Exam (elaborations) NR 509 Week 1 Study Guide

Exam (elaborations) NR 509 Week 1 Study Guide 1. After completing an initial assessment of a patient, the nurse has charted that his respirations are eupneic and his pulse is 58 beats per minute. These types of data would be. A. Objective B. Reflective C. Subjective D. Introspective 2. A patient tells the nurse that he is very nervous, is nauseated and feels hot. These types of data would be A. Objective B. Reflective C. Subjective D. Introspective 3. The patients record, laboratory studies, objective data, and subjective data combine to form the A. Data base B. Admitting data C. Financial Statement D. Discharge Summary 4. When listening to a patients breath sounds, the nurse is unsure of a sound that is heard. The nurses next action should be to A. Immediately notify the patients physician B. Document the sound exactly as it was heard. C. Validate the data by asking a coworker to listen to breath sounds D. Assess it again in 20 minutes to note whether the sound is still present 5. The nurse is conducting a class for new graduate nurses. During the teaching session, the nurse should keep in mind that novice nurses, without a background of skills and experience from which to draw, are more likely to make their decisions using: A. Intuition B. A set of rules C. Articles in journals D. Advice from supervisors 6. Expert nurses learn to attend to a pattern of assessment data and act without consciously labeling it. These responses are referred to as: A. Intuition B. The nursing process C. Clinical knowledge D. Diagnostic reasoning 7. The nurse is reviewing information about EBP. Which statement best reflects EBP? A. EBP relies on tradition for support of best practices B. EBP is simply the use of best practice techniques for the treatment of patients C. EBP emphasizes the use of best evidence with the clinicians experience D. The patients own preferences are not important with EBP. 8. The nurse is conducting a class on priority setting for a group of new graduate nurses. Which is an example of a first-level priority problem A. Patient with postoperative pain NR 509 Week 1 Study Guide B. Newly diagnosed patient with diabetes who needs diabetic teaching C. Individual with a small laceration on the sole of the foot D. Individual with shortness of breath and respiratory distress 9. When considering priority settings of problems, the nurse keeps in mind that secondlevel priority problems include which of these aspects? A. Low self-esteem B. Lack of knowledge C. Abnormal laboratory values D. Severely abnormal vital signs 10. Which critical thinking skill helps see relationships among the data? A. Validation B. Clustering related cues C. Identifying gaps in data D. Distinguishing relevant from irrelevant 11. The nurse knows that developing appropriate nursing interventions for a patient relies on the appropriateness of the ________ diagnosis A. Nursing B. Medical C. Admission D. Collaborative 12.The nursing process is a sequential method of problem solving that nurses use and includes which steps? A. Assessment, treatment, planning, evaluation, discharge, and follow-up B. Admission, assessment, diagnosis, treatment and discharge planning C. Admission, diagnosis, treatment, evaluation and discharge planning D. Assessment, diagnosis, outcome identification, planning, implementation, and evaluation 13. A newly admitted patient is in acute pain, has not been sleeping well lately, and is having difficulty breathing. How should the nurse prioritize these problems A. Breathing, pain, and sleep B. Breathing, sleep and pain C. Sleep, breathing and pain D. Sleep, pain and breathing 14. Which of these would be formulated by a nurse using diagnostic reasoning? A. Nursing diagnosis B. Medical diagnosis C. Diagnostic hypothesis D. Diagnostic assessment 15. Barriers to EBP include: A. Nurses lack research skills in evaluating the quality of research studies B. Lack of significant research studies C. Insufficient clinical skills of nurses D. Inadequate physical assessment skills 16. What step of the nursing process includes data collection by health history, physical examination and interview? A. Planning B. Diagnosis C. Evaluation D. Assessment 17. During a staff meeting, nurses discuss the problems with accessing research studies to incorporate evidence-based clinical decision making into their practice. Which suggestion by the nurse manager would best help these problems? A. Forma committee to conduct research studies B. Post published research studies on the units bulletin boards C. Encourage the nurse to visit the library to review studies D. Teach the nurses how to conduct electronic searchers for research studies 18. When reviewing the concepts of health, the nurse recalls that the components of holistic health include which of these? A. Disease originates from the external environment B. The individual human is a closed system C. Nurses are responsible for a patients health state D. Holistic health views the mind, body, and spirit as interdependent 19.The nurse recognizes that the concept of prevention in describing health is essential because A. Disease can be prevented by treating the external environment B. The majority of deaths among Americans under age 65 years are not preventable C. Prevention places the emphasis on the link between health and personal behavior D. The means to prevention is through treatment provided by primary health care practitioners 20.The nurse is performing a physical assessment on a newly admitted patient. An example of objective information obtained during the physical assessment includes the A. Patients history of allergies B. Patients use of medications at home C. Last menstrual period 1 month ago D. 2.5 cm scar on the right lower forearm 21. A visiting nurse is making an initial home visit for a patient who has many chronic health problems. Which type of data base is most appropriate to collect in this setting? A. A follow-up data base to evaluate changes at appropriate intervals B. An episodic data base because of the continuing, complex medical problems of this patient C. A complete health data base because of the nurses primary responsibility for monitoring the patients health D. An emergency data base because of the need to collect information and make accurate diagnoses rapidly 22. Which situation is most appropriate during which the nurse performs a focused or problem-centered history? A. Patient is admitted to a long-term care facility B. Patient has a sudden and severe shortness of breath C. Patient is admitted to the hospital for surgery the following day D. Patient in an outpatient clinic has cold and influenza-like symptoms 23. A patient is in the clinic to have her blood pressure checked. She has been coming to the clinic weekly since she changed medications 2 months ago. The nurse should: A. Collect a follow-up data base and then check her blood pressure B. Ask her to read her health record and indicate any changes since her last visit C. Check only her blood pressure because her complete health history was documented 2 months ago D. Obtain a complete health history before checking her blood pressure because much of her history information may have changed 24. A patient is brought by ambulance to the ED with multiple traumas received in an automobile accident. He is alert and cooperative, but his injuries are quite severe. How would the nurse proceed with data collection? A. Collect history information first, then perform a physical examination and institute lifesaving measures B. Simultaneously ask history questions while performing the examination and initiating life-saving measures C. Collect all information on the history form, including social support patterns, strengths, and coping patterns D. Perform life-saving measures and delay asking any history questions until the patient is transferred to the ICU. 25. A 42-year-old patient of Asian descent is being seen at the clinic for an initial examination. The nurses knowns that including cultural information in his health assessment is important to: A. Identify the cause of his illness B. Make accurate disease diagnoses C. Provide cultural health rights for the individual D. Provide culturally sensitive and appropriate care 26. In the health promotion model, the focus of the health professional includes: A. Changing the patients perceptions of disease B. Identifying biomedical model interventions C. Identifying negative health acts of the consumer D. Helping the consumer choose a healthier lifestyle 27. The nurse has implemented several planned interventions to address the nurses diagnosis of acute pain. Which would be the next appropriate action? A. Establish priorities B. Identify expected outcomes C. Evaluate the individuals condition, and compare actual outcomes with expected outcomes D. Interpret data, and then identify clusters of cues and make inferences 28. Which statement best describes a proficient nurse? A proficient nurse is one who: A. Has little experience with a specified population and uses rules to guide performance B. Has an intuitive grasp of a clinical situation and quickly identifies the accurate solution C. Sees actions in the context of daily plans for patients D. Understands a patient situation as a whole rather than a list of tasks and recognizes the long-term goals for the patient 29. A nurse is reviewing data collected after an assessment. Of the data listed below, which would be considered related cues that would be clustered together during data analysis? Select all that apply A. Inspiratory wheezes noted in left lower lobe B. Hypoactive bowel sounds C. Nonproductive cough D. Edema +2 noted on the left hand E. Patient reports dyspnea upon exertion F. Rate of respirations 16 breaths per minute 30. Put the following situations in order according to the level of priority A. A patient newly diagnosed with type 2 DM does not know how to check his own blood glucose levels with a glucometer B. A teenager who was stung by a bee during soccer match is having trouble breathing C. An older adult with a urinary tract infection is also showing signs of confusion and agitation 1. First-level priority problem (B) 2. Second-level priority problem (C) 3. Third-level priority problem (A) 31. The nurse is conducting an interview what a woman who has recently learned that she is pregnant and who has come to the clinic today to being prenatal care. The woman states that she and her husband are excited about the pregnancy, but have a few questions. She looks nervously at her hands during the interview and sighs loudly. Considering the concept of communication, which statement does the nurse know to be most accurate? The woman is: A. Excited about her pregnancy but nervous about the labor B. exhibiting verbal and nonverbal behaviors that do not match C. Excited about her pregnancy, but her husband is not in this is upsetting to her D. Not excited about her pregnancy but believes the nurse will negatively respond to her if she states this. 32. Receiving is a part of the communication process. which receiver is most likely to misinterpret a message sent by a Health care professional? A. Well-adjusted adolescent who came in B. Recovering alcoholic who came in for a basic physical exam C. Man whose wife has just been diagnosed with lung cancer D. Man with a hearing impairment who uses sign language to communicate and who has an interpreter with him 33. The nurse makes which adjustment in the physical environment to promote success of an interview? A. Reduces noise by turning off televisions and radios B. Reduces the distance between the interviewer and patient to 2 feet or less C. Provides a dim light that makes the room cozy and helps the patient relax D. Arrange is sitting across a desk or table to allow the patient some personal space 34. In an interview, the nurse may find it necessary to take notes to aid his or her memory later. Which statement is true regarding notetaking A. Note taking may impede the nurses observation of the patients nonverbal behaviors B. Note taking allows the patient to continue at his or her own pace as the nurse records what is said C. Note taking allows the nurse to shift attention away from the patient resulting in an increased comfort level D. Note taking allows a nurse to break eye contact with the patient which may increase his or her level of comfort 35. The nurse asks, I would like to ask you some questions about your health and your usual daily activities so that we can better plan your stay here. This question is found at the ______ Phase of the interview process. A. Summary B. Closing C. Body D. Opening or introduction 36. A woman has entered the emergency Department after being battered by her husband. the nurse needs to get some information from her to begin treatment. what is the best choice for an opening phase of the interview with this patient? A. Hello, Nancy, my name is Mrs. C B. Hello, Mrs. H, my name is Mrs. C. It sure is cold today! C. Mrs. H, my name is Mrs. C. How are you? D. Mrs. H, my name is Mrs. C. I'll need to ask you a few questions about what happened 37. During an interview, the nurse states, you have mentioned having shortness of breath. Tell me more about that. Which verbal skill is used with this statement? A. Reflection B. Facilitation C. Direct question D. Open ended question 38. A patient has finished giving the nurse information about the reason he is seeking care. When reviewing the data, the nurse finds that some of the information about past hospitalizations is missing. At this point, which statement by the nurse would be most appropriate together these data? A. Mr. Y, at your age, surely you have been hospitalized before! B. Mr. Y, I just need permission to get your medical records from County medical C. Mr. Y you mentioned that you have been hospitalized on several occasions. would you tell me more about that? D. Mr. Y, I just need to get some additional information about your past hospitalizations when was the last time you were admitted for chest pain 39. In using verbal responses to assist the patient's narrative, some responses focus on the patients frame of reference and some focus on the health care providers perspective. An example of a verbal response that focuses on the health care providers perspective would be: A. Empathy B. Reflection C. Facilitation D. Confrontation 40. When taking a history from a newly admitted patient, the nurse notices that he often pauses and expectantly looks at the nurse. What would be the nurse's best response to this behavior? A. Be silent, and allow him to continue when he is ready B. Smile at him and say, don't worry about all of this. I'm sure we can find out why you are having these pains. C. Lean back in the chair and ask, you are looking at me kinda funny; There isn't anything wrong, is there? D. Stand up and say, I can see this interview is uncomfortable for you. We can continue it another time. 41. A woman is discussing the problems she is having with her 2 year old son. She says, he won't go to sleep at night and during the day he has several fits. I get so upset when that happens. The nurses best verbal response would be: A. Go on, I'm listening B. Fits? Tell me what you mean by this. C. Yes, it can be upsetting when a child has a fit. D. Don't be upset with me has a fit, every 2 year old has fits 42. A 17-year-old single mother is describing how difficult it is to raise a 3 year old child by herself. During the course of the interview she states, I can't believe my boyfriend has left me to do this by myself. What a terrible thing to do to me. Which of these responses by the nurse uses empathy? A. You feel alone. B. You can't believe he left you alone? C. It must be so hard to face this all alone. D. I would be angry too, raising a child alone is no picnic 43. A man has been admitted to the Observation unit for observation after being treated for a large cut on his forehead. As the nurse works through the interview, one of the standard questions has to do with alcohol, tobacco, and drug use. When the nurse asks him about tobacco use, he states, I quit smoking after my wife died 7 years ago. However, the nurse notices an open pack of cigarettes in his shirt pocket. Using confrontation, the nurse could say: A. Mr. K. I know that you are lying B. Mr. K, come on, tell me how much you smoke C. Mr. K, I did not realize your wife had died. It must be difficult for you at this time. Please tell me more about that. D. Mr. K, you have said that you don't smoke, but I see that you have an open pack of cigarettes in your pocket. 44. The nurse has used interpretation regarding a patient statement or actions. after using this technique, it would be best for the nurse to: A. Apologize, because using interpretation can be demeaning for the patient B. Allow time for the patient to confirm or correct the inference C. Continue with the interview as though nothing has happened D. Immediately restate the nurse's conclusion on the basis of the patients nonverbal response 45. During an interview, a woman says, I have decided that I can no longer allow my children to live with their father's violence. But I just can't seem to leave him. Using interpretation, the nurses best response would be A. Are you going to leave him? B. If you are a frayed for your children, then why can't you leave? C. It sounds as if you might be afraid of how your husband will respond. D. It sounds as though you have made your decision. I think it is a good one. 46. A pregnant woman states, I just know labor will be so painful that I won't be able to stand it. I know it sounds awful, but I really dread going into labor. The nurse responds by stating, oh don't worry about labor so much. I have been through it, and although it is painful, many good medications are available to decrease the pain. Which statement is true regarding this response? The nurses reply was : A. Therapeutic response. By sharing something personal, the nurse gives hope to this woman B. Non-therapeutic response. By Providing false reassurance, the nurse actually cut off further discussion of the woman's fears C. Therapeutic response. By providing information about medications available, the nurse is giving information to the woman. D. Non therapeutic response. The nurse is essentially giving the message to the woman that labor cannot be tolerated without medication. 47. During a visit to the clinic, patient states, the doctor just told me he thought I ought to stop smoking. He doesn't understand how hard I have tried. I just don't know the best way to do it. What should I do? The nurse is most appropriate response in this case would be : A. I'd quit if I were you. The doctor really knows what he is talking about B. Would you like some information about the different ways a person can quit smoking? C. Stopping your dependence on cigarettes can be very difficult. I understand how you feel. D. Why are you confused? Didn't the doctor give you the information about the smoking cessation program we offer? 48. As the nurse enters a patient's room, the nurse finds her crying. The patient states that she has just found out that the lump in her breast is cancer and says, I'm so afraid, um, you know. The nurse is most therapeutic response would be to say in a gentle manner: A. You are afraid you might lose your breast? B. No, I'm not sure what you are talking about. C. I'll wait here until you get yourself under control, and then we can talk. D. I can see that you are very upset. Perhaps we should discuss this later period 49. A nurse is taking complete health histories on all of the patients attending a wellness workshop. On the history form, one of the written questions asks, you don't smoke, drink, or take drugs, do you? This question is an example of: A. Talking too much B. Using confrontation C. Using biased or leading questions D. Using blunt language to deal with distasteful topics 50. When observing a patient verbal and nonverbal communication, the nurse notices a discrepancy. Which statement is true regarding this situation? The nurse should : A. Ask someone who knows the patient well to help interpret this discrepancy B. Focus on the patient's verbal message and try to ignore the nonverbal behaviors C. Try to integrate the verbal and nonverbal messages and then interpret them as an average D. Focus on the patient's nonverbal behaviors, because these are often more reflective of a patients true feelings 51. During an interview, a parent of a hospitalised child is sitting in an open position. And the interviewer begins to discuss his son's treatment, suddenly crosses his arms against his chest and crosses his legs. This changed posture would suggest that the parent is: A. Simply changing positions B. More comfortable in this position C. Tired and need a break from the interview. D. Uncomfortable talking about his son's treatment 52. A mother brings her 28-month-old daughter into the clinic for a well child visit. At the beginning of the visit the nurse focuses attention away from the toddler, but as the interview progresses, the toddler begins to warm up and a smiling shyly at the nurse. The nurse will be most successful and interacting with the toddler if which is done next? A. Tickle the toddler get her to laugh B. Stoop down to her level and ask her about the toys she is holding. C. Continue to ignore her until it is time for the physical examination D. Ask the mother to leave during the examination of the toddler, because toddlers often fuss less if their parent is not in view 53. During an examination of a 3 year old child, the nurse will need to take her blood pressure. What might think nurse do to try to gain the child's full cooperation? A. Tell the child that the blood pressure cuff is going to give her arm a big hug B. Tell the child that the blood pressure cuff is asleep and cannot wake up C. Give the blood pressure cuff a name and refer to it by this name during the assessment D. Tell the child that by using the blood pressure cuff we can see how strong her muscles are. 54. A 16 year old boy has just been admitted to the unit for overnight observation after being in an automobile accident. What is the nurses best approach to communicating with him? A. use periods of silence to communicate respect B. Be totally honest with him even if the information is unpleasant C. Tell him that everything that is discussed will be kept totally confidential D. Use slang language when possible to help him open up 55. A 75-year-old woman is at the office for a pre-op interview. The nurse is aware that the interview may take longer then interviews with younger persons. What is the reason for this? A. An aged person has a longer story to tell B. An aged person is usually lonely and likes to have someone with whom to talk C. Aged persons lose much of their mental abilities and require longer time to complete an interview D. As a person ages he or she is unable to hear, best the interviewer usually means to repeat much of what is said 56. The nurse is interviewing a male patient who has a hearing impairment. What techniques would be most beneficial in communicating with this patient? A. Determine the communication method he prefers B. Avoid using facial and hand gestures because most hearing impaired people find this degrading C. Request a sign language interpreter before meeting with him to help facilitate the communication D. Speak loudly with exaggerated facial movement when talking with him because doing so will help him lip read 57. During a prenatal check, a patient begins to cry as the nurse asked her about previous pregnancies. She says that she is remembering her last pregnancy, which ended in miscarriage. The nurses best response to her crying would be : A. I am so sorry for making you cry B. I can see that you are sad remembering this. It is alright to cry C. Why don't I stepped out for a few minutes until you are feeling better D. I can see that you feel sad about this, why don't we talk about something else. 58. A female nurse is interviewing a man who has recently immigrated. During the course of the interview he leaned forward and then finally moves his chair close enough that his knees are nearly touching the nurse's knees. The nurse begins to feel uncomfortable with his proximity. Which statement most closely reflects what the nurse should do next A. The nurse should try to relax, these behaviors are culturally appropriate for this person B. Cleaner should discretely move his or her chair back until the distance is more comfortable and then continue with the interview C. These behaviors are indicative of sexual aggression, and the nurse should confront this person about his behaviors D. The nurse should laugh but tell him that he or she is uncomfortable with his proximity and ask him to move away 59. A female American Indian has come to the clinic for follow up diabetic teaching. During the interview, the nurse notices that she never makes eye contact and speaks mostly to the floor. which statement is true regarding the situation? A. The woman is nervous and embarrassed B. She has something to hide and is ashamed C. The woman is showing inconsistent verbal and nonverbal behaviors D. She is showing that she is carefully listening to what the nurse is saying 60. The nurse is performing a health interview on a patient who has a language barrier, and no interpreter is available. Which is the best example of an appropriate question for the nurse to ask in this situation? A. Do you take medicine B. Do you sterilize the bottles? C. Do you have nausea and vomiting? D. You have been taking your medicine, haven't you? 61. A man arrives at the clinic for his annual wellness physical. He is experiencing no acute health problems. Which question or statement by the nurse is most appropriate when beginning the interview? A. How is your family? B. How is your job? C. Tell me about your hypertension. D. How has your health been since your last visit? 62. The nurse makes this comment to a patient, I know it may be hard, but you should do what the doctor ordered because she is the expert in this field. Which statement is correct about the nurses comment? A. This comment is inappropriate because it shows the nurses blame him B. This comment is appropriate because members of the health care team are experts in their area of patient care C. This type of comments promotes dependency and inferiority on the part of the patient and is best avoided in an interview situation D. Using authority statements when dealing with patients, especially when they are undecided about an issue comment is Nece