Summary NURS 262 Exam 1 Study Guide

Test 1: Breakdown of Questions
Test 1 has 50 questions. Most items are multiple choice, but a few items may be multiple answer (select all
that apply). The time limit is 75 minutes.

*Please note this is not an all-inclusive list of test items.
*Partial credit is not awarded for select all that apply items.
*Generic names and pharmacotherapeutic class will be provided for medications

Unit 1: Adult Health Promotion
 Adult Health Promotion: 2 questions
o Focus on primary, secondary, and tertiary prevention and know examples
 Primary: PREVENTION
 Measures to prevent the occurrence of a disease
 No disease
 Includes: VACCINES
 Secondary: DETECTION
 Taking actions aimed @ early detection of disease that can lead to interventions
to prevent it
 Subclinical disease
 Includes: SCREENINGS (BREAST CANCER, PAPSMEAR)
 Tertiary: REHAB
 Diagnosed disease
o ALREADY HAVE THE DISEASE
 Activities on does that LIMIT disease progression or return the patient to optimal
functioning
 Includes: REHAB, PHYSICAL THERAPY
 Health disparities are differences in the incidence (new cases), prevalence (all cases), mortality rate,
and burden of disease they exist among specific population groups.
o Examples:
 Ethnicity and Race
 Geographic Location
 Education
 Socioeconomic Status: insurance
 Sexual Identity
 Gender
 age
 Teaching and Learning: 6 questions
o Transtheoretical model (be able to identify different stages and associated nursing
interventions)
 Represents a person’s readiness to change
 Discovering where a person is helps determine what they need
 Person can EXIT and RE-ENETER at ANY stage
 STAGES
 Precontemplation
o Person is not worried about use
o Not interested in stopping
o Person not intending to take action in foreseeable future (6 mos.)
o NURSE INTERVENTIONS:

,  Validate lack of readiness
 Clarify that it is THEIR DECISION
 Provide support
 Increase awareness of condition
 Describe benefits of change and risks of not changing
 Contemplation
o Still enjoy using
o Start to notice problems from use
o Start weighing out what changing means for them
o Person is intending to make a change in the next 6 months
o Ambivalence is common
 Patient understands the behavior is a problem and change is
necessary BUT they believe it is challenging and the behaviors are
not worth the risk
o NURSE INTERVENTIONS:
 Introduce what is involved in changing the behavior
 Encourage evaluation of PROS & CONS
 Reinforce need to change
 Identify new and promote positive outcomes
 Preparation
o Not-good things outweigh the things they enjoy
o Prepare to make a change
o Person is planning to take action in the immediate future (1 mos.)
o NURSE INTERVENTIONS:
 Reinforce positive outcomes of change
 Identify and assist in problem solving obstacles
 Help identify social support
 Encourage small initial steps
 Give information and encouragement
 Help set goals and develop a plan with high priorities
 Action
o Start to make a change
o Person is making specific modifications to lifestyle (last around 6 months)
o NURSE INTERVENTIONS:
 Focus on restricting cues and social support
 Combat feelings of loss
 Reiterate long-term benefits
 Reinforce behavior with reward
 Discuss choices to help minimize relapse
 Maintenance
o Maintaining this change
o Keep here long enough, maintain goal
o Person is working to prevent relapse; increasing confidence (6 mos. To 5
years)
o NURSE INTERVENTIONS:
 Plan for follow-up support
 Reinforce internal rewards
 Provide more teaching on the need to maintain the change

,  Termination
o Person has no temptation and 100 % self-efficacy (difficult to achieve)
o NURSE INTERVENTION:
 Evaluate effectiveness of the new behavior
 Relapse
o Relapse: Return back to use
o Lapse: slip up
 Doesn’t not lead to relapse
o NURSE INTERVENTION
 Evaluate trigger for relapse
 Reassess motivation and barriers
 Plan stronger coping strategies
o Review motivational interviewing
 Uses nonconfrontational interpersonal communication techniques
 Guiding style
 Allows clinician to put control in the patient
 Listen to them rather than tell
 Adjust to patient resistance
 Express empathy through reflective listening
 Focus on patient strength
 Avoid arguments and direct confrontation
 Help patient recognize “gap”
o Teaching/learning process, evaluation of learning
 Observe patient or caregiver directly
 Ex. Ask patient to show you how to change a dressing directly
 Observe verbal and nonverbal cues
 Ex. Asks you to repeat instructions; loses eye contact
 Ask open-ended questions (“teach back”)
 Ex. “How often do you need to change the dressing?”
 Talk with caregiver (“teach back”)
 Ex. “What medications is she taking?”
 Seek the patient’s self-evaluation of progress
 Ex. Ask patient about his or her progress
 If goals are not met,
 Reassess the patient and revise teaching plan accordingly
o Goals of Patient Teaching:
 Health promotion: need to understand the risk
 Disease prevention
 Illness management
 Selection and use of appropriate treatment options
o “Teach back” vs. “Show back”
 Teach Back helps check for understanding
 Patient should be able to summarize what was said
 Advantages
 Helps patients remember and understand more information
 Raises patient satisfaction and helps patients feel more relaxed
 Helps gain the patients’ trust