NURS 309 Exam #1 Study Guide Questions With Complete Solutions, Exams of Nursing

Download NURS 309 Exam #1 Study Guide Questions With Complete Solutions and more Exams Nursing in PDF only on Docsity! NURS 309 Exam #1 Study Guide Questions With Complete Solutions Define mental disorder. Correct Answers -clinically significant behavioral emotional or cognitive syndrome that is associated w/ significant distress or disability involving social, occupational, or key activities Define mental status. Correct Answers -a person's emotional and cognitive functioning -optimal functioning aims toward simultaneous life satisfaction in work, caring relationships, and w/n self -strikes balance b/n good and bad days, allowing person to function socially and occupationally Define mental status. Correct Answers -cannot be scrutinized directly like the characteristis of skin or heart sounds -functioning interferred through assessment of individual's behavior: >consciousness, language, mood, and affect >orientation and attention >memory and abstract reasoning >thought process, through content, perception Describe acculturation. Correct Answers -process of adopting the culture and behavior of majority culture -assimilation: unidirectional in linear fashion -biculturalism + integration: allow for reciprocal change and maintaining ethnic identity -acculturative stress: based on input from environment, social/interpersonal and societal Describe achondroplastic dwarfism. Correct Answers -genetic -normal trunk -short arms and legs -short stature Describe acromegaly (hyperpituitarism). Correct Answers - adult: increased face, head, hands, feet size Describe anorexia nervosa. Correct Answers -psychological life threatening, weight loss and amenorrhea Describe auscultation technique. Correct Answers -eliminate extra noise -keep environment warm and warm stethoscope -avoid listening over hairy body areas -never listen through patient's gown or clothing -avoid your own artifact Describe auscultation. Correct Answers -stethoscope doesn't magnify sound, blocks out extraneous sounds -diaphragm: flat edge, high pitched sounds -bell: deep, hollow cuplike shape, soft pitched sounds -turnable diaphragms: allows you to listen to both high pitched and soft pithced sounds Describe characteristics of culture. Correct Answers -*learned* from birth through process of language acquisition and socialization -*shared* by all members of the same cultural group Describe percussion sounds. Correct Answers -tympany: over hollow organs (abdomen) -resonance: over organ that has air in it (lung) -dullness: when hit something solid (liver) -flatness: if hit something very solid, like bone Describe percussion technique. Correct Answers -stationary hand: pleximeter - middle finger hyperextension -striking hand: plexor - striking finger -structure w/ more air produces louder, deeper sound compared w/ denser structure -variations occur in clinical practice based on individual anatomical differences Describe percussion. Correct Answers -tap patient -percussion has following uses: mapping organs, determine density of structure, find abnormal mass (only goes down 5 cm) -may cause pain -deep tendon reflexes Describe spirituality and religion and how they influence pt. care. Correct Answers -spirituality: broader term that encompasses something larger than one's own existence with a belief in transcendence -religion: refers to an organized system of beliefs as shared experience that can assist in meeting one's individual spiritual needs -two two concepts can be interrelated but do not have to exist simultaneously -individuals define their feelings and beliefs Describe subjective and objective data. Correct Answers - subjective: data pt. gives you about themselves, something they feel (ex: knee pain) -objective: data collected using assessment skills (inspection, auscultation, etc.) Describe the steps to cultural competence. Correct Answers - culturally sensitive: caregivers possess basic knowledge and understanding -culturally appropriate: caregivers apply knowledge to improve health outcomes -culturally competent: caregivers apply a universal concept of understanding to all contextual aspects of care -cultural care: provision of health care across cultural boundaries in consideration of context Explain methods to keep pt. safe and comfortable during examination. Correct Answers -Standard Precautions: >hand hygiene, PPE, respiratory hygiene/cough etiquette -pt. usually anxious, try to reduce so they can be comfortable and data gathered will be more accurate How to perform orthostatic vitals? Correct Answers -supine 2- 3 min, take baseline pulse and BP, repeat with sitting and standing -if too weak/dizzy to stand, assess BP supine and the w/ legs dangling -record BP using even numbers -record position, arm used, cuff size -record pulse rate and rhythm, note where pulse regular -position chang from supine to standing normally slight decrease in systolic Identify and set priorities. Correct Answers -1st level priorities: life threatening, immediate priorities (ABCV) -2nd level priorities: urgent needs, but won't die immediately (ex: acute pain, abnormal potassium, low blood glucose) -3rd level priorities: important for patient's health; interventions are long-term, may require collaboration among HC professionals (ex: developing healthy plan for diabetic) Identify characteristics of critical thinking. Correct Answers - novice: starting out in learning, uses rules to guide performance -competent: building on 2-3 years of clinical experience, see actions in context of pt. goals or plans -proficient: adding time to experience, understands pt. situation as a whole rather than individual parts - apply long term goals -expert: attained mastery of an area of learning, performs clinical judgement using ituitive analysis Identify characteristics of diagnostic reasoning. Correct Answers -attend to available cues (pick up on pieces of info pt. gives you) >ex: pt. alert and oriented when first came in, now confused and clammy -formulate diagnostic hypothesis (make a guess about what is happening) >ex: pt. diabetic, maybe low blood sugar? -gather data relative to hypothesis >ex: take blood sugar -age, birth date, birthplace -gender (identification) and relationship status -race and ethnic origin -occupation: usual and present -primary language: language-concordant provider or medical interpreter Identify elements of family history. Correct Answers - highlights diseases/conditions that individual may be at risk for -provides age and health or cause of death of relatives -ability based on results to seek early screening, make possible lifestyle adjustments, undergo periodic surveillance -pedigree or genogram used as standardized tool to organize data Identify elements of past health. Correct Answers -childhood illnesses -accidents/injuries -serious or chronic illnesses -hospitalizations -operations -obstetric history -immunizations -last examination date -allergies -current meds Identify elements of source of history. Correct Answers -record who furnishes information, usually pt., but might be relative or friend -judge reliability of informant and how willing he or she is to communicate -note any special circumstances like use of interpreter Identify elements of symptom analysis. Correct Answers -P: provocative or palliative -Q: quality or quantity -R: region or radiation -S: severity scale 1-10 -T: timing or onset -U: understand patient's perception of problem Identify elements of the interview. Correct Answers -location: time and place w/ follow-up for physical exam -explanation: introduction and delineation of role -purpose: mutual goal is optimal health -time frame: length of time for process -participation: expected participation and/or presence of others -confidentiality: reasonable and/or limited as it applies to legal/ethical standards -cost: disclosure of any financial costs Identify levels of consciousness. Correct Answers -alert -lethargic (somnolent): not fully alert, drifts off when not stimulated -obtunded: sleeps most of time, difficult to arouse, speech may be mumbled/incoherent -stupor (semi-coma): spontaneously unconscious, responds only to persistent shake/pain -coma: unconscious, no response to pain or stimuli -delirium: clouding of consciousness, inattentive, incoherent, impaired recent memory, often agitated Identify methods for determining health literacy. Correct Answers -ability to understand and follow directions, navigate the healthcare system, and communicate concerns to healthcare provider -pt may be literate but not have health literacy -techniques to improve health literacy: >oral teaching >written materials based on standard educational level (5th grade reading) >teach back method (return demonstration) Identify normal and abnormal findings for BMI. Correct Answers -underweight: <18.5 -normal: 18.5-24.9 -overweight: 25-29.9 -obesity: 30+ -extreme obesity: 40+ Identify normal and abnormal findings for general survey. Correct Answers -physical appearance: appears older than stated age, delayed/precocious puberty, confused, drowsy, pallor/cyanosis, jaundice -body structure: excessively short or tall, obesity, stiff/tense, won't lie down, fetal position -mobility: stagger/stumbling, difficulty stopping, paralysis, jerky Identify normal and abnormal findings for vital signs. Correct Answers -temperature: 98.6 -Blacks: second largest population -Asians, American Indians, Alaska Natives, Native Hawaiians, and other Pacific Islanders make up 3rd largest part of population Understand normal adult vs. age-related changes in VS, general survey, body measurements. Correct Answers -general survey: >physical appearance: sharp, angular face >posture: flexion >gait: wider base, shorter steps -measurement: >weight: lose weight >redistribution of fat >height: shorter >legs: look longer Understand normal adult vs. aging adult mental status exam. Correct Answers -check sensory status, vision, and hearing before beginning any aspect of mental status exam -behavior: may need to use Glasgow Coma Scale to assess LOC -cognitive function: may be oriented to person and type of setting if in LTC facility >some age-related decline in recent memory Understand the process of communication. Correct Answers - sending: verbal + nonverbal communication -receiving: requires mutal understanding by sender and receiver -internal factors: liking others, empathy, ability to listen, self- awareness -external factors: ensure privacy, avoid interruptions, physical environment, dress, note-taking, documenting in EHR Understand the purpose of health history. Correct Answers -to collect subjective data -provides a complete picture of patient's past and present health -can be used as screening tool for detection of abnormalities -identify risk reduction and health promotion behaviors What are the three traditional causes of illness? Correct Answers 1. biomedical/scientific: cause and effect that can provide physical and psychological illness (ex: germ theory) 2. naturalistic or holistic: belief in forces of nature that there is balance in the universe (ex. yin/yang theory) 3. magicoreligious: supernatural forces dominate resulting in good versus evil (ex. voodoo or faith healing) What different types of data should be gathered during an assessment? Correct Answers -complete (total health) database: all health hx, physical assessment, creating database for initial stage of care (ex: brand new pt, new hospital admit) -focused (problem-centered) database: if pt. has specific problem (ex: rash - do assessment/database for particular problem) -follow-up database: on a problem to see if it's gotten better or worse (ex: if rash pt. back, only assess to see if improved or not) -emergency database: assessment while giving life saving measures (ex: pt. bleeding on ground, putting pressure while asking questions about what happend) When would you take orthostatic vital signs? Correct Answers -you suspect volume depletion -person is known to have hypertension or taking antihypertensive meds -person reports fainting or syncope