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NU 311 Nursing Final Exam Questions with complete solutions. Graded A+ NU 311 Nursing Final Exam Questions with complete solutions. Graded A+ NU 311 Nursing Final Exam Questions with complete solutions. Graded A+
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education -theoretical body of knowledge -specific service -autonomy in decision making -code of ethics
optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations.
implement, evaluate
o Airway o Breathing o Circulation o Pain
profession of nursing, collectively through its professional organizations, must articulate nursing values, maintain the integrity of the profession, and integrate principles of social justice into nursing and health policy.
participates in establishing, maintaining, and improving health care environments and conditions of employment conducive to the provision of quality health care and consistent with the values of the profession through individual and collective action
in all roles and settings, advances the profession through research and scholarly inquiry, professional standards of development, and the generation of both nursing and health policy."
collaborates with other health professionals and the public in promoting community, national, and international efforts to meet health needs.
and others -INTEGRITY is an aspect of wholeness of character and is primarily a self-concern of the individual nurse. -Nurses have a responsibility to remain consistent with both their personal and professional values
has authority, accountability, and responsibility for nursing practice; makes decisions; and takes action consistent with the obligation to promote health and to provide optimal care
advocates for, and strives to protect the health, safety, and rights of the patient This means: -Participate in review and development of policies -Reporting errors and near misses per facility policy (whether you or other made error) -Disclosing errors to patients -Use the Chain of Command
boundaries The nurse's primary commitment is to the patient, whether an individual, family, group, or population. When acting within one's role as a professional, the nurse recognizes and maintains boundaries that establish appropriate limits to relationships.
scope of practice in each state -protected by the public -law that regulates the practice of nursing: to have a nursing licensure and pass the NCLEX-RN exam in order to practice. (RN, LPN, APN) -establishes the Alabama Board of Nursing (ABON) and gives the board authority over nursing practice. They have the right to give and take away nursing liscense
respect others,use direct statements of feeling What is the difference between assigning, delegating, and supervising? -
responsibility of client care to another Delegating - transferring the authority and responsibility to another team member to complete a task, while retaining the accountability Supervising - directing, monitoring, and evaluating the performance of tasks by another. RNs are responsible for supervising delegated tasks to an LPN or AP
responsibility for the performance of a task from one individual to another while retaining accountability and authority for the outcome -The individual receiving the assignment is responsible for the performance of the task The individual delegating the task retains accountability for the outcome.
assignment is unsafe for patients
-Talk with charge nurse -Take up the Chain of Command -Document Practice Situation and file with Administration -Failure to follow the steps above may result in a charge of patient abandonment - reportable to the BON
-Right supervision -Right circumstances -Right task -Right person
concise, correct, and complete initial and ongoing directions. (Include time, expectations, follow-up communication etc.)
assigned/delegated tasks (Huddles/checkpoints - solicit team members opinion; credit team for accomplishments
home health? -Knowledge and skill of delegatee -Verification of clinical competence -Stability of patient's condition -Availability of resources (including human)
supervision?
description; strengths, experience, competence?
An RN on a medical-surgical unit is making assignments at the beginning of the shift. Which of the following tasks should the nurse delegate to the LPN? A. Obtaining vital signs for a client who is 2 hr. post-procedure following a cardiac catheterization B. Administering a unit of packed red blood cells (RBCs) C. Instructing a client in the performance of wound care
C. Because it is reinforcing client teaching from the standard care plan
information from relevant, valid research -BEST evidence is comes from well designed, systematically conducted research studies Other sources (non-research): -General literature review -Quality improvement data -Risk management data -Infection control data -Chart reviews -Clinician's expertise
solving approach to clinical practice that combines the best available evidence in combination with a clinician's expertise, patient preferences and values, and available health care resources in making decisions about patient care
or problem I: intervention or issue of interest C: comparison with the intervention O: Outcome (measurable) T: Time (an optional component of a clinical question)
does epidural analgesia (I) compared to patient-controlled analgesia (C)affect pain severity(O) in the first 48 hours after surgery (T)? -Is an adult patient's (P) blood pressure more accurate (O) while measuring with the patient's legs crossed (I) versus the patient's feet flat on the floor (C)?
Cumulative Index of Nursing and Allied Health Literature. Includes studies in nursing, allied health, and biomedicine Cochrane Database of Systematic -Cochrane Collaboration. Includes completed reviews: Full text of regularly updated systematic reviews prepared by the and protocols. -PubMed: Health science library at the National Library of Medicine. Offers free access to journal articles. -MEDLINE: US National Library of Medicine; bibliographical database that contains more than 22 million references to journal articles in the life sciences with a concentration in biomedicine -EMBASE:
susceptibility, infectious agent, reservoir, portal of exit
Asepsis: clean technique that reduces organisms and prevents the transfer of them as well -HAND HYGEINE!!!, barrier techniques, routine environment cleaning Sterile Technique: eliminates pathogenic organisms used in surgery or other invasive procedures A nursing assistive personnel (NAP) arrives to assist the nurse with a dressing change by opening sterile packages. The NAP states that she does not need to perform hand hygiene before assisting the nurse because she is not going to touch the patient. Is the NAP correct? A. True
Rationale: The nursing assistive personnel (NAP) is incorrect in saying that hand hygiene does not need to be performed before she assists the nurse. Although she may not touch the patient, she is still participating in patient care. Hand hygiene is performed by all caregivers.
changes in self-concept or body image. Know cultural views and preferences of your patients. When a patient from another culture requires isolation, use caution to be sure that the patient and family understand the therapeutic purpose of isolation.) -PPE required (gown, goggles, mask, gloves) -leave equipment in the room
gown, mask, goggles, gloves Removing: gloves, goggles, gown, mask
When donning sterile gloves, you take your non-dominant hand to touch which part of
the cuffs How should you hold your gloved thumb to avoid touching the skin when donning
skin to skin away from other people and downward towards the trashcan
(Review Check-Off) -soap and water are required for VISIBLY soiled hands or C.diff -Alcohol-based can be used for non-visible germs
How long should you lather and apply friction to your hands for when washing hands? -
When washing hands, you should interlace fingers and rub your palms how? -
wiping from fingers up to wrists and forearms
-CAUTI's -retained objects -VAP
of the Institute of Medicine (IOM) concluded that it is not acceptable for patients to be harmed by the health care system that is supposed to offer healing and comfort--a system that promises, "First, do no harm." prevention of medical errors
patient correctly -Improve staff communication -Use medications safely -Use alarms safely -Prevent infection -Identify patient safety risks -Prevent mistakes in surgery
each patient's rights. -A hospital must inform each patient whenever possible or, when appropriate, the patient's representative, of the patient's rights in advance of furnishing or discontinuing patient care. -The hospital must have a process for prompt resolution of patient grievances and must inform each patient about whom to contact to file a grievance
in the development and implementation of his or her plan of care.
-The patient or his or her representative has the right to make informed decisions regarding his or her care. -The patient's rights include being informed of his or her health status, involved in care planning and treatment, and able to request or refuse treatment. This right must not be construed as a mechanism to demand the provision of treatment or services deemed medically unnecessary or inappropriate -The patient has the right to formulate advance directives and to have hospital staff and practitioners who provide care in the hospital comply with these directives. -The patient has the right to have a family member or representative of his or her choice and his or her own health care provider notified promptly of his or her admission to the hospital.
privacy. -The patient has the right to receive care in a safe setting. -The patient has the right to be free from all forms of abuse or harassment.
right to the confidentiality of his or her clinical records. -The patient has the right to access within a reasonable time frame information contained in his or her clinical records.
free from physical or mental abuse and corporal punishment. -The patient has the right to be free from restraints or seclusion of any form that is not medically necessary or is used by staff as a means of coercion, discipline, convenience, or retaliation. A restraint is any manual method or physical or mechanical device, material, or equipment attached or adjacent to the patient's body that he or she cannot easily remove that restricts freedom of movement or normal access to one's body. A drug used as a restraint is a medication used to control behavior or to restrict the patient's freedom of movement and is not a standard treatment for the patient's medical or psychiatric condition. Seclusion is the involuntary confinement of a patient alone to a room or area from which the patient is physically prevented from leaving. -A restraint or seclusion can be used only if needed to improve the patient's well-being and if less restrictive interventions have been determined to be ineffective.
A. True
Do not delegate admission vital signs, because a nurse must conduct the baseline assessment. The nurse can delegate some tasks to nursing assistive personnel (NAP), such as preparing the patient's room and collecting specimens; however, the actual assessment must be performed by the nurse. The nurse admits to the unit a 4-year-old child who is experiencing separation anxiety from her parents. What age-appropriate behavior related to separation anxiety might this child exhibit? A. Having difficulty sleeping B. Throwing items C. Screaming at the nurse
Rationale: This is the only age-appropriate behavior. The other behaviors may be seen as well; however, a 4-year-old child should not be exhibiting these. The patient tells the nurse she will not cooperate this evening with the physical therapist to perform exercises because she was in pain the entire time during exercise last evening. What question should the nurse ask the patient? A. Do you like the therapist who was assigned to you? B. Why are you trying to be difficult tonight? C. Have you ever liked to exercise in the past?
Did you receive pain medication before exercise? Pain may reduce a patient's motivation to perform isometric exercises. Pain relief before attempts at exercise may enhance the patient's participation; it may be appropriate to medicate the patient 30 to 60 minutes before exercise.
Can the skill of promoting early activity and exercise for patients be delegated to a
In the outpatient setting, education regarding activity and exersize CANNOT be delegated to a NAP A. True
An 82-year-old man with a rotator cuff tear is not a candidate for surgery. Which of the following exercises can the nurse teach the patient to do to assist with range of motion? A. Lift 15-pound weights, raising the arm slowly to shoulder height. B. Perform 5-count sets of push-ups 3 times daily. C. Reach to the bedside table to lift a book.
Rationale: Reaching sideways to a bedside table is performing ROM activity without putting more stress on the shoulder.
stockings Sequential compression devices (SCDs) pump blood into deep veins, thus removing pooled blood and preventing venous stasis. Another venous plexus foot pump promotes circulation by mimicking the natural action of walking.
cyanotic skin, pain Common risk factors that include conditions that influence virchow's triad -
-venous wall abnormalities -blood flow stasis (all these contribute to developing a DVT)
with them. Let them slide down your knee"
heel, pull through. slide over the pt's calf until sock is completely extended making sure there are no rough ridges. make sure to measure pt's leg when selected sizes. you can also apply powder or cornstarch to legs
and/or underlying tissue, usually over a bony prominence, as a result of pressure or pressure in combination with shear (a never event)
prominences
-immobile -pt's with loss of sensory and perception -pt's who are malnourished -anemia -age -heavy sedation and anesthesia -fever -circulatory changes -dehydration -hx of pressure ulcers
of intact skin Stage 2: partial thickness skin loss with exposed dermis. wound bed is pink and moist Stage 3: full thickness skin loss in which adipose and granulation tissue is visible Stage 4: full thickness and tissue loss with exposed palpable fascia, muscle, tendon, or bone. slough and eshcar may be visible
tissue consistency is compared to surrounding skin. localized area may be purple-ish instead of red
sensory perception, moisture, activity, mobility, nutrition, fiction and shear
A 49-year-old woman is recovering from a pressure injury on her left hip. The patient refuses lunch and tells the nurse that she fasts at lunchtime as part of her weight loss plan. How should the nurse respond to this patient? A. The nurse should explain to the patient that fasting is against the hospital policy . B. The nurse should scold the patient for her choice of diet. C. The nurse should inform the patient that fasting will hinder her healing progress.
progress. Rationale: Adequate nutrition helps to prevent and treat pressure ulcers. A diet high in protein with enough calories, vitamins, and minerals helps maintain normal tissue status and promotes healing. With tissue injury, the body needs more calories for healing; nutrient deficiencies may result in impaired or delayed healing. Do not EVER massage redness areas because doing so may cause additional tissue trauma A. True
lateral position -pillow bridging
deep red, purple or maroon discoloration