NU 302 Exam 2 Flashcards
Is the following statement true or false?
Evidence-based practice involves clinical reasoning.
True
Rationale: Clinical reasoning is an important
component of evidence-based practice.
What does PICOT stand for?
P – patient population/problem
* I – Intervention
* C – Comparison intervention or issue of interest
* O – Outcome
* T - Time
What is evidence based practice?
a process used to review, analyze, and translate the latest scientific evidence into client care
What are the steps of the EBP process?
- Cultivate a spirit of inquiry
- Ask the question (PICOT format)
- Critically appraise the evidence
- Integrate evidence with expertise
- Evaluate outcomes
- Disseminate outcomes
What is quantitative research?
Provides information that can be quantified
* Objective measurement
* May be as simple as providing specific numbers
* Helps identify problems or relationships
What is qualitative research?
Subjective
* Asks how or why?
* Perceptions are
often evaluated
What is mixed method research?
Both quantitative
and qualitative data
are collected and
analyzed
What is a systemic review?
Compilation and summarization of recent studies
Research done to evaluate the relationship of the implementation of a
VAP bundle on the number of Ventilator Acquired Pneumonia cases
is an example of what type of research?
A. Qualitative
B. Quantitative
C. Systematic
D. Mixed Methods
B – Quantitative
* Rationale: This research is able to be quantified and shows the
relationship between two factors.
Evaluating the emotional affects of long-term care on the elderly
would be what type of research?
A. Qualitative
B. Quantitative
C. Systemic Review
D. Mixed Methods
A – Qualitative
* Evaluates – emotions and perceptions
What is validity?
instrument measures what it is supposed to measure
What is reliability?
Consistency of an instrument measurements within a
population
Where do you get approval to use human subjects in research?
Institutional Review Board
What are values?
personal beliefs regarding worth, truth, behaviors
What doctrine dictates the way we show respect and dignity to clients?
Code of Ethics for Nursing
What is respect?
regard for the feelings, wishes, rights, or traditions of others.
Ex. You leave the room upon the client’s request.
What is autonomy?
The ability to make decisions for yourself.
Ex. Decide about your medical decisions
What is beneficence?
Being generous and doing good.
Ex. Holding a dying patient’s hand.
What is nonmaleficence
Avoid hurting the patient.
Ex. Stopping a harmful medication
What is justice?
Treating people in a fair manner.
Ex. Avoiding treating one patient better then another.
What is veracity?
Being truthful.
Ex. Being honest about the side effects of drugs.
What is fidelity?
Being faithful.
Ex. Keeping a promise to return to a patient.
Which ethical principle is applied when the nurse
ensures the groups’ involvement in decision-making?
A. Beneficence
B. Autonomy
C. Respect
D. Justice
B. Autonomy
* Rationale: Autonomy is applied when the nurse
promotes a group’s right to and involvement in decision
-making. Beneficence is demonstrated when the nurse
makes decisions that actively promote the community’s
best interests and well-being. Respect is demonstrated
by acknowledging the clients as participants in shaping
their own and the community’s health outcomes.
Justice is demonstrated when clients are treated fairly
and equally.
What is considered a low birth weight?
Less than 5.5lbs
What is considered a very low birth weight?
Less than 3lbs 4oz
What are risk factors of low birth weight?
Lifestyle (smoking, secondhand smoke, nutrition, alcohol and drugs, violence, prenatal care)
◦ Sociodemographic
◦ Medical and gestational history
Is the following statement true or false?
◦ Passive smoking is associated with health problems
in the neonate.
True
◦ Rationale: Passive smoking has been shown
to result in decreased head circumference,
depressed cognitive development, and lower
birth weight
If a pregnant women’s BMI is 18.5-24.9, what is normal weight gain for her in lbs?
25-35lbs
If a pregnant women’s BMI is less than 18.5 what is normal weight gain for her in lbs?
28-40lbs
If a pregnant women’s BMI is 25-29, what is normal weight gain for her in lbs?
15-25lbs
What can prenatal stress lead to?
learning problems, anxiety
and depression, and coping problems.
What are some socioeconomic and social equality issues poorer women face?
often lack health insurance, have less
access to quality prenatal care services, have poorer
nutrition, and are exposed to more situational and
psychological stressors
What are risks for adolescent mothers?
Infants born to teenage mothers: increased
risk for preterm delivery, neonatal, and post
neonatal mortality
◦ Increased psychological risks for teen mothers
◦ Less likely to receive early and continuous
prenatal care; more likely to use alcohol and
smoke during pregnancy
What are some pregnancy complications?
HTN – preeclampsia
◦ Gestational Diabetes
◦ Postpartum Depression
◦ Fetal or infant death
Is the following statement true or false? A woman with gestational diabetes is at
risk for delivering a small-for-gestational-
age newborn
False Rationale: Due to the effect of glucose on
the fetus, a woman with gestational diabetes
is at risk for delivering a large-for-gestational
-age newborn
What are risk factors for SIDS?
- Side/Stomach sleeping
- Exposure to cigarette smoke
- Premature birth
- Co-sleeping
- Having a sibling who has died
of SIDS - Bedding in crib
What are some benefits of breastfeeding?
Convenient
* Cost
* Nutrition
* Immunities/Antibodies
* Fewer digestive issues
* Promotes growth
* Promotes bonding
How long does the AAP recommend breastfeeding?
6 months and then continued for a year
A nurse educator is teaching a class on breastfeeding. Which of the following statements by a
client indicates the need for further education?
A. Breast-feeding can help protect your baby from sickness
B. Babies who are breastfed often have constipation issues
C. Breast-feeding promotes growth
D. Breast-feeding promotes uterine contraction
B
◦ Rationale: Babies who are breast-fed often have fewer digestive issues
What is the goal of Healthy People 2020 for children?
- Increase the proportion of children
and adolescents who communicate
positively with their parents. - Increase the proportion of children
whose parents read to them at least 4
days per week. - Increase the number of children who
get sufficient sleep. - Increase the proportion of children
with developmental delays who get
intervention services by age 4 years.
What are some common chronic diseases in school age children?
Asthma
Autism
Diabetes
Juvenile rheumatoid arthritis
Seizure disorders
What are some common triggers for asthma?
- Overcrowded conditions
- Air pollution
- Allergens
- Cigarette smoke
- Infections
- Stress
- Exercise
- Weather changes
What percentage of children have asthma?
13%
What is the EXHALE asthma strategy?
E-education on asthma management
X-extinguishing smoking and secondhand moke.
H-Home visits for trigger reduction.
A-achievement of guidlines based management
L-linkages of care across health systems
E-environmental policies to reduce triggers.
What are some common food allergies in children?
fish shellfish, soy, milk,
eggs, wheat, peanuts, and tree nuts
Who is 5x more likely to have autism?
Boys
What are some characteristics of autism?
Social and Communication Issues
* Unusual interests and behaviors
What are some common communicable diseases for school age children?
Flu
* RSV
* Measles
* Mumps
* Pertussis
* Head Lice
* MRSA
What are symptoms of the flu in children?
fever, cough,
sore throat, runny nose, body
aches, headache, fatigue, nausea,
vomiting
How is the flu spread?
Droplets
What are complications of the flu?
pneumonia,
dehydration, encephalopathy, ear
infections
What are symptoms of Respiratory Syncytial Virus?
fever, runny nose, coughing, sneezing, decrease in appetite
What are some complications of RSV?
bronchiolitis and pneumonia
What are s/s of mumps?
Fever
* Headache
* Muscle aches
* Tiredness
* Loss of appetite
* Swollen and tender salivary glands under
the ears on one or both sides (parotitis)
results in puffy cheeks
What are s/s of measles?
fever,
cough, runny nose, red, watery, eyes,
rash, and Koplik spots
What are s/s of Pertussis (whooping cough)?
runny nose, low
-grade fever, mild occasional cough,
apnea (in babies), cough, vomiting,
exhaustion
How do you treat whooping cough?
With antibiotics
How is whooping cough transmitted?
Via droplets
How is lice spread?
Spread by close contact, sharing hats,
brushes, accessories, pillows, towels
T or F, headlice can jump or fly to another persons head
False
What is MRSA?
Methicillin resistant Staphylococcus
aureus
How is MRSA spread?
May spread through close contact, gyms,
sports equipment, towels, sharing razors
What are common signs of learning disabilities in children?
Reading Problems
* Writing Problems
* Math Problems
* Language Problems
* Motor Problems
* Sequencing
* Memory
What % of children are in poverty?
34%
What are some common symptoms for children in poverty?
Depression, anxiety, greater exposure to violence, issues with school attendance and performance, inadequate nutrition.
Is the following statement true or
false?
Learning disabilities are a major
chronic disease affecting children.
FALSE
RATIONALE: ALTHOUGH LEARNING
DISABILITIES CAN BE LIFELONG, THEY ARE
CONSIDERED A BEHAVIOR OR LEARNING
PROBLEM, NOT A CHRONIC DISEASE.
What is the #1 cause of death due to disease in children?
Cancer
At what percentile are children considered obese?
95th
At what percentile are children considered a healthy weight?
5th-85th percentile
What does childhood obesity increase risk of?
Increased chance of overweight/obesity as
adult
* Increases risk of CV disease, diabetes, HTN
What is the 2nd leading cause of death in adolescents?
Suicide
What is the most frequently used substance among adolescents?
Alcohol
What are some common emotional problems among adolescents?
Anxiety, depression, eating disorders, suicide ideation.
What does teen sexuality and pregnancy increase the risk of?
STI, school completion/attendance/health risk to mom and babies
Is the following statement true or false?
* For teenagers, suicide is the 10th
leading cause of death.
False
Rationale: Teenage suicide is the 2nd leading cause of
death for this age group.
Who was the first school nurse?
Lina Rogers Struthers
What are the different roles and functions of a school nurse?
Conduct screenings, promote wellness, clinician, promote health services (immunizations, safety measures etc.)
What are some responsibilities of school nurses?
Diabetes management, first aid, medication administration.
T or F, all meds including OTC, must have a form signed by a parent.
T
Which of the following scenarios would be an example
of a nurse caring for a child with a chronic condition?
A. The nurse provides first aid to a student who has
sustained a knee laceration while playing on the
playground.
B. The school nurse assists a student with counting
carbs before going to lunch.
C. A student reports to the nurses office with a red
sore on his leg resembling a spider bite, which is
very painful, and warm to the touch.
D. A student reports to the school nurse office
multiple times a week with a complaint of a
stomach ache but reports not eating breakfast
before arrival.
B
Counting carbs is a part of the care of a child with
diabetes. Diabetes is a chronic child disease.
What is the global average life expectancy?
67 years.
By 2050 what % of the population will be older adults?
16%
What are some common misconceptions about older people?
- Inability to live independently
- Chronologic age as a determinant
of oldness - Most with diminished intellectual
capacity or senility - All content and serene
- Inability to be productive
- Resistant to change
- No social security on retirement
Is the following statement true
or false?
* A healthy older adult has a
positive emotional outlook
True
* Rationale: A healthy older adult
is characterized by a lifetime of
healthy habits, a strong social
support system, and a positive
emotional outlook.
What are some traits of healthy older adults?
Lifetime of healthy habits
Strong social support system
Positive emotional outlook
What are some successful aging strategies?
Exercise
* Diet
* Sleep
* Cognitive activities
* Independence
* Activity
Who recieves medicare?
individuals 65 and older or disbaled
What does medicare exclude?
longterm, dental, and eyecare
What are the different parts of medicare?
Part A – Hospital insurance
* Part B – Supplementary
* Part C – Medicare Advantage
* Part D – Prescription
What is elder abuse?
“Intentional or neglectful acts by a caregiver or any other person that
causes harm or a serious risk of harm to a vulnerable adult”
What are some examples of elder abuse?
Physical abuse
* Neglect
* Emotional or psychological abuse
* Verbal abuse and threats
* Financial abuse and exploitation
* Sexual abuse
* Abandonment
Which of the following reflects the goal of service programs
for healthy older adults?
A. Provision of necessary care
B. Comprehensiveness of services
C. Maintenance of functional independence
D. Ensured access to care
C. Maintenance of functional independence
* Rationale: The goal of services for healthy older adults
focuses on maintaining the adults’ functional independence.
Comprehensiveness and accessibility are criteria for effect
service delivery. Provision of care reflects the activity of a
service.
Who and where did the first home health visits begin?
Lillian Wald began first visits in New York City
Who recieves medicaid?
Primarily low income populations
Who oversees medicare and medicaid?
Centers for Medicare and
Medicaid Services
IS THE FOLLOWING STATEMENT TRUE
OR FALSE?
THE MEDICARE HOME HEALTH
BENEFIT LED TO THE CLOSURE OF
MANY HOME HEALTH AGENCIES.
False
Rationale: The Medicare
Prospective Payment System led
to the closure of many agencies
due to the changes in payment.
What home health agency is charitable; exempt from paying taxes; financed with nontax funds; VNAs.
Voluntary non-profit
What home health agency is part of hospital as a separate department; nonprofit or generate revenue.
Hospital based
What home health agency has individual owners, often part of large regional or national chain
administered through corporate headquarters; pay taxes on profits
For-profit proprietary agencies
What home health agency is private; funding from direct payment by the client or insurers; governed by
individual owners or corporations
Noncertified agencies
What home health agency is certified by Medicare/Medicaid and can receive reimbursement for services?
Certified agencies
What is the criteria for medicare for home health ?
The pt. should have had a face-to-face encounter with pcp for
the reason of HH services 90 days prior or within 30 days after the
start of services.
2. Client should be homebound
3. Plan of care in Medicare forms
4. Client must need skilled services
5. Services should be intermittent.
6. Under care of physician
* Requires OASIS assessment for admission as well assists with
measuring outcomes for quality improvement
Which of the Following would be Considered Home Bound? Select
All that apply:
A. Patient is home the majority of the time but once a week goes
to her hair appointment.
B. Patient is able to leave home with difficulty to an adult daycare
facility
C. Patient uses a walker but is able to attend church services
regularly.
D. Patient uses a cane and attend social club monthly.
E. Patient leaves home only to attend doctor appointments
B & E
* Only leaving for adult daycare or doctors appointments meets
Medicare criteria for homebound. The ability to go out for hair
appointments or social/religious meetings does not qualify the
patient for being homebound.
What are the most common diagnoses of hospice care?
essential hypertension, heart failure, diabetes, chronic skin ulcers, and
osteoarthritis
What are some big challenges of home health?
medication safety, infection control, and falls
Is the following statement true or false?
* Currently, most clients receiving hospice care
were diagnosed with cancer.
False
* Rationale: Today, hospice care involves a
variety of diagnoses involving end-stage
diseases, not just cancer.
What are the four major changes in end of life care?
Care should attend to the body, mind, and spirit.
* Death must not be a taboo topic.
* Medical technology should be used with discretion.
* Clients have a right to truthful discussion and involvement in
treatment decisions.
What are symptoms of compassion fatigue?
Symptoms may include isolation, apathy, exhaustion, substance abuse, sleep disturbances, difficulty
focusing
What vaccines do you get at 2 months? (DIHHPeR)
Dtap, IPV, Heb B, Hib, PCV-13, Rotavirus
What vaccines do you get at 4 months? (DIHPeR)
Dtap, IPV, Hib, PCV-13, Rotavirus
What vaccines do you get at 6 months? (DIHHPeR)
Dtap, IPV, Heb B, Hib, PCV-13, Rotavirus. Can begin flue vaccine
What vaccines do you get at 12-15 months? (Hello Harry V. Potter MD)
Hib, Hep A, Varicella, PCV-13, MMR, Dtap
What vaccines do you get at 4-6 years? (I Didd My Vaccines)
IPV, DTap, MMR, Varicella
What vaccines do you get at 11-12 years? (Tweens Have Money)
TDap, HPV (x3 doses), Meningococcal
What vaccines do you get as an adult? (IT)
Influenza yearly, TDap every 10 years
What vaccines do you get at 60-65 years? (HIP)
Herpes Zoster, Influenza, Pneumococccal
Who can’t get the flu vaccine?
Children under 6 months?
Who can take the Pfizer COVID vaccine?
5 y/o and up
Who can get the Moderna COVID vaccine?
18 y/o and up
Who can get the Johnson and Johnson vaccine?
18 y/o and up.
What increases your risk of Reye’s?
Aspirin with varicella vaccine
What are some barriers to vaccination?
Religion, misconceptions, insurance coverage, socioeconomics, disparities
Common diseases and conditions of older adults
Alzheimer’s, arthritis, cancer, CV disease, depression, suicide, diabetes, obesity, osteoporosis
