Nursing Intro - Exam 1 Flashcards
(120 cards)
1
Q
What are the roles of nurses?
A
- respond to needs of patients
- actively participate in determining best practices
2
Q
Who is Florence Nightingale?
A
the mother of modern nursing
3
Q
What was her role in the community?
A
- organized first school of nursing
- improved sanitation in battlefield hospitals
4
Q
Who is Clara Barton?
A
Founder of the Red Cross
5
Q
Who is Mother Bickerdyke?
A
She organized ambulance services, and walked the battlefield at night looking for wounded soldiers
6
Q
Who is Mary Mahoney?
A
She was the first professionally trained African- American nurse
7
Q
Who is Lillian Wald and Mary Brewster?
A
- they opened the Henry Street Settlement
- their nurses were some of the first to demonstrate autonomy in their practice
8
Q
Which century did these changes occur in?
- a movement toward developing a scientific, research-based practice and defined body of knowledge
- nurses assumed advanced practice roles
A
20th century
9
Q
Which century did these changes occur in?
- changes in nursing school curriculum
- advances in technology and informatics
- new programs address current health concerns
- nursing taking a leadership role in developing standards and policies
A
21st century
10
Q
What is the importance of nurses’ self- care?
A
- compassion fatigue
- secondary traumatic stress
- burnout
11
Q
What is the Affordable Care Act (ACA)?
A
Affecting how health care is paid for and delivered. More nursing in community- based settings
12
Q
What are Rising health care costs?
A
Presents challenges to the nursing profession, consumer, and health care delivery system
13
Q
What are Demographic changes?
A
Movement of people from rural to urban areas, increased life span, increase in patients living with chronic and long- term illnesses
14
Q
Who are the Medically underserved?
A
Unemployment, low-paying jobs, mental illness, homelessness
15
Q
What is patient- centered care?
A
Patient includes individual, families, and/or communities
16
Q
What is professionalism?
A
- administer quality care
- be responsible and accountable
17
Q
What are Benner’s stages of nursing proficiency?
A
Novice Advanced beginner Competent Proficient Expert
18
Q
At what stage would a practicing nurse of 2-3 years be in?
A
Competent
19
Q
At what stage would a nurse with some experience be in?
A
Advanced beginner
20
Q
At what stage would a nurse of 10 years in the same department be in?
A
Expert
21
Q
At what stage would a nursing student be in?
A
Novice
22
Q
At what stage would a practicing nurse of more than 2-3 years be in?
A
Proficient
23
Q
What does ADPIE stand for?
A
Assess Diagnose Plan Implement Evaluate
24
Q
What are some professional roles and responsibilities?
A
Autonomy Accountability Caregiver Advocate Educator Communicator Manager
25
What are some essential skills a nurse must have?
- time management
- therapeutic communication
- patient education
- compassion
26
What are the two stages of assessment?
Collection and verification of data
| Analysis of data
27
What are sources of data?
- patient
- family and significant others
- health care team
- medical records
- scientific literature
28
What are the types of data?
- subjective
| - objective
29
Should you document subjective data?
No! Only if that pt stated the words and they are in quotes
30
What are the types of assessments?
- patient centered interview
- physical examination
- periodic assessment
31
What is a cue?
Information obtained through use of senses
32
What is an inference?
Your judgement or interpretation of these cues
33
When is motivational interviewing often used?
In counseling
34
What is effective communication?
Requires courtesy, comfort, connection, and confirmation
35
What are the phases of the patient-centered interview?
- orientation (introduce yourself, your position, and explain the purpose of the interview)
- working phase (listen and gather information)
- termination (summarize discussion and check for accuracy)
36
What are some interview techniques?
- observation
- open ended questions (allows for conversation)
- leading questions (can be risky but useful)
- back channeling (promotes active listening)
- direct close-ended questions (limits to “yes” or “no”)
37
What are some cultural considerations you should look for?
- respect the unfamiliar and be sensitive to patients uniqueness
- ask for clarification if you are unsure of what the pt is wanting
38
What questions are involved in the nursing health history?
- biographical information (age, address, occupation ...)
- chief concern (learn the pt chief concern or problem)
- pt expectations (learn what the pt expects to happen while they are seeking treatment)
- present illness or health concerns (determine when the problem began, how severe, quality...)
- health history (family history)
- environmental history (home/work environment)
- psychosocial history (support system, spouse, friends...)
- spiritual health (pt beliefs, source of guidance, rituals or practices)
- review of systems (an approach to collect subjective data from the pt about each body system)
39
What is diagnostic and laboratory data?
- Results that provide further explanation of alterations or problems identified during the health history and physical examination
- compare with normals
40
What is interpreting and validating assessment data?
- ensures collection of complete database
- leads to clinical decision making
- compare with other sources for accuracy
- can lead you to reassess and gather additional data
41
When documenting data you should ...?
- use clear, concise appropriate terminology
| - it becomes the baseline for care
42
What is concept mapping?
A visual representation that allows you to graphically show the connections among a patients many health problems
43
You should always observe a patients verbal and nonverbal behaviors because
It can add depth to objective data
44
Important aspects of observation include... ?
The pt physical, developmental, psychological, and social aspects of everyday living
45
What is a care plan?
- provides direction for individualized care of the client
- flows from each pt unique assessment and organized by the pt specific needs
- means of communication and organizing actions of constantly changing nursing staff
46
What are the components of a care plan?
- client database
- interviewing
- physical assessment
- diagnostic studies
47
What are the pieces of a care plan?
- Diagnosis (what is the area of concern that nurses treat/prevent/monitor?)
- Outcome/Goal (what is an appropriate goal for this pt?)
- Intervention (what treatment is most effective?)
48
Diagnosis (I have no idea how to make this into a question 😂)
- during our assessment, we create our database of info
- with this data we identify a nursing diagnosis for our pt
- nursing diagnosis allow for clear communication among the care team
- allow for collection of data for continuous improvement
- can be an individuals response to health problems or life processes
49
What is a nursing diagnosis?
A clinical judgement about actual or potential individual, family, or community experiences
50
What are the components of nursing diagnosis?
- distinguishes nurses role from physicians role
- help nurses focus on their scope of practice
- foster the development of nursing knowledge
51
What are NANDA - I nursing diagnoses used for?
To create our care plans
52
What is an “actual” nursing diagnosis?
A problem focused nursing diagnosis
53
Is etiology (related to) required for an “actual” nursing diagnosis?
Yes! because it is an actual issue there is something occurring in the body causing the problem
54
Are sxs (as evidenced by) required for an “actual” nursing diagnosis?
Yes! need at least 3 pieces of evidence in your diagnosis
55
What is a “risk for” nursing diagnosis?
A potential problem approved by NANDA (risk for infection, risk for skin breakdown)
56
Is etiology (related to) required for a “risk for” diagnosis?
No! because there is not an actual problem yet, it’s only risk for
57
What other components are needed for a “risk for” nursing diagnosis?
3 pieces of evidence (risk factors) that pose the potential problem
58
What components are needed for a “readiness for” nursing diagnosis?
- NANDA
- as evidenced by
- 3 pieces of evidence
59
When more than one diagnoses are being created for one pt, they must be ___________?
prioritized
60
How do we prioritize them?
A, B, C ‘s first then Maslow’s
| meaning if all A, B, C ‘s are met
61
After you prioritize diagnoses, you then select _____?
Interventions
62
What do you do if your pt POC has changed from shift to shift?
First: assess
Then: determine nursing diagnosis from the new assessment and plan for new goal and new intervention
63
You are preparing a presentation for your classmates regarding the clinical care coordination conference for a pt with terminal cancer. As part of the preparation you have your classmates read the Nursing Code of Ethics Professional Registered Nurses. Your instructor asks the class why this document is important. Which statement best describes this code?
A. Improves self-health care
B. Protects the pt’s confidentiality
C. Ensures identical care to all pt’s
D. Defines the principles of right and wrong to provide pt care
64
<<<<< answer
D. Defines the principles of right and wrong to provide pt care
65
A nurse is caring for a pt with end-stage lung disease. The pt wants to go home on oxygen and be comfortable. The family wants the pt to have a new surgical procedure. The nurse explains the risk and benefits of the surgery to the family and discusses the pt’s wishes with them. The nurse is acting as the pt’s:
A. Educator
B. Advocate
C. Caregiver
D. Communicator
66
<<<<< answer
B. Advocate
67
The nurse spends time with a pt and family reviewing a dressing change procedure for the pt’s wound. The pt’s spouse demonstrates how to change the dressing. The nurse is acting in which professional role?
A. Educator
B. Advocate
C. Caregiver
D. Communicator
68
<<<<< answer
A. Educator
69
The examination of registered nurse licensure is the same in every state in the United States. This examination:
A. Guarantees safe nursing care for all pt’s
B. Ensures standard nursing care for all pt’s
C. Provides a minimal standard of knowledge for an RN in practice
D. Guaranteed standardized education across all prelicensure programs
70
<<<< answer
C. Provides a minimal standard of knowledge for an RN in practice
71
Contemporary nursing requires that the nurse has knowledge and skills for a variety of professional roles and responsibilities. Which of the following are examples of these roles and responsibilities? (Select all that apply)
```
A. Caregiver
B. Autonomy
C. Pt advocate
D. Health promotion
E. Genetic counselor
```
72
<<<< answer
A. Caregiver
B. Autonomy
C. Pt advocate
D. Health promotion
73
Which type of nurse provides independent care, including pregnancy and gynecological services?
a nurse- midwife
74
Which type of nurse is an expert clinician in a specialized area of practice such as adult diabetes care?
a clinical nurse specialist
75
Which type of nurse provides comprehensive care, usually in a primary care setting, directly managing the medical care of pt’s who are healthy or have chronic conditions?
a nurse practitioner
76
Which type of nurse provides care and services under the supervision of an anesthesiologist?
a nurse anesthetist
77
Health care reform will bring changes in the emphasis of care. Which of these models is expected from health care reform?
A. Moving from an acute illness to a health promotion, illness prevention model
B. Moving from an illness prevention to a health promotion model
C. Moving from hospital-based to community-based care
D. Moving from an acute illness to a disease management model
78
<<<< answer
A. Moving from an acute illness to a health promotion, illness prevention model
79
A nurse meets with the registered dietitian and physical therapist to develop a plan of care that focuses on improving nutrition and mobility for a pt. This is an example of which Quality and Safety in the Education of Nurses competency?
A. Pt-centered care
B. Safety
C. Teamwork and collaboration
D. Quality improvement
80
<<<< answer
C. Teamwork and collaboration
81
A critical care nurse is using a new research-based intervention to correctly position her ventilated pt’s to reduce pneumonia caused by accumulates respiratory secretions. This is an example of which Quality and Safety in the Education of Nurses competency?
A. Pt- centered care
B. Evidence-based practice
C. Teamwork and collaboration
D. Quality improvement
82
<<<< answer
B. Evidence- based practice
83
The nurses on an acute care medical floor notice an increase in pressure injury formation in their pt’s. A nurse consultant decides to compare two types of treatment. The first is the procedure currently used to assess for pressure injury risk. The second uses a new assessment instrument to identity at-risk pt’s. Given this information, the nurse consultant exemplifies which career?
A. Clinical nurse specialist
B. Nurse administrator
C. Nurse educator
D. Nurse researcher
84
<<<<< answer
D. Nurse researcher
85
A nurse completes the following steps during her shift of care. Which are the steps of nursing assessment? (Select all that apply)
A. The review of pt data in the medical record
B. Confirming a pt’s self-report of abdominal pain by inspecting the abdomen
C. Reporting results of an ongoing assessment to a nurse working the next scheduled shift
D. Analyzing a set of signs revealing lower leg weakness and unsteady gait with a pattern of mobility alteration
E. Conducting an interview of a family caregiver
86
<<<< answer
All of them!
87
Which of these is a problem focused assessment and which of these is a comprehensive assessment? (2 each)
A. Assessment conducted at beginning of a nurses shift
B. Review of pt’s chief complaint
C. Completion of admitting history at time of pt admission to a hospital
D. Completion of the Long Term Care Minimum Data Set during an elderly pt admission to a nursing home
88
<<< answer
Problem focused
A and B
Comprehensive
C and D
89
A nurse initiates a brief interview with a pt who has come to the medical clinic because of self-reported hoarseness, sore throat, and chest congestion. The nurse observed that the pt had a slumped posture and is using intercostal muscles to breathe. The nurse as cultured the pt’s lungs and hears crackles in the left lower lobe. The pt’s respiratory rate is 20 per min compared with an average of 16 per min during previous clinic visits. The pt tells the nurse. “It is hard for me to get a breath.” Which of the following data sets are examples of subjective data? (Select all that apply)
A. Heart rate of 20 per min and chest congestion
B. Lung sounds revealing crackles and use of intercostal muscles to breathe
C. Pt statement. “It’s hard for me to get a breath”
D. Slumped posture and previous respiratory rate of 16 per min
E. Pt report of sore throat and hoarseness
90
<<<< answer
C. Pt statement, “It’s hard for me to get a breath”
| E. Pt report of sore throat and hoarseness
91
The nurse asks a pt the following series of questions: “Describe for me how much you exercise each day.” “How do you tolerate the exercise?” “Is the amount of exercise you get each day the same, less, or more than what you did a year ago?” This series of questions would likely occur during which phase of a pt-centered interview?
A. Orientation
B. Working phase
C. Data interpretation
D. Termination
92
<<<<< answer
B. Working phase
93
A young male pt enters the ED with fever and signs of a possible STD. The nurse enters the pt’s cubicle and begins to enter a history in the computer screen. Before beginning the nurse introduces himself and tells the pt all information will be held confidentially. The nurse starts data collection by establishing eye contact with the pt and then looks at the computer prompts to select a series of questions. As the nurse fills out questions on the computer, the pt asks a question about his treatment. The nurse states, “Let me get through these questions first.” Which action interferes with the nurses ability to use connnection as a communication skill.
A. Introducing self to pt
B. Using the computer as a prompt for questions
C. Making the nurses questions a priority
D. Assuring the pt all information is confidential
94
<<<<< answer
C. Making the nurses questions a priority
95
A nurse observed a pt walking down the hall with a shuffling gait. When the pt returns to bed, the nurse checks the strength in both of the pt’s legs. The nurse applied the information gained to suspect that the pt has a mobility problem. This conclusion is an example of:
A. Reflection
B. Clinical inference
C. Cue
D. Validation
96
<<< answer
B. Clinical inference
97
Place the following steps of the assessment process in the correct order.
1. Compare data with another source to determine data accuracy
2. As a pattern forms, probe and frame further questions
3. Interview a pt, observe behavior, and gather physical assessment findings
4. Cluster cues that relate together, make inferences, and identify emerging patterns
5. Differentiate important data from the total data you collect
3,5,4,2,1
98
In preparing to collect a nursing history for a pt admitted for elective surgery, which of the following data are part of the review of present illness in the nursing health history?
```
A. Current medications
B. Pt expectations of planned surgery
C. Review of pt’s family support system
D. History of allergies
E. Pt’s explanation for what might be the cause of symptoms that require surgery
```
99
<<< answer
E. Pt’s explanation for what might be the cause of symptoms that require surgery
100
A nurse is conducting a pt-centered interview. Place the statements from the interview in the correct order, beginning with the first statement a nurse would ask.
A. “You say you’ve lost weight. Tell me how much weight you’ve lost in the past month.”
B. “My name is Terry. I’ll be the nurse taking care of you today.”
C. “I have no further questions. Is there anything else you wish to ask me?”
D. “Tell me what brought you to the hospital.”
E. “So, to summarize, you’ve lost about 6 pounds in the past month, and your appetite has been poor-correct?”
101
<<< answer
B,D,A,E,C
102
Which of the following approaches are recommended when gathering assessment data from an 82-year-old male pt entering primary care clinic for the first time? (Select all that apply)
A. Recognize normal changes associated with aging
B. Avoid direct eye contact
C. Lean forward and smile as you pose questions
D. Allow for paused as pt tells his story
E. Use the list of questions from the clinic assessment form to complete all data
103
<<<< answer
A. Recognize normal changes associated with aging
C. Lean forward and smile as you pose questions
D. Allow for paused as pt tells his story
104
A nursing student is working with a faculty member to identify a nursing diagnosis for an assigned pt. The student has assessed that the pt is undergoing radiation treatment, has liquid stool, and the skin is clean and intact. The student selects the nursing diagnosis Impaired Skin Integrity. The faculty member explains that the student has made a diagnostic error for which of the following reasons?
A. Incorrect clustering of data
B. Wrong diagnosis
C. Condition is a collaborative problem
D. Premature ending assessment
105
<<<< answer
B. Wrong diagnosis
106
A nurse conducts an assessment of a 42-year-old woman at a health clinic. The woman is married and lives in a condo with her husband. She reposted having frequent voiding and pain when she passes urine. The nurse asks whether she has to go to the bathroom at night, and the pt responds, “Yes, usually twice or more.” The pt had an episode of diarrhea 1 week ago. She weights 300lb and reports having difficulty cleansing herself after voiding or passing stool. Which of the following demonstrate assessment findings that cluster to indicate the nursing diagnosis Impaired Urination. (Select all that apply)
```
A. Age 42
B. Dysuria
C. Difficulty performing perineal hygiene
D. No tutus
E. Episode of diarrhea
```
107
<<<< answer
B. Dysuria
| D. Nocturia
108
Review the following nursing diagnoses and identify the diagnoses that are stated correctly. (Select all that apply)
A. Offer frequent skin care because of Impaired Skin Integrity
B. Risk of Infection
C. Chronic Pain related to osteoarthritis
D. Activity Intolerance related to physical reconditioning
E. Lack of Knowledge related to laser surgery
109
<<<<< answer
B. Risk of Infection
| D. Activity Intolerance related to physical deconditioning
110
Which of the following best describe a collaborative health problem? (Select all that apply)
A. An actual or potential physiological complication that nurses monitor to detect the onset of changes in a pt’s health status
B. The language medical practitioners use to communicate a pt’s health problem and associated treatments and response
C. A diagnostic label that classified a pt’s response to illness so that all nurses can be familiar with a specific pt’s health care needs
D. A language used by health care providers to communicate and consider each other’s unique perspective, so they can better manage the multiple factors that influence the health of individuals
111
<<<< answer
A. An actual or potential physiological complication that nurses monitor to detect the onset of changes in a pt’s health status
D. A language used by health care providers to communicate and consider each other’s unique perspective, so they can better manage the multiple factors that influence the health of individuals
112
Which of the following is a diagnostic error involving identification of a goal of care rather than a pt need?
A. Pt obtains social support care related to caregiver stress
B. Fear related to open-heart surgery
C. Acute pain related to splinting of incision
D. Impaired Family Coping related to insufficient caregiver support
113
<<< answer
A. Pt obtains social support care related to caregiver stress
114
A nurse is assigned to a new pt admitted to the medical unit. The nurse collects a nursing history and interviews the pt. Place the following steps for making a nursing diagnosis in the correct order.
1. Consider the context of pt’s health problem and select a related factor
2. Review assessment data, noting objective and subjective clinical information
3. Cluster clinical data elements that form a pattern
4. Identify appropriate assessment findings for diagnosis
5. Identify a nursing diagnosis
2,3,5,1,4
115
A nurse interviews and conducts a physical examination of a pt that includes the following findings: reduced movement of lower leg, reduced range of motion in left knee, and difficulty turning in bed without assistance. This data set is an example of:
A. Collaborative data set
B. Diagnostic label
C. Related factors
D. Data cluster
116
<<<< answer
D. Data cluster
117
A nurse reviews data gathered regarding a pt’s response to a diagnosis of cancer. The nurse notes that the pt is restless, avoids eye contact, has increased BP, and expressed a sense of helplessness. The nurse compared the pattern of assessment findings for Anxiety with those of Fear and selects Anxiety as the correct diagnosis. This is an example of the nurse avoiding an error in? (Select all that apply)
```
A. Data collection
B. Data clustering
C. Data interpretation
D. Making a diagnostic statement
E. Goal setting
```
118
<<< answer
B. Data clustering
C. Data interpretation
D. Making a diagnostic statement
119
A(n) _______ diagnosis is one that applies when there is an increased potential or vulnerability for a pt to develop a problem.
Risk diagnosis
120
You are preparing a presentation for your classmates regarding the clinical care coordination conference for a pt with terminal cancer. As part of the preparation you have your classmates read the Nursing Code of Ethics Professional Registered Nurses. Your instructor asks the class why this document is important. Which statement best describes this code?
A. Improves self-health care
B. Protects the pt’s confidentiality
C. Ensures identical care to all pt’s
D. Defines the principles of right and wrong to provide pt care
