Effective Communication Strategies in Healthcare, Exams of Advanced Education

Download Effective Communication Strategies in Healthcare and more Exams Advanced Education in PDF only on Docsity!

NUR 210 Exam 1 With 100% Correct

Answers 2023

what makes up an assessment - Correct answer-subjective data objective data data base subjective data - Correct answer-What patient says about himself or herself during history taking objective data - Correct answer-Observed when inspecting, percussing, palpating, and auscultating patient during physical examination data base - Correct answer-formed from subjective data, objective data, and a patient's record and diagnostic studies what is the nursing process - Correct answer-Assessment Diagnosis Outcome identification Planning Implementation Evaluation First-level priority problems - Correct answer-- require immediate intervention

• ABCs (airway, breathing, circulation)
• vital signs Second-level priority problems - Correct answer-Require prompt medical attention ex:
• Mental status change
• Untreated medical problems requiring immediate attention
• Acute pain
• Acute urinary elimination problems
• Abnormal laboratory values
• Risks of infection, safety or security Third-level priority problems - Correct answer-those that are important to the patient's health but can be addressed after more urgent health problems are addressed.
• Knowledge deficit
• altered family processes
• low self esteem
• activity
• rest
• family coping

4 types of data base collection - Correct answer-- complete total health data base

• focused or problem-centered data base (for limited or short-term problems)
• follow up data base
• emergency data base what makes up a complete total health data base? - Correct answer-- Complete health history
• Head to Toe physical examination
• Describes current and past health state and forms baseline to measure all future changes what makes up a focused or problem-centered data base - Correct answer-For limited or short-term problems
• Collect "mini" data base, smaller scope and more focused than complete data base
• Concerns mainly one problem, or one body system
• History and examination follow direction of presenting concern what makes up a follow-up data base? - Correct answer-- Status of all identified problems should be evaluated at regular and appropriate intervals
• Note changes that have occurred
• Evaluate whether problem is getting better or worse
• Identify coping strategies being used what makes up an emergency data base? - Correct answer-- Rapid collection of data, often compiled concurrently with lifesaving measures
• Diagnosis must be swift and sure
• Person is questioned simultaneously while his or her airway, breathing, circulation, level of consciousness, and disability are being assessed goals of the health interview - Correct answer-- Obtain and record complete health history
• Obtain subjective data
• Establish rapport
• Teach about health
• Begin health promotion teaching the process of communication - Correct answer-- mutual understanding by sender and receiver
• Communication can be learned and polished
• Communication is a tool, as basic to quality health care as tools of inspection or palpation internal factors that influence communication - Correct answer-- Liking others
• Empathy

interpretation - Correct answer-- Based on your inference or conclusion

• It links events, makes associations, implies cause, ascribes feelings
• Helps person understand his or her own feelings in relation to the verbal message explanation - Correct answer-These statements inform the person summary - Correct answer-- Final review of what person has said
• it condenses facts and presents your view of health problem traps of interviewing - Correct answer-- Providing false assurance or reassurance
• Giving unwanted advice
• Using authority
• Using Avoidance Language
• Distancing
• Using professional jargon
• Using leading or biased questions
• Talking too much
• Interrupting
• Using "why" questions nonverbal skills - Correct answer-- Physical Appearance
• Posture
• Gestures
• Facial expression
• Eye contact
• Voice
• Touch closing interview questions - Correct answer-- Is there any further information?
• Does the patient have any question?
• What is the patient's priority? interviewing parent or caregiver - Correct answer-- Develop a rapport with both the parent/caregiver and the child
• Keep the child's developmental stage in mind when communicating communicating with infant - Correct answer-- Establish a rapport
• Gentle handling of an infant
• Quiet, calm voice communicating with toddler - Correct answer-- One direction at a time
• Use a friendly voice
• Explain what you are doing

• Keep it simple communicating with preschooler - Correct answer-- Take time for short, simple explanations
• Play can be used to explain
• Preschoolers' communication is direct, concrete & literal communicating with school-aged - Correct answer-- Make sure you are non-judgmental
• Interview the child and care-giver together
• Ask the child about any symptoms communicating with adolescents - Correct answer-- Demonstrate an attitude of respect
• Honest communication
• The patient will want to talk about themselves before discussing the health problem
• Explain what you are doing and why
• Provide privacy communicating with the older adult - Correct answer-- Address by proper surname
• Longer story to tell
• Allow for a longer response time interviewing hearing impaired patients - Correct answer-- Recognize hearing impairment
• Sign language interpreter
• Don't shout Interviewing Acutely Ill People - Correct answer-Combine interview with exam and life saving measures interviewing people under the influence of street drugs or alcohol - Correct answer-- Simple, direct questions
• Find out the time of the last drink or drug, how much was taken and what type interviewing cultural considerations - Correct answer-- Be non-judgmental
• Don't make assumptions
• Don't marginalize a homosexual couple working with an interpreter - Correct answer-- Used a trained interpreter
• Most hospitals have a video service
• Allow extra time for the interview
• Speak to the client, not the interpreter what is health literacy - Correct answer-- Understand instructions
• Navigate the health care system
• Communicate concerns with the health care provider patient teaching - Correct answer-- Keep it Simple

Hospitalizations Operations Obstetric history Immunizations Last examination date Allergies Current medications family history - Correct answer-- Age and health or cause of death of relatives

• Health of close family members Parents Grandparents Siblings Children health history cross-cultural care - Correct answer-- Spiritual resource and religion: assess if certain procedures cannot be done
• Health perception
• How does person describe health and illness
• How does person see problems he or she is now experiencing
• Nutrition: taboo foods or food combinations functional assessment - Correct answer-- ADLs
• Self-esteem, self-concept
• Activity and exercise
• Sleep and rest
• Nutrition and elimination
• Interpersonal relationships and resources
• Spiritual resources
• Coping and stress management
• personal habits
• Environment and work hazards
• Intimate partner violence
• Occupational Health
• Perception of health How to ask a patient about tobacco, alcohol, and illicit drugs CAGE - Correct answer-CAGE C = cut (drinking) A = annoyed (by drinking) G = guilty (for drinking) E = eye opener (drinking in the morning) pediatric health past history includes - Correct answer-Prenatal status Postnatal status Childhood illnesses

Serious accidents or injuries Serious chronic illnesses Operations or hospitalizations Immunizations Allergies Medications pediatric developmental history includes - Correct answer-- Growth

• Milestones: age when:
  • First held head erect
  • Rolled over
  • Sat alone
  • Walked alone
• Current Development
  • Gross motor skills
  • Language skills
  • Personal-social skills pediatric nutrition history - Correct answer-Infants:
• Breast or bottle fed Preschool - adolescents:
• 24 hour recall pediatric functional assessment - Correct answer-- Interpersonal relationships
• Activity and rest
• Home environment psychosocial interview for adolescents HEEADSSS - Correct answer-H = home E = education / employment E = eating A = activities D = drugs S = sexuality S = suicide and depression S = safety older adult health history - Correct answer-May have many chronic problems
• May be difficult to prioritized health problems
• Focus on health over past 5 years Current medications
• May be many medications from several different physicians
• Have patient bring in prescription bottles
• Include over-the-counter medications Types of violence - Correct answer-- Intimate partner violence
• Child abuse/neglect

• Consider history of injuries
  • Ask about: previous hospitalization, recent injuries and delay in seeking care. Is there a history of:
• Substance abuse in the family
• Financial stressors?
• Social stressors? physical exam of children - Correct answer-pay attention to:
• Bruising in "atypical" places such as buttocks, hands, feet, and abdomen is exceedingly rare and should arouse concern
• Any bruise in shape of an object should be considered highly concerning for abuse
• Bruising found in non-mobile children should raise concern abrasion - Correct answer-wound caused by rubbing the skin or mucous membranes bruise or contusion - Correct answer-injury to tissues without breakage of skin hematoma - Correct answer-localized collection of extravasated blood. hemorrhage - Correct answer-external or internal bleeding laceration - Correct answer-tearing or splitting of body tissue stab wound - Correct answer-penetrating, sharp, cutting injury patterned injury - Correct answer-an object leaves a distinct pattern on the skin traumatic alopecia - Correct answer-loss of hair from pulling and yanking documentation of abuse must include - Correct answer-- Detailed, non-biased nursing notes
• Photographs
• Description of injuries
• Patient statements
  • Verbatim, but within reason
  • Don't sanitize words
  • Any severe threats of harm made by perpetrator
  • Reports of past abuse can be paraphrased T/F screening for family violence is part of every health care encounter - Correct answer- True

T/F

Nurses should respond with sensitivity and caring to patients experiencing abuse and victimization - Correct answer-True T/F All states have mandatory reporting - Correct answer-True T/F "Proof" is not required for reporting - Correct answer-True skills performed during physical exam - Correct answer-Inspection Palpation Auscultation T/F inspection always comes first - Correct answer-True what does inspection require - Correct answer-Good lighting Adequate exposure what are you inspecting CSSS - Correct answer-Color Size Shape Symmetry what does palpation assess - Correct answer-it applies sense of touch to assess

• Texture
• Temperature
• Moisture
• Organ location and size
• Swelling, vibration or pulsation
• Rigidity or spasticity
• Crepitation
• Presence of lumps or masses
• Presence of tenderness or pain how long should stethoscope typing be - Correct answer-36-46 cm 14-18 in what does the diaphragm hear - Correct answer-high pitched sounds what does the bell hear - Correct answer-low pitched sounds T/F never listen through the gown - Correct answer-True

the older adult developmental competence - Correct answer-- Position on exam table

• Arrange sequence for as few position changes as possible
• Use physical touch when appropriate general survey - Correct answer-- a study of whole person
• ABCs
• Covers general health state and any obvious physical characteristics the moment you encounter the person
• What leaves an immediate impression? general survey objective data - Correct answer-- Age
• Gender
• Level of consciousness:
• Skin color
• Facial features
• Overall appearance: Any acute distress?
• body structure
• mobility
• behavior Underweight BMI - Correct answer-<18.5 kg/m Normal BMI - Correct answer-18.5 - 24. Overweight BMI - Correct answer-25 - 29. Obesity class 1 BMI - Correct answer-30 - 34. Obesity class 2 BMI - Correct answer-35 - 39. Obesity class 3 BMI - Correct answer-40 < increased waist circumference for women - Correct answer-35 or more inches increased waist circumference for men - Correct answer-40 or more inches infant general survey - Correct answer-- Physical appearance, body structure and mobility
• Behavior
• Level of alertness
• Parental bonding
• Measurement
• Weight
• Length/height
• Head circumference

(2 cm larger than chest)

• Chest circumference
• Plot on growth chart the general survey for the aging adult - Correct answer-Height Weight BMI Temperature values - Correct answer-Oral
• 35.8° - 37.3° C
• 96.4° - 99.1° F Rectal
• 0.4° - 0.5° (0.7° - 1° F) higher rectal temperature procedure - Correct answer-- insert 2-3 inches for adults
• ½ for infants tympanic membrane temperature procedure - Correct answer-Place into ear Aim toward tympanic membrane not as accurate as other devices temporal artery thermometer procedure - Correct answer-Slide the probe across the forehead and behind the ear
• More accurate than tympanic
• Accuracy is questionable radia pulse procedure - Correct answer-- Use pads of first 3 fingers
• Flexor aspect of the wrist
• Laterally along the radius bone
• If regular: count for 30 seconds and multiply by 2
• If irregular; count for a full minute Normal newborn HR - Correct answer-Resting awake: 100- Resting asleep: 80- Exercise/fever: up to 220 Normal 1wk-3mo HR - Correct answer-Resting awake: 100- Resting asleep: 80- Exercise/fever: up to 220 3mo-2yo HR - Correct answer-Resting awake: 80- Resting asleep: 70- Exercise/fever: up to 220 2-10yo HR - Correct answer-Resting awake: 70-

• Inaccurate cuff size
• Deflating cuff too quickly
• Deflating cuff too slowly normal o2 saturation - Correct answer-97% - 99% Nociception - Correct answer-Occurs due to actual or potential tissue damage neuropathic - Correct answer-- an abnormal processing of pain message
• This type of pain is most difficult to assess and treat
• Often perceived long after site of injury heals
• Sustained on a neurochemical level that cannot be identified by x-ray, CT scan, or MRI
• Electromyography and nerve-conduction studies may be needed referred pain - Correct answer-Pain that is felt at a particular site but originates from another location is termed referred pain types of pain - Correct answer-acute chronic breakthrough acute pain - Correct answer-Short term and self-limiting
• Surgery
• Trauma
• Kidney stones chronic pain - Correct answer-Continues for 6 months or longer
• does not stop when the injury heals
• Level of pain intensity does not correspond with the physical findings breakthrough pain - Correct answer-Transient spike in pain level
• Moderate to severe
• Otherwise controlled pain syndrome infant pain risk - Correct answer-- Infants have same capacity for pain as adults
• Preverbal infants are at high risk for under-treatment of pain aging adult pain risk - Correct answer-- No evidence exists to suggest that older individuals perceive pain to a lesser degree or that sensitivity is diminished
• Assumption that pain should be expected in aging
• Under reporting of pain
• Less aggressive treatment
• Dementia decreases the person's ability to report pain. gender differences in pain - Correct answer-Men
• Raised to be more stoic about pain

Women

• Affective or emotional displays of pain are more accepted for women
• Hormonal changes are found to have strong influences on pain sensitivity cultural differences in pain - Correct answer-Language barriers Pain perceptions and tolerance Expression of pain opioids - Correct answer-Produce pain relief and euphoria Physical dependence Can lead to addiction side effects of opioids - Correct answer-Respiratory depression leading to respiratory arrest Severe constipation PQRST pain assessment - Correct answer-P = palliative factors / provocative factors Q = quality R = region / radiation S = severity T = timing nonverbal behaviors of acute pain - Correct answer-- Guarding
• Grimacing
• Moaning
• Agitation
• Restlessness
• Stillness
• Diaphoresis
• Change in vital signs nonverbal behavior of chronic pain - Correct answer-- Person adapts over time
• May be limited behavioral cues to pain
• Bracing
• Rubbing
• Diminished activity
• Sighing
• Change in appetite
• Sleeping FLACC pain assessment for nonverbal patients (infants, children, nonverbal adults) - Correct answer-F = face L = legs A = activity

• Sleep apnea
• Chronic kidney disease
• Gallstones
• Gastroesophageal reflux obesity - Correct answer-For adults:
• Overweight defined as BMI of 25 or greater
• Obesity defined as BMI of 30 or greater
• 1/3 of children/adolescents are overweight or obese
• 2/3 of adults are overweight or obese
• 1/3 of adults are obese obesity etiology - Correct answer-- Genetic predisposition
• Dietary intake
• Physical inactivity
• Obesogenic environment
  • Encourages large portions
  • High-fat, energy-dense foods
  • Fails to encourage healthy behaviors
  • Physical activity Developmental Competence: Infants and Children - Correct answer-Breast milk is recommended for first year
• Fewer food allergies
• Less cost that formula
• Increased mother-infant bonding time No cow's milk till 1 year old No skim or low-fat milk till at least 2 years old Developmental Competence: Adolescence - Correct answer-Factors that affect teens' diet:
• Skipped meals
• Excessive fast food
• Sweetened beverage consumption
• Limited fruit and vegetable intake
• Peer pressure
• Alternative dietary pattern
• Eating disorders
• Hectic schedules
• Possible use of drugs and/or alcohol Recommendations for Exercise
• At least an hour of physical exercise every day
• Exercise should include

• Aerobic exercise
• Bone-strengthening and muscle-strengthening workouts Developmental Competence: The Aging Adult - Correct answer-Factors that affect nutritional status:
• Poor dentition
• Decreased visual acuity
• Decreased saliva production
• Slowed GI motility
• Decreased GI absorption
• Diminished olfactory and taste sensitivity Lower energy/calorie needs Exercise needs:
• Aerobic and resistance training nutrition screening - Correct answer-Identify individuals at nutrition risk:
• Recent weight loss
• Inadequate food intake
• Recent illness
• Use the screening tool approved by your facility assess dietary intake - Correct answer-24-hour recall Food frequency questionnaire Food diary Calorie count nutrition assessment subjective data - Correct answer-- eating patterns
• usual weight
• Changes in appetite, taste, smell , chewing, swallowing
• Recent surgery, trauma, burns, infection
• Chronic illnesses
• Nausea, vomiting, diarrhea, constipation
• Food allergies or intolerances
• Medications and/or nutritional supplements
• patient centered care
• exercise and activity patterns nutrition assessment objective data - Correct answer-- height
• weight
• BMI
• waist circumference fasting glucose value - Correct answer-fasting <