cultural assessment?
Culturally significant foods, restrictions, fasting practices, and use of herbal remedies.
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What workforce and socioeconomic factors might influence ethnic history?
Employment status, financial stress, legal/immigration concerns, and barriers to accessing healthcare.
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What assessment tools can nurses use to explore ethnic and cultural backgrounds?
Kleinman’s Explanatory Model, RESPECT Model, FICA, and HOPE tools.
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Give an example of an open-ended question to explore cultural practices.
“Can you tell me about any traditional health practices that are important to you?”
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How should nurses use the information gained from an ethnic history?
Incorporate culturally appropriate preferences into care plans and document for continuity of care.
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What are common emotional responses families may experience after a developmental delay diagnosis?
Shock, denial, sadness, anger, guilt, and self-blame—similar to stages of grief.
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How might emotions fluctuate over time for families of children with developmental delays?
Emotions can resurface around developmental milestones or when comparing the child to peers.
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How can a developmental delay diagnosis impact family dynamics?
It may strain marital relationships, shift sibling roles, and cause emotional or physical stress for caregivers.
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What financial challenges might families face after a developmental diagnosis?
Costs of therapy, reduced income due to caregiving, and limited access to support services.
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What coping strategies are helpful for families managing a child’s developmental delay?
Early intervention, emotional support, consistent provider communication, support groups, and community resources.
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How can nurses provide effective support for families during the diagnostic period?
Offer anticipatory guidance, emotional validation, and referrals to early intervention and social services.
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Why is it important for nurses to highlight a child’s strengths to families?
It promotes hope, shifts focus to what the child can do, and encourages active participation in care.
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What role do community resources play in family coping?
They provide respite, transportation, financial assistance, and advocacy services, reducing caregiver burden.
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How should cultural values be considered in family support?
Nurses should integrate cultural beliefs into care planning and respect diverse coping styles and health practices.
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What are signs that a family may need additional mental health support?
Persistent sadness, caregiver burnout, anxiety, depression, or social isolation.
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What long-term outcomes can occur as families adapt to a child’s developmental delay?
Increased resilience, advocacy skills, stronger family bonds, and a deeper sense of purpose.
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How can nurses help families build long-term resilience?
Encourage realistic goals, celebrate progress, monitor for burnout, and maintain regular supportive contact.
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What are common spiritual concerns experienced by terminally ill patients?
Fear of death, isolation, the unknown, questioning life’s meaning, guilt, regret, and spiritual distress.
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How can terminal illness impact a patient’s spirituality?
It may deepen faith, provoke existential questions, or lead to spiritual struggle.
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What emotions might family members of terminally ill patients experience?
Spiritual and emotional distress, grief, anxiety, and feelings of helplessness.
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What communication strategies should nurses use with terminally ill patients?
Empathetic listening, presence, validation of emotions, and open-ended questions that invite reflection.
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Give an example of an open-ended question to ask a terminally ill patient.
“What matters most to you right now?” or “What does a good day look like for you?”
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Why should nurses avoid false reassurance when speaking to terminally ill patients?
It can invalidate the patient’s feelings and hinder open, honest communication about fears and needs.
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How can nurses provide culturally sensitive spiritual care?
By honoring religious practices, integrating rituals, offering chaplain support, and respecting diverse beliefs.
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What are two spiritual assessment tools commonly used in end-of-life care?
FICA and HOPE tools.
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What areas do the FICA and HOPE tools assess in spiritual care?
Faith/beliefs, importance/influence, community support, spiritual needs, and preferences related to healthcare.
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What are examples of nursing interventions that support spiritual needs?
Facilitating prayer, arranging chaplain visits, providing space for reflection, and offering spiritual resources.
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How should the environment be structured for terminally ill patients?
Quiet, peaceful, and comfortable—supportive of rest, reflection, and family presence.
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What physical needs must be addressed in terminally ill care to ensure comfort?
Effective pain management and symptom control.
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How can nurses support families of terminally ill patients?
Keep them informed, offer emotional support, validate their grief, and refer to counseling or bereavement services.
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What legacy activities can nurses facilitate for terminally ill patients and their families?
Storytelling, writing letters, blessings, or final conversations to promote closure and meaning.
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What is cultural awareness in nursing practice?
It is the self-examination of one’s own cultural background, values, beliefs, biases, and assumptions.
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Why is cultural awareness considered the first step in cultural competence?
Because it involves understanding how your own culture influences your perceptions and interactions with others.
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What belief does cultural awareness help prevent in healthcare providers?
Ethnocentrism—the belief that one’s own culture is superior to others.
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How does developing cultural awareness improve patient care?
It reduces unintentional bias and supports equitable, respectful, and patient-centered care.
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What is a key reflective practice to develop cultural awareness?
Self-reflection on how your personal culture affects how you perceive and treat others.
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What mindset supports growth in cultural awareness?
Cultural humility—approaching others with openness, curiosity, and a willingness to learn.
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What are some strategies nurses can use to cultivate cultural awareness?
Education on diverse cultures, examining privilege, reflecting on bias, and engaging with diverse communities.
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How can cultural awareness be applied in clinical practice?
By asking culturally sensitive questions, validating patient experiences, and adapting care to align with patient beliefs and values.
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Give an example of a culturally sensitive question a nurse might ask.
“What are your cultural beliefs about health or illness?”
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Which models support the development of cultural awareness in nursing?
The Campinha-Bacote Model and the RESPECT Model.
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What does the Campinha-Bacote Model say about cultural awareness?
It is one of five key constructs and emphasizes continuous self-reflection in developing competence.
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Why is cultural awareness considered a lifelong process?
It grows through ongoing education, meaningful cultural encounters, openness to feedback, and personal growth.
