nursing exam 3

Question 1

managed care

Answer 1

controls cost while maintaining quality but, limits choice of care-provider and requires approval for specialty care

Question 2

gatekeeper

Answer 2

primary care provider, plans and monitors care

Question 3

Role of nurses in hospitals, 8:

Answer 3

DAMN PRIC:

1. Direct care providers
2. Administrator
3. Manager of Members of healthcare team
4. Nurse practitioner
5. Patient educators
6. Researcher
7. In-service educator
8. Clinical nurse specialist

Question 4

Role of nurses in physician office (primary care centers), 4:

Answer 4

P,P,P, Ass (think “P” for primary or physician)

1. Perform health assessments
2. Perform technical procedures
3. Provide health education
4. Assist the Dr.

Question 5

Role of nurses in ambulatory (urgent) care centers, 3:

Answer 5

1. provide technical services
2. Determine priority of care needs
3. Provide teaching about all aspects of care

Question 6

home health care, 5:

Answer 6

“I CRAM at home”

1. Increasing numbers of elderly w/chronic illness
2. COLLABORATE W/OTHER HEALTHCARE PROVIDERS (TEST HORN)
3. Reimbursment system of payment
4. At home death (with dignity)
5. Most rapidly growing area of healthcare

Question 7

Long term care facilities, 4:

Answer 7

1. intermediate and longterm
2. nursing homes
3. retirement centers
4. residential institutions for mentally or physically disabled ANY AGE

Question 8

specialized care centers, (school nurse), 4:

Answer 8

SCHOOL is making me MENTAL! I am going to end up HOMELESS or in REHAB!

1. Schools, lots of teaching (test horn)
2. Mental health centers
3. Homeless shelters
4. Rehabilitation centers

Question 9

Bereavement care (end of life), 4:

Answer 9

At the end of your life all you need is a Pal, bere (beer), hoes and rest

1. Pal=Palliative (A pal relieves pain and suffering)
2. Bere=Bereavement (gonna need a beer “following death”)
3. Ho(e)s=Hospice (Hoes to take care of dying person and loved ones)
4. Rest=Respite (for the caregiver)

Question 10

Members of Healthcare team, 6:

Answer 10

1. Physician, PA
2. Physical, reparatory, occupational, speech, therapist
3. dietitian
4. pharmacist
5. social worker
6. unlicensed assistive personnel

Question 11

Rose of Physician, 5:

Answer 11

Diagnose, PIMP:

1. diagnose illness
2. Prescribe medicines
3. Interpreting labs and diagnostics
4. Medical or surgical treatment
5. Performing procedures and surgery

Question 12

Payment, federally funded programs

Answer 12

medicare (DRGs)

Medicaid

Question 13

Payment, Group Plans

Answer 13

HMO (health maintenance organization)

PPO (preferred provider organizations)

Question 14

Payment, Private Insurance

Answer 14

3ed Party Payer

TEST HORN

Question 15

Payment, Long-term care insurance

Answer 15

…

Question 16

Trends in nursing

Answer 16

changing demographics
increased diversity
techo explosion
globalization
educated consumers
complexity of patient care
costs of healthcare
policy and regulation
CURRENT NURSING SHORTAGE * (HORN)

Question 17

Role of nurse in community based care, 5:

Answer 17

CHIMP:
1**Provide CONTINUITY of care when patient moves from one level of care to another
2. Promote HEALTH
3. Provide INTERVENTIONS
4. MANAGE acute/chronic illness
5. PROMOTE self-care

Question 18

Continuity of care

Answer 18

a process by which healthcare providers give appropriate, uninterrupted care and facilitate the patients transition between different setting and levels of care

Question 19

*3 important roses of the nurse

Answer 19

CAT

1. Collaborator
2. Advocate
3. Teacher

Question 20

Info obtained on the admission sheet, 9:

TEST HORN

Answer 20

NAG DR. FOR ID:

1. Name, add & DOB for patient
2. Admitting physician
3. Gender and Marital status
4. Date & time of admission/diagnosis
5. Religious pref
6. Financial status
7. Occupation / employer
8. Relative, nearest
9. ID #

Question 21

Preparing room for patient

Answer 21

Nurse may delegate, but is responsible for the following tasks:

• position and open bed
• assemble necessary equip/supplies
• assemble special equip/supplies
• adjust physical environment of room

Question 22

Info in verbal report (holistic assessment), 8:

Answer 22

SCAN PLAN:

1. Surgical procedure (if applicable)
2. Current condition
3. Allergies
4. Nursing care priorities
5. Physician and admitting diagnosis
6. Lab/equipment data
7. Advanced directives
8. Name and age of patient

Question 23

Essential components of Discharge Planning, 4:

Answer 23

IM ACE:

1. IMplement plan of care
2. Assess strength and limits of patient, family, support person & assess environment
3. Consider individual, family and community resources
4. Evaluate effectiveness of care

Question 24

Guidelines for discharge planning, 6:

Answer 24

HE FAST (at discharge planning)

1. Home healthcare referals (provide) (4)
2. Evaluate discharge planning effectivness (5)
3. Focused assessment guide (pg 166) (6)
4. Assess and ID healthcare needs (1)
5. Set goals w/patient (2)
6. Teach patient and fan (3)

Question 25

Leaving AMA, 6:

Answer 25

1. patient is leagally free to leave 2. choice carries risk 3. must sign release 4. patient informed of risks prior to signing 5. signature witnessed 6. form is part of medical record

Question 26

Transfer to long term facility, 3:

Answer 26

1. copy of chart sent w/patient; original remains at hospital 2. detailed assessment and care plan is sent 3. nurse provides verbal report to new nurse

Question 27

5 parts of communication process

Answer 27

1. stimulus/referent (reason) 2. sender/ source of message (teacher) 3. the message 4. medium/channel of communication (like audio, visual, etc...) 5. the receiver (who the message is aimed at)

Question 28

Non-verbal communication | TEST HORN

Answer 28

90% ...expresses more of the message than verbal | touch, eye contact, facial expressions, etc...

Question 29

Four levels of communication | TEST HORN

Answer 29

1. intrapersonal - self-talk 2. Interpersonal- 2 or more 3. small group - support group 4. organizational - grouped to achieve common goal

Question 30

Factors Influencing communication, 4:

Answer 30

1. gender 2. socioculture 3. space and territoriality (test horn) 4. physical, mental, and emotional state

Question 31

The helping relationship, 3:

Answer 31

1. does not occur spontaneously 2. characterized by an unequal sharing of info 3. Always built on patients needs!!

Question 32

Characteristics of the helping relationship, 3:

Answer 32

1. dynamic 2. purposeful and time limited 3. person providing assistance in professionally accountable for the outcomes

Question 33

Phases of Helping relationship, 3:

Answer 33

1. orientation 2. working 3. termination

Question 34

Goals of the orientation phase, 4:

Answer 34

1. establish tone and guidelines for relationship 2. ID ea. other by name 3. clarify roles of both people 4. establish an agreement about the relationship

Question 35

Goals of the working phase, 3:

Answer 35

1. work together to meet the patients needs 2. provide whatever assistance is needed to achieve ea. goal 3. provide teaching and counseling (test horn)

Question 36

Goals of termination phase, 3:

Answer 36

1. examine goals of helping relationships for attainment 2. make suggestions for future efforts if necessary 3. encourage patient to express his or her emotions about the termination

Question 37

The difference between "dispositional traits" and "rapport builders"

Answer 37

dispositional=characteristics or customary way of behaving: friendliness, respect, empathy, honesty, caring... Rapport=a feeling of mutual trust which facilitates open communication: environment, privacy, confidentiality, optimal pacing, etc...

Question 38

SBAR communication (test horn)

Answer 38

S-situation (objective data what is the major problem?) B- background (objective, history?) A- assessment (subjective, what you have assessed the problem is) R - recommendations (suggestions to improve care)

Question 39

Developing conversation skills

Answer 39

control tone of voice, be knowledgable about topic, be clear and concise, truthful, open minded...take advantage of available opportunities to converse while proving care

Question 40

Develop listening skills

Answer 40

sit with a patient, eye to eye, be alert and relaxed, use appropriate facial expressions, think before responding, don't pretend to listen, listen for themes, use silence, therapeutic touch and humor appropriately

Question 41

Interviewing techniques

Answer 41

OPEN ENDED QUESTIONS (allows for more info) closed questions (yes, no)=inedffective validating questions or comments, clarifying, reflective (puts the focus back on the patient)

Question 42

Blocks to communication (test horn), 5:

Answer 42

1. advice 2. judgmental 3. changing the subject 4. false assurance 5. gossip, rumors