PRN1178/ PRN 1178 Exam 1 (New 2026/ 2027 Update) Client-Centered Care II Review| Questions and Answers| 100% Correct| A Grade - Rasmussen

PRN1178/ PRN 1178 Exam 1 (New 2026/ 2027 Update) Client-Centered Care II Review| Questions and Answers| 100% Correct| A Grade - Rasmussen Q. In Maslow's Hierarchy of needs where does the topic of sleep fall under? ANSWER Physiological Needs Q. If someone has sleep apnea what do they need when sleeping? ANSWER CPAP (continuous positive airway pressure) Q. What does insomnia mean? ANSWER can't sleep Q. What is transient insomnia? ANSWER insomnia related to emotional stress. (short term periods of insomnia) Q. How to promote better sleep ANSWER (day, night, and alternative options) Day- Turn off lights Night-Cluster Care (do everything at once) Alternatives-Offer ear plugs/ another room (if possible) Q. What is narcolepsy? ANSWER Sudden onset, recurrent, brief episodes of sleep during normal hours Q. How to measure sleep ANSWER sleep diary- give times/ amount of sleep We need AT LEAST 6 hours of sleep Q. When should I stop caffeine before bed? ANSWER 6 hours before bed Q. When should I stop drinking water before bed and why? ANSWER 6PM to reduce the risk of waking up and falling Q. When should I stop drinking alcohol before bed? ANSWER 4 hours before bed Q. If somebody has a high BMI what type of diet should they have? ANSWER low calorie diet Q. What is anorexia nervosa? ANSWER A disorder where food is severely limited and exercise might be used to control weight. Q. What is bulimia nervosa? ANSWER Binge eating followed by inducing vomit or using laxatives to eliminate calories Q. What is preventative health for? ANSWER To promote health and prevent disease (this is a primary intervention) Q. What is healthy people 2030? ANSWER - Promoting healthier food access - Improving the presence of nutrition in the healthcare settings - Reducing food insecurity -Improve healthy weight status of the nation's population -Improving the quality of food+ nutrient consumption -Reducing iron deficiency Q. What are the 3 basic functions of nutrition to sustain life? ANSWER -Provide energy -Build tissue -Regulate metabolic process Q. What is the weight gain for an obese pregnant woman during the first trimester? ANSWER 11-20 lbs Q. When an older person doesn't want to eat what should you asses first? ANSWER To see if their dentures fit well Q. How should you feed somebody with aspiration risk? ANSWER -Sit up (30 mins) -Chin-tuck, swallow -Reinforce education Q. What do low income people struggle with? ANSWER Getting enough food Q. How often should you revaluate pain when oral meds are given and for IV? ANSWER 60 minutes oral 30 minutes IV7 Q. What is acute pain? ANSWER actual/ potential injury Q. What is chronic pain? ANSWER body is at baseline, not really in "fight" or "flight" Q. What is nociceptive pain? ANSWER physical or potential (injuries, procedures, arthritis) Q. 6 rights of medication administration ANSWER drug, dose, route, time, client, and documentation Q. What is phantom pain? ANSWER pain that seems to come from a limb that has been amputated Q. What is a PCA pump? ANSWER Patient Controlled Analgesia; gives patient more control and relieves anxiety Q. What should you do before paging the DR? ANSWER Revaluate pain, get more info, check for pain when doing vitals Q. What is the type of pain for people with diabetes mellitus? ANSWER Neuropathy Q. Types of pain scales ANSWER numerical vs nonverbal (facial, grimacing, crying, moaning) Q. what can decreased peristalsis lead to? ANSWER constipation Q. what can does increased peristalsis lead to? ANSWER diarrhea Q. Non-pharmacological pain distractions ANSWER Meditation, massages, aqua K (water heat pack), guided imagery Q. When given a opioid what should you watch for? ANSWER Reduced breathing and very high risk of constipation Q. What does the WHO do? ANSWER (world health organization) They have a 3-step ladder for pain management. 1. start with non-opioid drugs with or without one adjuvant therapy. 2. If pain persists or increases, add an opioid designated for mild to moderate pain with non-opioid drug and/or adjuvant therapy as needed. 3. If pain persists or increases, change to an opioid designated for moderate to severe pain with a non-opioid drug and/or adjuvant therapy as needed. Q. When giving somebody a hot pack watch for ANSWER If they have decreased sensation because they can burn themselves and not know it. Q. How long should a cold pack be applied for ANSWER 20 minutes Q. What does the Joint Commission do? ANSWER They are the ones who develop goals for patient safety. The joint commission, on average, does a yearly check and provides the hospital with accreditation. Q. When a fire occurs what do PASS and RACE stand for? ANSWER Pull the pin. Aim at the base of the fire. Squeeze the trigger. Sweep side to side. Rescue any patients in immediate danger by removing them from the area Activate the protocol Contain the fire by closing all doors and windows Extinguish and or evacuate What are the ABC's in a healthcare facility? A-Airway B-Breathing C-Circulation What are important things to remember if somebody has impaired sensation in their feet? Remember well fitting shoes and not to forget to change water settings What is the only thing you are ALLOWED to document? ONLY FACTS!!!! What is OSHA? Occupational Safety and Health Administration. They developed guidelines to limit workplace violence and stop it once it starts. What is a Safety Data Sheet (SDS)? A document that describes the health and physical hazards associated with a particular chemical or material What does RDN stand for? Registered Dietitian Nutritionist They have the nutrition authority on the care team. Healthy People 2030 Goals Promote strengthen and evaluate the nations efforts to improve the health and well-being of all people Attain healthy, thriving lives and well-being, free of preventable disease, disability, injury and premature death. Eliminate health disparities, achieve health equity Create social, physical, and economic environments Promote healthy development Engage leadership What are kilocalories? unit of human energy Carbohydrates Make up 45-65% of total kilocalories (primary) Fats 20-35% of total kilocalories (secondary) Proteins 10-35% (critical function, may be drawn on for energy) defense against infection, provide amino acids, repair tissue Vitamins and minerals Vitamin C is for collagen Calcium/phosphorus (bone tissue)iron for building hemoglobin Fatty Acids Blocks of lipids, facilitate transport (omega 3, fish,soybean oil and walnuts) What is optimal nutrition? Balancing the intake of each nutrient malnutrition Undernutrition Poverty Illness Hospitalization Overnutrition Obesity Vitamin or mineral toxicities What are refined grains? white rice and white bread What is the response to honey? Same as sugar What are monosaccharides? simple sugars glucose, fructose, galactose They are soft at rook temp From plant sources What are polysaccharides? Liquid in room temp Found in Plants source Starch:Complex carb What are disaccharides? 2 monosaccharides sucrose, lactose, maltose What is an indwelling catheter? Foley 2 lumens one for balloon and sits in the bladder (invasive) Post/Pre Op What is an external catheter? Condom and pure wick (noninvasive) no order incontinence What is a straight catheter? Order needed Invasive Retention How often do you do oral cares? Every time you reposition/ Q2H What are the types of restraints physical and chemical Fall Prevention Methods Bed alarms, 2 side rails, sitting close to the nurse's station, reorientation, wheelchair alarms NG placement Goes through the nose and down to the stomach (right tube, measure, placement, x-ray) Feeding Medicating Decompression NONpermanent (chapter 27 on fundamentals) When ausculating bowel sounds Different pitch sounds, ask if they have used the bathrooms, etc. Florence Nightengale based her curriculum on? -Nutrition on being an important part of nursing care. Nurses should help identify and meet patients personal needs, including providing emotional support. 2015, the ANA (American Nurses Association) Revised the Standards of Nursing Practice which contains? 17 standards of national practice of nursing, describing all facets of nursing practices: who, what, when, where,and how. DRGs --Were created by medicare in 1983 as an attempt to contain rising health care costs. --DRGs system means that a hospital receives a set amount of money for a patient who is hospitalized with a certain diagnosis. HMOs (a type of group practice, enroll patients for a set fee per month) -Provide a limited network of physicians, hospitals and other health care providers from which to choose. -Must be referred by their PCP for test, hospitalizations, with specialist. 1 goal of HMO? Is to keep patients healthy and put of the hospital. Preventative and Primary care -Prenatal care -Family planning -wearing seat belt Acute illness one that develops suddenly and resolves in a short time. Chronic illness (hypertension) tends to develop slowly, can be controlled but not cured, and is long-lasting. Primary illness Develops without being caused by another health problem. Secondary illness Results from or is caused by a primary illness. Congenital -present at birth -Sickle cell anemia (inherited disease) -Fetal Alcohol Syndrome (FAS) is a CONGENITAL disorder caused by alcohol intake during pregnancy. Maslow Hierarchy of basic needs Oxygenation, nutrition, elimination, safety, rest&comfort, hygiene, activity, and sexual procreation. Physiologic needs Oxygen comes first, followed by cardiovascular function comes next. Nutrition and for elimination comes after that. Security belonging -Security for pts mainly depends on the reassurance that their physiologic and safety needs will be met. -Also includes protection from psychological harm, freedom from anxiety&fear, and the need for structure, order, and a peaceful environment. Self-actualization Is an ongoing process, not something reached at a particular time. Defense mechanism -Strategies that protect us from increasing anxiety. -Reduce both anxiety and the secretion of stress hormones. -Maintain and improve our self-esteem Primary prevention Avoids or delays occurrence of a specific disease or disorder. Secondary prevention Consists of following guidelines for screening for diseases that are easily treated if found early or for detecting return of a disease. Tertiary prevention Consists of rehabilitation measures after the disease or disorder has been stabilized. Nurse responsibility under delegation -A licensed nurse is responsible for assurance that assigned person can preform the assignment safely. Also making sure no one is not preforming nurse duties and are not licensed to do so. -Follow up to make sure assignment was done correctly and no other follow up steps are needed. Discrimination Is making a decision or treating people based on a class or group to which they belong, such as race, religion, or sex. Sentinal Event Is an unexpected patient care event that results in death or serious injury to the patient. (re-portable) ISBAR-R Introduction, situation, background, assessment, recommendation, readback Consent Written consents must contain a clause that says the patient agrees to allow the provider to use and disclose his information for treatment, payment, and health care operations. Social Media and HIPPA NO PHI must be shared over social media! Positing x-rays pics, or pics in general will result in legal action! Protecting Pts Privacy -Keep all interactions with pts private as possible. -Never leave pt information on display. -Check for authorization before disclosing information to family, etc. Consent and release Consent and releases are legal documents that record the pts permission to perform a treatment or surgery or to give information to insurance companies or other health care providers. Implied consent Is assumed when, during a life-threatening emergency, consent cannot be obtained from the pt or family. Negligence Is failing to meet the standard of care, failing to do something that a reasonable and prudent (sensible and careful) person would do or not do. Assault vs battery Assault= threat to harm or threat to touch someone without their permission. Battery= actual physical contact carried out against person will. Defamation When 1 person makes remarks about another person that are untrue, and the remarks damage that persons reputation. Nurses responsibilities involving invasion of privacy? Nurses are required by law in most states to report information regarding child or elder abuse, sexual abuse, or violent acts that may be crimes. Invasion of privacy extends to? -leaving the curtains or door open while a treatment or procedure is being done. -leaving pt in a positions that might cause them loss of dignity or embarrassment. False imprisonment Prevention of a person from leaving or restricting their movements in a facility. Protective devices May be mechanical, such as locks, rails, belts, or garments, that prevent a person from getting out of a room, bed, or chair, or they may be chemical (tranquilizers, sedatives..) Incident or occurrence reports -If occurrence is out of ordinary, incident report is often used to document what happened, facts about it, who was involved or witnessed it. -It's a tool used by risk-management department. Bold: Incident report Incident reports generally not filled as part of the pts medical record and make no reference to the record. Ethical terms in nursing: BENEFICENCE To do good, taking positive action to help others. Whitsle-blowing Reporting illegal or unethical actions, and provision of care. Nurse Code of Ethics Provides guidelines for behavior that promote excellence in pt care and the profession. They promote values such as dignity, honesty, integrity, and compassion. 4 most common multidrug-resistant 1) MRSA 2) VRE 3) ESBL 4) C. Diff With antimicrobial drugs? Pts must be educated about the correct use and possible misuse of antimicrobial agents. Encourage each pt to take the entire antimicrobial prescription as ordered by health care provider to ensure full treatment of infection. Preventing spread of drug resistant organisms -Wash hands frequently, use an alcohol-based rub when soap and running water are unavailable. -Avoid contact with other people's bandages or wounds. Reservoirs -Are places where microorganisms are found. -Can be infected wounds, human or animal waste, animals and insects, contaminated food or water, or a person with an infection. Portal of exit -Is the route by which a pathogen leaves the body of it's host. -The respiratory tract is a portal of exit when microorganisms (measles, mumps, pulmonary tb, and flu) are released with coughing and sneezing. Factors that increase susceptibility to infection Age, malnutrition, chronic illness First LOD: Intact skin serves as a first line of defense against harmful environmental agents. Second LOD Includes the mechanisms of fever, leukocytosis, phagocytosis, inflammation, and the action of interferon. Fever is? A natural defense mechanism and it should not be treated right away unless it is dangerously high. Inflammatory response basic purpose? 1) neutralize and destroy harmful agents. 2) limit their spread to other tissues in the body. 3) prepare the damaged tissues for repair. Third LOD the immune response is the 3rd LOD against pathogenic organisms. Microorganisms and other substances that do not belong in the body, (pollen) are recognized as foreign invaders and trigger an immune response. Naturally acquired passive immunity Occurs when the fetus receives antibodies from the mother through placental blood before birth. Artificially acquired immunity Achieved through injection of vaccines or immunizing substances that contain dead or inactivate microorganisms or their toxins. With standard precautions? Use standard precautions or the equivalent, for the care of all patients. CDC developed Standard precautions for? -Facilities breaking the chain of infection. -They protect the nurse and pt and must be used with all pt contact. PPE consists primarily of? Gloves, gowns, masks, protective eyewear, shoe and hair coverings. With isolation precautions, when do you use a gown and a mask? -Use a gown whenever your clothing might be contaminated with body substances or airborne microorganisms from an isolated pt. -Mask is used when a pt is infected with an organism that can be transmitted by droplet or airborne particles. Sterilization -Is the best method of eliminating microorganisms from equipment and supplies. -Moist heat is often used by applying steam under pressure in a autoclave. Incubation period Begins when the organism first enters the body and lasts until the onset of symptoms. Prodromal period -The short time frame from the onset of vague, nonspecific symptoms to the beginning of specific symptoms of infection. -pt may experience malaise, or a general feeling of discomfort or illness. Convalescent period Begins when the symptoms begin to subside and extends until the pt has returned to a normal stage of health. Healthcare care-associated infections (HAIs) Are infections transmitted to a person while receiving healthcare services. Examples of airborne precautions? -Measles (rubella) -Varicella (including disseminated zoster) -TB Why is hand hygiene so important? When to use it? -Hand hygiene prevents transmission of infection. -Use it before and after pt contact, wound care, invasive procedures, and before and after glove application. What should be on specimen label? -Pt name, medical record # -Also don gloves When opening sterile packs? -Preform hand hygiene -Open sterile pk away from the body. -Only touch outside of the wrapper -Do not reach across sterile field. -Always face the sterile field, never turn back on it. When is a surgical scrub performed? Before entering the operating room, the labor and delivery area, the newborn nursery, or the neonatal intensive care unit (NICU). Performing Surgical Hand Antisepsis? 1. Make sure all needed supplies are available. 2. Remove rings and watches. 3. Adjust the to a comfortable temp using the foot control. 4. Eash hands and forearms with antimicrobial soap and running water. Clean under nails with nail stick. 5.Rinse hands and arms under running water with hands held above the elbows. Dry throughly with paper towels. Regarding the outside of sterile pk? The outside of the sterile pk is not considered sterile and can be touched. Sterile Gloving and Ungloving: #7 7. Pick up 1 sterile glove by slipping the thumb into the opening and grasping the glove with the thumb and fingertips at the folded over cuff edge. -Lft it up at least 12 inches off the wrapper. and be careful not to touch the glove to yourself or surrounding objects. Sterile Gloving and Ungloving: #8 Insert the fingers of the other hand onto the glove, extend and hold the fingers slightly apart. Pull the cuff outward as you slip your into the glove. Sterile Gloving and Ungloving: #10 Adjust the fingers in the gloves as needed by pulling the glove fingers out with the opposite hand to straighten them and allow the proper finger to enter the space. What is ANA? American Nurses Association How does the ANA define nursing? As a science and an art Nurses deliver - Client-Centered Care Who is the LPN's supervisor when working on a unit? Registered Nurse/RN 4 basic concepts of care Rest, sleep, nutrition, hydration What is Maslow's hierarchy of needs? - Human motivation based on the pursuit of different levels of needs What are the 5 levels of Maslow's Hierarchy of Needs? 1. Self actualization 2. Love and belonging 3. Esteem needs 4. Safety and security 5. Physiological needs What level are rest and sleep in Maslow's hierarchy of needs? Level 5 - physiological Inadequate rest and sleep negatively affect what? Systems of the body including cardiovascular, respiratory, immune, and neurological systems In what environment is the biggest risk for disturbed sleep and rest? Hospital/inpatient settings What can cause disturbed rest and sleep in the hospital? Noise, commotion, diagnostic tests, and vital sign measurements How can nurses promote rest and sleep? Adjusting environmental factors and carrying out nursing interventions What is a macronutrient? carbohydrate, protein, fat What is a macronutrient? Vitamins and minerals How can food and water intake be affected while in the hospital? Illness, surgery, and medications Brushing teeth? Impaired oral hygiene can affect taste and appetite What 3 things will you do as an LPN related to nutrition and hydration? Collect nutritional data, assist clients with meals and oral care, and reinforce culturally competent dietary education What are signs of fluid deficit? Dry skin and mucous membranes, decreased urinary output, and weight loss What are signs of fluid overload? Swelling, increased blood pressure, and shortness of breath If you see fluid deficit or overload, what do you do? Report signs to the RN or healthcare provider Is elimination a basic human need? Yes What cells produce waste? All of them What system eliminates metabolic waste from the blood? Urinary system How many times do adults usually void per day? 5-10 times per day How much urine should we have out per hour? 30 mL per hour Nurses individualize patient care with urinary elimination by using what 4 terms? Bathroom, commode, urinal, bedpan What is a bladder scanner? An ultrasound performed to determine how much urine is in the bladder When should a bladder scanner be used? When a client has not voided in 8+ hours What could be ordered after a bladder scan? Catherization or indwelling Foley catheter What does the digestive system do? eliminates solid waste What happens to the food we eat? It is digested and removed via the large intestine Stool is normally- soft, tubular, and light to dark brown in color What is the best position to have a bowel movement? Sitting Should you provide privacy when a client is having a bowel movement? If possible How do you remove a fecal impaction? Oil retention enema and digital disimpaction Pain results from an interaction between: nerves, the spinal cord, and the brain What is acute pain? short lived and often intense What is chronic pain? Lasts longer - mild or severe - may be constant or intermittent What is nociceptive pain? Physical or potential damage to a part of the body What is neuropathic pain? damage to the nervous system or neurological diseases What can LPNs do with pain? Monitor pain stats, provide non pharmacological and pharmacological pain management, reinforce client teaching How do you measure pain? Varies based on age, cognitive level, and health status How do you manage acute and chronic pain? Non-pharmacological and pharmacological methods Non-pharmacological pain methods include: Biofeedback, distraction, guided imagery, massage, meditation Pain medication classes include: NSAIDS, COX-2 inhibitors, narcotics, opioids Adverse effects of opioids are: Respiratory depression, sedation, and constipation What is WHO? World Health Organization How does the World Health Organization define client safety? The absence of preventable harm during the process of healthcare and reduction of risk of unnecessary harm associated with healthcare to an acceptable minimum Is client safety a global issue? Yes Who is the Joint Commission? a group that seeks to better healthcare organizations What do the Joint Commission Standards do? Provide a basis for objective evaluation of healthcare organizations What do the standards do? Help facilities assess, measure, and improve performance Who is responsible for client safety? All healthcare professionals What is a reporting culture? Reporting errors Should you report errors? Yes - you can recognize and learn from them Whenever you have a question about a procedure, can you look for the procedure in the policy book? Yes What is an incident report? ●Form that is filled out with any event not consistent with the routine care of a patient ●Used when patient care was not consistent with facility or national standards of expected care ●Give only objective, observed information ●Do not admit liability or give unnecessary details ●Do not mention the incident report in the nurse's notes What is the purpose of an incident report? To prevent errors in the future Are incident reports part of the client's medical record? No What are the four steps for developing a reporting culture with organizations? Establish trust, encourage reporting, eliminate fear of punishment, examine the reports Every point in the process of client care involves: Potential safety risks Who is first to meet the client and observe the environment for safety hazards? Nurses Nurses are considered what? Last line of defense What does the last line of defense mean? Prevent against medication errors What is a significant safety issue? Client falls What are the three most common risk factors for falls? Impaired physical mobility, altered mental status, neurological deficits When should the client be oriented to the room? Upon admission What is a fall risk assessment? any initial fall risk an admitted patient may have (assessment performed for all patients) What are some examples of safety hazards? rugs, dim lighting, unsafe tubs or showers What do you do if you discover a fire? RACE What does RACE stand for? rescue, alarm, confine, extinguish What patient education should occur if oxygen is used in the home? Clients and families that no smoking is allowed in the home When do medication errors occur? At anytime When do most medication errors occur? During medication administration What can increase medication errors? Receiving several at one or high alert medications What are the six rights of medication? drug, dose, route, time, client, documentation Main source of energy is carbohydrates What are proteins? build and repair tissues What does fat do? Supports many essential functions in the body Water is used in what part of the body? All parts What is homeostasis? A state of dynamic equilibrium in the body Poor diet is associated with Chronic diseases What is contributing to the diabetes epidemic in the US? Obesity and American diet What can we do to combat poor nutrition? Policies can be developed Current healthcare is focused on ___ and ___. Push for more ___ care. disease, treatment, and preventative What is the typical American diet? High sugar, saturated fat, and energy dense food What factors contribute to poor dietary choices? Advertisement, fast food, vending machines, large portion sizes How did carbohydrates get their name? chemical structure - carbon, hydrogen, and oxygen What are the 3 main types of carbohydrates? monosaccharides, disaccharides, polysaccharides What are monosaccharides? Simplest - made up of a single sugar What are disaccharides? two monosaccharides joined together What are polysaccharides? made of many single sugars What is another name for polysaccharides? complex carbohydrates Primary function of carbohydrates is what? Provide energy to cells Carbohydrates that break down quickly include: refined grains ex: white bread Complex carbohydrates take longer to break down like: brown rice Complex carbohydrates are ___ on the glycemic index low What does low glycemic index foods do? Maintain blood glucose What does high glycemic index foods do? Spike blood glucose What do non-digestible carbohydrates do? Promote regular bowel function What is another name for non-digestible carbohydrates? dietary fiber Examples of dietary fiber include: Fruits, vegetables, and whole grains Proteins are made up of amino acids What are amino acids made of? Carbon, hydrogen, oxygen, nitrogen 20 amino acids build one ___. Nine must come from ___ and called essential amino acids protein, food Protein primary function: build and repair tissues Protein is rarely used as an energy source When carbohydrates are depleted the body can use ___ for energy protein Breakdown of amino acids itself requires energy, which is why high protein diets are associated with weight loss Another name for lipids is fat What re three classifications of lipids? saturated - monounsaturated - polyunsaturated What is saturated fat? Hard at room temp - found in animal products What is a monounsaturated fat? soft at room temp - comes from plants What is polyunsaturated fat? liquid at room temp - found in plants What are the essential fatty acids? omega 3 and omega 6 Why are they called essential? the body cannot synthesize them itself What fat is healthier? unsaturated What fat is really bad? Trans fat