Sue's sets Transitions - Flashcards

Q: Informal Teaching

Unplanned teaching sessions dealing with the patient\'s immediate learning needs and concerns

Q: Learning

Increasing one\'s knowledge; having one\'s behavior changed in a measurable way as a result of an experience

Q: Learning Readiness

Patient\'s willingness to engage in the teaching- learning process (emotional readiness) and experiential readiness to begin the challenge of learning

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Affective Learning

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Changes in attitudes, values, and feelings

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Andragogy

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The study of teaching adults

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Cognitive Learning

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Storing and recalling of new knowledge in the brain

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Contractual Agreement

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Pact made between two people or parties for the achievement of mutually set goals

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Couseling

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Giving guidance assisting with problem solving

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Developmental Crisis

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Predictable patterns of behavior and change occurring throughout the lifespan

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Formal Teaching

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Planned teaching based on learning objectives

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Health Literacy

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Ability to read, understand, and act on health information

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Informal Teaching

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Unplanned teaching sessions dealing with the patient's immediate learning needs and concerns

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Learning

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Increasing one's knowledge; having one's behavior changed in a measurable way as a result of an experience

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Learning Readiness

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Patient's willingness to engage in the teaching- learning process (emotional readiness) and experiential readiness to begin the challenge of learning

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Literacy

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Ability to read and write

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Negative Reinforcement

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An ineffective teaching strategy that uses criticism or punishment

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Nurse Coach

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A registered nurse who integrates coaching competencies into any setting or specially area of practice to facilitate a process of change or development that assists individuals or groups to realize their potential

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Patient Education

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Process of influencing the patient's behavior to effect changes in knowledge, attitudes, and skills needed to maintain and improve health

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Pedagogy

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Science of teaching that generally refers to the teaching of children and adolescents

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Positive Reinforcement

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Affirmation of the efforts of a patient

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Psychomotor Learning

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Acquisition of physical skills

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Situational Crsis

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Change that results when a person faces an event or situation that causes a disruption in one's life

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Teaching-Learning Process

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Process of patient teaching that encompasses critical steps necessary to provide teaching and to measure learning; the teaching=-learning process models the nursing process

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Describe the teaching- learning process, including domains, developmental concerns, and specific principles

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Teaching Learning Process: 1. Assess Learning Needs and Learning Readiness 2. Diagnose the Patient's Learning Needs 3. Develop Learning Outcomes 4. Develop a Teaching Plan 5. Implement Teaching Plan and Strategies 6. Evaluate Learning Domains: 1. Cognitive 2. Psychomotor 3. Affective Developmental Concerns: 1. The patient's physical maturation and abilities 2. Psychological development 3. Cognitive Capacity Specific Principles 1. Be sincere and honest; show genuine interest and respect 2. Avoid giving to much detail; stick to the basics 3. Ask if the patient has any questions 4. Be a "cheerleader" for the patient. Avoid lecturing 5. Use simple words 6. Vary your tone of voice 7. keep the content clear and concise 8. Listen and do not interrupt when the patient speaks 9. Ensure that the environment is conductive to learning and free of interruptions 10. Be sensitive to the timing of teaching sessions (children vs adult)

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Describe the factors that should be assessed in the learning process

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1. Knowledge, attitudes, and skills needed for the patient and family to manage health care independently 2. Readiness to learn 3. Ability to learn 4. Learning Strengths

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Discuss strategies that improve health literacy and promote patient safety

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*include plain language without medical jargon * May Incorporate the use of visual models to explain the disease or procedure *May involve patients in a "teach-back" demonstration that verifies their understanding of the information presented

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Describe the factors that influence patient compliance with the therapeutic pain

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*When patients understand their diagnosis, treatment rationale, medication regimen, and the benefits of compliance

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Formulate diagnosis for identified learning needs

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page 491 Box 21-7

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Explain how to create and implement a culturally competent, age-specific teaching plan for a patient

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1. Contractual Agreement 2. Learning Activities 3. Implementing >Promote Patient learning by using a warm and accepting approach >Consider the physical environment when implementing the teaching plan > Review the patient's expectations and role functions as a learner > Assess the patient's comfort level > Be prepared and organized before implementing the teaching plan >Make each learning session interesting and enjoyable for the patient

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Discuss the role of a nurse coach in promoting behavior change

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* Establishing relationships and identifying readiness for change *Identifying opportunities, issues, and concerns *Establishing patient-centered care *Creating the structure of the coaching interaction *Empowering and motivating patients to reach goals *Assisting patient's to determine progress towards goals

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Name 3 methods for evaluating learning

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*Cognitive domain learning may be evaluated through oral questioning *Affective domain learning through the patient's response *Psychomotor domain learning by a return demonstration

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Explain what should be included in the documentation of the teaching-learning process

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*Summary of Learning Need * The Plan * The implementation of the Plan * The Evaluation Results The EVALUATION STATEMENT is crucial and must show concrete evidence that demonstrates that learning has occurred

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Discuss the nurse's role as a counselor

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Posses the interpersonal skills of warmth, friendliness, openness, empathy, and caring are necessary for successful counseling

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Summarize how the nursing process is used to help patients solve problems

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Situation Assessing Diagnosing Planning Goal Implementing Evaluating Example page 501 Box 21-13

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Describe how to use the counseling role to motivate a patient toward health promotion

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Instead of focusing on the issue, the nurse attempts to gain a better understanding of the barriers that exist to changing family behavior . This technique, lets the family gain self confidence needed to promote better health outcomes

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Aerobic

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Bacterial that require oxygen to live and grow

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Anerobic

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Bacteria that can live without oxygen

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Antibody

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Immunoglobin produced by the body in response to a specific antigen

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Antigen

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Foreign material capable of inducing a specific immune response

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Antimicrobial

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Antibacterial agent that kills bacteria or suppresses their growth

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Asepsis

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Absence of disease-producing microorganisms, using methods to prevent infection

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Bacteria

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Most significant and most commonly observed infection-causing agents

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Bundles

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Evidence-based best practices that have proven positive outcomes when implemented together to prevent infection

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Colonization

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Organism resides in a person's body but there are no clinical signs of an infection

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Disinfection

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Process used to destroy microorganisms, destroys all pathogenic organisms except spores

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Endemic

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Something that occurs with practicability in one specific region or population and can appear in a different geographical location

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Endogenous

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Infection in which the causative organism comes from microbial life the person himself or herself harbors

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Exogenous

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Infection in which the causative organism is acquired from outside the host

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Fungi

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Plant-like organisms (molds and yeasts) that can cause infection

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Health care-associated infection (HAI)

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Infection that was not present on admission to the hospital and develops during the course of treatment for other conditions (nosocomial)

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Host

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Animal or person on or within which microorganisms live

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Iatrogenic

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Infection that occurs as a result of a treatment or diagnostic procedure

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Infection

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Disease state resulting from pathogens in or on the body

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Isolation

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Protective procedure designed to prevent the transmission of specific microorganisms, also called protective aseptic techniques and barrier techniques

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Medical Asepsis

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Practices designed to reduce the number and transfer of pathogens, synonym for clean technique

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Nosocomial

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Practices designed to reduce the number and transfer of pathogens, synonym for clean technique

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Parasites

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Organism that live on or in a host and rely on it for nourishment

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Pathogens

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Disease producing microorganism

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Personal Protective Equipment (PPE)

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Gloves, gowns, masks, and protective eye gear designed to minimize or prevent the healthcare workers exposure to infectious material

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Reservoir

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Natural habitat for the growth and multiplication of microorganisms

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Standard Precautions

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CDC precautions used in the care of all patients regardless of their diagnosis or possible infection status; this category combines universal and body substance precautions

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Sterilization

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the process by which all microorganisms, including spores are destroyed OR - a surgical procedure performed to render a person infertile

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Surgical Asepsis

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Practices that render and keep objects and areas free from microorganisms, synonym for sterile technique

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Transmission-Based Precautions

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CDC precautions used in patients known or suspected to be infected with pathogens that can be transmitted by airborne, droplet, or contact routes, used in addition to standard precautions

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Vector

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Nonhuman carriers, such as mosquitoes, ticks and lice that transmit organisms from one host to another

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Virulence

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Ability to produce disease

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Virus

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Smallest of all microorganisms, can be seen only by using an electron microscope

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Difference between medical & surgical asepsis

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SURGICAL = STERILE Medical asepsis is as clean as possible, daily precautions such as wearing gloves and washing hands Surgical asepsis is completely sterile and includes keeping sterile hands above the waste and never reaching across a sterile field

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List the 4 best ways to decrease spread of infection

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1.) PPE; wear masks, gowns etc when changing surgical dressings 2.) Place pt's w/infection in isolation 3.) Wear gloves @ all times, whenever possible 4.) Hand Hygiene, wash those puppies after every chance of contamination

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Assessment of Infectious Pt's includes: (3)

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Client Susceptibility; age, immunocompromised, impaired skin integrity etc. Clinical Appearance; local or systemic Laboratory Data; Signs of infections include: WBC > 10,000, changes in specific WBS i.e. neutrophils, macrophages, Increased Sed rate (blood marker shows inflammation), & cultures of drainage

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Nursing Diagnosis & Asepsis/Infectious Pt

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Identify risk for infection Identify realistic, measurable goals (i.e. prevention & education) Set priorities & treat by highest priority first (i.e. breathing issues before cut on foot)

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What are the differences between cleaning, disinfection, & sterilization?

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Cleaning = removal of soil Disinfection = eliminating MANY microorganisms Sterilization = removal/elimination of ALL microorganisms

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How can you as a nurse, control or eliminate reservoirs?

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Anything that comes in contact w/ pt, bodily fluids....Bathing, bedding, drainage bottles & bags, surgical wounds, contaminated articles of clothing, needles, etc

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As a nurse, how can you control portals of exit? Portals of entry? Control Transmission?

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P of Exit - Careful handling of bodily fluids & laboratory specimens. P of Entry - Maintain skin integrity, cleanse after bathroom, maintain integrity of closed systems, & use proper technique of wound cleansing. Transmission - Self-care items, keep soiled equipment away from uniform, hand hygiene (i.e. take off scrubs and shoes in garage and change b4 entering home, being around kids etc.)

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Current CDC guidelines on Asepsis

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Standard Precautions - used in care of all hospital pt's (Apply to all bodily fluids and secretions) Transmission based precautions - used in addition to standard precautions when pt has suspected infection (includes airborne (respiratory, TB), droplet (usually w/in 3 ft), & contact (C.diff in stools of infected pt)

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Give an example of an infectious disease which is transmitted via airborne, droplet, and contact

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Airborne: Pulmonary TB, Measles, Varicella Zoster (N95 Particulate Respirator Mask, 95% air filtered) Droplet: Influenza (Flu, stay 3ft away) Contact: MRSA, C. Difficile (gloves, apron, etc.)

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Cyclic Process (6 components)

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Infectious agent Reservoir Port of exit Means of transmission Portals of entry Susceptible host

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Cocci (bacteria)

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Spherical

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Bacilli (bacteria)

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Rod shaped

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Spirochetes (bacteria)

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Corkscrew shaped

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Gram-positive bacteria

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Thick cell wall, resists decolorization (loss of color), stained violet

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Gram-negative bacteria

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Thin cell wall (more complex), can be decolorized by alcohol, do not stain

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Normal flora

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Microorganisms that commonly inhabit various body sites and are part of the body's natural defense system

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Opportunists

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Bacteria that normally cause no problem, but with certain factors, may potentially be harmful in susceptible people

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Reservoir - infected animal

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Rabies

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Reservoir - animal

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West Nile Virus

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Reservoir - soil

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Gas gangrene and tetanus

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Reservoir - water

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Giardia, E. coli and Shigella

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Reservoir - food

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E. coli

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Reservoir - milk

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Listeria

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Reservoir - inanimate object

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Influenza virus

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Portal of exit

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Point of escape for the organism from the reservoir

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Means of Transmission

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Blood, food, water, inanimate objects, airborne, droplet particles

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Portal of entry

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Point at which organisms enter a new host

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Susceptibility

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Degree of resistance the potential host has to the pathogen

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Stages of infection

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Incubation period Prodromal stage Full stage of illness Convalescent period

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Incubation period

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Interval between the pathogen's invasion of the body and the appearance of symptoms of infection; organisms grow and multiply

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Prodromal stage

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Person is most infectious, vague and nonspecific signs of disease

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Full stage of illness

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Presence of specific signs and symptoms of disease

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Convalescent Period

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Recovery from the infection

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Localized symptoms

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Symptoms that are limited or occur in only one body area

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Systemic symptoms

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Symptoms manifested throughout the entire body

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Hand hygiene

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Handwashing with plain soap and water, use of antiseptic handrubs including waterless alcohol-based products, or surgical hand antisepsis

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Moment 1

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Before touching a patient

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Moment 2

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Before a clean or aseptic procedure

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Moment 3

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After a body fluid exposure risk

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Moment 4

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After touching a patient

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Moment 5

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After touching a patient surroundings

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Infectious agent

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Bacteria, viruses, fungi

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Reservoir

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Natural habitat of the organism

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Portal of exit

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Point of escape for the organism

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Means of transmission

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Direct contact, indirect contact, airborne route

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Inflammatory Response - 2 stages

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Vascular stage: vessels constrict; histamine released Cellular stage: Leukocytes move into area

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Humoral immunity

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Overall immune response

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Cellular immunity

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Cell-mediated defense

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Lab data: Elevated Leukocytes (WBC)

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Normal value 5,000 to 10,000/mm3

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Lab data: Neutrophils

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Normal 60%-70% Elevated: Bacterial

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Lab Data: Lymphocytes

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Normal 20%-40% Elevated: Viral

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Lab Data: Monocytes

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Normal 2%-8%

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Lab Data: Eosinophil

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Normal 1-4% Elevated: Parasites

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Lab Data: Basophil

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Normal 0.5%-1% Elevated: Allergic reaction

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Lab Data: Erythrocyte

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Red blood cells settled rapidly on bottom when inflammation is present

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Targeted Solutions Tool (TST)

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Facilitates step-by-step process to accurately measure an organization's actual performance, identify their barriers to excellent performance, and direct them to proven solutions that are customized to address their particular barriers

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Transient bacteria

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Easily removed by thorough handwashing

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Resident bacteria

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Pathogenic organisms remain on skin

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Situations when alcohol-based hand rub can be used to decontaminate hands

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-Before direct contact with patient -After direct contact with patient's skin -After contact with body fluids -After removing gloves -Before inserting catheters or invasive devices -Before donning sterile gloves -Moving from contaminated body to clean body site during patient care -After contact with objects

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Alcohol-based hand rubs

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Quick way to remove germs when hands are not visibly soiled

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4 categories responsible for majority of HAIs in acute care hospital setting

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-Urinary tract infections -Surgical site infections -Bloodstream infections -Pneumonia

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Method of selection

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-Nature of organisms present -Number of organisms present -Type of equipment -Intended use of equipment -Available means for sterilization and disinfection -Time

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Pruritus

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Severe itching of the skin

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Rhinitis

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Stuffy nose

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Standard precautions

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Non-infections

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Transmission-based precautions

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Infectious

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Autocratic leadership

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The leader assumes complete control over all decisions; directive or authoritarian leadership

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Change

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Process of transforming or modifying something

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Decentralized decision-making process

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Autonomous, accountable professional nursing practice

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Delegation

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Transfer of responsibility for the performance of an activity to another individual while retaining accountability for the outcome

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Democratic leadership

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Sense of equality among the leader and participants; participative leadership

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Explicit power

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Power obtained by virtue of a person's position

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Implied power

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Power obtained by force of a person's personality that might enable that person to have more power to influence others than designated leaders

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Just culture

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Organization's commitment to accountability and a focus supporting universal safety in health care

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Laissez-faire leadership

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Power is relinquished to the group, outsiders could not determine a leader, little or no direction is given; nondirective leadership

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Leadership

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Ability to direct or motivate others toward the achievement of predetermined goals

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Management

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Act of planning, organizing, directing, and controlling available human resources and financial resources to deliver quality care to patients and families

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Planned change

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Change agent's purposeful, systematic effort bring about change

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Power

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Ability to influence others to achieve a desired effect

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Quantum leadership

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Leadership that moves beyond the traditional modes previously experienced by all levels of workers; spawned by the impact of the information age on work and the worker

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Self-governance

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Employing a decentralized organizational structure for decision making; professional autonomy

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Transactional leadership

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Task-and-reward orientation; leadership style based on maintaining control by rewarding good behavior and punishing negative or detrimental behavior

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Transformational leadership

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Creates intellectually stimulating work environment that encourages people to grow personally, professionally, and to learn

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Unfreezing

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Need to change is recognized

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Competing

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Resolution in which one party wins at the other party's expense

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Smoothing

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Is an effort to compliment the other party and focus on an agreement rather than disagreement Note: the original conflict is rarely ever solved with this method

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Avoiding

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Both parties either avoid the conflict or postpone its resolution

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Coercive management

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Forces actions upon employees

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Participative leadership

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Involves followers in goal setting, problem solving, and decision making

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Leadership Styles

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Autocratic Democratic Laissez-faire Quantum Transactional Transformational

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Role of Nurse Manager

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Planning Organizing Staffing Directing Controlling

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Management Structures

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Centralized Decentralized

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Centralized

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Senior managers generally make decisions with little input from the group

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Decentralized

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Decisions are made by those who are most knowledgeable about the issues being decided. Nurses are thus intimately involved in decisions concerning patient care.

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Conflict Resolution Strategies

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Avoiding Collaborating Competing Compromising Cooperating/accommodating Smoothing

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Collaborating

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This is a joint effort to resolve the conflict with a win-win solution

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Compromising

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Both parties must be willing to relinquish something of equal value

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Cooperating/Accommodating

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One party makes a conscious decision to let the other group win and frequently collects an "IOU" for use in the future

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Lewin's Theory of Change

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Unfreezing: The need for change is recognized Moving: Change is initiated after a careful process of planning Refreezing: Change becomes operational

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Steps for Using Time Effectively

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-Establish goals and priorities for each day. -Evaluate goals in terms of your ability to meet needs of patients. -Establish a time line. -Evaluate your success or failure in managing time. -Use these results to direct your next day's priorities and time line

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Mentorship

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Relationship in which an experienced person (the mentor) advises and assists a less experienced person (protégé)

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Preceptorship

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The preceptor (experienced nurse) is selected (and generally paid) to introduce an employee to new responsibilities through teaching and guidance

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Quantum leadership theory

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Views an organization and its members as interconnected and collaborative; helpful for unpredictable events and changing environments

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Magnet hospital

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Attract and attain professional nurses who experience a high degree of professional and personal satisfaction through their practice

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Moving

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Change is initiated after a careful process of planning

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Refreezing

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Change becomes operational

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change

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Alters the balance of a group

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resistance

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An expected accompaniment to change

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Evidence-based strategies to improve leadership skills

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-Strive to become an authentic leader -Develop leadership skills -Promote a healthy work environment -Engage staff to commit to their best effort at work -Assist new graduates to transition into the RN role

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Certified nurse leader (CNL)

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Advanced practice nurses with specialist education in a defined area of practice

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CNL role

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Patient advocate Educator Provider of patient care in complex situations

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Case manager roles

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Discharge plans Length-of-stay issues Insurance constraints

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Unlicensed assistive personnel (UAP)

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Nurses' aides, certified nursing assistants, unlicensed caregivers that assist RNs

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Planning

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Identifying problems and developing goals, objectives, and related strategies to meet the demands of the clinical area

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Organizing

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Acquiring, managing, and mobilizing resources to meet both clinical and financial objectives

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Staffing

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Hiring, orienting, scheduling to facilitate team building; also includes staff development

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Directing

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Leading others in achieving goals with the constraints of the current fiscal and workforce shortage scenarios, a demanding task for managers and staff alike

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Controlling

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Implementing mechanisms for ongoing evaluation, particularly in areas of clinical quality and financial accountability

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gestation

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The entire time span of pregnancy is called

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embryo

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For the first two months of growth, the developing offspring is termed a(n)

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eye color

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Which of these terms/phrases refers to an aspect of someone's phenotype?

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Y sperm and X ovum

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Taylor and Martine gave birth to a baby boy. Which of these gamete combinations occurred?

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hormone required for parturition

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Oxytocin is a(n)

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genes

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The small units on the chromosomes that carry genetic information are the ___

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prolactin

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Which of these hormones induces milk production by the mammary gland?

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aa

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If gene "A" is dominant, and gene "a" is recessive, which of these gene pairs is homozygous recessive?

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false

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Fraternal twins share the same amniotic sac and placenta

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any form of a gene that occurs on a specific site on a chromosome

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An allele is ___

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obstetrics

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The branch of medicine concerned with caring for women during pregnancy, childbirth, and the six weeks following childbirth is ___

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shortly after birth

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When does the foramen ovale normally close?

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37th

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A "premie," or a premature infant, is defined as a baby who is born before the ______ week of gestation

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true

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Over the course of a feeding, breast milk varies from a watery thirst-quenching fluid to a thicker, fat-rich fluid

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morula

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The cluster of identical cells travelling from the uterine tube towards the uterus is called a(n) ___

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Punnett square

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Which of these terms describes the grid used by geneticists to show the combinations of genes that can result from a mating?

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parturition

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The process of giving birth is clinically termed ___

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It is composed of both fetal and maternal tissue

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Which of these statements is true regarding the placenta?

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Chromosomes contain many genes

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Which of these statements is true? Genes contain many chromosomes. Chromosomes contain many genes.

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the period of development in the uterus

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Gestation is

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Genes contain the blueprints to make proteins

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Which of these two statements about genes is true?

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Hormones stimulate it, it lives 11-12 weeks longer, and secretes progesterone and estrogen

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What happens to the corpus luteum during pregnancy?

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genotype

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Your genetic makeup is called your

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zygote

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The ovum and spermatozoon form a combined cell called a(n) ___

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second

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During which trimester does the fetus grow the fastest?

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ductus venosus

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Which of these structures is only found in the fetus but not in healthy adult women?

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3 months

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A trimester consists of approximately

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umbilical cord

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The structure that carries blood between the mother and the offspring is the __

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heterozygous

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Which of these terms best describes a gene pair composed of two different alleles?

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46

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How many chromosomes are present in the zygote?

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8

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If an imaginary animal has 16 chromosomes per cell, how many chromosomes will be found in each spermatozoon?

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two umbilical arteries and one umbilical vein

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The umbilical cord contains

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human chorionic gonadotropin

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Pregnancy is commonly confirmed by measuring urinary levels of

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Males must have two copies of the recessive genes to exhibit that trait.

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Which of these is NOT true about sex-linked traits? a) They almost always appear in males. b) Males must have two copies of the recessive genes to exhibit that trait. c) Most sex-linked traits are recessive. d) Most sex-linked traits occur on the X chromosome.

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testosterone

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Which of these hormones is NOT secreted in large amounts during pregnancy?

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perineum

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The area involved in an episiotomy is the

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sex-linked

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If only females can be carriers for a particular trait, is the trait sex-linked or autosomal (determine by an autosome)?

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Human chorionic gonadotropin

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The hormone produced early in pregnancy that maintains the corpus luteum is

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False

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If a mutation occurs in the kidney cells of an individual, the mutation can be transmitted to the individual's offspring

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Each gene usually codes for a specific trait

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Which of these statements is true? -Each chromosome usually codes for a specific trait -Each gene usually codes for a specific trait

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pigmented ring

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An areola is a

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lactation

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The production of colostrum is followed by

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foramen ovale

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In the fetus, blood flows through a small opening into the atrial septum and bypasses the right ventricle and the pulmonary circuit. This small hole is known as the ___

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dominant

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Which type of gene expresses its effect in both heterozygous and homozygous individuals?

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Foramen ovale

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Which of these structures is a small hole in the interatrial septum?

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fourth

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Hortense just gave birth and is resting comfortably under a prewarmed blanket while the midwife massages her abdomen to help control the bleeding. What stage of labor is she in?

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Sex-linked

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Which of these terms best describes a trait carried by a single gene on the X chromosome, such as hemophilia?

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one of two matching genes for a particular trait in a chromosome pair

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An allele is which one of the following? -the physical trait associated with a particular gene -one of two matching genes for a particular trait in a chromosome pair

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relaxin

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Which of these hormones loosens the pelvic joints to facilitate the passage of the fetus?

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multifactorial

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Height is influenced by multiple genes and the environment. Which of these terms best describes this trait?

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2

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How many complete cell divisions occur in meiosis?

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All somatic cells contain 46 chromosomes

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Choose the correct statement -All gametes (sex cells) contain 46 chromosomes -All somatic cells contain 46 chromosomes

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23

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Following meiosis, each reproductive cell contains ___ chromosomes

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Human chorionic gonadotropin

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Which of these hormones promotes progesterone secretion during pregnancy, but is not produced in non-pregnant women?

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Aggressive behavior

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Standing up for one's rights in a negative manner that violates the rights of others

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Assertive behavior

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Standing up for one's rights and others using open, honest and direct communication

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Body language

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Nonverbal communication

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Bullying

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Negative, often repetitive, disruptive behavior also referred to as horizontal violence, lateral violence, and professional incivility

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Channel

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Denotes the medium selected to convey the message the channel may target any of the receiver senses

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Cliche

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A stereotyped or trite or pat answer

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Communication

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The process by which information is exchanged between the sender and receiver

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Empathy

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Intellectually identifying the way another person feels

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Feedback

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Verbal and or non verbal evidence that the message is received and understood

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Group dynamics

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How individual group members relate to one another during the process of working toward group goals

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Helping relationship

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Exists among people who provide and receive assistance in meeting human needs

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Horizontal violence

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Anger and aggressive behavior between nurses or nurse to nurse hostility

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Incivility

answer

Rude, intimidating and undesirable behavior directed at another person

question

Interpersonal communication

answer

Communication that occurs between two or more people with the goal of exchanging messages

question

Interviewing techniques

answer

Communication skills specifically design together and validate information

question

Intrapersonal communications

answer

Communication techniques or self-talk to enhance positive interactions with a patient and family

question

Language

answer

Prescribed way of using words and means to express thoughts and feelings

question

Message

answer

Actual communication product form the source; (speech,interview, phone conversation, chart)

question

Noise

answer

Factors that distort the quality of a message-can interfere with communication at any point in the process

question

Nonverbal communication

answer

Exchange of communication without the use of words; aka body language

question

Organizational communication

answer

Process of communication that involve individuals and groups to achieve established goals

question

Professionalism

answer

A way of being / commitment to secure the interest and welfare of those entrusted to one's care

question

Rapport

answer

Feeling of mutual trust experienced by people in a satisfactory relationship

question

Receiver (decoder)

answer

Specifies the person or object to which the message is directed

question

SBAR

answer

Consistent, clear, structured and easy to use method of communication between health care for personnel it organizes communication by the categories of situation, backgrounds, assessment, and recommendations

question

Semantics

answer

The study of the meaning of words

question

Small-group communication

answer

Communication that occurs when two or more nurses interact with two or more individuals allowing members to achieve a goal through communication

question

Social media

answer

Web-based technologies that allow users to create share and participate in the log in virtual communities and networks

question

Source (encoder)

answer

A person or group who initiates or begins the communication process

question

Stimulus

answer

Patient need that needs to be addressed

question

Verbal communication

answer

Exchange of information using words, including both the spoken and written word

question

Eye contact

answer

Communication begins with what?

question

Touch

answer

Is personal and means different things to different people

question

Different channels

answer

Visual, auditory or kinesthetic (touch)

question

Levels of communication

answer

Interpersonal, intrapersonal, small-group, organizational, group dynamics

question

Open ended question

answer

Elaborations of patient

question

Facial expressions

answer

Is the most expressive part of the body

question

Close ended question

answer

"yes" or "no" answer

question

Use SOLER with patient

answer

Sit straight, observe, lean forward, eye contact, relax

question

Common record keeping forms

answer

Admission, flow sheets, patient care summary

question

Using hand-off communication

answer

Involves the process of accurate presentation and acceptance of patient-related information from one caregiver or team to another caregiver or team using effective communication

question

Orientation Phase

answer

-The patient will call the nurse by name -The patient will accurately describe the roles of the participants in the relationship -The patient and nurse will establish an agreement *Goals of the relationship *Location, frequency, and length of the contacts *Duration of the relationship

question

Working Phase

answer

-The patient will actively participate in the relationship -The patient will cooperate in activities that work toward achieving mutually acceptable goals -The patient will express feelings and concerns to the nurse

question

Termination Phase

answer

-The patient will participate in identifying the goals accomplished or the process made toward goals -The patient will verbalize feelings about the termination of the relationship

question

Impaired Verbal Communication

answer

Decreased, delayed, or absent ability to receive, process, transmit, and/or use a system of symbols

question

Communication process

answer

Source (encoder), message, channel, and receiver (decoder)

question

Encoder message types

answer

Auditory, visual, kinesthetic

question

Four levels of communication

answer

Intrapersonal, interpersonal, small-group, organizational

question

Factors influencing communication

answer

Developmental level, gender, sociocultural differences, space and territoriality, physical/mental/emotional state, environment

question

Four communication zones

answer

Intimate, personal, social, public

question

Proxemics

answer

Study of distance zones between people during communication

question

Intimate zone

answer

0-18 inches

question

Personal zone

answer

18-4 feet

question

Social zone

answer

4-12 feet

question

Public zone

answer

12-25 feet

question

ISBAR-R

answer

Identification, situation, background, assessment, recommendations, readback

question

Three phases of helping relationship

answer

Orientation, working, termination

question

Task-centered caring

answer

Task to be performed

question

Relation-centered caring

answer

Cared about and cared for

question

Sympathy

answer

Shifts emphasis from the patient to the nurse

question

Therapeutic touch

answer

Unruffling or clearing, congested ares of energy int he body and redirecting this energy

question

Elderspeak

answer

Using speaking patterns and words mimicking "baby talk" that imply that the older person is not competent

question

Speech-language pathologist

answer

Professional educated in the study of human communication, its development, and its disorders

question

Audiologist

answer

Professional educated in the study of normal and impaired hearing

question

Sender

answer

Person or group with a purpose for the communication

question

Affective Learning

answer

Changes in attitudes, values, and feelings

question

Andragogy

answer

The study of teaching adults

question

Cognitive Learning

answer

Storing and recalling of new knowledge in the brain

question

Contractual Agreement

answer

Pact made between two people or parties for the achievement of mutually set goals

question

Couseling

answer

Giving guidance assisting with problem solving

question

Developmental Crisis

answer

Predictable patterns of behavior and change occurring throughout the lifespan

question

Formal Teaching

answer

Planned teaching based on learning objectives

question

Health Literacy

answer

Ability to read, understand, and act on health information

question

Informal Teaching

answer

Unplanned teaching sessions dealing with the patient's immediate learning needs and concerns

question

Learning

answer

Increasing one's knowledge; having one's behavior changed in a measurable way as a result of an experience

question

Learning Readiness

answer

Patient's willingness to engage in the teaching- learning process (emotional readiness) and experiential readiness to begin the challenge of learning

question

Literacy

answer

Ability to read and write

question

Negative Reinforcement

answer

An ineffective teaching strategy that uses criticism or punishment

question

Nurse Coach

answer

A registered nurse who integrates coaching competencies into any setting or specially area of practice to facilitate a process of change or development that assists individuals or groups to realize their potential

question

Patient Education

answer

Process of influencing the patient's behavior to effect changes in knowledge, attitudes, and skills needed to maintain and improve health

question

Pedagogy

answer

Science of teaching that generally refers to the teaching of children and adolescents

question

Positive Reinforcement

answer

Affirmation of the efforts of a patient

question

Psychomotor Learning

answer

Acquisition of physical skills

question

Situational Crisis

answer

Change that results when a person faces an event or situation that causes a disruption in one's life

question

Teaching-Learning Process

answer

Process of patient teaching that encompasses critical steps necessary to provide teaching and to measure learning; the teaching=-learning process models the nursing process

question

Describe the teaching- learning process, including domains, developmental concerns, and specific principles

answer

Teaching Learning Process: 1. Assess Learning Needs and Learning Readiness 2. Diagnose the Patient's Learning Needs 3. Develop Learning Outcomes 4. Develop a Teaching Plan 5. Implement Teaching Plan and Strategies 6. Evaluate Learning Domains: 1. Cognitive 2. Psychomotor 3. Affective Developmental Concerns: 1. The patient's physical maturation and abilities 2. Psychological development 3. Cognitive Capacity Specific Principles 1. Be sincere and honest; show genuine interest and respect 2. Avoid giving to much detail; stick to the basics 3. Ask if the patient has any questions 4. Be a "cheerleader" for the patient. Avoid lecturing 5. Use simple words 6. Vary your tone of voice 7. keep the content clear and concise 8. Listen and do not interrupt when the patient speaks 9. Ensure that the environment is conductive to learning and free of interruptions 10. Be sensitive to the timing of teaching sessions (children vs adult)

question

Factors that affect learning process

answer

1. Knowledge, attitudes, and skills needed for the patient and family to manage health care independently 2. Readiness to learn 3. Ability to learn 4. Learning Strengths

question

Strategies that improve health literacy and promote patient safety

answer

*Include plain language without medical jargon * May Incorporate the use of visual models to explain the disease or procedure *May involve patients in a "teach-back" demonstration that verifies their understanding of the information presented

question

Factors that influence patient compliance with the therapeutic pain

answer

When patients understand their diagnosis, treatment rationale, medication regimen, and the benefits of compliance

question

Formulate diagnosis for identified learning needs

answer

page 491 Box 21-7

question

How to create and implement a culturally competent, age-specific teaching plan for a patient

answer

1. Contractual Agreement 2. Learning Activities 3. Implementing >Promote Patient learning by using a warm and accepting approach >Consider the physical environment when implementing the teaching plan > Review the patient's expectations and role functions as a learner > Assess the patient's comfort level > Be prepared and organized before implementing the teaching plan >Make each learning session interesting and enjoyable for the patient

question

Role of a nurse coach in promoting behavior change

answer

* Establishing relationships and identifying readiness for change *Identifying opportunities, issues, and concerns *Establishing patient-centered care *Creating the structure of the coaching interaction *Empowering and motivating patients to reach goals *Assisting patient's to determine progress towards goals

question

Name 3 methods for evaluating learning

answer

*Cognitive domain learning may be evaluated through oral questioning *Affective domain learning through the patient's response *Psychomotor domain learning by a return demonstration

question

What should be included in the documentation of the teaching-learning process

answer

*Summary of Learning Need * The Plan * The implementation of the Plan * The Evaluation Results The EVALUATION STATEMENT is crucial and must show concrete evidence that demonstrates that learning has occurred

question

Nurse's role as a counselor

answer

Posses the interpersonal skills of warmth, friendliness, openness, empathy, and caring are necessary for successful counseling

question

How the nursing process is used to help patients solve problems

answer

Situation Assessing Diagnosing Planning Goal Implementing Evaluating Example page 501 Box 21-13

question

Describe how to use the counseling role to motivate a patient toward health promotion

answer

Instead of focusing on the issue, the nurse attempts to gain a better understanding of the barriers that exist to changing family behavior . This technique, lets the family gain self confidence needed to promote better health outcomes

question

TJC "Speak Up" initiative

answer

Effort to educate patients how to get involved in their care and prevent health care errors

question

Teaching

answer

Planned method or series of methods used to help someone learn

question

TEACH

answer

Tune into the patient Edit patient information Act on every teaching moment Clarify often Honor the patient as a partner in the education process

question

COPE

answer

Creativity Optimism Planning Expert Information

question

Ask Me 3 brief tool

answer

Intended to promote understanding and improve communication between patients and their providers

question

Ask Me 3 questions

answer

What is my main problem What do I need to do Why is it important for me to do this

question

Understanding Personal Perception (UPP) tool

answer

An attempt to determine if additional education is necessary; patient looks at images

question

Newest Vital Sign (NVS)

answer

Additional reliable screening tool to assess health literacy; patient looks at numbers and words

question

Related nursing diagnoses include

answer

Ineffective Health Maintenance Ineffective Therapeutic Regimen Management Noncompliance Self-Care Deficit (specify)

question

Team teaching

answer

When two or more nurses plan and coordinate the implementation of the plan

question

Teaching strategies

answer

Techniques used by a teacher to promote learning

question

Lecture

answer

Presentation of information by a teacher to a learner; used for large group

question

Discussion

answer

Two-way exchange of information, ideas, and feelings between the teacher and learners

question

Panel discussion

answer

Presentation of information by two or more people; effective for sharing experiences and emotions

question

Demonstration

answer

Techniques, procedures, exercises, and use of special equipment, combined with a lecture and discussion; models or body parts or practice models frequently used

question

Discovery learning

answer

Problem or situation is presented to the patient or group of patients, who are then guided to discover the solution or approach

question

Role playing

answer

Gives learner a change to experience, relive, or anticipate an event; can be used to work through emotional traumas or to plan for possible traumas

question

Audiovisual materials

answer

Computer programs, online courses, PowerPoint presentations, films, television programs, DVDs, overhead transparencies, flip charts, posters, diagrams combined with a lecture or discussion

question

Printed material

answer

First make sure printed material is available; brochures, fact sheets, and pamphlets

question

Short-term counseling

answer

Situation crisis

question

Long-term counseling

answer

Developmental crisis

question

Motivational interviewing

answer

Evidence-based counseling approach that involves discussing feelings and incentives with the patient

question

Their readiness to learn is often related to a developmental task or social role

answer

A parish nurse is preparing to provide a health promotion class to a group of adults in the parish. In preparing to meet the learning needs of this group, the nurse recognizes which of the following as a characteristic of an adult learner?

question

Lecture/discussion

answer

What is the most appropriate teaching strategy for the nurse to use for a 1-hour presentation on the prevention of osteoporosis to a group of 30 college-age women?

question

Short-term counseling

answer

A nurse may attempt to help a patient solve a situational crisis during what type of counseling session?

question

• The nurse uses critical thinking skills to assess the learning needs and learning readiness of the parents. • The nurse formulates a verbal or written contract with the client. • The nurse relates new learning material to the client's past life experiences to help him to assimilate new knowledge.

answer

A nurse is using the teaching-learning process to teach new parents how to care for their infants. Which nursing actions reflect recommended steps of this process? Select all that apply.

question

A 70-year-old female; learning care so spouse can come home

answer

Which statement best describes the client most motivated to learn?

question

The client and the nurse are equal participants

answer

When establishing a teaching-learning relationship with a client, it is most important for the nurse to remember that effective learning can best be achieved through which concept?

question

The client belongs to a different culture

answer

A Chinese client who was previously treated at the health care facility for an open wound has been admitted again because the wound has become gangrenous. It has been identified that the client failed to understand proper wound care. What is the probable reason for the client failing to understand the instruction?

question

Role-playing

answer

The nurse is conducting a community health promotion class and has developed scenarios that will involve active participation by the class attendees. What type of education strategy is the nurse incorporating into her class?

question

"You have made an amazing recovery."

answer

The nurse is visiting a client who was released from inpatient rehabilitation 6 weeks ago after a 5-month recovery from a motor vehicle accident that left him immobile. As the nurse enters the home, the client braces his hands on the arms of his chair to rise and uses crutches to walk across the room. What is the best response by the nurse?

question

Motivational counseling

answer

A nurse is discussing the benefits of smoking cessation with a client. The nurse informs the client that smoking cessation will reduce his risk for cancer, improve his respiratory status, and enhance the quality of his life. The nurse also shares her story of smoking cessation, provides information on other individuals who have successfully quit, and encourages the client to attend a support group for smoking cessation. The client discusses his feelings on smoking cessation and verbalizes a desire to quit smoking. What type of counseling did the nurse provide to this client?

question

Revise the education plan that has guided education

answer

A client is experiencing difficulty in adjusting to a new prosthesis despite conscientious client education by numerous members of the health care team. How should the team respond to the client's lack of learning to this point?

question

The client organizes materials needed and gives return demonstration

answer

The nurse knows which evaluation best represents that the client has learned a new skill?

question

Discuss the client's case with a colleague

answer

The nurse is coaching a client who stated a desire to stop smoking without medication. At several sessions to assess the client's success with agreed-upon interventions, the client reports roadblocks to each action and continues to smoke. What is the best action of the nurse?

question

"I will be doing well if I lose between 5 and 10 pounds a week."

answer

The client reports to the clinic as ordered by her primary care provider for counseling on weight loss to improve overall health. The client received printed information in the mail to review before the session, and states having read through it before the appointment. Which client statement alerts the nurse to a need for clarification and further education?

question

Have client rate pain level and reschedule the teaching session

answer

As the nurse enters the room to teach the client about self-care at home, the client states, "I am glad you are here. I need some pain medicine. I can't stand it anymore." What is the best action of the nurse?

question

Personal perception of health and aging

answer

An active, otherwise healthy, older adult client presents to the clinic with severe osteoarthritis in the bilateral knees. The nurse knows this client does not want to be a burden on his family, and he remains stoic even though he reports the pain as severe. He avoids the topic of surgery and attends church weekly. His family is supportive of any decisions he makes regarding his health. Which of the assessment data are most important to forming an individualized education plan for this client concerning treatment for his osteoarthritis?

question

A 28-year-old female; works nights, willing to try, asking about insurance coverage of appointment

answer

A nurse is counseling several clients for depression. Four of them do not seem to be improving, which leads the nurse to suggest a referral to a psychiatric nurse practitioner. Which of these clients would be most likely to attend the scheduled appointment?

question

Ineffective Coping; verbalizes support systems

answer

An older adult female client who is recovering from a stroke is scheduled to be transferred to the rehabilitation unit in the morning. She is tearful and verbalizes that she feels lonely and abandoned in the hospital unit. The nurse noticed that family visits daily and that there are flowers and cards in the room. Documentation in the chart indicates that the client's pastor has been by twice in the past week to visit. Which nursing diagnosis and outcome criteria need to be addressed immediately for this client?

question

Allow ample time for psychomotor skills

answer

Which guideline is most important for the nurse to keep in mind when planning to teach an exercise class to a group of older adults?

question

Cognitive domain

answer

A 20-year-old client reads the nutritional chart and follows it accurately. The nurse also notes that the client understands the need of a balanced diet and its relationship with a quick recovery. Which domain correctly identifies the client's learning style?

question

The client describes signs and symptoms of hypoglycemia

answer

A nurse is educating a client with a new diagnosis of diabetes. Which example demonstrates cognitive learning by the client?

question

Cognitive learning theory

answer

The nurse has educated the client on the pathophysiology of osteoarthritis and degenerative joint disease. This is an example of what learning theory?

question

Psychomotor

answer

A nurse assisting a new mother in the act of breastfeeding is represented by which form of learning?

question

client understanding of illness, motor skills and developmental stage assessed, clarification provided

answer

The nurse must instruct a 35-year-old client with Down syndrome about use of an albuterol rescue inhaler. Which of the following demonstrates individualization of the education plan for this client?

question

The nurse writes one long-term objective for each diagnosis, followed by several specific objectives

answer

A nurse is writing learner objectives for a client who was recently diagnosed with type 2 diabetes. Which statement best describes the proper method for writing objectives?

question

motivational counseling

answer

When a client says, "I don't care if I get better; I have nothing to live for, anyway," which type of counseling would be appropriate?

question

illness prevention

answer

When the nurse instructs a client about breast self-examination, the primary purpose of the client education is:

question

The nurse and the client

answer

When a nurse is planning for learning, who must decide who should be included in the learning sessions?

question

"The medicine and blood work for atrial fibrillation can help prevent blood clots that have the potential to cause debilitating strokes. What have you heard about warfarin therapy?"

answer

A 56-year-old executive meets with the nurse for education about recently diagnosed atrial fibrillation. He verbalizes concerns about the time he will spend away from his work, and that he is not sure it is necessary to have blood tests every week. He feels it is a waste of time when he does not have any symptoms. Which is the best motivational statement by the nurse for this client?

question

Ask the client to recall after approximately 15 minutes

answer

The nurse is caring for a 70-year-old client with a fractured wrist. Which of the following is the best method to determine if the client has retained the information taught?

question

by implementing effective teaching

answer

Before starting the education process, the nurse should determine the preferred learning style, age and developmental level, capacity to learn, motivation level, readiness to learn, and learning needs of the client. How does this help the nurse in the client's health education?

question

Content

answer

When deciding what information the patient needs to meet the learner objectives successfully, the nurse is planning which part of the teaching plan?

question

Tell me what you know about these tests

answer

A client is reluctant to learn to do finger sticks for her home INR monitoring. What is the best statement by the nurse?

question

Cord care shown to mother, questions answered. Return demonstration observed.

answer

Nursing documentation is inclusive. Which is the best example of documentation of a teaching plan?

question

Deficient Knowledge: Imbalanced nutrition: more than body requirements, and ineffective health maintenance

answer

The parents of a school-age child are meeting with the nurse for health promotional education for their child. The child has the following assessment data: 7-year-old male, diabetes mellitus type 1 with a hemoglobin A1C of 8.3%, BMI of 31.7, BMI percentile of 99. What are the most appropriate learning diagnoses for this first session?

question

cognitive

answer

Which learning domain is the focus for instruction when the nurse educates a new mother about the breast and its role in milk production for feeding the newborn?

question

• Patient and nurse's expectations of one another • Orientation to treatment center and staff • The medical and nursing regimens and how the patient can participate in care

answer

Which topics would the nurse be most likely to explore with a patient with the aim of restoring health? (Select all that apply.)

question

The nurse writes one long-term objective for each diagnosis, followed by several specific objectives.

answer

A nurse is writing learner objectives for a client who was recently diagnosed with type 2 diabetes. Which statement best describes the proper method for writing objectives?

question

Begin the session with a reference to the client's actual experience

answer

The nurse is caring for a 60-year-old client with an improper bowel movement regimen. Which of the following is the most appropriate method the nurse should use to conduct new learning?

question

• The nurse directs the health education for a 3-year-old to the parents. • The nurse includes a school-age child in the teaching-learning process. • The nurse provides material that is useful immediately to adult clients. • The nurse uses the same learning strategies for an adolescent as for an adult.

answer

Nurses plan client learning based on the client's developmental stage. Which nursing actions best reflect this consideration? Select all that apply.

question

• The nurse uses medical jargon frequently when discussing the teaching plan. • The nurse fails to accept that patients have the right to change their minds. • The nurse ignores the restrictions of the patient's environment.

answer

A nurse is providing teaching to patients in a short-term rehabilitation facility. Which examples are common teaching mistakes made by health care professionals? (Select all that apply.)

question

Gather pertinent information from the client

answer

A nurse is caring for a 45-year-old male client who lost function in both of his legs due to an automobile accident. Which of the following should the nurse do first to personalize the learning?

question

Identify and recommend some credible Web sites appropriate to his learning needs

answer

A female client has recently been diagnosed with early-stage Alzheimer's disease and her husband has asked the nurse to recommend Web sites that may supplement his learning about her diagnosis. How should the nurse respond to the husband's request?

question

• The medical and nursing regimens and how the patient can participate in care • Orientation to treatment center and staff • Patient and nurse's expectations of one another

answer

Which topics would the nurse be most likely to explore with a patient with the aim of restoring health? (Select all that apply.)

question

Assess for cultural differences

answer

When caring for a client at the health care facility, the nurse observes that the client is having difficulty understanding the health education. Which action is most appropriate?

question

creating an atmosphere for discussion of feelings

answer

A client shares with the nurse how much she appreciates understanding the physiology of her breastfeeding. She states, "I felt very comfortable with what you explained to me and I feel I will be successful at breastfeeding." In affective learning, this represents:

question

Preventing illness

answer

A school nurse is discussing bike and outdoor safety measures with a group of Boy Scouts. What type of health education and counseling is the nurse providing to this group of children?

question

Knowledge Deficient: Risk for altered perfusion secondary to re-occlusion

answer

A nurse is forming an education plan for a client who is being discharged from the nursing unit after cardiac catheterization. Which diagnosis and intervention are most appropriate for this client?

question

The nurse should be able to draw from the previous experience of the client to emphasize the importance of stress reduction

answer

When teaching an adult client how to control stress through relaxation techniques, the nurse should consider what assumption concerning adult learners?

question

Client

answer

A nurse is documenting assessment data for a new client. What is the best source of assessment information for the nurse?

question

Use interactive and learner-appropriate teaching techniques

answer

Which of the nurse's following actions is most likely to promote a patient's compliance with her antiretroviral drug regimen for the treatment of human immunodeficiency virus (HIV)?

question

The client is not demonstrating readiness to learn due to the effects of medication

answer

A client, eager to go home from an acute care facility, calls out to have discharge education completed. The nurse is not able to get to the client's room until an hour later, and finds the client asleep. The client's significant other states, "She will be out for a couple hours after that pain medication." Which of the following best describes what must happen with the education session?

question

Andragogy

answer

The nurse is assisting a male client 55 years of age to understand the anatomy and physiology of the heart following a heart attack. What type of learning is taking place?

question

"You've just about figured out how to give yourself an injection." "Lots of people have the same concern." "Try to angle the syringe a little more this way."

answer

A nurse is showing an older adult client with severe diabetes the correct method of self-administering an insulin injection. What should be the nurse's comment be if the client continues making mistakes when learning how to self-administer an insulin injection? Select all that apply.

question

The parents of a teenager who has just been diagnosed with diabetes

answer

With which of the following groups should the nurse apply the COPE (Creativity; Optimism; Planning; Expert Information) model to facilitate learning?

question

Independent use of new learning

answer

During the health education session at the health care facility, the nurse notes that a client is able to recognize what is being taught, and is able to describe the information to others. The client is also able to explain the information learned. What is the final learning stage of the client in this case?

question

Use verbal and visual modes

answer

When caring for a client at a health care facility, the nurse discovers that the client is unable to read or write. Which of the following teaching approaches is most useful for the client?

question

Illness prevention

answer

When the nurse instructs a client about breast self-examination, the primary purpose of the client education is what?

question

The nurse and client relationship is based on mutual sharing and negotiation

answer

While applying dressings to a client's wound, the nurse teaches the client about his wound care. To promote the most effective teaching-learning relationship with this client, which of the following would be most important for the nurse to keep in mind?

question

Divide information into manageable amounts

answer

A nurse is caring for a client 72 years of age with arthritis. Which action is the highest priority for the nurse when conducting the health education for the client?

question

Psychomotor domain

answer

When caring for a diabetic client, the nurse notes that the client learns better when he practices the self-administration of the insulin injection by himself. In which of the following learning domains does this client's learning style fall?

question

Critical thinking

answer

An experienced nurse is educating a client about his disease and how best to promote his optimal health. The nurse is focusing the education on the cognitive domain of learning. The nurse would focus the education on which of the following?

question

Return demonstration

answer

A nurse evaluates whether a middle-aged client with chronic back pain has been performing the different exercises and physiotherapy procedures recommended by the physician. Which of the following would the nurse most likely use to evaluate the client?

question

Cognitive

answer

Which learning domain is the focus for instruction when the nurse educates a new mother about the breast and its role in milk production for feeding the newborn?

question

Affective domain

answer

The nurse observes that a client responds better to health education when the nurse motivates him and assures him about the benefits of the teaching. In which of the following learning domains does the client's learning style fall?

question

Hopelessness

answer

A nurse has been working with a client whose vision has been deteriorating as a result of glaucoma. The client is reluctant to participate in education surrounding adaptations and home modifications that could aid in her adjustment to sensory loss, stating, "What's the point of even fighting the inevitable?" The nurse would recognize the potential for which of the following nursing diagnoses?

question

Affective learning

answer

A client states to the nurse, "I understand that I need a mastectomy for the treatment of my breast cancer, but I am fearful of learning about the drains I will need to empty." This is an example of what kind of learning?

question

-Determine their emotional readiness to learn. -Draft learning outcomes. -Select educational strategies. -Implement various educational techniques. -Revise the learning plan if needed.

answer

A couple has just learned that their newborn infant has a congenital cardiac anomaly that will require many lifestyle modifications, surgical corrections, and hospital stays. Place the following aspects of the couple's client education in the correct order that nurses should conduct them.

question

Pedagogy

answer

A client age 8 years has just been diagnosed with insulin-dependent diabetes. What type of learning will the nurse focus on?

question

Acknowledge the client's ability to accept or reject suggestions

answer

A nurse is trying to encourage a client with paraplegia, who is depressed and not adhering to his treatment program, to join a support group. Which of the following would be most appropriate for the nurse to do when attempting to modify the client's attitude?

question

Empathy

answer

A family has lost a member who was treated for leukemia at a nursing unit. The nurse provides emotional support to the family and counsels them to cope with their loss. Which quality should the nurse use in this situation?

question

Orientation phase

answer

The nursing instructor is discussing communication with a student. The student identifies that a contract is made with the client during which phase of the nurse-client relationship?

question

"All of the victims got themselves out of the car?"

answer

Paramedics arrive in the emergency department with a victim of a motor vehicle collision. The paramedic reports the driver was restrained, the car was traveling about 30 miles per hour, and the air bags were not deployed. The paramedic continues to report the car was struck from behind and that all individuals in the car were able to self-extricate. Which statement made by the nurse is verifying the report from the paramedic?

question

"This must be very difficult for you to hear. How do you feel right now?"

answer

A nurse has developed strong rapport with the wife of a client who has been receiving rehabilitation following a debilitating stroke. The wife has just been informed that her husband will be unlikely to return home and will require care that can only be provided in a facility with constant nursing care. The client's wife tells the nurse, "I can't believe it's come to this." How should the nurse best respond?

question

• The nurse shows patience with the client and gives the client time to respond. • The nurse maintains eye contact with the client. • The nurse keeps communication simple and concrete.

answer

A nurse is communicating the plan of care to a client who is cognitively impaired. Which nursing actions facilitate this process? Select all that apply.

question

"Were you tired and depressed before starting the new medication?"

answer

A client with a cardiac dysrhythmia was recently prescribed metoprolol and is at a follow-up appointment at the cardiologist's office. The client tells the nurse, "I feel depressed, tired, and I have no desire to exercise." To determine a cause-and-effect relationship, the nurse should ask:

question

"The needle causes discomfort or pain when it goes in, but I will be by your side throughout and will help you hold your position."

answer

A client is scheduled for thoracentesis. The nurse assesses that the client appears anxious about the procedure and needs honest support and reassurance. What is the most appropriate response by the nurse to this client?

question

"Have you ever thought of laser surgery?"

answer

A nurse is discussing cataract treatment with a client. Which statement by the nurse would be most therapeutic?

question

"Why did the health care provider prescribe this medication for you?"

answer

The nurse faculty is observing a student nurse gather data from a client. Which question, if asked by the student, would indicate to the faculty that the student has a clear understanding of open-ended questions?

question

easy wrinkling of the skin and sunken eyes

answer

A nurse is caring for a client admitted to the hospital for dehydration. The physical findings consistent with the diagnosis include:

question

"I know this is hard for you. Is there any way I can help?"

answer

A nurse is caring for a client who is newly diagnosed with terminal cancer. The nurse enters the client's room and finds the client sitting in the dark crying. Which of the following statements conveys empathy on part of the nurse?

question

allow the client to set the pace

answer

A nurse is attempting to complete an admission database. While taking the history, the nurse notices the client appears uncomfortable and slightly tachypneic. The nurse should:

question

involve the child's stuffed animal in the educational session

answer

A nurse is providing care to a 3-year-old child admitted with a diagnosis of infectious diarrhea. The nurse needs to insert an intravenous catheter in order to administer prescribed intravenous fluids. In an attempt to foster communication, the nurse should:

question

The working phase

answer

A dialysis nurse is educating a client on caring for the dialysis access that was inserted into the client's right arm. The nurse assesses the client's fears and concerns related to dialysis, the dialysis access, and care of the access. This information is taught over several sessions during the course of the client's hospitalization. Which phase of the working relationship is best described in this scenario?

question

• "Is there any chance you might be pregnant?" • "Do you smoke cigarettes?" • "Are you ready to get out of bed?" • "Does it hurt when I touch you here?"

answer

The nurse is collecting health data and avoids using closed-ended questions. Which of the following are examples of closed-ended questions? Select all that apply.

question

incongruent relationship

answer

A nurse communicating with a client states, "I will be changing your dressing, but we have plenty of time to talk first." She is already wearing sterile gloves and a mask and is busy working with her back to the client. The nurse is conveying a (an)

question

swaddling the child and gently stroking its head

answer

A nurse is attempting to calm an infant in the nursery. The nurse responds to the highest developed sense by:

question

tell herself to "remain calm" and remember that she was trained to perform this skill

answer

A nurse is preparing to enter a client's room to perform wound care. The shift report revealed that this client has a tunneling wound in the sacral area that cannot be staged. The wound was also documented as having a foul odor. The nurse is nervous because she has not performed wound care on a complex wound in the past. Using effective intrapersonal communication, this nurse should:

question

Working phase

answer

Care provided to a client following surgery and until discharge represents which phase of the nurse-client relationship?

question

have group members confront the dominant member to promote the needed team work

answer

A unit-based infection control task force was developed in an attempt to reduce catheter-acquired infections. The group consists of 10 team members. During the past three meetings, one person dominated the meeting and did not allow other members ample time to speak. The best way to address the team dysfunction is to:

question

intimate zone

answer

A nurse is performing a wet to dry dressing change on a client's abdomen. During this intervention the nurse is communicating with the client in the:

question

orientation phase

answer

A home care nurse discusses with a client when visits will occur and how long they will last. In what phase of the nurse-client relationship is this type of agreement established?

question

reviewing health changes

answer

A nurse who has been caring for a client for the past few days is preparing the client for discharge and termination of the nurse-client relationship. Which activity would the nurse be carrying out?

question

The client stares at the floor and states, "I feel fine."

answer

A nurse has been caring for a client who suffered a myocardial infarction 2 days ago. During the morning assessment, the nurse asks the client how he feels. Which scenario warrants further investigation?

question

Encouraging elaboration

answer

The nurse is visiting a hospice client in his home. He is explaining the difficulties he is having with his home infusion pump. By making statements such as "I see" and "go on" during the conversation, the nurse is utilizing which therapeutic nurse-client communication technique?

question

aggressive

answer

A nurse during orientation notices that the preceptor gives all subcutaneous injections on a 45-degree angle. When the new nurse asks the preceptor the rationale for the practice the preceptors states, "This is how I do it, and this is how you will do it." The new nurse recognizes this behavior to be:

question

"Sir, I understand this is uncomfortable but I assure you I am experienced with this task and would like to continue."

answer

A client comes into the urgent care center to have sutures removed on his right arm. The nurse assesses the sutures and finds significant crusting along the suture line. The client indicates he didn't have time to get his sutures removed a week prior as directed. The nurse soaks the crust and attempts to remove the sutures. As the nurse attempts the suture removal, the client frequently pulls his arm away and tells the nurse, "you do not know what you are doing." In response, the nurse should answer:

question

message

answer

A nurse gives a speech on nutrition to a group of pregnant women. What is the speech itself known as?

question

"Can you tell me why your physician sent you here to be admitted?"

answer

During an admission intake assessment, a nurse uses open-ended questions to gather information. An example of an open-ended question is:

question

"What questions do you have about the surgery?"

answer

A client scheduled to have hip replacement surgery states, "I am so scared of the surgery and of the anesthetic." What is the best response by the nurse?

question

remain honest, open, and frank

answer

A nurse is caring for a client who presents with a skin infection. While obtaining the client's medical history, it is determined that the client is an intravenous drug abuser. To foster effective communication, the nurse should:

question

Small-group communication

answer

When attending a staff meeting, a nurse is participating in what type of communication?

question

asking the client if he or she has recently taken ferrous sulfate (iron) or bismuth subsalicylate

answer

A client arrives at the emergency department after experiencing several black, tarry stools. The nurse will develop a cause and effect by:

question

Therapeutic communication

answer

In order to provide effective nursing care, the nurse should engage in what type of communication with the client and significant others?

question

Interpersonal

answer

The nurse and the physical therapist discuss the therapy schedule and goals for a client on a rehabilitation unit. What type of communication is occurring between the nurse and the therapist?

question

• The nurse controls the tone of his or her voice so that it conveys exactly what is meant. • The nurse makes statements that are as simple as possible, gearing conversation to the patient's level. • The nurse takes advantage of any available opportunities to communicate information to patients in routine caregiving situations.

answer

Which nursing actions would most likely help improve communications with patients and achieve a more effective helping relationship? (Select all that apply.)

question

"Do you have any questions about your cholecystectomy?"

answer

The newly hired nurse is collecting assessment data for an upcoming surgical procedure from a client who speaks English as a second language. Which statement made by the newly hired nurse would indicate to the nurse educator that intervention is needed?

question

• A nurse takes into consideration a patient's culture when planning how far away to sit when communicating. • A nurse uses simple language and demonstrations to explain a procedure to a preschooler. • A nurse checks a patient's occupation for clues on how this will affect communication but avoids stereotyping the person

answer

Nurses must take into considerations factors that influence communication when communicating with patients. Which examples accurately reflect communication that considers these variables? (Select all that apply.)

question

Kinesthetic

answer

The nurse is communicating with a client who begins to cry. The nurse places her hand on the client's arm and sits quietly at the client's beside. What mode of communication is the nurse using to offer caring and comfort for the client?

question

ask to speak to the physician in private and address any disrespectful remarks or behaviors

answer

A nurse is on his lunch break in the hospital cafeteria and sits at a table near a group of physicians eating their lunch. The nurse recognizes one of the physicians as being in charge of his clients. The nurse witnesses the physician point at the nurse and state, "That guy needs to get fired." The best response by the nurse would be to:

question

eliminate as many distractions as possible

answer

A nurse is preparing to provide discharge instructions to a postpartum client regarding infant care. Before beginning the education session, the nurse should:

question

Sender

answer

A nurse is interviewing a client for the establishment of long-term care insurance. During the interview, the nurse asks questions regarding the client's past medical history. The nurse is the:

question

Take note of the client's cues when choosing a position and act on these cues

answer

Which guideline should a nurse use when choosing a position (location) in relation to a client during a verbal interaction?

question

sits at the client's bedside and faces the client

answer

A nurse enters a client's room to complete an admission history. The nurse will convey interest in the client's story if the nurse:

question

A nurse who easily developed a rapport with clients

answer

Which of the following nurses most likely is the best communicator?

question

• "Cheer up. Tomorrow is another day." • "Your doctor knows best." • "Don't worry. You will be just fine in another day or two." • "Everything will be all right."

answer

A client has just been given a diagnosis of cirrhosis of the liver. Which statements by the nurse should be avoided because they could impede communication? Select all that apply.

question

Closed question

answer

During an assessment of a newly admitted client the nurse asks the client many questions. The nurse begins the assessment by asking, "How many times have you been hospitalized this year for your back pain?" This is an example of which type of question?

question

Identifying with the client's feelings

answer

It is important for the nurse to empathize with the client to develop a positive, therapeutic relationship. Which of the following is the characteristic of empathy?

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