Unit 1

Question 1

Problem-focused dx

Answer 1

Describes existing problem

Question 2

Risk dx

Answer 2

Describes potential prob that pt is vulnerable to

Risk for _____ r/t _________

Question 3

Health Promotion dx

Answer 3

Describes pt’s, family’s or community’s desire to realize human health potential. Focus = being as healthy as possible.
Ex: Effective breastfeeding

Question 4

Syndrome dx

Answer 4

Group of S&S that occur together

Ex: Sleep deprivation

Question 5

Characteristics of Critical Thinkers

Answer 5

1. Raise Q’s
2. Willingness to search for answers
3. Inquisitive
4. Eager to acquire new knowledge
5. Consider multiple perspectives
6. Explore ideas/problems in new ways
7. open-minded

Question 6

What is Critical Thinking

Answer 6

character + knowledge + skills

Question 7

What is the Nursing Process

Answer 7

Problem-solving process

Question 8

ADPIE

Answer 8

Assessment
Diagnosis
Planning
Implementation
Evaluation

Question 9

2 Types of data

Answer 9

Subjective (what a pt “says”)

Objective (measurable)

Question 10

Secondary sources of data

Answer 10

Family, friends, caregivers, pt records, literature

Question 11

Steps after assessment

Answer 11

1. Cluster (like info together)
2. Validate
3. organize
4. Document

Question 12

What is etiology

Answer 12

problem + reason

Question 13

Nursing diagnosis format?

Answer 13

Diagnostic label + related factors

Question 14

Diagnosis formula =

Answer 14

problem + r/t + reason

impaired comfort r/t bld glucose testing

Question 15

Planning:

Answer 15

1) initial
2) Ongoing
3) Discharge

Question 16

Planning has what priority settings:

Answer 16

ABC’S
Airways, breathing, circulation, & safety
High, med, low

Question 17

Characteristics of pt-centered goals (PLANNING)

Answer 17

Singular; observable; measurable; time-limited; mutual; realistic.
Short-term / long-term.
Simple

Question 18

Word formula for planning

Answer 18

Combine verb with condition and criterion:

Ex: Patient will demonstrate minimal episodes of agitation
as evidenced by a calm demeanor over 48 hours

Question 19

What do you always use with implementation

Answer 19

scholarly resources

Question 20

During implementation when do you initiate interventions…after:

Answer 20

1. Reassessing the pt
2. Organize resources
3. Anticipate/prevent complications

Question 21

What is the evaluation focused on?

Answer 21

ONLY Pt and Plan

Question 22

What is the evaluation NOT focused on

Answer 22

Nurses action

Question 23

What part do you refer to during evaluation step?

Answer 23

The goal

Question 24

What are the 3 Outcomes of goal?

Answer 24

1. Goal met
2. Goal partially met
3. Goal not met

Question 25

1. According to the biomedical model, a narrow definition of health is: a) an optimal functioning of mind, body, and spirit within the environment. b) the absence of disease. c) the response of the whole person to actual or potential problems. d) prevention of disease.

Answer 25

B

Question 26

``` 2. What type of database is most appropriate when a rapid collection of data is required and is often compiled concurrently with life-saving measures? A. Episodic B. Follow-up C. Emergency D. Complete ```

Answer 26

C

Question 27

3. A medical diagnosis is used to evaluate: A. a person’s state of health. B. the response of the whole person to actual or potential health problems. C. a person’s culture. D. the cause of disease.

Answer 27

D

Question 28

4. Which of the following is considered an example of subjective data? A. Decreased range of motion B. Crepitation in the left knee joint C. Left knee has been swollen and hot for the past 3 days D. Arthritis

Answer 28

C

Question 29

``` 5. What type of database is most appropriate for an individual who is admitted to a long-term care facility? A. Episodic B. Follow-up C. Emergency D. Complete ```

Answer 29

D

Question 30

``` 6. Which of the following is considered an example of objective data? A. Alert and oriented B. Dizziness C. An earache D. A sore throat ```

Answer 30

A

Question 31

7. An example of objective data is: A. complaint of left knee pain. B. crepitation in the left knee joint. C. left knee has been swollen and hot for the past 3 days. D. report of impaired mobility from left knee pain as evidenced by an inability to walk, swelling, and pain on passive range of motion.

Answer 31

B

Question 32

8. A nursing diagnosis is best described as: A. a determination of the etiology of disease. B. a pattern of coping. C. an individual’s perception of health. D. a concise statement of actual or potential health concerns or level of wellness.

Answer 32

D

Question 33

9. A complete database is: A. used to rapidly collect data and is often compiled concurrently with life-saving measures. B. used for a limited or short-term problem usually consisting of one problem, one cue complex, or one body system. C. used to evaluate cause and etiology of disease. D. used to perform a thorough or comprehensive health history and physical examination.

Answer 33

D

Question 34

10. A patient admitted to the hospital with asthma has the following problems identified, based on an admission health history and physical assessment. Which problem is a first-level priority? A. Ineffective self-health management B. Risk for infection C. Impaired gas exchange D. Readiness for enhanced spiritual well-being

Answer 34

C

Question 35

Which of the following statements about nursing diagnoses is true? Nursing diagnoses: A. Evaluate the reason for a disease. B. Are a process based on medical diagnosis alone. C. Evaluate the response of the patient to actual or potential health problems. D. Focus on the function and malfunction of a specific organ system in response to disease

Answer 35

C

Question 36

What are the SMART Outcomes

Answer 36

``` Specific Measurable Attainable Realistic Time ```

Question 37

4 major components of diagnostic reasoning

Answer 37

1. Attending to cues (S&S, info, lab data) 2. Formulating diagnostic hypotheses 3. Gather data 4. Evaluate hypothesis ...leads to final diagnosis

Question 38

Evidence-informed practice uses: (3) _______ to make decisions about care & treatment

Answer 38

1. best evidence 2. Clinician's experience 3. Pt's preferences & values

Question 39

Biomedical health model

Answer 39

Absence of disease

Question 40

Behavioral Model

Answer 40

include primary and secondary prevention with emphasis on changing behaviour and lifestyle.

Question 41

Socioenvironmental Model

Answer 41

biomedical + behavioural models + sociological and environmental aspects of health.

Question 42

Social determinants of health

Answer 42

social, economic, and political conditions that shape the health of individuals, families, and communities.

Question 43

Relational Approach to Nursing Practice

Answer 43

considers health and illness and the meaning they hold as being shaped by social, cultural, family, historical, and geographical as well as by the patient’s gender, age, ability, and other individual contexts.

Question 44

Steps to setting priorities

Answer 44

1. 1st level (ABC'S + V[vital sign concerns]) 2. 2nd level (mental status, acute pain, irregular lab, ect) 3. 3rd level (lack of knowledge, rest, coping) 4. Collaborative problems