D439: FOUNDATIONS UPDATE|EXAM QUESTIONS WITH MULTIPLE CHOICES |VERIFIED & REVISED ANSWERS (NEW)!!!

D439: FOUNDATIONS UPDATE|EXAM
QUESTIONS WITH MULTIPLE
CHOICES |VERIFIED & REVISED
ANSWERS (NEW)!!!
SBARmFormatm-mCORRECTmANSWERm-
modelmformeffectivemcommunicationmidentifyingmSituation,mBackground,mAssessment,mandmReco
mmendation



-
theremaremtwomtypesmofmwaysmthatmcommunicationmtoolsmaremusedmtomcommunicatemampatientsmc
hangeminmcondition:mCUSmtoolm(Concerned,mUncomfortable,mSafety)mandmSBAR



-notemtomalwaysmmaintainmptmprivacymandmconfidentiality



SBARmEXAMPLEm:



CasemStudy:mYoumadministeredm1mtabletmofmoxycodonemHClm5mmg/ibuprofenm400mmgmPOmtomampat
ientm30mminutesmagomformpostsurgicalmpain.mYoumreturnmtomthempatient'smroommtomevaluatemtheme
ffectivenessmofmthemmedicationm30mminutesmlater.mThempatientmratesmhismpainmasmanm8monmamscale
mofm0-10.mYoumusemSBARmtomcontactmthempatient'smhealthmcaremprovider.




mSituation:mThempatientmismratingmhismpainmasmanm8monmamscalemofm0-
10.mHemhadmhismpainmmedicationm30mminutesmago.



mBackground:mThempatientmhadmamkneemreplacementmandmreturnedmfrommthempostanesthesiamcar
emunitm6mhoursmago.mHemhasm1mtabletmofmoxycodonemHClm5mmg/ibuprofenm400mmgmPOmorderedmev
erym6mhours.mThismismthemfirstmpainmmedicationmhemhasmtakenmsincembeingmadmittedmtomthemunit.

,mAssessment:mHismcurrentmmedicationmordermismnotmsufficientlymmanagingmthempatient'smpain.mHe
mdoesmnotmwantmtomsitmupmormmovembecausemofmthempainmhemismexperiencing.




m Recommendation:mItmmightmbemhelpfulmtomchangemthempainmmedicationmordermformthempatient.



guidedmimagerym-mCORRECTmANSWERm-mind/bodymintervention

-Concentratingmonmanmimagemormseriesmofmimagesmtomtreatmpathologicalmconditions



Maslow'smHierarchymofmNeedsm-mCORRECTmANSWERm-
wherem(1)mphysiologicalmneedsmaremPRIORITYmthenm(2)msafetymandmsecurity,m(3)mlovemandmbelongi
ngmneeds.m(4)mselfmesteemmneeds,mandmFINALLYm(5)mselfmactualizationmneeds



Themnursemplanningmcaremformamclientmexperiencingmdystociamdeterminesmthatmthemprioritymismwhi
chmaction?

1.mPositionmchangesmandmprovidingmcomfortmmeasures

2.mExplanationsmtomthemclientmaboutmwhatmismhappening

3.mMonitoringmformchangesminmthemconditionmofmthembirthingmparentmandmfetus

4.mEncouragingmthemusemofmbreathingmtechniquesmlearnedminmchildbirthmpreparatorymclasses



Answer:m3



Test-
TakingmStrategy:mNotemthemstrategicmword,mpriority,mandmusemMaslow'smHierarchymofmNeedsmtheo
rymtomprioritize,mrememberingmthatmphysiologicalmneedsmcomemfirst.mThemnursemneedsmtomhavemk
nowledgemofmthemclient'smprioritymneedsmandmgeneratemsolutions.mAllmthemoptionsmaremcorrectman
dmwouldmbemimplementedmduringmthemcaremofmamclientmwithmdystocia.mAlsomnotemthatmthemcorrect
moptionmismthemonlymonemthatmaddressesmbothmthembirthingmparentmandmthemfetus.mRemembermtom


usemMaslow'smHierarchymofmNeedsmtheorymtomhelpmprioritizemandmgeneratemsolutions!

,EHRmsystemmandmlimitationsm-mCORRECTmANSWERm-
EHRmANDmEMRmaremdifferentmfrommeachother

-
Amhealthmcaremagencymoftenmreliesmonmthemnursingmhistorymmodelmincludedminmthemelectronicmhea
lthmrecordm(EHR)masmthemorganizingmframeworkmformanmassessment.mHowever,mEHRmframeworksm
aremoftenmmedicallymdriven.mFrameworksmdevelopedmfrommnursingmtheoriesmaremmoremholisticma
ndmpatient-centered,mprovidingmammoremcomprehensivempatientmreview.

-
WhenmitmcomesmtomthemEMRmfreezingmit'smbestmtomnotifymITmormwhenmthemcomputermsystemmshuts
mdownmduringmdatamentry.mThemnursemshouldmfollowmestablishedmprotocolsmandmpreparemtomre-


entermdatamasmamlatementrymwhenmthemsystemmismoperational.mAlsomnevermattemptmtomrebootmormfi
xmthemEMRmsystemmwhichmmaymprolongmthemcomplication.

It'smalsomnotmrecommendedmtomprintmEMRmfrommambackupmservermwithoutmpropermauthorizationm
andmensuringmdatamprivacymandmsecurity.



-
patientmoutcomemdata;mandmusemclinicalmdecisionmsupportmsystems.mThemelectronicmhealthmrecor
dm(EHR)mismanmefficientmmethodmformdocumentingmandmmanagingmpatientmhealthmcareminformatio
nm(seemChapterm26.)mComputerizedmphysician/providermordermentrym(CPOE),mallowingmhealthmcar
emprovidersmtomdirectlymentermmedicalmorders,mismamcriticalmpatientmsafetyminitiativemespeciallyminm
themareamofmmedicationmorderingmandmadministration

-Change-of-shift,mhand-
offmreporting,mandmhourlymbedsidemroundsmaremwaysmtomkeepmallmhealthmcaremprovidersmandmpati
entsminformed



HandmHygeinem-mCORRECTmANSWERm-
handmwashingmdoesmnotmkillmmicroorganismsmbutmreducesmthemamountmofmthemmpresent

-
fourmtechniques:mhandmwashing,mantisepticmhandmwash,mantisepticmhandmrub,msurgicalmhandmanti
sepsis

-4melementsmofmhandmwashing:mwater,mfriction,msoapm,mandmtime

, DosagemCalculationm(ml,mtbsp->ml)m-mCORRECTmANSWERm



VITALmSIGNSm-mCORRECTmANSWERm-whatmtomdomifmreassessmentmismneeded

-knowmthemptmusualmrangemofmvitalmsignsm(baseline)

-assessmrespiratory



Factorsmaffectingmvitalmsignsmofmoldermadults:



MOBILITY:mHowmdomyoumusemcrutches?m-mCORRECTmANSWERmTYPESmOFmGAITS:

-2-
point:m2mpointsm(crutchmormfoot)monmthemground:mptmmovesmrightmcrutchmandmleftmfootmtogether,ml
eftmcrutchmandmrightmfootmtogether

-4mpointmgait:m

-3mpointmgait:mmovingmbothmcrutchesmandmtheminjuredmlegmatmthemsamemtimem



-weightmismonmbothmhands

supportmweightmatmthemhandmgrips,mwithmelbowmflexedmatm30mdegrees,mpositionmcrutchesmonmthem
unaffectedmsidemwhenmsittingmormraisingmfrommthemchair

-
Howmtomusemcrutches:mDomNotmAdjustmCrutchmSettingsmAftermFittingm(Shouldmbem3mFingermWidthsm
BetweenmAxillamandmTopmofmCrutch)mSupportmBodymWeightmonmHandmGripsm(NotmAxilla),mWithmElb
owsmFlexedmormbentmatm30mDegrees

-
anmaccuratemmeasurementmismimportantmandmthemdistancembetweenmthemaxillaemandmarmmpiecem
hasmtombem2-3mfingermwidthsminmthemaxillamspacemandmthemarmmbars

-allmweightmshouldmbemonmthemhandmgrips

-whenmambulatingmpt,mstandmonmtheirmaffectedm(weak)mside

-nevermrestmarmpitmonmthemaxillarymbars