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MJC Theory N271 Exam 1 Questions And
Complete Answers
Position - answer Group of tasks assigned to an individual Job - answer A group of positions that are similar in nature and level of skill that can be carried out by 1 or more individuals Occupation - answer A group of jobs that are similar in type of work and that one usually funds in an industry or work environment Profession - answer A type of occupation that meets certain criteria that raise it to a level above that of an occupation Career - answer Someone's life work (Position, job, occupation, profession) What are the approaches to determining a profession? - answer - Process approach
- Power approach
- Trait approach ** Describe the traits of a profession. - answer - High intellectual level
- High level of individual responsibility and accountability
- Specialized body of knowledge
- Knowledge that can be learned in institutes of higher education
- Public service and altruistic activities
- Public service valued over financial gain
- High degree of autonomy/independence
- Well organized and strong organization
- Code of ethics that guide members
- Strong professional identity and commitment to the development of profession
- Demonstrate professional competency and possession of a legally recognized license The nature of power - answer The ability or capacity to exert influence over another person or group of persons Referent - answer Establishing/maintaining a close relationship with someone Expert - answer Expert source of power derives from amount of knowledge, skills. and expertise that an individual or group has Reward - answer Reward for behavior or change Coercive - answer Ability to punish, withhold rewards, and threaten punishment Legitimate - answer Legislative or legal act gives individual or organization the right to make decisions Collective - answer Individual client care and is the underlying source for many other sources of power ANA Code of Ethics for Nurses - answer (1) The nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth and uniqueness of every individual unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems (2) The nurse's primary commitment is to the patient, whether an individual, family, group, or community (3) The nurse promotes, advocates for and strives to protect the health, safety, and rights of the patient (4) The nurse is responsible and accountable for individual nursing practice and determines the appropriate delegation of tasks consistent with the nurse's obligation to provide optimum patient care (5) The nurse owes the same duties to self as others, including the responsibility to preserve integrity and safety, to maintain competence and to continue personal and professional growth (6) The nurse participates in establishing, maintaining and improving healthcare environments and conditions of employment conducive to the provision of quality healthcare and consistent with the values of the profession through individual and collective action
being of the client Nonmaleficence - answer Ethical principle that requires the professional to do no harm to the client Fidelity - answer The obligation of an individual to be faithful to commitments made to self and others Justice - answer Fairness; giving people their due Confidentiality - answer Right of the client to expect the communication with a professional to remain unshared with any other person unless a medical reason exists or unless the safety of the public is threatened Veracity - answer The principle of truthfulness. It requires the health-care provider to tell the truth and not intentionally deceive or mislead clients. Natural law - answer Inherent tendency that humans have to take actions that follow our nature and purpose to human beings based on the idea to promote good Criminal law - answer Law concerned with violation of criminal statues or laws (state) Civil law - answer Law concerned with the violation of the rights of one individual by another; it includes contract law, treaty law, tax law, and tort law What are the 3 types of tort law? - answer - Unintentional
- Intentional
- Quasi-intentional
Unintentional tort - answer A wrong occurring to a person or that person's property even though it was not intended (negligence, malpractice, or professional misconduct) Negligence - answer Failure to perform at an expected level of functioning or the performance of an inappropriate function resulting in damages to another party; not doing what a reasonable and prudent person would do in a similar situation What 4 elements must be in place for a nurse to have committed malpractice? - answer 1. Duty (to act)
- Breach of duty
- Causation
- Damage or injury Intentional tort - answer A willful act that violates another person's rights or property and may or may not cause physical injury What are the 3 requirements of intentional tort? - answer 1. Intention
- Interference
- Injury Quasi-intentional - answer - Violation of a person's reputation or personal privacy
- Defamation of character
- Invasion of privacy
- Breach of confidentiality (exceptions?)
California Nurse Practice Act: Section 2725 - answer Described the role of the RN and outlined activities which comprise the practice of nursing; recognized the field of nursing as a dynamic field, continually evolving to include more sophisticated patient care activities
- Independent
- Dependent
- Interdependent Independent functions - answer Direct and indirect patient care services that insure:
- Safety
- Comfort
- Personal hygiene
- Protection
- Disease prevention/restorative measures
- Delegation of patient care activities to subordinates
- s/s of illness
- Reaction of treatment
- Behavior and general physical condition
- Determine abnormal base on:
- Report or referral
- Initiate emergency procedures What are tasks that you cannot delegate to a CNA, LVN, or MA? - answer - Nursing knowledge
- Nursing assessment
- Patient teachings
- Evaluation of care given Dependent functions - answer Must obtain a dr.'s order
- Medication administration
- Therapeutic agent administration Interdependent functions - answer - Standard protocols
- Changes in treatment regimen after observing s/s of illness, reaction, etc. What are the NPSGs? - answer (1) Identify patients correctly (2) Improve staff communication (3) Use medicines safely (4) Use alarms safely (5) Prevent infection (6) Identify patient safety risks (7) Prevent mistakes in surgery NPSG - answer National Patient Safety Goals What is the purpose of the NPSGs? - answer Improve patient safety. The goal focus on problems within the healthcare system regarding safety and implement ways to increase safety. (overlap with QSEN)
CAUTI - answer Catheter associated urinary tract infections Identify patient safety risks - answer At risks for suicide Universal protocol (prevent mistakes) - answer Prevention of wrong
- surgical site, procedure, person, surgeries (time out) Use Medicines safely - answer - Label all meds
- Reduce harm from anticoagulants
- Teach patients accurate medication information
- Compare current and new meds
- Communicate medications to next provider (nurse)
- Medication reconciliation (list- discharge) The nursing process - answer An assertive, problem solving approach to the identification and treatment of patient problems. It provides an organizing framework for the practice of nursing and the knowledge, judgments, and actions that nurses bring to patient care. What are the 5 steps of the nursing process? - answer 1. Assessment
- Diagnosis
- Planning
- Implementation
- Evaluation
ADPIE - answer A-assessment D- diagnosis P- planning I- implementation E- evaluation What are the 2 types of data that can be collected during the assessment phase? - answer Subjective and objective What is an assessment? - answer It is the first part of the nursing process; includes systematic collection, verification, organization, interpretation, and documentation of data for use by health care professionals Objective data - answer Observable and measurable data (Signs)
- See
- Hear
- Smell
- Touch Subjective data - answer Information from the client's point of view (Symptoms)
- Feelings
- Perceptions
- Concerns
- used modifiers E- Etiology - answer The cause of the problem
- also based on your assessment
- don't use medical diagnosis S- signs and symptoms - answer The evidence of the problem
- what did you see, hear, touch, and/or smell?
- what did the patient tell you? It comes FIRST!!! Planning - answer Establish priorities (ABC's); once priorities are established, then outcomes for the patient should be identified
- high priority diagnosis require immediate interventions
- patient centered goals
- measurable goals Implementation - answer Nursing interventions
- Specific actions
- patient centered and individualized
- Measurable
- Can it be delegated? Evaluation - answer - Did your interventions work?
- Was your goal/outcome reasonable and measurable? QSEN - answer Quality and Safety in Educating Nurses What is the goal of QSEN? - answer Address challenge of preparing future with KSA's as necessary to continuously improve the quality and safety of health care system in which they work Knowledge - answer Cognitive (thinking, reasoning) Skills - answer Psychomotor (doing) Attitudes - answer Affective (feelings, values) skills and abilities of the nurse QSEN competencies are based on.... - answer - Inquiry
- Evidence based standards
- Investigations of critical incidents (Sentinel events) Root Cause Analysis - answer What contributed to the event or caused the event Sentinel events - answer Unaccepted death, psychological or physical (injury) events What are the 6 competencies? - answer (1) Patient- centered care (2) Teamwork and collaboration
Interdisciplinary teamwork - answer Involving 2+ disciplines working together for the patient Teamwork and Collaboration: Knowledge - answer A. Describe scopes of practice and roles of health care team members and the impact of collaboration on patient outcome B. Analyze differences in communication style preferences among patients, families, nurses, and other members of the healthcare team C. Demonstrate knowledge and use of SBAR communication Teamwork and Collaboration: Skills - answer A. Function competently within own scope of practice as a member of the health care team B. Follow communication practices that minimize risks associated with handoffs among providers and across transitions in care
- SBAR or I-SBAR-R Teamwork and collaboration Attitudes - answer A. Appreciate the importance of both intra- professional inter-professional communication B. Value the expertise of all health care team members C. Acknowledge own potential to contribute to effective team functioning D Respect the centrality of the patient/family as core members of any health care team SBAR - answer S- situation B- background A- assessment R- recommendation/request
Safety - answer Minimizes risk of harm to patients and providers through both system effectiveness and individual performance Safety: Knowledge - answer A. Demonstrate knowledge and use of SBAR communication B. Describe factors that create a culture of safety Safety: Skills - answer A. Communicate observations or concerns related to hazards and errors to patients, families, and the health care team B. Demonstrate effective use of technology and standardized practices that support safety and quality Safety: Attitudes - answer A. Appreciate the cognitive and physical limits of human performance IOM's 9 for culture of safety - answer (1) User-centered design (2) Avoid reliance on memory (3) attend work safely (4) avoid reliance on vigilance (5) training concepts for teams (6) Involve patients in their care (7) Anticipate the unexpected (8) Design for recovery (9) Improve access to accurate, timely information
and safety of health care systems Quality Improvement: Knowledge - answer A. Describe root cause analysis and how it affects patient care B. Explain and understand the use of quality measures in assessing quality of care Quality Improvement: Skills - answer A. Seek information about outcomes of care for populations served in care settings B. Identify gaps in local and best practice Quality Improvement: Attitudes - answer A. Value the continuous quality improvement is an essential part of the daily work of all health professionals Patient-centered care - answer Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient's preferences, values, and needs Patient-centered care: Knowledge - answer A. Integrate understanding of multiple dimensions of patient centered care
- patient/family/community preferences, valves
- Coordination and integration of care
- Physical and emotional comfort
- Involvement of family and friends B. Examine how the safety, quality, and cost effectiveness of health care can be improved through the active involvement of patients and families C. Discuss strategies to empower patients or families in all aspects of the health care process
Patient-centered care: Skill - answer A. Provide patient centered care with sensitivity and respect for the diversity of human experience B. Engage patients or designated surrogates in active partnerships that promote health, safety, and well being and self care management Patient-centered care: Attitudes - answer A. Value seeing health care situations "through the patient's eyes" B. Recognize personal attitudes about working with patients from different ethnic, cultural, and social backgrounds Evidence-based Practice - answer Integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care Evidence-based practice: Knowledge - answer A. Explain the role of evidence in determining best clinical practice B. Identify reliable sources for locating evidence reports and clinical practice guidelines Evidence-based practice: Skills - answer A. Create individualized care plan based on patient values, clinical expertise, and evidence B. Locate evidence reports related to clinical practice topics and guidelines Evidence-based practice: Attitudes - answer A. Value the concept of EBP as integral to determining the best clinical practice What are some barriers that keep nurses from providing good and accurate patient care? - answer - Busy
