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NUR 2102 > Mod 1 > Flashcards

Mod 1 Flashcards

1
Q

Pain described as stabbing, numbness, shooting, burning, tingling

A

Neuropathic

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2
Q

When asked to describe the differences between ethnicity & race, what should the student nurse explain?
-Ethnicity & race are the same
-Ethnicity can be understood only thru ethnic worldview
-Race refers to shared identity, ethnicity is limited to biologic attributes
-Ethnicity refers to shared identity but race is limited to biologic attributes

A

Ethnicity refers to shared identity but race is limited to biologic attributes

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3
Q

To gather info about a patient’s home and work surroundings, the nurse will use which method of data collection?
-Review lab results
-Preform a thorough nursing health history
-Prolong termination phase of interview
-Conduct physical assessment before subjective info

A

Preform a thorough nursing health history

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4
Q

A ER nurse is interviewing a client c/o abdominal pain. Which of the following questions would be of priority at this time?
-What have you done to ease the pain?
-Have you had this problem before?
-Can you describe the pain?
-When did the pain begin?

A

When did your abdominal pain begin?

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5
Q

A client interview consist of 3 phases. The nurse recognizes these phases are:
-Intro, discuss, summary
-Orientation, working, termination
-Intro, control, selection
-Intro, assess, conclude

A

Introduction, discussion, & summary

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6
Q

Subjective Data includes:
-Measurements of health status
-Description of patient behavior
- Patients feelings, perceptions, and reported symptoms
-Observation of patients health status

A

A patient’s feelings, perceptions, & reported symptoms

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7
Q

The nurse is gathering a health history and the PT says he just lost his job. Job loss fits best where in HH?
-Family History
-Psychosocial History
-Environmental History
-Biographical History

A

Psychosocial History

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8
Q

The use of critical thinking skills during the assessment phase of the nursing process ensures that the nurse:
-Completes a comprehensive database
-Intervenes based on patient goals & priorities of care
-Generates a potential problem list
-Determines whether outcomes have been achieved

A

Completes a comprehensive database

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9
Q

The PT stated he “felt hot”. His vitals: 101.2 PO, b/p 166/92 & HR 101 bpm. What is subjective data?
-HR 88 bpm
-B/P 168/80 mmHg
- The statement regarding his feeling hot
-The fact that he became febrile

A

The statement regarding his feeling hot

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10
Q

The nurse decides to interview the PT using the open-ended question technique. Which is an example of this?
-Is your pain better or worse?
-Do you believe that your nausea is from antibiotic?
-What do you think has caused your depression?
-What have you done to alleviate the side effects of your meds?

A

What do you think has been causing your depression?

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11
Q

What is bradycardia?

A

Slow heart beat

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12
Q

What is tachycardia?

A

Fast heartbeat

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13
Q

The PT rates their headache 8/10. What info of OLD CARTS is this?
-O
-S
-R
-D

A

S=severity

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14
Q

A nurse using the problem oriented approach to data collection will first
-Complete observation overview
-Disregard cues/complete database in chron order
-Make accurate interpretations of data
-Focus on the patient’s presenting situation

A

Focus on the patient’s presenting situation

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15
Q

When working w/ patient of diff culture, it is important that
-Nurse protects patient from family intrusion of care
-Women as primary caregivers make independent health decisions
-Gender is not a factor when it comes to role expectations
-Working within est. family hierarchy = better outcomes

A

Working within est. family hierarchy =better outcomes

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16
Q

PT c/o trouble breathing at night. For problem-focused assessment what should nurse ask 1st?
-His personal smoking, alcohol use
-Any family members w/ heart disease?
-Changes in other body systems that seem problematic
-Onset/duration of his present breathing problem

A

Onset/duration of his present breathing problem

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17
Q

The process of data collecting begins with
-Physical exam
-Review medical records
-Patient interview
-Discussion w/ other team members

A

Patient Interview

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18
Q

A client rings the call light and says, “ I think I have a fever and my stomach hurts”. What should the RN do?
-Ask UAP to check his concerns
-Go to clients room and assess client
-See if client has an order for pain & fever
Call physician and ask them to come see the patient

A

Go to clients room and assess

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19
Q

OLD CARTS

A

Onset
Location
Duration

Characteristics
Aggravating factors
Relieving factors
Treatments
Severity

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20
Q

How many calories for protein?

A

4 calories per gram

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21
Q

How many calories for fats?

A

9 calories per gram

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22
Q

How many calories for carbohydrates?

A

4 calories per gram

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23
Q

What can affect B/P readings?

A

-incorrect cuff size
-arm unsupported
-repeating taking the b/p too quickly
-rate of cuff deflation
-arm position
-patient position

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24
Q

What is BMI scale?
Calculated by weight(lbs) x 705/ height (in2)

A

Normal: 18.5-24.9
Overweight: 25-29.9
Obese: 30-34.9

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25
Q

JNC BP Levels

A

Normal: <120 (SBP) & <80mm Hg (DBP)
Elevated: 120-129 (SBP) & <80mm Hg (DBP)

Hypertension:
Stage 1: 130-139mm Hg or 80-89mm Hg
Stage 2: >140mmHg or >90mm Hg (greater than or equal to)

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26
Q

Primary Preventions

A

Preventative, prevents disease from developing through healthy lifestyle

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27
Q

Secondary Prevention

A

Screenings, efforts to promote the detection of disease to halt the progression of the disease process

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28
Q

Tertiary Prevention

A

You got it already, now making ease of it,

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29
Q

Pain Scales (NRS, FLACC, Wong-Baker)

A

NRS- numeric 0-10
FLACC- for children
Wong baker faces- peds or elderly

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30
Q

Nociceptive Pain: Tissue damage
-Cutaneous
-Somatic
-Visceral

A

-Cutaneous: superficial surface of skin
-Somatic: achy, throbbing, dull, localize (ortho)
-Visceral: poor localized, just hurts, when organs are stretched weird ( stomach issies)

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31
Q

Sizes for BP Cuff

A

Small Adult: 12x22cm (4.7 x 8.6 inch)
Adult: 16 x 30cm (6.3 x 11.8 inch)

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32
Q

What technique assess temp, edema, tenderness & pulsation?
-Auscultation
-Percussion
-Palpation
-Inspection

A

Palpation

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33
Q

What is best way to describe clinical judgement related to vital signs?
-Collect vital signs & contacts provider if abnormal
-Delegates vital signs to most experience UAP
-Collects and analyzes data to formulate plan of care
-Collects & documents vital signs

A

Collects & analyzes date to formulate a plan of care

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34
Q

Which of the following is true?
- Culture is biologically determined
-Culture is determined by region
-Culture is learned through language and socialization
-Culture is genetically determined based on racial background

A

Culture is learned through language & socialization

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35
Q

What is best used to assess position, texture, shapes, size, and fluid?
-Heel of hand
-Palmar surface of fingers & pads
-Dorsal surface of hands
-Ulnar surface of hands

A

Palmar Surface of fingers/pads

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36
Q

Which is best to assess vibrations?
-Heel of hand
-Palmar surface of fingers & pads
-Dorsal surface of hands
-Ulnar surface of hands

A

Ulnar surface of the hand

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37
Q

The client may have a fungal infection on his leg. What supplies would nurse anticipate needing?
-Monofilament
-Snellen chart
-Wood’s lamp
-Doppler

A

Wood’s lamp

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38
Q

What is a woods lamp?

A

Detects fungal infections of the skin or corneal abrasions

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39
Q

59 YO C/O bloody stool x 24 hrs. + hx of ulcerative colitis. How should the nurse document is reason for seeking care?
- 59 yo presents w/ ulcerative colitis & bloody stools
-59 yo presents c/o bloody diarrhea
-59 yo client presents w/ “bloody stools x 24 hrs”
- 59 yo client presents today w/ ulcerative colitis

A

-59 yo client presents w/ “bloody stools x 24 hrs”

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40
Q

Clients respirations are 10/min. What is the correct term?
-Tachypnea
-Bradypnea
-Apnea
-Dyspnea

A

Bradypnea

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41
Q

Tachypnea?

A

Abnormal rapid breathing

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42
Q

Apnea?

A

Breathing stops and starts

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43
Q

Bradypnea?

A

Slower than normal breathing

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44
Q

Dyspnea?

A

Difficult or labored breathing

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45
Q

Client denies eye discharge, visual changes or eye pain. Where does this information belong in the assessment?
-Review of systems
-Physical exam
-Reason for seeking health care
-Past health history

A

Review of systems

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46
Q

Client reports experiencing shortness of breath (SOB). What would the nurse document?
-Tachypnea
-Bradypnea
-Apnea
-Dyspnea

A

Dyspnea

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47
Q

Which is correct regarding blood pressure assessment?
-Deflating cuff too quick will give too high reading
-Cuff should be inflated 50 mm Hg above the estimated SBP
-A too narrow cuff results in inaccurate and high reading
- Waiting 5 min between b/p measurements will result in false high

A

-A too narrow cuff results in inaccurate and high reading

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48
Q

What level of prevention is speech therapy?
-Primary
-Secondary
-Tertiary
-Combo of secondary and tertiary

A

Tertiary

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49
Q

What level do health professionals retrain, re-educate, and rehabilitate a client that has an impairment?
-Primary
-Secondary
-Tertiary

A

Tertiary

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50
Q

Managing a disease to slow or stop disease progression is what level of prevention. Ex. Chemotherapy
-Primary
-Secondary
-Tertiary

A

Tertiary

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51
Q

Identifying diseases in the earliest stages is what level of prevention?
-Primary
-Secondary
-Tertiary

A

Secondary

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52
Q

Intervening before health effects occur is what level of prevention? Ex. Vaccinations & altering risky behaviors
-Primary
-Secondary
-Tertiary

A

Primary

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53
Q

What is ANA’s first step in the nursing process?
-Diagnosis
-Implementation
-Planning
-Assessment

A

Assessment

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54
Q

ANA’s nursing process?

A

Assessment, diagnosis, outcome identification,planning, implementation, Evaluation

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55
Q

The mother of a 16 mo old states her daughter has an earache. What is the best response?
-Maybe she is teething
-Are you sure she is having pain?
-I will check for an ear infection
-Describe what makes you think she is having pain

A

-Describe what makes you think she is having pain

56
Q

A pt w/ a left BKA reports pain in his LLE. He asks, “How I can feel pain- my foot is gone!” What is a good response?
-“After your amputation, pain perception increases”
-“Nerves send impulses to the brain- you feel pain although your leg is gone”
-“Amputating your leg caused damage to the normal tissues”
-“This is unexpected and you should see the pain center soon”

A

-“Nerves send impulses to the brain- you feel pain although your leg is gone”

57
Q

What is the correct term for the moment boiling water is perceived as painful?
-Pain tolerance
-Pain threshold
-Pain intensity
- Pain Stimulus

A

Pain Threshold

58
Q

The patient dislocated his shoulder while playing soccer causing what type of pain?
-Cutaneous
-Visceral
-Somatic
-Neuropathic

A

Somatic

59
Q

Bowel disorders, labor pain, GI infection & organ cancer are what type of pain?
-Cutaneous
-Visceral
-Somatic
-Neuropathic

A

Visceral

60
Q

When assessing mental status, the nurse uses which techniques?
-Asking them about relatives who have mental disorders
-Having them describe their ability to work w/ others
-Asking them to recall how they cope w/ stress
-Having them demonstrate their ability to reason & calculate

A

-Having them demonstrate their ability to reason & calculate

61
Q

A PT who has anorexia nervosa reports a healthy diet & no protein calorie malutrition. Which lab value best confirms?
-Prealbumin
-Blood glucose
-Serum albumin
-Serum Cholesterol

A

-Prealbumin

62
Q

What is prealbumin?

A

Reflection of protein & calorie intake for the previous 2-3 days

63
Q

PT presents to ED w/ SOB & CP. He receives an EKG & labs. What level of prevention?
-Prim
-Sec
-Tert
-Health prevention

A

Secondary

64
Q

PT presents to rehab after a CVA w/ right side weakness & unable to speak. What level of prevention?

A

Tertiary

65
Q

ChooseMyPlate program includes guidelines for
-Children under 2
-Increasing portion size
-Balancing calories
-Eliminating fats

A

Balancing calories

66
Q

Patient has a calculated BMI of 34. This is classified as:
-Overweight
-Unclassifiable
-Normal Weight
-Obese

A

Obese

67
Q

What is serum albumin?

A

Measures circulating protein, occur over 3-4 weeks

68
Q

The nurse is caring for a new PT. Which intervention is the best example of being culturally appropriate?
-Maintain personal space of 2 ft
-Consider ethnicity the most important factor in care plan
-Ask permission before touching patient
-Insist family members to provide most personal care

A

Ask permission before touching a patient during the physical assessment.

69
Q

A PT w/ chronic leg pain controls it w/ imagery & hypnosis. What is the best response when asked how these work?
-Both strategies prevent transmission of painful stimuli to the brain
-The strategies work by affecting the perception of pain
-These techniques block the pain pathways of the nerves
-These slow the release of chemicals in the spinal cord that cause pain

A

The strategies work by affecting the perception of pain

70
Q

The RN cares for a patient who was admitted a few hrs ago. Which action can the RN delegate to a UAP?
-Finish documenting the admission assessment
-Obtain the health history from the patient’s caregiver
-Develop the patient’s problem list
-Take the patient’s temp, pulse, and BP

A

-Take the patient’s temp, pulse, and BP

71
Q

When assessing for a possible blood clot in the lower leg of a patient, which action should the nurse take first?
-Feel for the temp of leg
-Check the patient’s pedal pulses using fingertips
-Visually inspect the leg
-Compress the nail beds to determine capillary refill time

A

Visually inspect the leg

72
Q

When admitting a patient who has just arrived on the unit w/ a severe headache, what should the nurse do first?
-Inform the patient that the headache will be treated after the hx
-Complete only basic demographic data before addressing patient’s pain
-Take initial vital signs and address the headache before completing the hx
- Medicate the PT for the headache before doing health history and examination

A

-Take initial vital signs and address the headache before completing the hx

73
Q

A nurse is caring for a PT w/ heart failure. Which task is appropriate for the nurse to delegate to experienced UAP?
-Assist w/ bathing & toileting
-Monitor for shortness of breath or fatigue after ambulation
-Determine whether the patient is ready to increase the activity level
-Instruct the PT about the need tp alternate activity & rest

A

-Assist w/ bathing & toileting

74
Q

PT’s vital are: b/p 178/92, HR 54, RR 26, Temp 98.9 PO, Which best describes this PT?
-Tachycardic, tachypneic, hypertensive, febrile
-Bradycardic, tachypneic, hypertensive, afebrile
-Bradycardic, apneic, hypertensive, febrile
-Tachycardic, bradypneic, hypotensive, afebrile

A

-Bradycardic, tachypneic, hypertensive, afebrile

75
Q

Febrile vs Afebrile

A

Febrile- fever, abnormal temp
Afebrile- no fever, normal temp

76
Q

PT is sitting upright, eyes open & says their name correctly, think they’re at the park & its 2010. The PT is:
-A&OX1
-A&OX2
-A&OX3
-A&DX3

A

-A&OX1

77
Q

Orientation
X1 person
X2 place
X3time

A

Ask patient year, location, name
Time is first thing to be lost, then orientation to place, and orientation to person is last to be lost

78
Q

Which vitamin must be ingested daily?
-Vit A
-Vit D
-Vit C
-Vit K

A

Vitamin C

79
Q

Neuropathic Pain

A

-Results from injury or nerves
-burning, shooting, tingling, numbness

80
Q

Acute pain

A
  • rapid, varies in intensity & duration
81
Q

Chronic Pain

A

Limited, persistent, last 6 months or longer

82
Q

Pain Threshold
-does not vary among people

A
  • point where stimulus is perceived as pain
83
Q

Pain Tolerance
-decreases after repeated exposure
-increases after alcohol, meds, distractions

A

Duration or intensity of pain a person will endure

84
Q

What is blood glucose?

A

Reflects carbohydrate metabolism

85
Q

What is a standard drink?

A

12oz beer, 8-9 fl oz malt liqour, 5fl oz of wine, 1.5 fl oz shot

86
Q

Expected findings associated w/ nutrition

A

-Normal BMI 18.4-24.9
-Well nourished, alert
-skin w/o lesions, cracks, bruising, smooth, elastic
- Hair is shiny, nails pink & intact w/o deformity, smooth & firm
-Eye mucous membrane pink, moist, free of lesions

87
Q

Unexpected findings associated w/ nutrition

A
  • High BMI= indicator of poor nutrition
    -Irritability, disorientation (niacin deficiency)
    -Multiple bruises = vit c & k deficiency
    -Fatty acid deficiency = dry flaky skin/eczema
  • Edema= dehydration
    -bumpy skin - vit a deficiency
    -hair is dull & falls out easily
    -spoon shape nails - iron deficiency
    -eyes pale= anemia
    -mouth lesions/dental = poor nutrition intake
    -Muscle weakness= low protein
88
Q

ANA Standards of Nursing Practice

A

Standard 1: Assessment
Standard 2: Diagnosis
Standard 3: Outcome Identification
Standard 4: Planning
Standard 5: Implementation
Standard 6: Evaluation

89
Q

Clinical Judgment Cognitive Skill

A

-Recognize cues (what matters most)
-Analyze cues (what could it mean)
-Prioritize hypothesis (where do i start)
-Generate solutions (what can i do)
-Take action (what will I do)
-Evaluate outcomes (did it help)

90
Q

Components of assessment

A

-Health history
-Physical examination
-Laboratory findings
-Diagnostic findings
-Documentation of data

91
Q

Comprehensive Assessment

A
  • detailed health history & physical exam upon admission
    -regular full health exam
92
Q

Problem-based/focused assessment

A
  • Exam limited to specific problems or complaints (ex. sprained ankle)
    -Generally walk in clinic or ER
93
Q

Episodic/Follow Up Assessment

A

Following up with provider about previous identified problem

94
Q

Shift Assessment

A

-When PT are hospitalized, these are conducted each shift
-Identify changes

95
Q

Screening Assessment

A

Short exam focused on disease detection ( ex. bp screening, glucose, cholesterol)

96
Q

3 Parts of Patient Interview

A

-Intro
-Discussion
-Summary

97
Q

Components of Comprehensive Health History

A

-Biographic data
-Reason for seeking care
-History of present illness (OLD CARTS)
-Present health status (Current conditions, meds, allergies)
-Past medical history (childhood illness, surgeries, accidents etc)
-Family history
-Personal and psychosocial history (occupation, mental health, habits etc.)
-Review of all body systems

98
Q

4 Basic Techniques of Physical Assessment

A

-Inspection(looking)
-Palpation(feeling)
-Percussion (tapping)
-Auscultation (hearing)

99
Q

Inspection- What do I see?

A
  • All body systems
    -First
  • Equipment: Penlight, otoscope (ear), ophthalmoscope, speculum (vagina)
100
Q

Palpation- What do I feel?

A

-Size, shape, location, identify painful areas
-Use palmar surface & finger tips (light 1cm, then deep 4cm)
-Dorsal surface for temp (back hand)
-Painful areas last

101
Q

Percussion- What do I hear?

A

Evaluate: size, borders, consistency, tenderness, fluid
Five tones:
Tympany- loud, high-pitch, abdomen
Resonance- low- pitch, normal lung tissue
Hyperresonance- overinflated lungs such as emphysema
Dullness- over liver and solid organs
Flatness- bones and muscle

102
Q

Auscultation- What do I hear?

A

-Listening to sounds within the body
-Uses stethoscope
Listen for sound characteristics: Intensity, Pitch, Duration, Quality
Helpful tip: close your eyes when listening to block out other sensory information
Optimize quality:
Quiet room
Place stethoscope DIRECTLY on skin NOT over top of clothes
Friction of body hair can sound like abnormal sounds- crackles in the lungs

103
Q

Snellen Chart (what you see for eye exam)

A

-vision from far away

104
Q

Tuning Fork

A

Tests auditory screening and assessment of vibratory sensation

105
Q

Doppler ( looks like ipod touch)

A

-Amplifies sounds that are hard to hard w/ stethoscope
-Swishing pulsating sounds

106
Q

Skinfold Caliper

A

Test for body fat

107
Q

Jaegar & Rosenbaum Charts (Vision)

A

-Test for near vision

108
Q

Goniometer

A

-Two rulers and a pizza cutter
-Measures degree of knee flex/extend

109
Q

Percussion Hammer (Triangle)

A

-Deep tendon reflex test
-Triangular stick

110
Q

Monofilament (small)

A

-Small, flexible wire like device
- test for sensation of lower extremities

111
Q

Transilluminator

A

-Lightbox
-Shows characteristics of tissue, fluid, and air within a specific body cavity

112
Q

General Survey

A

Initial data before examining body
-Vital signs
-Observations

113
Q

Conversions

A

1kg=2.2lbs
1L=1kg=2.2lbs

114
Q

Orthostatic Hypotension

A

-Low blood pressure, dropping too fast

115
Q

Hypoxemia

A

Low oxygen in blood concentration

116
Q

Dysrhythmia

A

Irregular heart beat

117
Q

Apical Pulse

A

Pulse Point in chest at bottom of heart

118
Q

Hypotension

A

-Uusually <90mm Hg

119
Q

General Inspection

A

-Initial meeting: age, physical appearance, hygiene, body structure
Movement- range of motion, gait,
Emotional and mental status behavior- tone, mood, alertness, speech

120
Q

Genetics

A

Study of heredity, function/comp of single genes

121
Q

Genomics

A

Study of gens and their functions: incorporates all the genes and their relationships.

122
Q

Context of Care

A

Refers to circumstances or situations related to healthcare delivery. May be related to environment, setting, physical, psychological or socioeconomic. Different types of assessments are preformed.

123
Q

Patient tells the nurse that he has had a headache and nausea for three days which type of assessment should the nurse perform?

A

Focused assessment

124
Q

Patient is admitted to the medical surgical unit with a diagnosis of hypertension the nurse is using nursing process to develop the plan of care which steps should the nurse incorporate? 

A

Assessment, diagnosis, outcome identification,planning, implementation,evaluation

125
Q

A patient complains of a cough for four days unrelieved with position changes the nurse interprets this as a symptom and documents to finding under ______ on the patient’s chart

A

History bc it is subjective data from the patient

126
Q

What objective data does a nurse collect during a physical assessment? 

A

Heart Murmur, Vital signs

127
Q

The nurse is incorporating the principles from the Institute of medicine recommendations into the health assessment of a patient in the long-term care setting what principles should the nurse consider?

A

-Use evidence to support interventions
-place the patient at the center of care
-use technologies and informatics in delivering care
-include other disciplines in the plan of care

128
Q

The student nurse is preparing to assess a patient in the hospital clinical setting which components best describe the concept of health assessments?

A

Collection of objective data, analysis of data, planning and evaluation of data

129
Q

What is symptom analysis?

A

Systematic collection of subjective data related to the patient’s chief complaint

130
Q

The nurse is assessing a patient’s activity level, which question or comment best facilitates discussion with the patient regarding his or her level of activity

A

What do you do to get exercise?

131
Q

The nurse is conducting an interview with a patient who is mentally challenged the nurse knows that __________ assessment is to preferred method for the interview

A

Focused assessment: short simple

132
Q

The nurse needs to assess an adolescent patient’s risk for a sexually transmitted diseases what technique shows the most sensitivity?

A

“ how many young people have questions regarding STDs what questions do you have?”

133
Q

The introduction phase of the interview, the nurse asked why the patient came into the clinic this is known as______

A

History of present illness, may be problem or routine care issues

134
Q

The nurse is focusing the interview for a patient who complains of headaches and nausea which interview format is based on body function as opposed to body systems? 

A

Functional health patterns: based on body systems

135
Q

The nurse knows that the single most important factor in conducting an interview with the communication process which factors will most likely affect the positive interview process and therapeutic communication?

A

Obtaining patients history, asking closed ended questions, maintaining privacy

136
Q

Sounds: tympany, resonance, dullness, flatness

A

Tympany- heard over abdomen
Resonance- heard on healthy lung tissue
Dullness- over liver
Flatness- over bones & muscles
Usually easier from resonance to dull

NUR 2102 (3 decks)

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