NRS 420 EXAM QUESTIONS WELL ANSWERED LATEST UPDATE 2026

NRS 420 EXAM QUESTIONS WELL ANSWERED LATEST UPDATE 2026 Development - Answers "A variety of gradual changes that occur across multiple domains and result in an individual's functional abilities" (Giddens, 2021). Adaptive delays - Answers Result of complex integration of multiple skills and abilities easily impacted by injury, illness, substance use, exposure to trauma, or accumulation of toxic chronic stressors" (Giddens, 2021). Five Attributes to Professional Identity - Answers DOING BEING ACTING ETHICALLY FLOURISHING CHANGING IDENTITIES Ethical Issues - Answers Most frequent ethical issues • Protecting patients' rights and human dignity • Respecting/not respecting informed consent to treatment • Providing care with possible risk to nurse's health • Using/not using physical or chemical restraints • Working with staffing patterns that limit patient access to nursing care Most disturbing ethical issues • Coping w/staffing patterns that limit patient access to nursing care • Prolonging the living/dying process with inappropriate measures • Not considering the quality of a patient's life • Implementing managed care policies that threaten quality of life • Working with unethical/impaired colleagues Health Laws - Answers Common Law - derived from decisions made by supreme courts •HIPPATort Law (Medical negligence or malpractice) - wrongful/unreasonable action or omission that causes harm •Liability of nurses, physicians, etc... Contract Law - mutual agreements between 2 or more individuals •Healthcare contracts between insurance & consumers Criminal Law - crime that threatens or harms others or endangers the property or safety of people •Intentional or neglectful patient care Consent for treatment - Answers Outlines patient self‐determination Right to privacy and protection Must be voluntarily in writing Patient must have capacity Patient has right to refuse Capacity - Answers •Determination made by physician or other healthcare practitioner •Evaluation or assessment required •Can change over time •Drugs and medical conditions can impact •Progress dementia, recent brain surgery Advanced Directives - Answers Written document outlines patient's wishes Can assign someone to make decisions Must be signed Other names: Durable power of attorney, living will POLST - Answers Physician orders for life‐sustaining treatment •Set of portable medical orders •Complement to advance directive•Doctor & patient MUST sign •Does NOT appoint surrogate •Copy should be in chart, original with patient 8 Principles of Patient‐centered care - Answers 1. Respect for patient's values, preferences, and expressed needs 2. Coordination and integration of care 3. Information and education 4. Physical comfort 5. Emotional support and alleviation of fear and anxiety 6. Involvement of family and friends 7. Continuity and transition 8. Access to care Nurses' Role - Answers Respect and uphold patient beliefs Involve patient and family in decision‐making Provide education Collaboration Clinical Judgement - Answers Interpretations & inferences that influences actions in clinical practice Clinical reasoning - thinking process where nurse reaches a clinical judgement Critical thinking - cognitive process used for analysis of an issue/problem Standards-Based Approaches - Answers Involves use of algorithms, decision trees, patient care guidelines (standards of care) Standardized approaches to patient care within an institution Based on best practices/evidenced-based If there is a rule/guideline that covers situation, clinical judgement is not required Evidence-Based Practice - Answers Uses best evidence to inform practice to improve patient outcomes Scientific knowledge & clinical experience are important to determine if particular research is relevant Clinical judgement helps nurses question current practices & when guidelines need to be updated Interpretivist Perspective - Answers -Belief that life experiences are culturally-bound, people interpret these experiences on the basis of their encounters within a given culture ◦ Based on intuition and experience ◦ Requires holistic view of patient situation Nursing process - Answers Nursing Process Key words: Diagnose (Analyze) A - Assessment A - Assessment D - Diagnose A - Analyze P - Plan P - Plan I - Implement I - Implement E - Evaluate E - Evaluate Disability & Impairment - Answers Functional disabilities-Negative aspects that affect health condition causing social or physical limitation Functional impairment-Physical abnormalities that underlies these limitations and caused by some type of disease process or illness Two dimensions - Answers Attributes: defining characteristics of functional ability Capacity to perform specific functional activity Antecedents: events that must happen before functional ability can exist Development of physiologic process - neural, cognitive, endocrine, muscuoloskeletal, metabolic Importance in healthcare - Answers Signal need for services Monitor treatment Facilitate cost-effectiveness Interprofessional Collaboration BADLs & IADLs - Answers BADLs (ADLs): basic activities of daily living Personal care, mobility, eating, hygiene, grooming, bathing, oral care, dressing, toileting IADLs: instrumental activities of daily living; complex skills to live in community Managing money, grocery shopping, cooking, house cleaning, doing laundry, taking meds, using phone, accessing transportation Primary vs. Secondary - Answers Primary: Ability to perform particular function never developed Cerebral Palsy Secondary: Occur after functional ability attained then a loss of it happens Pt admitted for MVC -- sustained tibia fx Risk Recognition - Answers Identify and anticipate actual and potential risks Allows for better planning of care Risks that impair functional ability Functional Assessment - Answers Multiple tools exist Need to observe how much patient can do Older adults require comprehensive assessment Care Delivery - Answers DETERMINE FUNCTION LEVEL (BASELINE AND CURRENT) MAINTAIN AUTONOMY INTERPROFESSIONAL EFFORT AND EARLY INTERVENTION IS KEY Healthcare errors - Answers Commission (doing the wrong thing) Omission (not doing the right thing) Execution (doing the right thing incorrectly) Any member of healthcare team can make an error Levels of errors - Answers Adverse event: Unintended harm occurs Due to commission or omission Near miss: COULD have harmed patient but serious harm did not due to chance • Received contraindicated medication but no adverse reaction Prevention example • Lethal dose was prescribed but nurse identified error before giving Mitigation example• Lethal dose was given but discovered early & countered with antidote Sentinel miss Sentinel miss - Answers Unexpected occurrence involving death or serious physical/psychological injury, or risk for Serious injury occurs Immediate investigation & response Hypothalamus - Answers •Regulates temperature control through negative feedback system •Lowering body temp hypothalamus starts heat‐producing & conserving mechanisms •Thermoreceptors - located in skin •Central thermoreceptors - located in spinal cord, abdominal organs, hypothalamus Ages at risk - Answers Infants and older adults Thermoregulation - Answers Normal: 36.2°C t0 37.6°C (97.0◦°F to 100°F) or average of 37°C (98.6°F) Hypothermia: temp below normal range 36.2°C (97.2°F) Cool skin, slow cap refill, pale and cyanotic, rigid muscle, shivering, poor coordination, sluggish thought process, abnormal heart rhythms Hyperthermia: temp above normal range 37.6°C (99.7°F) •Fever: pathophysiological reaction in response to pyrogens -- increased temperature •Exogenous pyrogens (external) - bacteria, viruses •Endogenous pyrogens (internal) - produced by phagocytic WBCs; example - Cancer •↑ leads to fatal physiological changes Somatosensory System - Answers Nociceptors: open nerve endings with somatosensory receptors for pain•Found on all tissue except CNS Nociception: when tissue activates nociceptors to transmit pain info Nociceptive pain: interpretation of transmitted info Acute Pain: sudden onset - Answers Cause: Clearly linked to specific event injury or illness (physiological) Short lived Diminished with normal healing Different experiences - intensity, frequency, duration Chronic Pain: persisting 3 mos - years - Answers Cause: Underlying medical conditions (pathological) Can develop from initial injury, treatment, inflammation, or unknown causes Can be affected by genetics and changes in chemical balance Nociceptive vs. Neuropathic - Answers Nociceptive "normal pain transmission" • Aching, cramping, throbbing • Can be somatic or visceral Neuropathic "pain is pathologic" • Burning, sharp, shooting • Ex: diabetic neuropathy, post‐stroke pain Untreated pain - Answers Physiological: impacts physical functioning & bodily systems •Endocrine - stress response•Immune - more infections •Respiratory - decreased lung function •Cardiac - increased HR and BP •Physical - Pain association w/mobility Populations at risk - Answers Infants and children Older adults Women Pain assessment - Answers LOCATION