Professional Nursing Final Exam Questions and Answers

Professional Nursing Final Exam Questions and Answers What is the Nursing process? (ADPIE) Assessment Diagnosis Planning Implementation Evaluation What do nurses do during the assessment stage? Data gathering What do nurses do during the diagnosis stage? Identify actual or potential problems, can be different than medical diagnosis What do nurses do during the planning stage? Interventions, timeline, expected outcomes What do nurses do during the Implementation stage? Communicate everything that will be done for the patient What do nurses do during the evaluation stage? Re-adjust their plan and determine how successful they were What is objective data? Examples? What you can see and observe Ex: Vital signs, sweating, grimacing What is subjective data? Examples? What the patient tells you Ex: Headache, pain What is evidence based practice? Integrating best evidence into practice and management, patient-centered care What are the three research approaches? Basic, Applied, Outcomes How did Florence Nightingale contribute to research? First researcher; Created National Institute of Nursing Research (NINR), which funded nursing research What is the research process? Plan or proposal Research problem statement Hypothesis Research design Research analysis What is Quantitative research? Relationship between variables, statistical analysis, data is numbers What is Qualitative research? Lived experience, data is words, observations What is the Institutional Review Board (IRB)? Participant Rights What are examples of the IRB? Nuremberg Trials Tuskegee Syphilis Study Willowbrook Study What are research participant rights? Confidentiality, privacy, self-determination, fair treatment, protection from harm What are barriers to EBP? Lack of knowledge Limited time Nursing shortage Lack of resources Lack of leadership support What are the three components of EBP? Research/ Evidence Patient values and preferences Practitioner experience What is the purpose of EBP? Effective decision making Control costs Improve quality Improve patient outcomes What does PICOT stand for? Population Intervention Comparison Outcome Timeframe What is the role of staff nurses in EBP? Questioning current practice Reviewing studies Consumer of systemic reviews Apply evidence to their practice Participates in quality improvement Suggests solutions to problem based on evidence What is research? Systemic investigation of a problem What is EBP? Systemic review and appraisal of evidence (existing evidence) What is Quality Improvement (QI)? Process to improve outcomes Chapter 12: Quality of Practice What is Triple Aim? -Made by IOM to apply quality improvement Improve the health of the population Enhance the patient experience of care Reduce or control the per capita cost of care Define Safety Freedom from accidental injury Ex: Falls, Wrong surgery What is Error? Errors of planning or execution Ex: Medication error (Wrong dose, wrong time, wrong med) What is an Adverse event? Unintended consequence Ex: Someone with a-fib given med to prevent blood clots (blood thinner)- patient develops stomach ulcer and bleeds out and dies- Right dosage and right timing was followed Define Misuse Patient has allergic reaction to medication that wasn't prescribed Define Overuse Patient sees many physicians who don't communicate with each other, they all prescribe many different medications that aren't compatible with each other Define Underuse Don't see physicians, aren't getting preventive care- When they finally do seek health care, their condition is very advanced and they require much more care Define Near Miss Catching the mistake before it happens, and fixing it Ex: Hanging wrong IV fluids but not starting it yet What is an Sentinel event? A preventable event that results in serious injury or death Ex: Giving medication to wrong patient, which kills them What is a Root Cause Analysis? Examining errors, figuring out what happened How do you analyze Root Cause Analysis as said by the Joint Commission? -What happened? -Why did it happen? -What were the most proximate factors? Ex: Human, equipment, interruptions, distractions -Which systems and processes underlie those proximate factors? Ex: Human resources, leadership, communication What is Just Culture? A culture of safety and a blame-free work environment What are some safety issues for nursing staff? Needle sticks Infections Ergonomics (lifting) Violence What are the National Patient Safety Goals? -Improve the accuracy of patient identification -Improve the effectiveness of communication around caregivers -Improve the safety of using medications -Improve the system of clinical alarm systems (alarm fatigue) -Reduce the risk of health care-associated infections -The hospital identifies safety risks inherent in its patient population What is the Joint Commission focused on? -Evaluate organizations and accredit them -Committed to CQI (Continued Quality Improvement) -Survey and visits -Standards (Environment of care and outcomes) What are National Database of Nursing Quality Indicators? Examine performance based on clearly defined criteria, report cards What does Benchmarking mean? Evaluating or checking something by comparison with another institution What are Standards of Care? Minimum requirements that must be met in a certain situation, apart of policy Ex: Patient comes in with MI Chapter 6: Law and Ethics What does the Nurse Practice Act do? -Defines practice professional nursing -Sets educational and other requirements for licensure -Determines legal titles -Provides for disciplinary action What is the MAIN goal of the Nurse Practice Act? Protect the public's health, safety, and welfare What is the primary purpose of the Ohio Board of Nursing? Actively safeguard the health of the public through the effective regulation of nursing care Who makes up the Ohio Board of Nursing? 8 RNs: Advanced practice nurse Staff nurse Educator Dialysis expert 4 LPNs Who may call themselves nurses? RNs and LPNs only (with a current licensure) What is the NCLEX? National nursing examination to obtain licensure What is Licensure by Endorsement? RNs may practice in different states without repeating the licensing examination (must pay fee and submit proof of licensure in another state) What are Compact states? Allows RNs to have one license yet practice in other compact member states, does not require application, has been adopted by 24 states What is Malpractice? Greatest legal concern for nursing practice, does not have to be intentional What reasons can cause a nurse to be sued? Failure to follow standards of care Failure to use equipment in a responsible manner Failure to communicate Failure to document Failure to assess and monitor Failure to act as a patient advocate What are the four elements of malpractice? Nurse has assumed the duty of care Nurse breached the duty by failing standard of care The failure was the proximate cause of the injury The injury is proven Describe the relationship between delegation and accountability Giving someone authority to act for another, must retain accountability for acts delegated to another person Define Confidentiality Protection of private information about a patient during provision of medical services What is HIPAA? Health Insurance Portability and Accountability Act; first federal privacy standard to protect patients' medical records; must ensure patients' privacy/ confidentiality What are the disadvantages to social networking for healthcare professionals? Inaccuracies can become "fact" Patient privacy can be breached Public's trust in nurses can be compromised Individual nursing careers can be damaged What are the advantages to social networking for healthcare professionals? Networking Exchange knowledge Educating the public Fostering professional connections Promoting timely communication with patients and familf Chapter 7: Health Promotion, Disease, Prevention, & Illness (Community Perspective) What is a Community? People and the relationships that emerge among them as they develop. Use in common, agencies and institutions, and sharing a physical environment What is a Healthy Community? A community that embraces the belief that health is more than merely an absence of disease; a healthy community includes those elements that enable people to maintain a high quality of life and productivity What is an Acute Illness? Sudden onset, self limited -Follows the curative model -Ex: Pneumonia What is a Chronic Illness? Disease processes that are not going away -Goals: Improve self-care capacity, manage disease, prevent complications, improve quality of life -Ex: AIDS, Cancer, Diabetes What is a Vulnerable Population? A group of people at risk for health problems -Ex: Children, elderly, immigrants, homeless, mentally ill How can we involve patients as a member of the healthcare team? Involving patients in assessment, planning, and decision-making What are the consequences of barriers to access of care? -Patient may not receive preventive care -Neglect routine care -Do not follow up with necessary care -Patient's may use the "safety net" (ER, free clinic) **Results in poor outcomes What is Access to care? Someone's ability to obtain health care What are the Barriers that prevent access to care? Finances, location, etc. What is a Health Disparity? An inequality or gap that exists between two or more groups Give an example of a Healthcare disparity? Someone who has more money will receive better care and be healthier What is Health promotion? Aimed at changing lifestyle to maximize health, primary prevention -Ex: Sleeping, eating right, vaccinations, check-ups What is Disease Prevention? Interventions to stop the development of disease -Primary: prevent disease before it occurs (vaccination) -Secondary: Preventing complications from existing disease (taking insulin when needed) -Tertiary: Disability has occurred; prevent worsening What is the World Health Organization (WHO)? Made up of 150 countries in the world to promote overall health -Direct and coordinate international health from the global perspective What are the three levels of Public Health? Federal State Local Give an example of what Federal level focuses on: Center for Disease Control (CDC): Focuses on epidemics and outbreaks and national disasters Give an example of what the State level focuses on: Ohio Department of Health (ODH): School health, long-term care facilities, environment health issues Give an example of what the Local level focuses on: Summit County Public Health (SCPH): School setting, restaurants, free clinics, Sanitarians What is the goal of Public Health? To secure health and promote wellness How does Public Health achieve these goals? Assessment Policy development Assurance What is the goal of Continuum of Care? To decrease fragmented care and costs What is Continuity of Care? Focuses on care over time, on individual patients -Provides share information -Patients have a relationships with a PCP What is Health People 2020? A national prevention initiative, focusing on improving the health of Americans, provides a comprehensive set of disease prevention and health promotion goals What is Rehabilitation? Tertiary care, retain best level of functioning What is Extended Care or Long-term Care? Aging population needs care What is Hospice Care? Supporting life as long as possible -Patient and family actively participate in decisions