18, 19, 20, & 25 (Includes chapter quizzes) Exam 1 Study
Guide Questions With Complete Solutions
A nurse prepares to insert a Foley catheter. The procedure
manual calls for the patient to lie in the dorsal recumbent
position. The patient complains of having back pain when lying
on her back. Despite this, the nurse positions the patient supine
with knees flexed as the manual recommends and begins to
insert the catheter. This is an example of
Basic critical thinking.
A nurse has seen many cancer patients struggle with pain
management because they are afraid of becoming addicted to the
medicine. Pain control is a priority for cancer care. By helping
patients focus on their values and beliefs about pain control, a
nurse can best make clinical decisions. This is an example of
Applying ethical criteria.
Two patient deaths have occurred on a medical unit in the last
month. The staff notices that everyone feels pressured and team
members are getting into more arguments. As a nurse on the
unit, what will best help you manage this stress?
Participate in a unit meeting to discuss feelings about the patient
deaths.
Nursing assessment includes what 2 steps?
,1. Collection of information from a primary source (a patient)
and secondary sources (family, friends, health professionals, and
the medical record)
2. The interpretation and validation of data to ensure a complete
database.
What is a vital part of assessment?
Critical thinking.
Rounding
A a vital opportunity to build trust with patients, increasing the
likelihood that you will gain more information that will help you
identify and communicate their health care problems more
accurately and effectively.
What types of assessment are there?
- The patient-centered interview during a nursing health history.
- A physical examination.
- The periodic assessments you make during rounding or
administering care.
Subjective Data
Information gathered from patient statements; the patient's
feelings and perceptions. Not verifiable by another except by
inference.
Objective Data
Information that can be observed by others; free of feelings,
perceptions, prejudices.
List the sources of data.
,- Patient
- Family and significant others
- Health care team
- Medical records
- Other records and the scientific literature
- Nurse's experience
Patient Centered Interview
Relationship based and is an organized conversation focused on
learning about the well and the sick as they seek care.
Types of Patient Centered Interviews.
- Motivational interviewing
- Effective communication
- Interview preparation
- Phases of an interview: Orientation & setting an agenda,
working phase, & termination
List interview techniques.
- Observation
- Open-ended questions
- Leading questions
- Back channeling
- Direct closed-ended questions
Open-Ended Question
Prompts patients to describe a situation in more than one or two
words. This technique leads to a discussion in which the patients
actively describe their health status. It shows you want to hear a
patient's thoughts and feelings.
, Close-Ended Question
Form of question that limits a respondent's answer to one or two
words.
"Yes or no."
PQRST
P - Provokes (What causes symptom? What makes it better or
worse?)
Q - Quality (What does the symptom feel like? If patient
cannon describe, offer probes such as, "Is it sharp? Dull?
Burning?")
R - Radiate (Where is the symptom located? Is it in one place?
Does it go anywhere else? Have the patient be as precise as
possible.)
S - Severity (Ask a patient to rate the severity of a symptom on
a scale of 0-10? This gives you a baseline with which to
compare in follow-up assessments.)
T - Time (Assesses onset & duration of symptom. When did it
start? Does it come & go?)
Cultural Considerations
- To conduct an accurate and complete assessment, you need to
consider a patient's cultural background.
- When cultural differences exist between you and a patient,
respect the unfamiliar and be sensitive to a patient's uniqueness.
- If you are unsure about what a patient is saying, ask for
clarification to prevent making the wrong diagnostic conclusion.