Exam 1)NSG 316 Exam 1: Questions & Answers: Latest Updated A+ Score Guide

Identify changes that occur when a client's pain is poorly controlled. (AnsCardiac changes: tachycardia, elevated BP, increased myocardial oxygen demand, increased cardiac input Pulmonary changes: hypoventilation, hypoxia, decreased cough, atelectasis GI changes: nausea, vomiting, ileus Renal changes: oliguria, urinary retention Musculoskeletal changes: spasm, joint stiffness Endocrine changes: increased adrenergic activity CNS changes: fear, anxiety, fatigue Immune changes: impaired cellular immunity, impaired wound healing Poorly controlled chronic pain: depression, isolation, limited mobility and function, confusion, family distress, diminished quality of life what information is important for the nurse to know when providing care for people from diverse backgrounds (Ans- cultural competence which interventions will the nurse do to obtain objective data (Ans- conduct physical exam, review lab reports, summon previous med recordswhen would a nurse establish a complete database of a patient (Ans- during initial home visit, in primary health setting, community health care setting ACE unit (Ans- focuses on preventing functional decline in older adults during hospitalization TUG test (Ans- timed up and go test; quantifies functional mobility; going outside alone safely, walking 10 ft, turn, walk back to chair and sit down, ADL (Ans- activities of daily living; walking, dressing, using stairs, eating, feeding, grooming, toileting IADLs (Ans- instrumental activities of daily living; shopping, meal cooking, cleaning, laundry, managing finances, counting, housekeeping, taking meds, using transportationMini Mental State Exam (Ans- Concentrates only on cognitive functioning, not on mood or thought processes Montreal Cognitive Assessment (MoCA) (Ans- Mild cognitive dysfunction; Attention and concentration, executive functions, memory, language, visuoconstructional skills, conceptual thinking calculations and orientation AADLs (Ans- Advanced Activities of Daily Living; activities performed in the community- social or recreational, activities performed within the family Katz Index of ADL (Ans- -Assessment for evaluation of activities of daily living -Focus: assessment of level of independence functioning and type of assistance required in six areas of ADL: 1) bathing 2) dressing 3) toileting 4) transferring 5) continence 6) feeding