Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Nursing > N471 Final Exam > Flashcards

N471 Final Exam Flashcards

You may prefer our related Brainscape-certified flashcards:
Nursing Mental Health flashcards Nursing Management of Care flashcards NCLEX-PN® flashcards NCLEX-RN® flashcards Nursing Fundamentals flashcards Nursing Pediatrics flashcards Nursing Safety & Infection flashcards Nursing Pharmacology flashcards Nursing Maternity flashcards Family Nurse Practitioner (FNP) flashcards
1
Q

Reduced uninsured, increased access to care
Focus on VALUE vs VOLUME

A

Patient Protection and Affordable Care Act

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Group of providers working together to take care of patient groups, goal of seamless, quality care, coordination of care

A

Accountable Care Organizations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Focus on efficient, effective, and quality services, equals out in revenue
Everyone is responsible, unit manager considers each unit’s budget

A

Cost Containment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

A financial plan
Must be as accurate as possible
Value is directly related to its accuracy

A

Budget

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Mortgages, salaries

A

Fixed expenses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Payroll of hourly employees, cost of supplies

A

Variable expenses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How many people work during a shift, number of personnel employed

A

Controlled expenses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Emergencies, needing more staff/time, specific supplies needed to care for patients

A

Uncontrolled expenses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Each of an organization’s revenues, expenses, assets, and liabilities are someone’s responsibility
Leader-manager at unit level is active participant in unit budgeting

A

Responsibility Accounting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Assess- what are the needs
Diagnosis- what needs are priority
Plan- set time/goals
Implementation- continue to assess for change
Evaluation- review, add, remove

A

Steps to Budgeting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Largest expenditure in a budget
Workforce

A

Personnel Budget

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Expenses that change- electricity, repairs, maintenance, supplies

A

Operating Budget

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Buildings, major equipment budget
NOT USED DAILY
MORE EXPENSIVE THAN OPERATING BUDGET

A

Capital Budget

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Predetermined payment schedule based off specific pt conditions/diagnoses

A

Diagnosis Related Groups

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Federally funded program for seniors over age 65 or disabled
Recipient pays into the insurance plan

A

Medicare (MC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

MC Hospital insurance plan

A

Medicare A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

MC outpatient care and physician services coverage

A

Medicare B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

MC managed care plan coverage

A

Medicare C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

MC prescription drug coverage

A

Medicare D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Federal/state plan to assist indigent population, disabled, long-term care

A

Medicaid (MA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Regulations as to what providers/healthcare agencies can charge based on a diagnosis rather than patient-specific

A

Prospective Payment System (PPS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Health program that looks at efficiency, access, and cost, primary care provider as gatekeeper

A

Managed Care Organization (MCO)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Communication with patients, families, colleagues, leadership
Necessary for continuity and productivity

A

Interpersonal communication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

More complex than interpersonal communication
More communication channels
More individuals
More information
New technology

A

Organizational Communication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Includes values, feelings, stress levels of both sender and receiver

A

Internal climate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Status, power, authority of sender and receiver, timing & organizational climate

A

External climate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Manager makes needs/wants known to a higher level

A

Upward communication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Manager communicates information to colleagues under them (subordinates)

A

Downward communication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Manager communicates with others on same hierarchical level

A

Horizontal communication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Manager interacts with other managers or physicians on different hierarchical levels

A

Diagonal communication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Information flows quickly and haphazardly among people at all levels

A

Grapevine communication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Used when documentation is needed, can be formal or informal, tone can be mistaken (e.g. never use caps lock in formal written communication)

A

Written communication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Can be formal or informal, depends on intent, sender/receiver needs, watch body language

A

Face to face communication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Rapid communication, can be formal or informal

A

Telephone/text communication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Facial expressions, body movement, gestures, tone, emotions

A

Non verbal communication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Direct honest, does not infringe on rights

A

Assertive verbal communication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Person remains silent about issue even though they have strong feelings; “suffer in silence”

A

Passive verbal communication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Direct, threatening, condescending, infringes on rights

A

Aggressive verbal communication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

An aggressive message presented in a passive way (incongruent message)

A

Passive aggressive verbal communication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Interprofessional communication
Standardized professional communication to provide quality patient care and reduce errors
-Situation
-Background- admitting diagnosis
mentioned here
-Assessment- where you state the
patient’s problem(s)
-Recommendation

A

SBAR communication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Way of establishing behaviors in groups, who are the leaders and the dependents, what behaviors are among the group. Identify rules, tasks and responsibilities
Process of the group meeting each other and interpersonal relationships forming

A

Forming (group communication)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Resistance is normal when forming groups. See what influences come within the group, how they resolve or rebel. How are demands of tasks resolved
COMPETITION

A

Storming (group communication)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Group starts to develop more efficiently, conflict resolves, cooperation develops
Conflict and resistance are overcome!

A

Norming

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Group completes tasks, members perform their roles, problems are resolved
The work gets done!

A

Performing (group communication)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

-The force within the individual that influences or directs behavior
-The act of stimulating someone or oneself to get a desired course of action or to push the right button to get a reaction
-The process of inducing, inspiring, and energizing people to work willingly with zeal, initiative, confidence, and an integrated manner to achieve desired goals it is a morale boosting activity

A

Motivation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Comes from within a person, often influenced by upbringing, family structure, culture, values, beliefs are formed at a young age, these can develop and change over time

A

Intrinsic motivation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Comes from outside the person, what factors motivate a person- financial, emotional, self, personal, relational, these can develop and change over time
Enhanced by job environment or external rewards

A

Extrinsic motivation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

The cooperative working together of two or more people or organizations when combined, their effect is greater than the sum of their individual efforts

A

Synergy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Employee’s emotional commitment to the organization and its goals
KEY TO RETENTION

A

Employee engagement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Validation of work effort
Be specific
Recognition of extra effort (can be key tool in retention)
Show trust in decisions
Let employees create at work
External rewards are not always positive
Give praise during huddles
Encourage one another
Hire for the fit, not just to fill a vacancy

A

Positive reinforcement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

DO NOT MICROMANAGE
Being a role model
Taking self care seriously

A

Leaders can motivate by…

52
Q

Giving employees the ability to make decisions and encouraging them to challenge the status quo

A

Employee empowerment

53
Q

Goal: do the greatest good for the greatest number of people

A

Disaster triage goal

54
Q

Situation in which medical resources are strained but NOT overwhelmed
The number of patients and the severity of their injuries do NOT exceed the capability of the facility to render care

A

Multi-casualty incident

55
Q

Situation in which casualty numbers are large enough to disrupt healthcare services
The number of patients and the severity of their injuries DOES exceed the capability of the facility and staff
Patients with the greatest chance of survival are treated first
Demand for resources ALWAYS exceeds the supply in an MCE!!

A

Mass Casualty Event (MCE)

56
Q

Your safety is of utmost importance
Practice body substance isolation precautions (gloves and mask at minimum)
Routinely assess your environment for safety concerns
DO NOT BECOME A PATIENT!!

A

Safety

57
Q

Perceiving critical elements in the environment
Understanding the significance of available information
Projecting what could happen next

A

Situational awareness

58
Q

IMMEDIATE priority
Breathing but unconscious
Respirations over 30
Perfusion capillary refill >2 or NO radial pulse
Mental status unable to follow commands
Patient with life-threatening problems including: severe altered mental status, airway compromise, severe difficulty breathing, cardiovascular problems, hemorrhage, major trauma, major wounds
Requires immediate evacuation and treatment

A

RED triage category

59
Q

DELAYED
Patient with injuries requiring evaluation that are not immediately life-threatening such as extremity burns, isolated extremity injuries, spinal injuries, awake and alert head injury patients
Evaluation can be delayed

A

YELLOW triage category

60
Q

MINOR
WALKING WOUNDED
Patients with non life-threatening injuries or medical conditions such as: small wounds, small burns, small abrasions, and exacerbated psychiatric conditions
ARE AMBULATORY

A

GREEN triage category

61
Q

DECEASED
Dead patients
No respirations after head tilt
No pulse

A

BLACK triage category

62
Q

EXPECTANT
some systems group this category into black
Patients who are mortally wounded and have non-survivable injuries (such as 100% third degree burns)
(Would be labeled red in non-disaster scenario)

A

GRAY triage category

63
Q

Respirations
Pulse, perfusion
Mental status

BREATHING IS ALWAYS CHECKED FIRST

A

Patient Assessment Criteria (disaster triage)

64
Q

Manually open airway (jaw thrust if trauma pt)
Clear the airway with a finger sweep
Insert nasal airway
Control major bleeding
Elevate the legs to prevent worsening shock

A

Patient Treatment (disaster triage)

65
Q

Simple Triage and Rapid Treatment
Can be used to track patients
The four color system is the NATO international standard
CHECK PT AND SEE WHAT THEY’RE DOING FIRST

A

START Triage

66
Q

Colored plastic tape
Labels, cards, tags, bandanas, etc.

A

Informal triage system

67
Q

START but adds normal vital parameters for children, making it appropriate for use with pediatric population

A

JUMP START

68
Q

Sort, Assess, Life-Saving Interventions, Treatment & Transport
Similar to START but sorts pts based on if pt can walk and respond to you

A

SALT Triage

69
Q

Formalized, structured method whereby a group of rescue and response workers reviews the stressful experience of a disaster
MENTAL HEALTH PRIORITY

A

Critical Incident Stress Debriefing (CISD)

70
Q

Emergency planning response and continued assessment
Improved coordination and cooperation with other communities
Developing and coordinating preparedness plans
Establishing warning systems
Stocking emergency supplies and equipment
Educating the public and training emergency personnel
Assessing the damage caused by the emergency
Recovering from the emergency and helping citizens return to normal life ASAP

A

Local Government Responsibilities

71
Q

Reviewing plans and providing guidance
Protecting communities and citizens within the state
Financial assistance on a supplemental basis
Pivotal point between policy guidance and resources available

A

State Government Responsibilities

72
Q

Assisting the states by reviewing plans, providing guidance, making plans and assessing their capability to provide protection from large-scale, nationwide disasters
FEMA acts in a coordinating role (mitigation, preparedness, response, and recovery activities)

A

Federal Government Responsibilities

73
Q

American Red Cross
Led by volunteers, provides relief to victims of disasters
Provides food, shelter, first aid, clothing, bedding, medicines, and other services
Salvation Army, Catholic Charities, Mennonite Disaster Services

A

Voluntary agencies and organizations

74
Q

Preventing future emergencies or minimizing their effects
Occurs BEFORE and AFTER emergencies
Ex: buying flood and fire insurance for your home

A

Prevention/Mitigation (emergency management cycle)

75
Q

Preparing to handle and emergency
Plans or preparations made to save lives and help response and rescue operations
Takes place BEFORE an emergency
Ex: evacuation plans and stocking food & water

A

Preparedness (emergency management cycle)

76
Q

Responding safely to an emergency
Takes place DURING an emergency
Ex: Seeking shelter from a tornado or turning off gas valves in an earthquake

A

Response (emergency management cycle)

77
Q

Recovering from an emergency
Includes actions take to return to a normal or an even safer situation following an emergency
Takes place AFTER an emergency
Ex: getting financial assistance to help pay for repairs

A

Recovery/rehabilitation (emergency management cycle)

78
Q

The best guideline for developing disaster plans is adherence to highest standards of medical practice

A

Developing disaster plans

79
Q

An occurrence of a natural catastrophe, technological accident, or human-caused event that has resulted in severe property damage, deaths, and/or multiple injuries

A

FEMA Disaster Definition

80
Q

Those caused by environmental forces. The WHO defines “natural disaster” as the “result of an ecological disruption or threat that exceeds the adjustment capacity of the affected community. Natural hazards are the consequence of the intersection of a natural hazard and human activity

A

Natural disaster

81
Q

Man-made (human-generated). Those in which the principle direct causes are identifiable human actions, deliberate or otherwise

A

Anthropogenic disaster

82
Q

Federal government to integrate all diff. agencies under one unit

A

Department of Homeland Security

83
Q

Disaster medical assistance team; a group of professional and paraprofessional medical personnel designed to provide medical care during a disaster or other event. Each team responds rapidly to supplement local resources until other resources can be mobilized or the emergency ends

A

DMAT

84
Q

A systematic, proactive approach to guide departments and agencies at all levels of government, nongovernmental organizations, and the private sector work together seamlessly and manage incidents involving all hazards- regardless of cause, size, location, or complexity- in order to reduce loss of life, property, and harm to the environment

A

National Incident Management System (NIMS)

85
Q

The ability of a hospital to expand care to manage the demand of a sudden dynamic influx of patients

A

Surge capacity

86
Q

Hazard identification is used to determine which events are most likely to affect a community and to make decisions about whom or what to protect as the basis of establishing measures for prevention, mitigation, and response

A

Hazard identification and mapping

87
Q

Vulnerability analysis is used to determine who is most likely to be affected, the property most likely to be damaged/destroyed, and the capacity of the community to death with the effects of the disaster

A

Hazard Vulnerability Assessment

88
Q

Droughts, wildfire, avalanche, winter storm/blizzard, tsunami, hurricane, biological event (virus, pandemic), flood, earthquake

A

Natural events (type of hazard)

89
Q

Economic failures, general strikes, terrorism, sabotage, bombs, hostage situation, arson, mass hysteria, etc.

A

Human events (type of hazard)

90
Q

Hazardous material release, explosion/fire, transportation accident, building collapse, power or utility failure, extreme air pollution

A

Technological events (type of hazard)

91
Q

Mass gatherings, concerts, sporting events, political gatherings, protests

A

Special events (type of hazard)

92
Q

Climate change, sea level rise, deforestation, loss of natural resources, intensive urbanization, catastrophic earth changes, extra-terrestrial (e.g. impact, space weather)

A

Context hazards (type of hazard)

93
Q

Community’s ability to resist, absorb, recover from, or adapt to an adverse occurrence

A

Resilience communities

94
Q

Laws can create certain responsibilities for nurses such as laws that impose civil liability for the failure to provide professionally adequate care
Nurses ethical obligations to family and loved ones may supersede legal obligations depending on the degree of risk to the nurse’s family

A

Legal Issues in Disaster Response

95
Q

All healthcare professionals, including nurses, are subject to civil liability for providing substandard healthcare
A nurse may be held liable for providing professional care that is below that standard followed by the profession

A

Professional Liability

96
Q

Some states have enacted special legislation which may provide immunity from civil liability for persons when they render care in emergency situations

A

Good Samaritan Laws

97
Q

Psychosocial effects can be variable, widespread, and may present differently among different individuals
No one who experiences a disaster is untouched by it
Disaster stress and grief reactions are “normal responses to an abnormal situation”

A

Psychosocial impacts of disaster

98
Q

Getting work done through others or directing the performance of one or more people to accomplish organizational goals
Transfer of AUTHORITY and RESPONSIBILITY but retaining ACCOUNTABILITY for the task
NOT assignment- the distribution of work to qualified persons

A

What is Delegation

99
Q

Focus on initiatives
Gain trust in staff performance
Earn respect from staff
Improves communication
Achieves goals
Balances workload and time
Decreases stress
Increases productivity

A

Personal benefits of delegation

100
Q

Improves level of trust and communication
Achieves goals that require cooperative group effort
Personal and professional development
Increased job satisfaction
Know-how, experience
Increased productivity

A

Benefits of delegation for staff

101
Q

Saves money
Increases productivity and efficiency
More motivated staff and improved retention

A

Organizational benefits of delegation

102
Q

Determines the SCOPE OF PRACTICE for RNs in each state
RN must understand scope of practice of others on nursing team
Different rules apply in each state and organization for delegation to UAPs

A

Nurse Practice Act

103
Q

Items that can/cannot be delegated
Description of professional nursing practice
Description of RN, LPN, and UAP scope of practice
Degree of supervision required to complete a task
Guidelines for lowering delegation risks
Warnings about inappropriate delegation

A

Essential Elements of Nurse Practice Act

104
Q

Dependent Practitioners
Must work under the supervision of an RN
Performing tasks and responsibilities within the framework of case finding, health teaching, health counseling, and provision of supportive and restorative care
IN NY, LPNs CANNOT PERFORM ASSESSMENTS INDEPENDENTLY
CANNOT directly push IV meds or administer chemo

A

LPN Scope of Practice

105
Q

NAs, CNAs, HHAs, PCTs, MOAs
Can perform in a limited manner some activities that fall within the nursing scope of practice
The supervising RN remains responsible for patient assessment, evaluation, and judgement –> these things cannot be done by UAPs
Non nursing functions: housekeeping, clerical, TRANSPORTATION, dietary
Health-related activities: tasks that do not require professional judgement, or critical thinking

A

Unlicensed Assistive Personnel

106
Q

It is a crime to permit unauthorized practice
Class E felony

A

Delegation in NYS

107
Q

RNs or LPNs

A

RNs can delegate to

108
Q

Other LPNs

A

LPNs can delegate to

109
Q

UAPs

A

RNs and LPNs cannot delegate to

110
Q

Potential for harm
Condition/stability of the patient
Complexity of the task
Problem solving and innovation required
Unpredictability of outcome
Requires coordination of care (RN, NOT LPN)

A

Factors to Consider with Delegation

111
Q

Define the task (complexity and components)
Decide on delegate (match task to individual)
Determine the task (clearly defining expectations)
Reach agreement (empower delegate)
Monitor performance and provide feedback (reward accomplishment)

A

Delegation Process

112
Q

One that is delegable for a specific patient

A

Right task
rights of delegation

113
Q

Appropriate patient setting, available resources, and other relevant factors considered

A

Right circumstances
rights of delegation

114
Q

Right person is delegating right task to be performed on the right person

A

Right person
rights of delegation

115
Q

Clear, concise description of the task, including its objective, limits, and expectations

A

Right direction/communication
rights of delegation

116
Q

Appropriate monitoring, evaluation, intervention, as needed, and feedback

A

Right level of supervision
rights of delegation

117
Q

Feeding (without swallowing precautions)
Drinking
Ambulating/turning
Grooming/dressing
Toileting
Collecting data such as vital signs, intake/output
TRANSPORTATION

A

Activities that CAN be assigned to UAPs

118
Q

Assessing, evaluating, or problem solving
Determining a nursing diagnosis
Providing patient education or health counseling
Feeding through NG tube
Administering oxygen
Performing tracheal suctioning or respiratory care

A

Tasks that CANNOT be delegated to UAPs

119
Q

Monitoring client findings (as input to RNs assessment)
Reinforcement of client teaching
Tracheostomy care and suctioning
Checking NG tube patency
Medication administration

A

Tasks that CAN be delegated to an LPN

120
Q

Assess, evaluate, or problem solve
Administer chemo
Administer direct IV push meds
Administer fluid bolus for plasma volume expansion
Access central lines

A

Tasks that CANNOT be delegated to an LPN

121
Q

Under Delegating
Over Delegating
Improper Delegating

A

Common Delegation Errors

122
Q

Appraiser lets one or two positive aspects of the assessment of the employee unduly influence all other aspects of the employee’s performance

A

Halo Effect

123
Q

Appraiser allows negative aspects of the assessment influence the assessment to the extent that other levels of the job performance are not accurately recorded

A

Horns Effect

124
Q

Manager is hesitant to risk the assessment and therefore rates all employees as average

A

Central Tendency

125
Q

Employees receive the same appraisal year after year. Those who did well will continue to do well and those who struggled will continue to struggle

A

Matthew Effect

Nursing (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions