NURSING PROCESS APPROACH 2026 MASTER
STUDY EXAM
◉ Maslows level 5: Self-Actualization. Answer: acceptance of self and
others as they are; each lower level must be met; focus of interest on
problems outside oneself; respect for all people; focus on strengths
and possibilities vs problems
◉ autonomy. Answer: respect rights of patients to make health care
decisions
◉ nonmaleficence. Answer: avoid causing harm
◉ beneficence. Answer: benefit the patient; balance benefits against
risks and harms
◉ nurse practice acts. Answer: each state has its own; protects
public with legal scope of nursing practice
◉ standards. Answer: used as guidelines for peer review (ANA)
,◉ establishing an effective nurse-patient relationship. Answer: -
reduce anxiety through therapeutic communication, teaching, and
acceptance
-remember that the patient has concerns and needs other medical
ones
-communicate with the patient as an individual
-take time to learn about the patient being admitted
-provide for the family participation in all aspects of care
◉ when does discharge planning start?. Answer: as soon as the
patient comes in the door
◉ oral temperature for healthy adult. Answer: 37.0 C, 98.6 F
◉ pulse rate for healthy adult. Answer: 60-100 (80 average)
◉ respirations for healthy adult. Answer: 12 to 20 breaths/min
◉ average blood pressure for healthy adult. Answer: 120/80
◉ intermittent fever. Answer: temperature returns to normal at least
once every 24 hours
, ◉ remittent fever. Answer: temperature does not return to normal
and fluctuates a few degrees up and down
◉ sustained or continuous fever. Answer: temp remains above
normal with minimal variations
◉ relapsing or recurrent fever. Answer: temp returns to normal for
one or more days with one or more episodes of fever, each as long as
several days
◉ rectal temp. Answer: 37.5 C, 99.5 F
◉ axillary temp. Answer: 36.5 C, 97.7 F
◉ tympanic temp. Answer: 37.5 C, 99.5 F
◉ forehead temp. Answer: 34.4 C, 94.0 F
◉ heat production. Answer: -primary source is metabolism
-hormones, muscle movements, exercise increase metabolism
-thyroid hormone and shivering also increase heat production
- energy production decreases and heat production increases