NURS 3112 Exam One Study Guide
Questions with Verified Answers
Self-Determination - ANSWER-Almost all ethical dilemmas in nursing involve the
right to self-determination of the patient and relate to the patient's rights to make his
or her own decision about treatment.
Nursing Practice Act - ANSWER-The nurse practice act is state laws that make sure
nurses provide professional and competent care and establishes the state board of
nursing (BON)
Nursing Professional Scope of Practice - ANSWER-In 2015, the Nursing Scope and
Standards of Practice (3rd Ed.) was published to guide nursing practice. The scope
of nursing practice describes the who, what, when, where, why and how of nursing
practice. Nursing today is practiced in many different settings requiring knowledge
and skills in the biological, physical, social and behavioral sciences. Registered
nurses are licensed by the state in which they practice and work collaboratively with
other health-care professionals.
Beneficence - ANSWER-Ask the questions of who benefits from the action(s) taken
by others.
Autonomy - ANSWER-Examines the individual's personal right to make decisions
concerning himself or herself and provides acknowledgement and respect for the
individual person's choices.
Justice - ANSWER-Examines who will be vulnerable in any actions taken. Questions
of equitability are taken into account with the decision making.
Fidelity - ANSWER-Requires the nurse to be accountable for commitments made to
others and to self. It also includes the responsibilities that the nurse has to the
profession of nursing by virtue of being a member.
Nonmaleficence - ANSWER-Examines issues related to who may be harmed by
actions and how any harm can be minimized or averted if harm (even minimal) is an
expected or unforeseen outcome.
Veracity - ANSWER-Is the requirement to tell the truth. It also requires that
intentional misleading or deception of the patient to influence decisions is not done.
Veracity or truth telling and truthful communication are part of making sure harm is
averted or minimized.
Confidentiality - ANSWER-Requires that information is not shared beyond those who
have a need to know.
The Nursing Process (Definition) - ANSWER-A systematic patient-centered, goal-
oriented method of caring that provides a framework for nursing practice.
,Components of the Nursing Process - ANSWER-ADPIE (Assessment, Diagnosis,
Plan, Implementation, Evaluation)
Three Types of Nursing Diagnoses - ANSWER-Actual (problem-focused,
Risk, and Health promotion
Actual Diagnosis - ANSWER-A clinical judgement concerning an undesirable human
response to a health condition/life process that exists in an individual, family, group,
or community.
Risk Diagnosis - ANSWER-A clinical judgement concerning the susceptibility of an
individual, family, group, or community for developing an undesirable human
response to health conditions/life processes.
Health Promotion Diagnosis - ANSWER-A clinical judgement concerning motivation
and desire to increase well-being and to actualize health potential. These responses
are expressed by a readiness to enhance specific health behaviors, and can be used
in any health state. In cases where individuals are unable to express their own
readiness to enhance health behaviors, the nurse may determine that a condition for
health promotions exists and then act on the client's behalf. Health promotion
responses may exist in an individual, family, group or communit
Components of an Actual Diagnosis - ANSWER-3 Parts:
1. Patient's problem
2. "Related to" - related factor, at risk populations, associated conditions
3: "As evidenced by (AEB)" - defining characteristics
Example: Excess Fluid volume related to excess sodium intake AEB edema
(2+lower extremities)
Components of an at Risk Diagnosis - ANSWER-2 Parts (because it hasn't
manifested)
1. Patient's problem
2. "Related to" - related factor, at-risk populations, associated conditions
Example: Risk for falls related to acute illness
Maslow's Hierarchy of Needs - ANSWER-Helps the nurse prioritize the patient's
problems in order to decide the appropriate order of treatment.
Components of Maslow's Hierarchy of Needs - ANSWER-- Physiological (breathing,
food, water, sex, sleep, homeostasis, excretion)
- Safety (security of body, employment, resources, mortality, the family
- Need for love, affection, belongings
- Need for Esteem
- Need for Self-actualization
Who is the subject/target of goals? - ANSWER-Patients
,7 Guidelines for Writing Patient-Centered Goals - ANSWER-Patient-centered
Specific
Measurable
Attainable
Relevant
Timely
What is the difference between short-term goals and long-term goals? - ANSWER-
Short term goals (STG) are expected within hours to a week, whereas long term
goals (LTG) are behaviors that are expected to be met in days, weeks, or months.
What is the difference among nurse-initiated, physician-initiated, and interdependent
nursing interventions? - ANSWER-
What standards are used to develop nursing interventions? - ANSWER-
Who is the subject of nursing interventions? - ANSWER-
Direct Care - ANSWER-Treatment performed through interactions with patients
Examples: medication administration, insertion of an intravenous (IV) infusion,
counseling during a time of grief
Indirect Care - ANSWER-Treatment performed away from the patient but on behalf
of the patient or group (documentation)
Examples: managing patient's environment, documenting on your patient/ working to
be an advocate (interdisciplinary collaboration)
What actions will a nurse take if an unexpected outcome results from nursing
intervention? - ANSWER-
What is the focus during evaluation phase of the nursing process? - ANSWER-
Evaluation is continuous and ongoing - going back and looking at if what you're
doing is working.
During the evaluation step of the Nursing Process, identify if the outcome/goal was
met, taking corrective action.
Young Old Subgroup Ages - ANSWER-65 to 74 years
Middle Old Subgroup Ages - ANSWER-75 to 84 years
Old Old Subgroup Ages - ANSWER-85 to 99 years
Senescence - ANSWER-Normal age-related changes
Sclerosis - ANSWER-Hardening
, Stenosis - ANSWER-Narrowing
Atrophy - ANSWER-Loss of substance
Depression in the Elderly - ANSWER-- Early morning insomnia
- Daytime sleeping
- Poor appetite
- Lack of energy
- Unwillingness to participate in social or recreational activities
Primary Treatment
- Drug therapy/psychotherapy→ SSRI are the first drug choice
- Distraction & engagement→ volunteering, working, identifying a purpose
Dementia - ANSWER-- Slowly progressive cognitive decline (chronic confusion)
- Usually chronic
- Global impairment of intellectual function and is generally chronic and progressive.
- Types of Dementia:
- Alzheimer's Disease
- Multi-infarct dementia- vascular disorders and can cause infarcts and patient will
become more and more confused (20-25% of dementia)
Delirium - ANSWER-- Acute state of confusion
- Often Short Term and Reversible
- Occurs in up to 50% of older adults who are hospitalized so where they are not
familiar
Types of Delirium - ANSWER-- Hyperactive- restless, aggressive, etc.
- Hypoactive- quiet, empathetic, withdrawn
- Mixed
- Unclassified
Causes of Delirium - ANSWER-- Medications (anticholinergics/psychoactive)
- Electrolyte Imbalance
- Infections
- Fecal Impaction/Severe Diarrhea
- Surgery
- Metabolic disorders
- Neurologic disorders
- Circulatory disorders
- Renal function
- Nutritional deficiencies
- Hypoxia
- Major Loss
Activities of Daily Living (ADLs) - ANSWER-Day-in-day-out elements that a person
takes to care for themselves (bathing, dressing, etc.)
Questions with Verified Answers
Self-Determination - ANSWER-Almost all ethical dilemmas in nursing involve the
right to self-determination of the patient and relate to the patient's rights to make his
or her own decision about treatment.
Nursing Practice Act - ANSWER-The nurse practice act is state laws that make sure
nurses provide professional and competent care and establishes the state board of
nursing (BON)
Nursing Professional Scope of Practice - ANSWER-In 2015, the Nursing Scope and
Standards of Practice (3rd Ed.) was published to guide nursing practice. The scope
of nursing practice describes the who, what, when, where, why and how of nursing
practice. Nursing today is practiced in many different settings requiring knowledge
and skills in the biological, physical, social and behavioral sciences. Registered
nurses are licensed by the state in which they practice and work collaboratively with
other health-care professionals.
Beneficence - ANSWER-Ask the questions of who benefits from the action(s) taken
by others.
Autonomy - ANSWER-Examines the individual's personal right to make decisions
concerning himself or herself and provides acknowledgement and respect for the
individual person's choices.
Justice - ANSWER-Examines who will be vulnerable in any actions taken. Questions
of equitability are taken into account with the decision making.
Fidelity - ANSWER-Requires the nurse to be accountable for commitments made to
others and to self. It also includes the responsibilities that the nurse has to the
profession of nursing by virtue of being a member.
Nonmaleficence - ANSWER-Examines issues related to who may be harmed by
actions and how any harm can be minimized or averted if harm (even minimal) is an
expected or unforeseen outcome.
Veracity - ANSWER-Is the requirement to tell the truth. It also requires that
intentional misleading or deception of the patient to influence decisions is not done.
Veracity or truth telling and truthful communication are part of making sure harm is
averted or minimized.
Confidentiality - ANSWER-Requires that information is not shared beyond those who
have a need to know.
The Nursing Process (Definition) - ANSWER-A systematic patient-centered, goal-
oriented method of caring that provides a framework for nursing practice.
,Components of the Nursing Process - ANSWER-ADPIE (Assessment, Diagnosis,
Plan, Implementation, Evaluation)
Three Types of Nursing Diagnoses - ANSWER-Actual (problem-focused,
Risk, and Health promotion
Actual Diagnosis - ANSWER-A clinical judgement concerning an undesirable human
response to a health condition/life process that exists in an individual, family, group,
or community.
Risk Diagnosis - ANSWER-A clinical judgement concerning the susceptibility of an
individual, family, group, or community for developing an undesirable human
response to health conditions/life processes.
Health Promotion Diagnosis - ANSWER-A clinical judgement concerning motivation
and desire to increase well-being and to actualize health potential. These responses
are expressed by a readiness to enhance specific health behaviors, and can be used
in any health state. In cases where individuals are unable to express their own
readiness to enhance health behaviors, the nurse may determine that a condition for
health promotions exists and then act on the client's behalf. Health promotion
responses may exist in an individual, family, group or communit
Components of an Actual Diagnosis - ANSWER-3 Parts:
1. Patient's problem
2. "Related to" - related factor, at risk populations, associated conditions
3: "As evidenced by (AEB)" - defining characteristics
Example: Excess Fluid volume related to excess sodium intake AEB edema
(2+lower extremities)
Components of an at Risk Diagnosis - ANSWER-2 Parts (because it hasn't
manifested)
1. Patient's problem
2. "Related to" - related factor, at-risk populations, associated conditions
Example: Risk for falls related to acute illness
Maslow's Hierarchy of Needs - ANSWER-Helps the nurse prioritize the patient's
problems in order to decide the appropriate order of treatment.
Components of Maslow's Hierarchy of Needs - ANSWER-- Physiological (breathing,
food, water, sex, sleep, homeostasis, excretion)
- Safety (security of body, employment, resources, mortality, the family
- Need for love, affection, belongings
- Need for Esteem
- Need for Self-actualization
Who is the subject/target of goals? - ANSWER-Patients
,7 Guidelines for Writing Patient-Centered Goals - ANSWER-Patient-centered
Specific
Measurable
Attainable
Relevant
Timely
What is the difference between short-term goals and long-term goals? - ANSWER-
Short term goals (STG) are expected within hours to a week, whereas long term
goals (LTG) are behaviors that are expected to be met in days, weeks, or months.
What is the difference among nurse-initiated, physician-initiated, and interdependent
nursing interventions? - ANSWER-
What standards are used to develop nursing interventions? - ANSWER-
Who is the subject of nursing interventions? - ANSWER-
Direct Care - ANSWER-Treatment performed through interactions with patients
Examples: medication administration, insertion of an intravenous (IV) infusion,
counseling during a time of grief
Indirect Care - ANSWER-Treatment performed away from the patient but on behalf
of the patient or group (documentation)
Examples: managing patient's environment, documenting on your patient/ working to
be an advocate (interdisciplinary collaboration)
What actions will a nurse take if an unexpected outcome results from nursing
intervention? - ANSWER-
What is the focus during evaluation phase of the nursing process? - ANSWER-
Evaluation is continuous and ongoing - going back and looking at if what you're
doing is working.
During the evaluation step of the Nursing Process, identify if the outcome/goal was
met, taking corrective action.
Young Old Subgroup Ages - ANSWER-65 to 74 years
Middle Old Subgroup Ages - ANSWER-75 to 84 years
Old Old Subgroup Ages - ANSWER-85 to 99 years
Senescence - ANSWER-Normal age-related changes
Sclerosis - ANSWER-Hardening
, Stenosis - ANSWER-Narrowing
Atrophy - ANSWER-Loss of substance
Depression in the Elderly - ANSWER-- Early morning insomnia
- Daytime sleeping
- Poor appetite
- Lack of energy
- Unwillingness to participate in social or recreational activities
Primary Treatment
- Drug therapy/psychotherapy→ SSRI are the first drug choice
- Distraction & engagement→ volunteering, working, identifying a purpose
Dementia - ANSWER-- Slowly progressive cognitive decline (chronic confusion)
- Usually chronic
- Global impairment of intellectual function and is generally chronic and progressive.
- Types of Dementia:
- Alzheimer's Disease
- Multi-infarct dementia- vascular disorders and can cause infarcts and patient will
become more and more confused (20-25% of dementia)
Delirium - ANSWER-- Acute state of confusion
- Often Short Term and Reversible
- Occurs in up to 50% of older adults who are hospitalized so where they are not
familiar
Types of Delirium - ANSWER-- Hyperactive- restless, aggressive, etc.
- Hypoactive- quiet, empathetic, withdrawn
- Mixed
- Unclassified
Causes of Delirium - ANSWER-- Medications (anticholinergics/psychoactive)
- Electrolyte Imbalance
- Infections
- Fecal Impaction/Severe Diarrhea
- Surgery
- Metabolic disorders
- Neurologic disorders
- Circulatory disorders
- Renal function
- Nutritional deficiencies
- Hypoxia
- Major Loss
Activities of Daily Living (ADLs) - ANSWER-Day-in-day-out elements that a person
takes to care for themselves (bathing, dressing, etc.)
