NURS 171 FINAL EXAM QUESTIONS WITH COMPLETE SOLUTIONS!!

*(P:308-9) know what battery, assault etc mean, what is Slander - and be able to apply. - ANS ASSAULT: intentional threat toward another person that places the person in reasonable fear of harmful, imminent or unwelcome contact. BATTERY: is any intentional offensive touching without consent, or lawful justification. FALSE IMPRISONMENT: occurs with unjustified restraint of a person without a legal reason. DEFAMATION OF CHARACTER: is the publication of false statements that result in damage to a person's reputation. SLANDER: occurs when one person speaks falsely about another ( e.g. a nurse spreads news that a patient has herpes, and it affects their business, the nurse is liable for slander) LIBEL: is the written defamation of character. *What word is used for improper use of equipment causing patient harm, and the definition. ... - ANS Adverse event/effect/ consequences: harmful or unintended effect of a medication, diagnostic test or therapeutic intervention (P61) Understand what's involved (research) making sure they have given permission to take part in research. In terms of legal form. - ANS INFORMED CONSENT: means that research subjects (1) are given full and complete information about the purpose of a study, procedures, data collection, potential harm and benefit and alternative methods of treatment. (2) are capable of fully understanding the research and the implications of participation(3) have the power of free choice to voluntary consent or decline participation in the research; and (4) understand how the researcher maintains confidentiality or anonymity. *(P2, ANA TJC)( NPAs - state board of Nursing P303)know what the facility or type of body is responsible for what type of act or action- if you are going over standardizing a care plan, that would be facility level. If you are going over making sure you enact a nurse practice act, that would be at the state legislature level. If you had accreditation - educational nursing program, faculty level. Basically, what level - ANS ANA ( American Nurses Association) defines the scope of nursing: The Standard of Practice describe a competent level of nursing care. The levels of care are demonstrated by a critical thinking model known as the nursing process, assessment, diagnosis, outcomes identification and planning, implementation, and evaluation. And Code of Ethics: Standards of Professional Performance: the ANA Standards of Professional performance describe a competent level of behavior in the professional role. The standards provide a method to assure patients that they are receiving high quality care, State Statutes : Nurse Practice Acts: describe and define the legal boundaries of nursing practice within each state. TJC The Joint Commission (agency): requires accredited hospitals to have written nursing policies and procedures FEDERAL: - ANS PPACA: Patient Protection and Affordable Care Act. ADA: Americans with Disabilities Act. Protects rights of people with physical or mental disabilities. EMTALA: Emergency Medical Treatment and Active Labor Act: provides that when someone comes to ED or hospital an appropriate medical screening occurs. MHPAEA : Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act: requires health insurance companies to provide equal coverage for mental health and substance abuse treatment. Advance Directives: include living wills, health care proxies, and durable powers of attorney for health care. Living Wills : represent written documents that direct treatment in accordance with a patient's wishes in event of terminal illness or condition. Heath Care Proxies or Durable Power of Attorney for Health Care: legal document that designates a person or people of one's choosing to make health care decisions, when Pt. is unable to make decisions on his or her own behalf. National Organ Transplant Act: prohibits the purchase or sale of organs. HIPPA Health Insurance Portability and Accountability Act: provides rights to patient and protects employees. Health Information Technology Act: (in conjunction with HIPPA) extends privacy and protection of personal health information, on technology , social media STATE STATUTORY - ANS Licensure: A State board of Nursing or Nursing commission licenses all RN in the state in which they practice. State Board of Nursing suspends or revokes a license if a nurse's conduct violate the Nurse Practice Act., which is a state law. Good Samaritan Law: All States have Good Samaritan laws to encourage health care professionals to assist in emergencies. Cover health care Professionals if they do, once they only provide care within scope of training. Public Health Laws: State legislatures enact statutes under health codes, to promote health and reduce health risks in communities. (CDC) The Uniform Determination of Death Act: (determining Legally Dead) Autopsy Death with Dignity Act. Providing end of life care . Oregon first State to implement Act Know what working INTERdependently means... eg. When you're not working solely to make a decision, with a Doc's order, or doing a certain task, like needing two nurses for blood transfusion. - ANS Interdependence : more than one entity working together to accomplish a shared goal. The concept of interdependence is of great importance in healthcare. As a single unit, one person, or department, cannot solely provide complete and competent patient care (P624-29) MALPRACTICE what do you think is the most reason for Malpractice: Medication Errors, what that involves.( 6 rights. How to prevent it)what causes, (quality control< reasons ..quality control - ANS Medication Errors: Can cause or lead or inappropriate medication use or patient harm. Med errors include inaccurate prescribing, administering the wrong medication. Giving medication the wrong route or time interval, administering extra doses, and or failing to administer a medication. 6 Rights of Medication Administration: (standards are actions that ensure safe nursing practice. Standards for medication administration are set by health care agencies and the nursing profession). Professional standards such as Nursing: Scope and Standards of Practice (ANA 2010) 1. Right Medication 2. Right Dose. 3. Right Patient. 4. Right Route. 5. Right Time. 6. Right Documentation. ((P.307)Know what Organization ensures that the RN are practicing at a minimal qualified level at a minimal qualified level - ANS ANA ( American Nurses Association) defines the scope of nursing: The Standard of Practice describe a competent level of nursing care. The levels of care are demonstrated by a critical thinking model known as the nursing process, assessment, diagnosis, outcomes identification and planning, implementation, and evaluation. The national council of state boards of nursing (NCSBN) establishes competencies (Potter p 279). They administer the NCLEX. The ANA sets standards of practice and performance (Potter p. 2 (P.753)Read Kubler Ross stages of grief. Look at all the stages and examples of those - ANS Stages of Grief: Denial: The person cannot accept the fact of the loss. It is a form of psychological protection from a loss that the person cannot yet bear. Anger: the person expresses resistance or intense anger at God, other people, or the situation. Bargaining: the person cushions or postpones awareness of the loss by trying to prevent it from happening. Depression: The person realizes the full impact of the loss. Acceptance: The person incorporates the loss into life. (P133)Freud. Go- over what did he believe re human behavior, and stages. - ANS FREUD HUMAN PERSONALITY AND BEHAVIOR. Freud believed that the components of the human personality develop in stages and regulate behavior: These components are: ID, EGO , SUPEREGO The ID: most primitive part of the personality and originates in the infant, who cannot tolerate delay and must have needs met immediately. The EGO: represent the reality component, mediating conflicts between the environment and the forces of the ID. It helps people judge reality accurately, regulate impulses and make good decisions, Ego is often referred to as one's sense of self. SUPEREGO: preforms regulating, restraining and prohibiting actions. Often referred to as the conscience. The Superego is influenced by the standards of outside social forces. Freud regarding Human Behavior and Stages: Freud's psychoanalytical model of personality development states that individuals go through five stages of psychosexual development and that each stage is characterized by sexual pleasure in parts of the body: the mouth, the anus, and the genitals. Freud believed that adult personality is the result of how an individual resolves conflicts between these sources of pleasures and the mandates of reality. - ANS Stage 1: Oral: (birth - 12,18 months)Sucking/oral satisfaction. Late in stage infant realizes mother is separate to themselves Stage 2; Anal (12-18 to 3 years)focus of pleasure transferred to anal. Kids become increasing aware of area of pleasure, toilet training time, child delays gratification to meet parental societal expectations. Stage 3: Phallic 3-6 years Genital organs, boys interested in penis, girls become aware of absence of penis, penis envy. This time child fantasies about parent of opposite sex. As his or her first love interest. By end of this stage child attempts to reduce this conflict by identifying with the parent of the same sex as a way to win recognition and acceptance. Stage 4: Latency (6-12) Freud believed that children repress and channel sexual urges into productive that are socially acceptable. Stage 5: Genital (puberty through adulthood) Final stage sexual urges reawaken and are directed to an individual outside the family circle. Some issues surface from prior stages, once resolved, capable of having a mature adult sexual relationship. (P17)Different levels of Health care system, Primary, secondary third .Emergency dept, or clinic etc - ANS PRIMARY CARE: Prenatal/well baby care Nutrition counselling, family planning. Exercise, yoga, meditation classes. SECONDARY CARE: Emergency care, Acute Medical-surgical care. Radiological for acute problems TERTIARY CARE: Intensive care, Subacute Care (P.33) Community Nursing; the most efficient way to meet needs as a community nurse - ANS Requires the ability to use interventions that include the broad social and political context of the community. Successful community health nursing practice involves building relationships with the community and being responsive to changes with the community. The nurse knows the community members, along wit their needs and resources, and then works in collaboration with community leaders to establish effective health promotion and disease prevention programs. This requires working with highly resistant systems and trying to encourage them to be more responsive to the needs of a population. Skills of patient and advocacy, communicating people's concerns, and designing new systems in cooperation with existing systems help to make community nursing practice effective. (P.134) Erikson: Trust Vs Mistrust. - ANS Trust Vs. Mistrust: Birth to 1 year. Establishing a sense of trust is essential for the development of a healthy personality. Infant's successful resolution of this stage requires a consistent caregiver who is available to meet his/her needs. From this trust in parents, infant is able to trust in himself, in others and in the world. Formation of trust results in faith and optimism. (Pharmacology: Elimination: Lungs, kidneys- what filtration goes on there, for older adults - ANS Fluid output normally occurs through four organs: the skin, lungs, gastrointestinal (GI) tract, and kidneys. Abnormal elimination would be vomiting, wound drainage, or hemorrhage. Kidney: In Older Adult; Major regulator of fluid output because they respond to hormones that influence urine production. In older adults the Glomular infiltration rate slows down, as does, renal blood flow (RBF), renal sodium handling, renal concentrating ability. predisposing the elderly patient to a number of fluid and electrolyte derangements and kidney injury or renal disease. Older adults' ability to hold urine between the initial desire to void and an urgent need to void decreases. Older adults are at increased risk for urinary incontinence because of chronic illnesses and factors that interfere with mobility, cognition and manual dexterity (P.183,84,89,341)Teaching for older adults, what would be appropriate for an older adult in (P775)terms of developmental stress of aging, what would be appropriate for teaching - ANS In old age stressors include the loss of autonomy and mastery resulting from general frailty or health problems that limit stamina, strength, and cognition. A nurse must know how to adapt routine patient education strategies to effectively meet the specific learning needs of elderly patients. Considerations regarding learning new medications, retrieving prescriptions and referrals, selecting providers from a list of names and addresses, calculating when to take multiple medications, interpreting medical terminology. Comparing different insurance plans. Teaching: schedule sessions mid-morning when energy levels are high. Several brief teaching sessions etc that might prevent fatigue. Minimize use of medical terminology and replace with lay terms when possible P.183,84,89,341)Teaching for older adults, what would be appropriate for an older adult in (P775)terms of developmental stress of aging, what would be appropriate for teaching PART 2 - ANS Allow additional time for older adult to process new info by pausing after presenting each new concept or bit of information. Link new knowledge or skill to clearly identifiable past experiences. K Keep the content practical and relevant to the older adult's daily activities. Social structure and physical function. Emphasize safety and maintaining independence. Help older adult focus during each interaction by minimizing distractions , limiting the message to a few essential key points. And avoiding extraneous information Speak slowly, face patient when speaking, and sit at the same level as the patient. Encourage the older adult to invite a family member or trusted friend to attend and actively participate in each teaching sessions. Validate understanding by using the Teach Back technique before moving on. Be sure the patient is able to demonstrate and do psychomotor skills independently. Ch.44)Pain management - knowing when to teach, whether the Pt. is ready to listen/ learn. (P.340)When in pain, not ready to listen. - ANS Motivation to Learn: desire to learn Active participation: learning occurs when a patient is actively involved in an educational session. Ability to learn: Cognitive development influences a pt. ability to learn. You need to know a patient's level of knowledge and intellectual skills before beginning a teaching plan. Physical capability: depends on a patient's level of physical development and overall physical health. To learn psychomotor skills a patient needs to possess a certain level of strength, coordination, and sensory acurity. Pain and Learning: any condition (eg. Pain and fatigue) that depletes a person's energy also impairs the ability to learn. Postpone teaching when an illness becomes aggravated by complications such as a high fever or respiratory difficulty. As you work with a patient assess energy level by noting the patient's willingness to communicate, the amount of activity initiated, and responses to questions. Temporarily stop teaching if the patient needs rest. You achieve greater teaching success when patients are physically able to participate in learning. (P.339)Learning: in psychomotor domain- pick out an example of that and understand it - ANS INVOLVES ACQUIRING MOTOR SKILLS THAT REQUIRE COORDINATION AND THE INTERGRATION OF MENTAL AND PHYSICAL MOVEMENT. (such as the ability to walk or use and eating utensil). Part 2: (P.339)Learning: in psychomotor domain- pick out an example of that and understand it - ANS Perception: being aware of objects or qualities through the use of sensory stimulation Set: Readiness to take a particular action; there are 3 sets: mental, physical, and emotional. Guided response: Early stages of learning a particular skill under the guidance of an instructor that involves imitation and practice of a demonstrated act. Mechanism: higher level of behavior in which a person gains confidence and proficiency in performing a skill that is more complex or involves several more steps than a guided response. Complex overt response: smoothly and accurately performing a motor skill that requires complex movement patterns. Adaptation: motor skills are well developed, and movements can be modified when unexpected problems occur. Origination: using existing psychomotor skills to create new movement patterns perform them as needed in response to a particular situation or problem. Pharmacology: when medications have a reverse effect: definition - ANS Paradoxical Effect : A paradoxical effect is the opposite of the intended drug response. A common example is the insomnia and excitement that may occur when some children and older adults are given benzodiazepines for sedation.