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Chapter Practice Questions for Fundamentals Exam 1.
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A patient has been on bed rest for over 4 days. On assessment, the nurse identifies the following as a sign associated with immobility: A. Decreased peristalsis B. Decreased heart rate C. Increased blood pressure D. Increased urinary output - ansAnswer: A Rationale: Immobility disrupts normal metabolic functioning: decreasing the metabolic rate; altering the metabolism of carbohydrates, fats, and proteins; causing fluid, electrolyte, and calcium imbalances; and causing gastrointestinal disturbances such as decreased appetite and slowing of peristalsis. A nurse is caring for an older adult who has had a fractured hip repaired. In the first few postoperative days, which of the following nursing measures will best facilitate the resumption of activities of daily living for this patient? A. Encouraging use of an overhead trapeze for positioning and transfer. B. Frequent family visits C. Assisting the patient to a wheelchair once per day D. Ensuring that there is an order for physical therapy - ansAnswer: A Rationale: The trapeze bar allows the patient to pull with the upper extremities to raise the trunk off the bed, aid in transfer from bed to wheelchair, or perform upper-arm exercises. It increases independence and maintains upper body strength to help in performing activities of daily living. An older-adult patient has been bedridden for 2 weeks. Which of the following complaints by the patient indicates to the nurse that he or she is developing a complication of immobility? A. Loss of appetite B. Gum soreness C. Difficulty swallowing D. Left-ankle joint stiffness - ansAnswer: D Rationale: Patients whose mobility is restricted require range-of-motion (ROM) exercises daily to reduce the hazards of immobility. Temporary immobilization results in some muscle atrophy, loss of muscle tone, and joint stiffness. Two weeks of joint immobilization without ROM can quickly result in contractures. The nurse is caring for a patient whose calcium intake must increase because of high risk factors for osteoporosis. Which of the following menus should the nurse recommend? A. Cream of broccoli soup with whole wheat crackers, cheese, and tapioca for dessert B. Hot dog on whole wheat bun with a side salad and an apple for dessert C. Low-fat turkey chili with sour cream with a side salad and fresh pears for dessert D. Turkey salad on toast with tomato and lettuce and honey bun for dessert - ansAnswer: A Rationale: Teach patient and/or caregiver the current recommended dietary allowances for calcium and review foods high in calcium (e.g., milk fortified with vitamin D, leafy green vegetables, yogurt, and cheese). A patient on prolonged bed rest is at an increased risk to develop this common complication of immobility if preventive measures are not taken: A. Myoclonus B. Pathological fractures C. Pressure ulcers D. Pruritus - ansAnswer: C
Chapter Practice Questions for Fundamentals Exam 1.
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Rationale: Immobility is a major risk factor for pressure ulcers. Any break in the integrity of the skin is difficult to heal. Preventing a pressure ulcer is much less expensive than treating one; therefore preventive nursing interventions are imperative. To prevent complications of immobility, what would be the most effective activity on the first postoperative day for a patient who has had abdominal surgery? A. Turn, cough, and deep breathe every 30 minutes while awake B. Ambulate patient to chair in the hall C. Passive range of motion 4 times a day D. Immobility is not a concern the first postoperative day - ansAnswer: B Rationale: Prevention of complications of immobility begins when the patient becomes immobilized. Every 30 minutes is not necessary and disruptive to the healing process. Active patient participation in exercises is more beneficial to preventing venous stasis. Which of the following nursing interventions should be implemented to maintain a patent airway in a patient on bed rest? A. Isometric exercises B. Administration of low-dose heparin C. Suctioning every 4 hours D. Use of incentive spirometer every 2 hours while awake - ansAnswer: D Rationale: Incentive spirometry opens the airway, preventing atelectasis. *What is the correct order in which elastic stockings should be applied?
- Identify patient using two identifiers.
- Smooth any creases or wrinkles.
- Slide the remainder of the stocking over the patient's heel and up the leg
- Turn the stocking inside out until heel is reached.
- Assess the condition of the patient's skin and circulation of the legs.
- Place toes into foot of the stocking.
- Use tape measure to measure patient's legs to determine proper stocking size.* A. 1, 5, 7, 4, 6, 2, 3 B. 1, 7, 5, 4, 6, 2, 3 C. 1, 5, 7, 4, 6, 3, 2 D. 1, 5, 4, 7, 6, 3, 2 - ansAnswer: C Which of the following are physiological outcomes of immobility? A. Increased metabolism B. Reduced cardiac workload C. Decreased lung expansion D. Decreased oxygen demand - ansAnswer: C Rationale: Physiologic outcomes of immobility include decreased metabolism, increased cardiac workload, decreased lung expansion, and increased oxygen demand. An older adult has limited mobility as a result of a total knee replacement. During assessment you note that the patient has difficulty breathing while lying flat. Which of the following assessment data support a possible pulmonary problem related to impaired mobility? (Select all that apply.) A. B/P = 128/ B. Respirations 26/min on room air C. HR 114 D. Crackles over lower lobes heard on auscultation E. Pain reported as 3 on scale of 0 to 10 after medication - ansAnswer: B, C, D
Chapter Practice Questions for Fundamentals Exam 1.
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The effects of immobility on the cardiac system include which of the following? (Select all that apply.) A. Thrombus formation B. Increased cardiac workload C. Weak peripheral pulses D. Irregular heartbeat E. Orthostatic hypotension - ansAnswer: A, B, E Rationale: The three major changes are orthostatic hypotension, increased cardiac workload, and thrombus formation. The nurse puts elastic stocking on a patient following major abdominal surgery. The nurse teaches the patient that the stockings are used after a surgical procedure to...? - ansAnswer: Promote venous return to the heart Rationale: Elastic stockings (sometimes called antiembolitic stockings) aid in maintaining external pressure on the muscles of the lower extremities and thus promote venous return. Increase in venous return helps reduce the stasis of blood thereby, reducing the risk for deep vein thrombosis in the lower extremities. Which assessment finding is expected for a patient who was just chased by an attacker? A. Blood sugar 45 mg/dL B. Blood pressure 180/ C. Pulse rate 55 beats/minute D. Hyperactive bowel sounds - ansB In the early part of the twentieth century, the fight-or-flight response was described. This arousal of the sympathetic nervous system prepares a person for action by increasing heart rate; diverting blood from the intestines to the brain and striated muscles; and increasing blood pressure, heart rate, respiratory rate, and blood glucose levels. The young child cries and tries to run away when after being told that a flu shot is to be administered. Which term best describes the psychological reaction of the child? A. Primary appraisal B. Ineffective denial C. Adventitious crisis D. Developmental Crisis - ansa When a person encounters an event, there is an immediate process of primary appraisal or rating of the event. If this appraisal results in the event being identified as a potential harm, loss, threat, or challenge, the person has stress. Ineffective denial is not indicated as the child realized the injection would be administered shortly and became upset. An adventitious crisis is a major disaster such as an earthquake or fire. A developmental crisis is when new coping strategies are needed to deal with stages of maturation such as getting married or having a child. The patient is severely injured in an accident but does not feel the pain until several hours afterward. Which type of hormone reduced the patient's sense of pain as part of the stress response? a. Endorphins b. Mineralocorticoids c. Prostaglandins d. Bradykinins - ansa Endorphins are hormones that interact with the opiate receptors in the brain to reduce the perception of pain and produce a sense of well-being. Mineralocorticoids control salt and
Chapter Practice Questions for Fundamentals Exam 1.
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water balance within the body. Prostaglandins cause vasodilation and inhibit platelet function. Bradykinins play a role in inflammation causing vasodilation and pain. Which hormone is the most important factor for the physiological response to stress? a. Cortisol b. Glucagon c. Histamine d. Vasopressin - ansa Corticotropin stimulates the adrenal gland to increase the production of corticosteroids, including cortisol, the primary hormone impacting the stress response. Cortisol increases blood glucose, enhances the brain's use of glucose, and increases the availability of substances for tissue repair. Vasopressin increases reabsorption of water by the kidneys and induces vasoconstriction, thereby raising blood pressure. Glucagon raises blood sugar levels. Histamine causes allergic reactions. The new mother experiences insomnia, irritability, and lack of appetite after several weeks in the neonatal care unit with her critically ill infant. Which stage of the general adaptation syndrome (GAS) is the new mother experiencing? a. Alarm b. Resistance c. Adaptation d. Exhaustion - ansD If the stressor remains and adaptation does not happen, the person enters the third stage of the GAS, exhaustion. The exhaustion stage occurs when the body is no longer able to resist the effects of the stressor and the struggle to maintain adaptation drains all available energy. During the alarm reaction, rising hormone levels result in increased blood volume, blood glucose levels, heart rate, blood flow to muscles, and mental alertness. During the resistance stage, the body stabilizes and responds in an opposite manner to the alarm reaction. In the adaptation stage, antiinflammatory adrenocortical hormones are released, and healing occurs. The new mother experiences insomnia, irritability, and lack of appetite after several weeks in the neonatal care unit with her critically ill infant. Which nursing diagnosis is most appropriate for the new mother? a. Stress overload related to ongoing stress and worry about her critically ill infant b. Chronic low self-esteem related to lack of success at beginning of motherhood c. Disturbed sensory perception related to change in problem-solving abilities d. Disturbed personal identity related to inability to distinguish day shift from night - ansa Stress overload related to ongoing stress and worry about her critically ill infant is the appropriate nursing diagnosis for the new mother. The new mother is at the exhaustion stage of the GAS due to the excessive demands of caring for her critically ill infant. The new mother does not demonstrate chronic low self-esteem, disturbed sensory perceptions, or disturbed personal identity. The nurse manager is overwhelmed as the unit prepares for an accreditation inspection. Which type of factor is causing the stress for the nurse manager? a. Situational b. Maturational c. Sociocultural d. Conventional - ansa Situational factors include work stress that happens with work overload (patient load,
Chapter Practice Questions for Fundamentals Exam 1.
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to communicate effectively regarding their needs and desires. The ability to resolve conflict with others through assertiveness training reduces stress. When a group leader teaches assertiveness, the effects of interacting with other people increase the benefits of the experience. Progressive muscle relaxation diminishes physiological tension through a systematic approach to releasing tension in major muscle groups. Mindfulness stress reduction is a form of meditation to reduce symptoms of stress. The patient's spouse is overwhelmed and exhausted trying to provide the ongoing care required by the patient. Which nursing diagnosis is most appropriate for the patient's spouse? a. Activity intolerance related to fatigue and generalized weakness b. Readiness for enhanced comfort related to change in personal health status c. Caregiver role strain related to amount and complexity of patient health needs d. Risk for compromised human dignity related to loss of control of bodily functions - ansc The patient's spouse is demonstrating caregiver role strain by feeling overwhelmed and exhausted trying to meet the patient's needs. The patient's spouse is not experiencing activity intolerance and is not at risk for compromised human dignity. The patient's spouse is exhausted and overwhelmed so readiness for enhanced comfort is not appropriate. Which intervention is appropriate for the nurse to reduce compassion fatigue? a. Increase nursing responsibilities at work. b. Hang out with co-workers when not at work. c. Strengthen relationships outside of the hospital. d. Take control over new areas at work to reduce stress. - ansc Compassion fatigue occurs as a result of chronic stress and is often associated with the human service professions. Make a clear separation between work and home life. Strengthening friendships outside of the workplace, socially isolating oneself for personal "recharging" of emotional energy, and spending off-duty hours in interesting activities all help reduce burnout. Identify the limits and scope of your responsibilities at work. Recognize the areas over which you have control and the ability to change and those for which you do not have responsibility. A patient telephones a crisis intervention hotline. The nurse assigned to this center assesses that the patient is experiencing a crisis. What is the most appropriate action for the nurse to take? a. Define the problem at hand and ensure that the patient is safe. b. Take control of the situation and tell the patient what needs to be done. c. Ask the patient how he would like to handle the crisis and follow through. d. Ask the patient to list all of his problems and prioritize which to deal with first. - ansa Crisis intervention begins with defining the problem, ensuring patient safety, and providing support. First determine that a patient is safe and is not at risk for injury to self or others, and then use crisis intervention to examine alternatives, make plans, and obtain a commitment to positive action from the patient. Ideally these last three steps are completed collaboratively with a patient, but a patient in crisis may be unable to participate actively and may need a very directive approach or a crisis interventionist. Emphasize focusing on the specific problem, and help a patient to avoid all-encompassing, catastrophic interpretations. The patient refuses to believe the physician's diagnosis and insists on a second opinion from a specialist. Which ego-defense mechanism is used by the patient? a. Denial b. Dissociation c. Deterioration
Chapter Practice Questions for Fundamentals Exam 1.
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d. Displacement - ansa The patient develops an inability to swallow after many years of emotional abuse. The physicians can find no medical reason for the patient's dysphagia. Which ego-defense mechanism is used by the patient? a. Displacement b. Dissociation c. Compensation d. Conversion - ansd A young child begins wetting the bed again after the parents bring home a new baby sister. Which ego-defense mechanism is used by the child? a. Regression b. Conversion c. Identification d. Compensation - ansa The patient concentrates on the mind-numbing details of the spouse's funeral to delay dealing with the overwhelming pain of the loss. Which ego-defense mechanism is used by the patient? a. Conversion b. Dissociation c. Compensation d. Reimbursement - ansb The nurse is caring for a patient who has just been diagnosed with amyotrophic lateral sclerosis (ALS). Which assessment findings justify the diagnosis of ineffective denial related to fear of loss of body function and death for the patient? (Select all that apply.) a. The patient attempts to hide shortness of breath from the nurse. b. The patient has fallen twice after insisting that a walker is not needed. c. The patient uses a gastrostomy tube for nutrition when unable to swallow. d. The patient attends support group meetings for families and patients with ALS. e. The patient insists that an uneven sidewalk caused a fall rather than leg weakness. - ansa b e Which interventions are appropriate to assist the patient who is exhausted and depressed from providing care to the spouse with advanced dementia? (Select all that apply.) a. Assist the patient to identify and utilize support systems. b. Teach the patient how to maintain a sleep and activity log. c. Arrange for intervals of respite care for the patient's spouse. d. Help the patient to find personal time to rest and recuperate. e. Educate the patient about advanced directive and living will options. - ansa c d The patient grieves the security of a solid supportive marriage after the spouse has an affair. Which type of loss was experienced by the patient? a. Actual b. Perceived c. Situational d. Maturational - ansB Perceived losses are uniquely experienced by a grieving person and are often less obvious to others. A perceived loss is very real to the person who has had a loss. For example, a person perceives she is less loved by her parents and experiences a loss of self-esteem. People experience an actual loss when they can no longer touch, hear, see, or have near them valued
Chapter Practice Questions for Fundamentals Exam 1.
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person may also take long periods to reflect on how and why the loss occurred. Falling sobbing to the floor and inability to eat or sleep demonstrate the yearning and searching stage. Putting the parent's financial estate in order demonstrates completion of a necessary monetary task after death. Which action demonstrates that the patient is experiencing the reorganization stage of mourning after having a stillborn baby? a. The patient volunteers at a local infant loss support group. b. The patient sits for hours and hours just looking at the empty crib. c. The patient has panic attack with shortness of breath and chest pain. d. The patient turns to alcohol to numb the overwhelming pain of the loss. - ansa During the final phase of reorganization, which usually requires a year or more, the person accepts unaccustomed roles, acquires new skills, and builds new relationships. In the numbing phase, a person has periods of extremely intense emotion and reports feeling "stunned" or "unreal." The numbing phase lasts from several hours to a week. The yearning and searching phase evokes emotional outbursts, tearful sobbing, and acute distress. To move forward, people need to experience this painful phase of grief. During the phase of disorganization and despair, an individual spends much time thinking about how and why the loss occurred. The person often expresses anger at anyone he or she believes to be responsible. Gradually this phase gives way to an acceptance that the loss is permanent. Which nursing diagnosis is most appropriate for a patient who is having difficulty with accepting the reality of a lung cancer diagnosis by attempting to hide periods of shortness of breath from the nurse? a. Ineffective denial related to threat of unpleasant reality of lung cancer b. Noncompliance related to failure to adhere to prescribed treatment plan c. Effective therapeutic regimen management related to illness symptom reduction d. Readiness for enhanced decision making related to realignment of personal values - ansa Which nursing diagnosis is most appropriate for a patient whose friends and family have grown distant after the death of the patient's spouse? a. Impaired verbal communication related to alteration in sensory perception b. Risk for loneliness related to insufficient interactions with friends and family c. Health-seeking behavior related to desire for increased control of personal health d. Readiness for enhanced spiritual well-being related to expressed desire for prayer - ansb The patient is at risk for loneliness because the patient's friends and family have grown distant after the death of the patient's spouse. The patient does not demonstrate any sensory perception, desire for increased control, or expressed desire for prayer based on the information presented. Which action by the patient demonstrates reminiscence of a lost parent? a. The patient obtains a copy of the parent's will and inventories all assets. b. The patient returns to school to start a new career in business administration. c. The patient sues the hospital for malpractice after reviewing the medical record. d. The patient creates a scrapbook to remember special times spent with the parent. - ansd The patient demonstrates reminiscence by taking the time to remember the lost loved one through creation of a scrapbook. Suing the hospital for malpractice does not remember individual characteristics of the loved one or shared experiences. Returning to school indicates that the patient has reached the acceptance stage of grief and is moving on to new activities. Obtaining the will and completing inventory of assets demonstrates completion of necessary monetary tasks after death.
Chapter Practice Questions for Fundamentals Exam 1.
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The patient is the caregiver to the spouse with advanced dementia. The patient mourns the loss of the spouse's mind and personality even though the body is still physically functioning. Which type of grief is being experienced by the patient? a. Normal b. Anticipatory c. Complicated d. Disenfranchised - ansb Which behavior supports inclusion of the nursing diagnosis complicated grieving related to sudden death of a sibling in the patient's care plan? a. The patient donates the sibling's clothes to a local charity. b. The patient withdraws from relationships with friends and family. c. The patient adopts the sibling's dog and arranges for veterinary care. d. The patient arranges for the gravestone to be placed at the sibling's burial site. - ansb The female patient grieves the loss of her child to adoption and finds it difficult to cope because the pregnancy was kept a secret from the family and community. Which type of grief is being experienced by the patient? a. Delayed b. Complicated c. Anticipatory d. Disenfranchised - ansd Disenfranchised grief occurs in situations in which others view a person's loss as insignificant or invalid or when the patient's friends and family are unaware of the loss. Complicated grief happens when a person has difficulty progressing through the loss experience. The person does not accept the reality of the loss, and the intense feelings associated with acute grief do not go away. Normal or uncomplicated grief consists of commonly expected emotional and behavioral reactions to a loss (e.g., resentment, sorrow, anger, crying, loneliness, and temporary withdrawal from activities). The process of "letting go" before an actual loss or death has occurred is called anticipatory grief. The chart lists the patient's daughter as having medical durable power of attorney for the patient. How does this impact the patient's care? a. The daughter is an attorney and plans to sue to the nursing staff and hospital for malpractice after the patient's death. b. The daughter can provide consent for medical procedures if the patient becomes unresponsive or disoriented. c. The patient's daughter must be consulted before asking the patient to consent to medical procedures. d. The patient's daughter will translate medical terminology used by health care providers when communicating with the patient. - ansb Which attitude of the nurse will facilitate effective care for hospice patients? a. The patient needs the nurse's presence and personal connection. b. Remaining silent signifies a noncaring attitude toward the patient. c. Reminiscing with the patient only makes a difficult situation worse. d. The patient does not recognize the impact of the loss if no tears are shed. - ansa Which treatment would be refused by a patient who has requested palliative care? a. Therapeutic touch b. Supplemental oxygen c. Narcotic pain medications
Chapter Practice Questions for Fundamentals Exam 1.
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a. Perceived b. Situational c. Conditional d. Maturational - ansd The nurse is caring for a patient who has just passed away. Which is the priority action of the nurse? Ask the family to leave the room so that postmortem care can be provided. Have the patient's family members sign consent forms for organ donation. Remove all drainage tubes and IV lines in case an autopsy is to be performed. Provide postmortem care in a manner consistent with religious or cultural beliefs. - ansd Which behaviors support inclusion of the nursing diagnosis compromised family coping related to loss of home in a fire in the care plan? (Select all that apply.) The children missed school and the parents missed work during the first few days after the fire. All of the family members were able to stay at the home of a neighbor for the first week after the fire. The parents have not been able to speak to each other without screaming in anger for the last 2 weeks. The children still have occasional nightmares about the fire and the damage to the family home. The parents are so preoccupied with insurance frustration that they have not noticed that the oldest child is failing school. - ansc, e Inability to speak to each other without screaming and not noticing the needs of other family members demonstrate the appropriateness of compromised family coping as a nursing diagnosis. It is expected that the family members would miss work and school for the first few days after the fire. The family is fortunate that they were able to stay with a neighbor. Occasional nightmares are to be expected following a house fire and do not demonstrate compromised family coping skills. Which assessment findings lead the nurse to inform the family that the patient's death is imminent? (Select all that apply.) The patient's pupils are fixed and dilated bilaterally. The patient is lethargic, drifting in and out of consciousness. The patient's breathing is harsh and congested with periods of apnea. The patient had only 40 mL in the urinary catheter bag for the last 8 hours. The patient's temperature is 102.6° F (39.2° C) but the hands and feet are cool and mottled. - ansb c d e
- A patient needs to learn to use a walker. Which domain is required for learning this skill? A. Affective domain B. Cognitive domain C. Attentional domain D. Psychomotor domain - ansD. Psychomotor domain Pg. 339 Using a walker requires the integration of mental and muscular activity.
Chapter Practice Questions for Fundamentals Exam 1.
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- The nurse is planning to teach a patient about the importance of exercise. When is the best time for teaching to occur? (Select all that apply.) A. When there are visitors in the room B. When the patient's pain medications are working C. Just before lunch, when the patient is most awake and alert D. When the patient is talking about current stressors in his or her life - ansB. When the patient's pain medications are working C. Just before lunch, when the patient is most awake and alert Plan teaching when the patient is most attentive, receptive, alert, and comfortable.
- A patient newly diagnosed with cervical cancer is going home. The patient is avoiding discussion of her illness and postoperative orders. What is the nurse's best plan in teaching this patient? A. Teach the patient's spouse B. Focus on knowledge the patient will need in a few weeks C. Provide only the information that the patient needs to go home D. Convince the patient that learning about her health is necessary - ansC. Provide only the information that the patient needs to go home This patient is in denial; thus it is appropriate to only give her information that is needed immediately.
- The school nurse is about to teach a freshman-level high school health class about nutrition. What is the best instructional approach to ensure that the students meet the learning outcomes? A. Provide information using a lecture B. Use simple words to promote understanding C. Develop topics for discussion that require problem solving D. Complete an extensive literature search focusing on eating disorders - ansC. Develop topics for discussion that require problem solving Adolescents learn best when they are able to use problem solving to help them make choices.
- A nurse is going to teach a patient how to perform breast self-examination. Which behavioral objective does the nurse set to best measure the patient's ability to perform the examination? A. The patient will verbalize the steps involved in breast self-examination within 1 week. B. The nurse will explain the importance of performing breast self-examination once a month. C. The patient will perform breast self-examination correctly on herself before the end of the teaching session. D. The nurse will demonstrate breast self-examination on a breast model provided by the American Cancer Society. - ansC. The patient will perform breast self-examination correctly on herself before the end of the teaching session.
Chapter Practice Questions for Fundamentals Exam 1.
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Patients are ready to learn when they understand the importance of learning and are motivated to learn.
- A patient who is hospitalized has just been diagnosed with diabetes. He is going to need to learn how to give himself injections. Which teaching method does the nurse use? A. Simulation B. Demonstration C. Group instruction D. One-on-one discussion - ansB. Demonstration Pg. 349 Demonstration is used to help patients learn psychomotor skills.
- When a nurse is teaching a patient about how to administer an epinephrine injection in case of a severe allergic reaction, he or she tells the patient to hold the injection like a dart. Which of the following instructional methods did the nurse use? A. Telling B. Analogy C. Demonstration D. Simulation - ansB. Analogy Pg. 349 Analogies use familiar images when teaching to help explain complex information.
- A nurse needs to teach a young woman newly diagnosed with asthma how to manage her disease. Which of the following topics does the nurse teach first? A. How to use an inhaler during an asthma attack B. The need to avoid people who smoke to prevent asthma attacks C. Where to purchase a medical alert bracelet that says she has asthma D. The importance of maintaining a healthy diet and exercising regularly - ansA. How to use an inhaler during an asthma attack It is important to start with essential life-saving information when teaching people because they usually remember what you tell them first. 1 3. A nurse is teaching a group of young college-age women the importance of using sunscreen when going out in the sun. What type of content is the nurse providing? A. Simulation B. Restoring health C. Coping with impaired function D. Health promotion and illness prevention - ansD. Health promotion and illness prevention Health promotion and illness prevention are the focus when nurses provide information to help patients improve their health and avoid illness.
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- A nurse is planning a teaching session about healthy nutrition with a group of children who are in first grade. The nurse determines that after the teaching session the children will be able to name three examples of foods that are fruits. This is an example of: A. A teaching plan. B. A learning objective. C. Reinforcement of content. D. Enhancing the children's self-efficacy. - ansB. A learning objective. Pg. 338 A learning objective describes what the learner will do after the teaching session.
- A nurse is teaching a 27-year-old gentleman how to adjust his insulin dosages based on his blood sugar results. What type of learning is this? A. Cognitive B. Affective C. Adaptation D. Psychomotor - ansA. Cognitive Pg. 339 Cognitive learning requires thinking; learning how to adjust insulin requires analysis, synthesis, and evaluation, which are all types of cognitive learning. The --------is a closed-loop communication technique used to evaluate patient understanding and retention of material. - ansTeach Back Method Pg. 351 Teach-back is a closed loop communication technique that assesses patient retention of the information imparted during a teaching session. The nurse is organizing a disease prevention program for a specific cultural group. To effectively meet the needs of this group the nurse will: (Select all that apply)
- Assess the needs of the community in general.
- Involve those affected by the problem in the planning process.
- Develop generalized goals and objectives for the program.
- Use educational materials that are simplistic and have many pictures.
- Asses commonly held health beliefs among the cultural group.
- Educate the specific cultural group about western concepts of health and illness.
- Include cultural practices that are relevant to the specific community. - ans2. Involve those affected by the problem in the planning process.
- Asses commonly held health beliefs among the cultural group.
- Include cultural practices that are relevant to the specific community. Pg. 350
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c. Intrapersonal communication to build strong teams. d. Transpersonal communication to enhance meditation. - ansANS: D Transpersonal communication is interaction that occurs within a person's spiritual domain. Many people use prayer, meditation, guided reflection, religious rituals, or other means to communicate with their "higher power." Interpersonal communication is one-on-one interaction between the nurse and another person that often occurs face to face. Meaningful interpersonal communication results in exchange of ideas, problem solving, expression of feelings, decision making, goal accomplishment, team building, and personal growth. Small group communication is interaction that occurs when a small number of persons meet. This type of communication is usually goal directed and requires an understanding of group dynamics. When nurses work on committees, lead patient support groups, form research teams, or participate in patient care conferences, they use a small group communication process. Intrapersonal communication is a powerful form of communication that occurs within an individual. For example, you improve your health and self-esteem through positive self-talk by replacing negative thoughts with positive assertions A nurse is standing beside the patient's bed. Nurse: How are you doing? Patient: I don't feel good. In this situation, which element is the feedback? a. Nurse b. Patient c. How are you doing? d. I don't feel good. - ansANS: D "I don't feel good" is the feedback because the feedback is the message the receiver returns. The sender is the person who encodes and delivers the message, and the receiver is the person who receives and decodes the message. The nurse is the sender. The patient is the receiver. "How are you doing?" is the message. A nurse is sitting at the patient's bedside taking a nursing history. Which zone of personal space is the nurse using? a. Intimate b. Personal c. Social d. Public - ansANS: B Personal space is 18 inches to 4 feet and involves such things as sitting at a patient's bedside, taking a patient's nursing history, or teaching an individual patient. Intimate space is 0 to 18 inches and involves such things as performing a physical assessment, bathing, grooming, dressing, feeding, and toileting a patient. Social zone is 4 to 12 feet and involves such things as making rounds with a physician, sitting at the head of a conference table, or teaching a class for patients with diabetes. Public zone is 12 feet and greater and involves such things as speaking at a community forum, testifying at a legislative hearing, or lecturing. A smiling patient angrily states, "I will not cough and deep breathe." How will the nurse interpret this finding? a. The patient's personal space was violated. b. The patient's affect is inappropriate. c. The patient's vocabulary is poor. d. The patient's denotative meaning is wrong. - ansANS: B
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An inappropriate affect is a facial expression that does not match the content of a verbal message (e.g., smiling when describing a sad situation). The patient is smiling but is angry, which indicates an inappropriate affect. The patient's personal space was not violated. The patient's vocabulary is not poor. Individuals who use a common language share denotative meaning: baseball has the same meaning for everyone who speaks English, but code denotes cardiac arrest primarily to health care providers. The patient's denotative meaning is correct for cough and deep breathe. The nurse asks a patient where the pain is, and the patient responds by pointing to the area of pain. Which form of communication did the patient use? a. Verbal b. Nonverbal c. Intonation d. Vocabulary - ansANS: B The patient gestured (pointed), which is a type of nonverbal communication. Gestures emphasize, punctuate, and clarify the spoken word. Pointing to an area of pain is sometimes more accurate than describing its location. Verbal is the spoken word or message. Intonation or tone of voice dramatically affects the meaning of a message. Vocabulary consists of words used for verbal communication. A patient has been admitted to the hospital numerous times. The nurse asks the patient to share a personal story about the care that has been received. Which interaction is the nurse using? a. Narrative b. Socializing c. Nonjudgmental d. SBAR - ansANS: A In a therapeutic relationship, nurses often encourage patients to share personal stories. Sharing stories is called narrative interaction. Socializing is an important initial component of interpersonal communication. It helps people get to know one another and relax. It is easy, superficial, and not deeply personal. Nonjudgmental acceptance of the patient is an important characteristic of the relationship. Acceptance conveys a willingness to hear a message or acknowledge feelings; it is not a technique that involves personal stories. SBAR is a popular communication tool that helps standardize communication among health care providers. SBAR stands for Situation, Background, Assessment, and Recommendation. Before meeting the patient, a nurse talks to other caregivers about the patient. The nurse is in which phase of the helping relationship? a. Pre-interaction b. Orientation c. Working d. Termination - ansANS: A The time before the nurse meets the patient is called the pre-interaction phase. This phase can involve such things as reviewing available data, including the medical and nursing history, talking to other caregivers who have information about the patient, or anticipating health concerns or issues that can arise. The orientation phase occurs when the nurse and the patient meet and get to know one another. This phase can involve such things as setting the tone for the relationship by adopting a warm, empathetic, caring manner; recognizing that the initial relationship is often superficial, uncertain, and tentative; or expecting the patient to test the nurse's competence and commitment. The working phase occurs when the nurse and the
