HESI practice notes - nursings sciences

Which statement about Orem's theory needs to be corrected?
1. It determines self-care needs.
2. It explains the types of nursing care.
3. It aids in the design of nursing interventions.
4. It describes factors supporting the health of the family.

4

Which statement made by a nursing student about Swanson's theory of caring needs correction?
1. The components of Swanson's theory of caring provide a foundation of knowledge for nurses to direct and deliver caring nursing practices.
2. Swanson's theory of caring defines five components of caring: knowing, being with, doing for, enabling, and maintaining belief.
3. Swanson's theory of caring provides a basis to help nurses understand how clients cope with uncertainty and the illness response.
4. Swanson's theory of caring was developed by Kristin Swanson by conducting extensive interviews with clients and their professional caregivers.

3

which theory describes nursing interventions fora specific phenomenon and the expected outcome of care?
-grand theories
-predictive theories
-descriptive theories
-prescriptive theories

prescriptive theories

who benefits from medicare?

people 65 and older

a record that contains descriptive and objective info about what a nurse sees, hearas, feels, and smells

factual record

a record that communicates info in a logical order

organized record

the nurse prepares a _______ record by providing a complete and appropriate record that includes all essential info

complete

_______ theory:
-explains the factors within a client's living situation
-these factors may support or interfere with the client's self-care abilities, but they do not refer to the family's health
-this theory interprets data that determine a client's self-care needs, self-care deficits, and self-care abilities
-explains, predicts, or describes nursing care that will help the client in bettering his or her health
-aids in the design of nursing interventions for the promotion of self-care by the client during times of illness, such as asthma, diabetes mellitus, or arthritis

orem's theory

_____ theory:
-provides a basis for identifying and testing nurse caring behaviors to determine if caring will improve client health outcomes
-provide a foundation of knowledge for nurses to direct and deliver caring nursing practices
-defines five components of caring: knowing, being with, doing for, enabling, and maintaining belief
-developed by Kristin Swanson by conducting extensive interviews with clients and their professional caregivers

Swanson's theory of caring

______ theories provide a basis to help nurses understand how clients cope with uncertainty and the illness response

middle-range

________ database is a good source of biomedical and pharmaceutical studies

EMBASE

_____ is the health science library at the national library of medicine; this database offers free access to many journal articles

PubMed

______ includes studies in medicine, nursing, dentistry, psychiatry, veterinary medicine, and allied health

MEDLINE

_______ is a good resource for pschology and psychology-related healthcare disciplines

PsychINFO

(1) ________ theories detail nursing interventions for a specific phenomenon and the expected outcome of the care
(2) ________ theories provide the structural framework for broad, abstract ideas about nursing
(3) ________ theories identify conditions or factors that predict a phenomenon
(4) ________ theories help to explain client assessments.

prescriptive grand predictive descriptive

provides a basis for identifying and testing nursing care behaviors to determine if caring improves patient health outcomes

swanson's thoery of nursing

theory focuses on stressors perceived by the client or caregiver.

neuman's system theory

explains the factors within a client's living situation that support or interfere with his or her self-care ability

orem's self-care deficit theory

focuses on a client's experiences with cancer while living with continual uncertainty.

mishel's theory of uncertainty in illness

maslow's hierarchy of needs

physiological safety belonging/love esteem self-actualization

(1) rely on a combination of dietary, herbal, and other naturalistic therapies to prevent and treat illness
(2) use yin treatment (which uses needles to restore balance and flow of qi) and yang treatment (which uses moxibustion or heat with acupuncture to restore the yin/yang balance)
(3) use a combo of prayers, herbs, and other rituals to treat traditional illnesses
(4) rely on a combo of prayers, chanting, and herbs to treat illnesses caused by supernatural, physiologic, and physical factors

-asian indians -east asians -hispanics -native americans

(1) used to determine the hours of care and staff required for a given group of clients
(2) helps to assess data about a client; data includes vitals and routine repetitive care
(3) based on an institution's standards of nursing practice and preprinted and established guidelines used to care for clients who have similar health problems
(4) includes meds, diet, community resources, follow-up care, and med contact info in case of emergency or query
<b>discharge documentation, acuity record, flow sheet, standardized care plan</b>

acuity record flow sheet standardized care plan discharge documentation

what focuses on palliative care?

hospice

SOAP?

-includes assessment info or diagnoses based on data -subjective, objective, assessment, plan -originates from medical records

internal or external factors:
-intellectual background
-family practices
-cultural background
-SES factors

only internal = intellectual

A registered nurse is teaching a nursing student about systems theories with a specific reference to Neuman's systems theory. Which statements made by the nursing student post teaching are accurate? Select all that apply.
1. "Factors that change the environment also affect an open system."
2. "The components are interrelated and share a common purpose to form a whole."
3. "A system is composed of separate components and the components can be open or closed."
4. "Neuman's systems theory defines a total-person model of holism and a closed-systems approach."
5. "An open system interacts with the environment, with an exchange of information between the system and the environment."

1, 2, 5

In __________, nurses living within a neighborhood provide services to older clients or those unable to leave their homes. Health promotion throughout a school curriculum is provided by school health. Nurse-managed clinics provide nursing services with a focus on health promotion and education, chronic disease assessment management, and support for self-care and caregivers. Community health centers are outpatient clinics that provide primary care to a client population living in a community.

block and parish nursing

In experimental research, the investigator controls the study variable and randomly assigns subjects to different conditions to test the variable. In ______ research, studies are designed to establish facts and relationships concerning past events. In evaluation research, studies test how well a program, practice, or policy is working. _______ research is an initial study designed to develop or refine the dimensions of phenomena or to develop or refine a hypothesis about the relationships among phenomena.

historical, exploratory

______'s theory focuses on nursing by caring through the environment. Nightingale's theory is oriented toward providing fresh air, light, warmth, cleanliness, quiet, and adequate nutrition. Nightingale's theory focuses on helping the client deal with the symptoms and changes in function related to an illness. Nightingale's theory does not limit nursing to the administration of medications and treatment. Nightingale's theory suggests that nurses do not need to know all about the disease process, which differentiates nursing from medicine.

nightingale's theory of

-right task, right circumstances, right person, right direction/communication, right supervision/evaluation

five rights of delegation

According to Swanson's theory, the nurse is engaging in ______ when explaining the care of a neonate to a parent. ________ includes informing/explaining/supporting/allowing, focusing, generating alternatives, validating, and giving feedback. The process of _______ includes avoiding assumptions, centering on the one being cared for, assessing thoroughly, seeking cues, and engaging the self or both. The process of ______ for includes comforting, anticipating, performing skillfully, protecting, and preserving dignity. The process of ______ with includes being there, conveying ability, sharing feelings, and not burdening.

enabling knowing doing being

domains of nursing intervention:
(a) includes care that supports physical functioning
(b) involves care that supports protection against harm
(c) incorporates care that supports psychosocial functioning and facilitates lifestyle changes
(d) includes electrolyte and acid-base management; physiologic complex, includes care that supports homeostatic regulation

1 4 3 2

Which is an example of an actual nursing diagnosis?

Risk for acute confusion

Impaired social interaction

Readiness for enhanced nutrition

Readiness for increased family coping

impaired social interaction

what kind of theory is Neuman's system model?

grand theory

_____ theory: the goal of nursing is to use communication to help the client reestablish a positive adaptation to his or her environment

king's theory

_____ theory: the goal of nursing is to develop and interaction b/w nurse and client; interpersonal relationships b/w nurse, client, and client's family

peplau's theory

______ theory: the goal of nursing is to facilitate the reparative processes of the body by manipulating

nightingale's

______ theory: the goal of nursing is to focus on a client's need for caring as a means of coping with stressors of illness

benner and wrubel

what kind of approach is evidence-based care?

problem solving

the tendency of a person to hold his or her own beliefs superior to those of other people; causes biases and prejudices

ethnocentrism

occurs when a nurse or health care provider ignores the differences b/w his or her own culture and others and imposes his or her beliefs on people of other cultures

cultural imposition

a nurse questions the staff about a change in a client's plan of care - what does this demonstrate?

authority

Henderson's theory comprises 14 basic needs of the whole person and includes phenomena from the following domains of the client: physiological, psychological, sociocultural, spiritual, and developmental. Orem's self-care deficit theory focuses on the client's self-care needs. The Neuman systems model is based on stress and the client's reaction to the stressor. Nightingale's concept of the environment includes the suggestion that nurses do not need to know all about the disease process differentiated nursing from medicine.

...

______ theory is organized into 14 basic needs of the whole person and includes phenomena from the following domains of the client: physiological, psychological, sociocultural, spiritual, and developmental

henderson's

Mishel's theory of uncertainty in illness is not an example of a grand theory; it is a middle-range theory. Neuman's systems model is a grand theory. Grand theories require further specification through research. Grand theories are systematic and broad in scope and complexity. Grand theories do not provide guidance for specific nursing interventions; instead they provide the structural framework for broad and abstract ideas about nursing.

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room

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room

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state-operated program that provides long-term care to low-income families and disabled older clients

medicaid

The nurse suspects that the client is in the stage of contemplation. This stage of health behavior is characterized by the client's attitude toward a change and the client is most likely to accept that change over the next 6 months. In the preparation stage, the client believes that a change in behavior will be advantageous. The client may need assistance to bring about the change in behavior. During the maintenance stage, changes need to be implemented in the client's lifestyle. In the precontemplation stage, the client is not willing to receive any information about changes in behavior and may become defensive and confrontational.

...

what model views the client as an adaptive system - the need for care occurs when a client cannot adapt to internal and external environmental demands
-goal of nursing is ot help a person adapt

roy adaptation model

<b>types of children?</b>
(1) adapts slowly with frequent communication and reacts to novelty with mild but passive resistance
(2) highly active, irritable, irregular habits
(3) regular and predictable habits
(4) reacts negatively with mild intensity to new stimuli

slow to warm up difficult easy slow to warm up

what type of questioning is asking a pt to rate pain on scale of 0 to 10?

close ended

question type?
-asking whether anything else is bothering the client

probing

"all right" and "go on" are examples of? encourages client to give more details

back channeling

a standardized survey developed to measure client perceptions of their hospital experience. The survey asks 27 questions about the client's hospital experience. The survey is taken by clients who were discharged from the hospital between 48 hours and six weeks ago.

HCAHPS

a data-driven approach to process improvement that reduces variation in the process

six sigma

focuses on the improvement of processes. It studies each step of a process to determine if that step adds value to that process. It also determines if the process reduces the organization's time, cost, and resources

value stream analysis

created HEDIS to collect various data to measure the quality of care and services provided by different health plans. It is the database of choice for the Centers for Medicare and Medicaid Services.

NCQA (national committee for quality assurance)

content vs feedback vs output?
(1) data or info from client's assessment
(2) serves to inform a system about how it functions
(3) product and info obtained from the system
(4) end product of a system

input feedback content output

model of primacy of caring is the basis of _____ - focuses on client's need for caring as a means of coping with stresses of illness

benner and wrubel's theory

what theory defines the outcome of nursing activity in regard to the HUMANISTIC aspects of life and promotes health, restoring the client to health, and preventing illness

watson's theory of transpersonal caring

what theory is based on stress ann the client's reaction to the stressor?

neuman's theory

(1) an inaccurate match b/w clinical cues and the nursing diagnosis, using insufficient number of cues, using unreliable cues
(2) failure to validate data
(3) includes inaccurate data, missing data, disorganization
(4) includes insufficient cluster of cues, premature or early closure, or incorrect clustering

interpreting error labeling error collecting errors errors at clustering level

(1) 0-18 inches is distance, example is changing perineum dressing
(2) lecturing students
(3) client's bedside taking history or teaching client individually
(4) special care needed

intimate zone public zone personal zone vulnerable zone

what theory is action-oriented?

prescriptive

(1) refers to analysis of the client's biological and psychosocial data to find out the relevant issues and problems
(2) the procedure of assessing the desired outcomes of treatment. (3) done at the very beginning when the nurse collects the data about the client to make an accurate diagnosis.
(4) giving a shot

diagnosis evaluation assessment implementation

what are the three levels of critical thinking in nursing judgment?

basic critical thinking (nurse has faith that expert has right answer), complex critical thinking (nurse analyzes info from expert), commitment (make decisions without help from others)

(1) reviews the quality, quantity, and cost of hospital care
(2) defined a list of 28 "Never Events" in health care. Death or injury due to medication error is an example of a "Never Event."
(3) a group of 28 organizations from a variety of health care disciplines that work together to transform health care on a national level.
(4) have utilization review committees to review admissions and identify and eliminate overuse of diagnostic and treatment services for clients on Medicare.

PSROs national quality forum national priorities partnership medicare-qualified hospitals

(1) comprises 14 basic needs of the whole person and includes phenomena from the following domains of the client: physiological, psychological, sociocultural, spiritual, and developmental
(2) focuses on the client's self-care needs
(3) based on stress and the client's reaction to the stressor.
(4) includes the suggestion that nurses do not need to know all about the disease process differentiated nursing from medicine.

henderson's theory orem's self care deficit theory neuman's systems model nightingale's concept of the environment

health belief model?

The first component is an individual's perception of susceptibility to an illness. The second component is an individual's perception of seriousness of an illness. The third component is the preventive actions taken by a person. The health promotion model focuses on behavioral outcomes, behavior-specific knowledge and affect, and individual characteristics and experience.

_____ has the ability to establish an appropriate care plan based on the assessment of clients and families

case manager

________ theories describe a phenomenon such as grief or caring

descriptive

Providing short-term relief to the family caregiver aka?

respite care, used with hospice

Neuman systems model is an example of a grand theory that provides a comprehensive foundation for scientific nursing practice, education, and research. Theories related to growth and development are descriptive theories. Prescriptive theories address nursing interventions for a phenomenon, describe the condition under which the prescription occurs, and predict the consequences. Mishel's theory of uncertainty is a prescriptive theory. Middle-range theories tend to focus on a specific field of nursing. Mishel's theory of uncertainty in illness is a middle-range theory.

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Mishel's theory of uncertainty in illness is not an example of a grand theory; it is a middle-range theory. Neuman's systems model is a grand theory. Grand theories require further specification through research. Grand theories are systematic and broad in scope and complexity. Grand theories do not provide guidance for specific nursing interventions; instead they provide the structural framework for broad and abstract ideas about nursing.

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Assessment involves the collection of comprehensive data pertinent to the client's health. During the planning level of nursing care, the nurse develops a plan that prescribes strategies and alternatives to attain expected outcomes. The nurse analyzes the assessment data to determine the diagnoses during the diagnosis level of nursing practice. The nurse implements the health care plan identified for the client during the implementation level of the standards of nursing practice. This level may include administering prescribed medications or healthcare procedures.

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The Roy adaptation model views the client as an adaptive system. The need for nursing care occurs when a client cannot adapt to internal and external environmental demands. Roy's model believes the goal of nursing is to help a person adapt to changes in physiological needs, self-concept, role function, and interdependent relations during health and illness. All individuals must adapt to the following demands: meeting basic physiological needs, developing a positive self-concept, performing social roles, and achieving a balance between dependence and independence.

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The nurse is exercising the preinteraction phase when he or she collects medical data from the client's caregivers. During the working phase, the nurse motivates the client to exercise self-exploration about his or her own health condition and the nurse uses appropriate self=disclosure and confrontation. The nurse tries to form a healthy relationship with the client during the orientation phase. The termination phase is when the nurse winds up the conversation and evaluates goal achievements with the client.

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which phase of erikson's includes self-care like feeding/dressing

autonomy vs shame/doubt

The program on caring for the elderly with dementia offered by a university is an example of a continuing education program. Such programs are formal, organized educational programs offered by universities, hospitals, or professional nursing organizations. An in-service education program is held in the institution or health care agency to increase the competencies of the nurses employed there. Therefore the programs on culturally sensitive approaches in health care, use of computers, and safe principles for administering chemotherapy are in-service educational programs.

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In the preoperational stage, the infant may learn to think with the use of symbols and mental images. In the sensorimotor stage, the individual may learn about the environment through motor and reflex actions. In the sensorimotor stage, the individual may develop schema or action patterns in order to deal with the environment. In the concrete operations stage, the individual may develop the ability to mentally classify objects according to their quantitative dimensions.

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The nurse practices autonomy by initiating independent nursing interventions without medical orders. Autonomy is an essential element of professional responsibility. The nurse explains concepts and facts related to health, but does not advise the client. The nurse acts as a client's advocate by speaking for the client and protecting the client's health care rights. As a caregiver, the nurse helps the client to improve physical, emotional, spiritual, and social well-being.

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The major concept of Leininger's theory is cultural diversity, where the goal is to provide a client with culturally specific nursing care. S

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After asking the clinical question, the nurse should gather the most relevant and best evidence. The nurse may perform a critical appraisal after gathering all the necessary evidence. Sharing the outcomes of the evidence-based practice changes with others is the last step of the decision-making process. After gathering relevant evidence and appraising the same, the nurse should integrate it with clinical expertise and client preferences.

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(1) _______ research studies are initial studies that are conducted to develop or refine dimensions of phenomena or to develop a hypothesis about the relationships among phenomena.
(2) _______ research focuses on determining the effectiveness of a program, practice, or policy.
(3) _______ research focuses on measuring the characteristics of people, situations, or groups and the frequency with which certain events or characteristics occur.
(4) _______ research aims to explore variables of interest without any active intervention by the researcher.

exploratory evaluation descriptive correlational

The client receives restorative care during rehabilitation. This care helps to restore the client to the fullest physical, mental, social, vocational, and economic potential. Immunization is an example of preventive care. The focus is on reducing and controlling risk factors for disease. Adult day care centers are an example of continuing care. The nurses in these centers provide continuity between care delivered in the home and the center. Tertiary health care is provided to acutely ill hospitalized clients who need comprehensive and specialized health care.

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kohlberg's theory of moral development stages

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<b>helping relationships phases:</b>
(1) when the nurse collects medical data from the client's caregivers
(2) when the nurse motivates the client to exercise self-exploration about his or her own health condition
(3) when nurse tries to form a healthy relationship with the client
(4) when the nurse winds up the conversation and evaluates goal achievements with the client

preinteraction phase working phase orientation phase termination phase

A registered nurse is teaching a nursing student about evidence-based practice. Which statements should the nurse include in the teaching?

"The funding source is usually external, such as a grant."

"Evidence-based practice is conducted by practicing nurses and other healthcare team members."

"Institutional review board approval is not needed to implement evidence-based practice."

"Evidence-based practice uses information drawn from research to determine safe and effective nursing care."

"Evidence is generated to find the answers for questions that are unknown about nursing practice."

2, 3, 4

read over: ^^

Evidence-based practice is conducted by practicing nurses and other members of the healthcare team. Institutional review board (IRB) approval is not needed to implement evidence-based practice. However, approval is required to conduct research. Evidence-based practice uses information from research, professional experts, and personal experience to determine safe and effective nursing care with a goal of improving the patient care and outcomes. The funding source is internal (from a healthcare agency) for evidence-based practice. An external funding source, such as a grant, is required for research. Evidence-based practice focuses on the implementation of evidence already known in practice. However, in case of research study, evidence is generated to find answers for questions that are not known about nursing practice.

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maslow's hierarchy of needs levels

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FREUD'S PSYCHOANALYTIC STAGES:
In the oral stage, the infant realizes that he or she is a separate individual. In the Oedipal stage, the infant develops an Electra complex feeling where the child fantasizes about the parent of the opposite sex as his or her first love interest. In the anal stage, the infant changes the pleasure focus to the anal zone. In the anal stage, the infant delays gratification to meet parental and societal expectations.

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Kohlbergs theory of moral development:
In the "social contract orientation" stage, an individual recognizes that the law needs to be changed in order to improve society. In the Society-Maintaining Orientation stage, an individual understands that certain actions are not done not because it can lead to punishment, but because the act is not right. In the Instrumental Relativist Orientation stage, a child understands that punishment is not a proof of being wrong, but is an action that one wants to prevent. In the Punishment and Obedience Orientation stage, a child thinks that he or she may get punished if he or she does not adhere to the rules and regulations.

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Telemedicine uses advanced technology to connect rural hospitals to specialists for consultation. Many big-city health care systems are branching out and merging with rural hospitals to provide better health care. Medicare is a federally administered health insurance program for people 65 years of age or older. Medicaid is a federally funded, state-operated program that provides health insurance to low-income families. Critical access hospitals are rural hospitals with no more than 25 inpatient beds. These hospitals provide emergency care to stabilize clients before they are transferred to a larger hospital.

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The stage of designing the study is when the nurse chooses the instrumentation for conducting the study. In this stage, the nurse prepares questionnaires and selects physiological measures, interviews, and treatments necessary for the study. The first stage of the research process involves identifying of the problem. At this stage the nurse may gather all relevant articles and review literature for the purpose of conducting the research. The stage of conducting the study involves the nurse obtaining approval from the appropriate authorities and enlisting research subjects. The nurse also monitors whether all investigators are following the appropriate study protocol in order to ensure accuracy of the findings.

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Narrative documentation is the use of a story-like format to document information specific to the client's conditions and nursing care. Acuity records are not part of a client's medical record; they are used to determine the hours of care and staff required for a given group of clients. Source records have a separate section for each discipline such as an admission sheet, nursing records, and medications. These are used for recording information from a client's admission until discharge. This documentation is not done in a story-like format. Hand-off reports are reports that get transferred from one healthcare provider to another. The purpose of hand-off reports is to provide better continuity and individualized care for clients.

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During the sensorimotor stage, the child learns that objects continue to exist even when they cannot be seen, heard, or touched. This is called object permanence. During the preoperational stage, the child learns to think with the use of symbols and mental images. In the formal operations stage, the child's egocentric thoughts would be prevalent and the child believes that his or her actions and appearance are constantly being scrutinized. In the concrete operations stage, the child is able to perform mental operations.

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piaget's stages

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-theory focused on the prescribed medication under particular circumstances
-nursing-intervention specific

prescriptive theory

The nurse is using cultural desire as a part of cultural competence. This component is related to motivation and commitment towards the care of an individual. Through this, an immigrant may become open to cultural differences and accept them. Cultural awareness is an in-depth self-examination of backgrounds and recognizing biases and prejudices. Cultural knowledge is a comparative study about the beliefs and care practices of other cultures. Cultural encounter is about transcultural interactions for effective communication and development.

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Input is the data or information that comes from a client's assessment, such as how the client interacts with the environment and the client's physiological function. Output is the end product of a system. The content is the information about nursing interventions for clients with specific healthcare problems. Feedback involves the assessment of how a system functions.

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A difficult child is highly active, irritable, and irregular in habits. A difficult child displays an intense and primarily negative mood and adapts slowly to new routines, people, or situations. An easy child displays a mild-to-moderately intense mood that is typically positive. A slow-to-warm up child responds with mild but passive resistance to novelty or changes in routine.

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According to Maslow's hierarchy of needs, the fifth level of needs include self-actualization needs. At this level, the individual wishes to reach his or her maximum potential while coping realistically with the situations of life. A client who wants to become the best swimmer in the world, become a successful engineer, or achieve maximum mobility after being bedridden is displaying self-actualization needs. Feeling the urge to urinate every 10 minutes is a physiological health problem that belongs to the first level of needs. A client who feels like a failure for not being able to complete college education may have a lack of self-worth and achievement. This situation belongs to the fourth level of needs.

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In exploratory research, the initial study is designed to develop or refine the dimensions of phenomena or to develop or refine a hypothesis about the relationships among phenomena. Therefore the pilot study conducted to improve or refine the study design before performing the full-scale study comes under exploratory research. In historical research, studies are designed to establish facts and relationships concerning past events. In evaluation research, the study tests how well a program, practice, or policy is working. In descriptive research, the study measures characteristics of persons, situations, or groups, and the frequency with which certain events or characteristics occur.

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A registered nurse is teaching a nursing student about nursing research. Which points mentioned by the nursing student post-teaching are accurate?

"Research means to search again or to examine carefully."

"Research is a theoretical process that only asks questions to generate knowledge."

"Nursing research improves professional education and practice but does not lead to the effective use of resources."

"Nursing research is a way to identify new knowledge, improve professional education and practice, and use resources effectively."

"The knowledge that is generated provides a scientific basis for nursing practice and validates the effectiveness of nursing interventions."

1, 4, 5

According to Piaget's theory of cognitive development, in the preoperational stage, the child demonstrates animism. Animism is defined as the humanization of non-living things. During this stage, the child believes that inanimate objects have lifelike thoughts, wishes, and feelings. He or she brushes the doll's hair and teeth to foster cognitive development. In the sensorimotor stage, the child learns that he or she is separate from the environment. During the formal operations stage, an individual demonstrates feelings and behaviors characterized by self-consciousness. During the concrete operations stage, the child is able to perform mental operations.

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If the client complains and often directs anger toward the nurse or others, the nurse should not argue with the client. Instead, the nurse should listen to the client's concerns carefully. The nurse should also reassure the family or significant others of the client's normalcy. If the client shows interest in changing his or her lifestyle to live a better life, then the nurse should continue to introduce only the reality of the situation. If the client realizes the effects of illness, the nurse should begin to share information needed for future. If the client denies any discussion about the illness, the nurse should be supportive and let the client know that the nurse is available for discussion.

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How should a nurse handle a client who blames and directs anger toward the nurse or others? .

By listening to the client's concerns

By continuing to speak of the reality of the situation

By beginning to share information needed for the future

By letting the client know that the nurse is available for discussion

By reassuring family and significant others of the client's normalcy

1, 5

An 8-year-old child is unable to identify the plate with a greater number of chocolates when a second plate with a different amount of chocolates is placed in front of him or her. Which stage of cognitive development has the child failed to attain?

Sensorimotor

Preoperational

Formal operations

Concrete operations
Eugene off target
So close!
The ability to mentally classify objects according to their quantitative dimensions is known as seriation, which is achieved during the concrete operations stage of cognitive development (7 to 11 years). If the child who is 7 to 11 years old is unable to recognize the quantitative dimensions, it is indicative that the child has failed to reach the concrete operations stage. If a child (birth to 2 years) does not develop object permanence, it indicates that the infant failed to attain the sensorimotor stage. If a child who is 2 to 7 years old is unable to think using symbols and mental images, it indicates that the child failed to attain the preoperational stage. If an adolescent is unable to demonstrate feelings and behaviors characterized by self-consciousness, it indicates a failure to attain the formal operations stage.

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space

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Havinghurst's theory does not include four periods that are related to age and does not demonstrate specific categories of knowing and understanding; this statement is associated with Piaget's theory of cognitive development. Havinghurst's theory states that the number of tasks differs in each age level for individuals. Havinghurst theory consists of six stages and six-to-ten developmental tasks for each stage. Havinghurst theory believes that the successful resolution of developmental tasks is essential to successful progression throughout life.

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A nursing student is recalling the Stage-Crisis Theory of Robert Havinghurst. Which step listed by the nursing student needs correction according to Havinghurst theory?

The number of tasks differs in each age level for individuals.

There are six stages and six-to-ten developmental tasks for each stage.

Successful resolution of the developmental task is essential to successful progression throughout life.

This theory includes four periods that are related to age and demonstrates specific categories of knowing and understanding.

4

The nurse practices autonomy by initiating independent nursing interventions without medical orders. Autonomy is an essential element of professional responsibility. The nurse explains concepts and facts related to health, but does not advise the client. The nurse acts as a client's advocate by speaking for the client and protecting the client's health care rights. As a caregiver, the nurse helps the client to improve physical, emotional, spiritual, and social well-being.

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The nurse decides to teach deep-breathing exercises to a client recovering from a surgery. Which professional responsibility does the nurse display?

Advisory

Advocacy

Autonomy

Caregiving

autonomy

Research-based practice uses knowledge based only on research studies. Evidence-based practice is a problem-solving approach to clinical practice. It involves the conscientious use of current best practice based on research findings. The nurse combines clinical expertise with client preferences and values to make health care decisions when implementing evidence-based practice.

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evidence-based care = ?

problem-solving approach

Which points about nursing care and nursing practice have been accurately stated?

Nursing theories help to describe, explain, predict, and/or prescribe nursing care measures.

Expertise in nursing is a result of clinical experience and substantial knowledge is not required.

The scientific work used in developing theories expands the scientific knowledge of the profession.

Nursing theories offer inadequate rationales for how and why nurses perform specific interventions and for predicting client behaviors and outcomes.

The expertise required to interpret clinical situations and make clinical judgments is the essence of nursing care and the basis for advancing nursing practice and nursing science.

1, 3, 5

According to Piaget's theory of cognitive development, the sensorimotor period is the time when the child learns that he or she is separate from his or her parents or favorite toy. In addition, the child develops a schema or action pattern for dealing with the environment by hitting, looking, grasping, and kicking. The child also learns about himself or herself and the environment through motor and reflex actions. In the preoperational stage, the child believes that non-living objects have realistic thoughts, wishes, and feelings. The child also promotes his or her cognitive development and learns about the world by playing.

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A nursing student notes the characteristics of middle-range theories. Which points noted by the nursing student are accurate?

Middle-range theories are systematic and broad in scope and complexity.

Middle-range theories provide a basis to help nurses understand how clients cope with uncertainty and the illness response.

Middle-range theories do not address a specific phenomenon and do not reflect practices such as administration, clinical, or teaching.

Middle-range theories include Mishel's theory of uncertainty in illness, which focuses on a client's experiences with cancer while living with continual uncertainty.

Middle-range theories tend to focus on a specific field of nursing (such as uncertainty, incontinence, social support, quality of life, and caring) rather than reflect on a wide variety of nursing care situations.

2, 4, 5

Tertiary care given by a nurse includes restoration and rehabilitation of clients. The nurse provides work therapy in hospitals, helping clients be more productive. The nurse also makes provisions in hospitals and facilities for client retraining and education to maximize clients' capabilities. Specific immunizations, such as the influenza vaccine, are provided as part of primary prevention. Attention to personal hygiene is a part of primary prevention. Selective examination of clients for the cure and prevention of disease is part of secondary prevention.

...

any stimuli that can produce tension and cause instability within the system

stressor

Health care organizations that apply for Magnet status must demonstrate innovations in professional practice. One of the forces of magnetism that impacts the structural empowerment of the organization is its personnel policies and programs. Personnel policies of an organization should provide an innovative environment in which the staff are developed and empowered. Empirical quality outcomes are reviewed by assessing the quality of care. New knowledge, innovations, and improvements are reviewed by assessing the quality improvement of the health care organization. Interdisciplinary relationships are assessed to review exemplary professional practice.

...

Moral development theory attempts to define how moral reasoning matures in an individual. Developmental theory provides a basis for nurses to assess and understand a client's responses. Cognitive development focuses on rational thinking processes that include the changes in children, adolescents, and adults to perform intellectual operations. Biophysical development explores theories of why individuals age from a biological standpoint as well as why development follows a predictable sequence. Psychosocial theories describe human development from the perspectives of personality, thinking, and behavior.

...

Information is defined as the organization and interpretation of data or pieces of reality. Datum is an individual piece of reality. When data are combined and relationships among data are identified, the nurse obtains knowledge.Information is defined as the organization and interpretation of data or pieces of reality. Datum is an individual piece of reality. When data are combined and relationships among data are identified, the nurse obtains knowledge.ore

...

According to Kohlberg's development of moral reasoning, in the middle childhood stage, the child is in the conventional level and develops a good boy-nice girl orientation. The child is in the post-conventional level and develops a social contract orientation in the adolescence developmental stage. The child develops punishment-obedience orientation in the toddler stage.According to Kohlberg's development of moral reasoning, in the middle childhood stage, the child is in the conventional level and develops a good boy-nice girl orientation. The child is in the post-conventional level and develops a social contract orientation in the adolescence developmental stage. The child develops punishment-obedience orientation in the toddler stage

...

theory that involves assisting client sin attaining health, maintaining health, and dying peacefully

watson's theory

According to Watson's theory, the nurse should always provide care to the client before curing the disease.

...

In the "family as context" approach, the primary focus is the health and development of an individual in a specific environment. The relationship and family processes are the primary focus when the family is viewed as client. When the family is viewed as context, the focus is the ability of the family to meet the basic needs of the individual, not their own needs. The process followed by the family when caring for the sick family member is assessed when family is viewed as client.

...

What makes a crisis access hospital (CAH) different from an intensive care unit (ICU)?

It offers 24-hour emergency care.

It offers health care to acutely ill people.

It provides temporary care for 96 hours or less.

It provides the most expensive health care delivery.

3

A nursing student is learning about the nursing process, which consists of four components. Which scenarios should the nursing student consider as the 'input' component?

"The nurse checks the client's health history for allergy to iodine before inserting a urinary catheter."

"The nurse finds that the client's urine has presence of blood after the urinary catheter is removed."

"The nurse checks if the client has a history of substance abuse before administering nasal medications."

"The nurse finds that the client's skin color has changed to bluish purple after cold therapy is applied to reduce swelling."

"The nurse checks the medical records of the client to know if he/she has had a rectal surgery in the past year before placing an internal fecal catheter."

1, 3, 5

The nurse should know that an easy child is open and adaptable to changes. A difficult child requires a more structured environment and shows an intense and primarily negative mood. An easy child displays a mild-to-moderately intense mood. A 'slow-to-warm up child' reacts negatively and with mild intensity to new stimuli.

...

stages of swanson's theory

...

In which process of Swanson's theory is the nurse engaging when explaining neonatal care to a parent?

Enabling

Knowing

Doing for

Being with

enabling

According to Erikson's theory, between the ages of 18 months and 3 years, a child develops self-control and independence. At the age of 3 to 6 years old, a child is highly imaginative. At the age of 6 to 12 years old, a child is engaged in tasks and activities. Between the ages of 12 and 19 years of age, a child can differentiate between identity and role confusion.

...

Block nursing involves the services of nurses living within a neighborhood. The nurse generally provides services for older clients or those who are unable to leave their homes. Therefore running errands is one of the services offered by the block nurse.

...

The nurse acts as a caregiver by encouraging the client to exercise daily. The nurse's role as a caregiver involves helping the client to maintain and regain health. As a caregiver, the nurse also sets goals and helps the client and family to achieve them. The duties of a caregiver involve restoring a client's emotional, spiritual, and social well-being. Therefore the nurse arranges for the client to meet a spiritual advisor to meet the client's spiritual needs. The nurse as an educator evaluates the client's understanding of prescribed diet. As an educator, the nurse demonstrates the procedure for administering insulin injection. The nurse also reinforces and evaluates learning.

...

HESI practice notes - nursings sciences - Subjecto.com

HESI practice notes – nursings sciences

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Which statement about Orem’s theory needs to be corrected?
1. It determines self-care needs.
2. It explains the types of nursing care.
3. It aids in the design of nursing interventions.
4. It describes factors supporting the health of the family.

4

Which statement made by a nursing student about Swanson’s theory of caring needs correction?
1. The components of Swanson’s theory of caring provide a foundation of knowledge for nurses to direct and deliver caring nursing practices.
2. Swanson’s theory of caring defines five components of caring: knowing, being with, doing for, enabling, and maintaining belief.
3. Swanson’s theory of caring provides a basis to help nurses understand how clients cope with uncertainty and the illness response.
4. Swanson’s theory of caring was developed by Kristin Swanson by conducting extensive interviews with clients and their professional caregivers.

3

which theory describes nursing interventions fora specific phenomenon and the expected outcome of care?
-grand theories
-predictive theories
-descriptive theories
-prescriptive theories

prescriptive theories

who benefits from medicare?

people 65 and older

a record that contains descriptive and objective info about what a nurse sees, hearas, feels, and smells

factual record

a record that communicates info in a logical order

organized record

the nurse prepares a _______ record by providing a complete and appropriate record that includes all essential info

complete

_______ theory:
-explains the factors within a client’s living situation
-these factors may support or interfere with the client’s self-care abilities, but they do not refer to the family’s health
-this theory interprets data that determine a client’s self-care needs, self-care deficits, and self-care abilities
-explains, predicts, or describes nursing care that will help the client in bettering his or her health
-aids in the design of nursing interventions for the promotion of self-care by the client during times of illness, such as asthma, diabetes mellitus, or arthritis

orem’s theory

_____ theory:
-provides a basis for identifying and testing nurse caring behaviors to determine if caring will improve client health outcomes
-provide a foundation of knowledge for nurses to direct and deliver caring nursing practices
-defines five components of caring: knowing, being with, doing for, enabling, and maintaining belief
-developed by Kristin Swanson by conducting extensive interviews with clients and their professional caregivers

Swanson’s theory of caring

______ theories provide a basis to help nurses understand how clients cope with uncertainty and the illness response

middle-range

________ database is a good source of biomedical and pharmaceutical studies

EMBASE

_____ is the health science library at the national library of medicine; this database offers free access to many journal articles

PubMed

______ includes studies in medicine, nursing, dentistry, psychiatry, veterinary medicine, and allied health

MEDLINE

_______ is a good resource for pschology and psychology-related healthcare disciplines

PsychINFO

(1) ________ theories detail nursing interventions for a specific phenomenon and the expected outcome of the care
(2) ________ theories provide the structural framework for broad, abstract ideas about nursing
(3) ________ theories identify conditions or factors that predict a phenomenon
(4) ________ theories help to explain client assessments.

prescriptive grand predictive descriptive

provides a basis for identifying and testing nursing care behaviors to determine if caring improves patient health outcomes

swanson’s thoery of nursing

theory focuses on stressors perceived by the client or caregiver.

neuman’s system theory

explains the factors within a client’s living situation that support or interfere with his or her self-care ability

orem’s self-care deficit theory

focuses on a client’s experiences with cancer while living with continual uncertainty.

mishel’s theory of uncertainty in illness

maslow’s hierarchy of needs

physiological safety belonging/love esteem self-actualization

(1) rely on a combination of dietary, herbal, and other naturalistic therapies to prevent and treat illness
(2) use yin treatment (which uses needles to restore balance and flow of qi) and yang treatment (which uses moxibustion or heat with acupuncture to restore the yin/yang balance)
(3) use a combo of prayers, herbs, and other rituals to treat traditional illnesses
(4) rely on a combo of prayers, chanting, and herbs to treat illnesses caused by supernatural, physiologic, and physical factors

-asian indians -east asians -hispanics -native americans

(1) used to determine the hours of care and staff required for a given group of clients
(2) helps to assess data about a client; data includes vitals and routine repetitive care
(3) based on an institution’s standards of nursing practice and preprinted and established guidelines used to care for clients who have similar health problems
(4) includes meds, diet, community resources, follow-up care, and med contact info in case of emergency or query
<b>discharge documentation, acuity record, flow sheet, standardized care plan</b>

acuity record flow sheet standardized care plan discharge documentation

what focuses on palliative care?

hospice

SOAP?

-includes assessment info or diagnoses based on data -subjective, objective, assessment, plan -originates from medical records

internal or external factors:
-intellectual background
-family practices
-cultural background
-SES factors

only internal = intellectual

A registered nurse is teaching a nursing student about systems theories with a specific reference to Neuman’s systems theory. Which statements made by the nursing student post teaching are accurate? Select all that apply.
1. "Factors that change the environment also affect an open system."
2. "The components are interrelated and share a common purpose to form a whole."
3. "A system is composed of separate components and the components can be open or closed."
4. "Neuman’s systems theory defines a total-person model of holism and a closed-systems approach."
5. "An open system interacts with the environment, with an exchange of information between the system and the environment."

1, 2, 5

In __________, nurses living within a neighborhood provide services to older clients or those unable to leave their homes. Health promotion throughout a school curriculum is provided by school health. Nurse-managed clinics provide nursing services with a focus on health promotion and education, chronic disease assessment management, and support for self-care and caregivers. Community health centers are outpatient clinics that provide primary care to a client population living in a community.

block and parish nursing

In experimental research, the investigator controls the study variable and randomly assigns subjects to different conditions to test the variable. In ______ research, studies are designed to establish facts and relationships concerning past events. In evaluation research, studies test how well a program, practice, or policy is working. _______ research is an initial study designed to develop or refine the dimensions of phenomena or to develop or refine a hypothesis about the relationships among phenomena.

historical, exploratory

______’s theory focuses on nursing by caring through the environment. Nightingale’s theory is oriented toward providing fresh air, light, warmth, cleanliness, quiet, and adequate nutrition. Nightingale’s theory focuses on helping the client deal with the symptoms and changes in function related to an illness. Nightingale’s theory does not limit nursing to the administration of medications and treatment. Nightingale’s theory suggests that nurses do not need to know all about the disease process, which differentiates nursing from medicine.

nightingale’s theory of

-right task, right circumstances, right person, right direction/communication, right supervision/evaluation

five rights of delegation

According to Swanson’s theory, the nurse is engaging in ______ when explaining the care of a neonate to a parent. ________ includes informing/explaining/supporting/allowing, focusing, generating alternatives, validating, and giving feedback. The process of _______ includes avoiding assumptions, centering on the one being cared for, assessing thoroughly, seeking cues, and engaging the self or both. The process of ______ for includes comforting, anticipating, performing skillfully, protecting, and preserving dignity. The process of ______ with includes being there, conveying ability, sharing feelings, and not burdening.

enabling knowing doing being

domains of nursing intervention:
(a) includes care that supports physical functioning
(b) involves care that supports protection against harm
(c) incorporates care that supports psychosocial functioning and facilitates lifestyle changes
(d) includes electrolyte and acid-base management; physiologic complex, includes care that supports homeostatic regulation

1 4 3 2

Which is an example of an actual nursing diagnosis?

Risk for acute confusion

Impaired social interaction

Readiness for enhanced nutrition

Readiness for increased family coping

impaired social interaction

what kind of theory is Neuman’s system model?

grand theory

_____ theory: the goal of nursing is to use communication to help the client reestablish a positive adaptation to his or her environment

king’s theory

_____ theory: the goal of nursing is to develop and interaction b/w nurse and client; interpersonal relationships b/w nurse, client, and client’s family

peplau’s theory

______ theory: the goal of nursing is to facilitate the reparative processes of the body by manipulating

nightingale’s

______ theory: the goal of nursing is to focus on a client’s need for caring as a means of coping with stressors of illness

benner and wrubel

what kind of approach is evidence-based care?

problem solving

the tendency of a person to hold his or her own beliefs superior to those of other people; causes biases and prejudices

ethnocentrism

occurs when a nurse or health care provider ignores the differences b/w his or her own culture and others and imposes his or her beliefs on people of other cultures

cultural imposition

a nurse questions the staff about a change in a client’s plan of care – what does this demonstrate?

authority

Henderson’s theory comprises 14 basic needs of the whole person and includes phenomena from the following domains of the client: physiological, psychological, sociocultural, spiritual, and developmental. Orem’s self-care deficit theory focuses on the client’s self-care needs. The Neuman systems model is based on stress and the client’s reaction to the stressor. Nightingale’s concept of the environment includes the suggestion that nurses do not need to know all about the disease process differentiated nursing from medicine.

______ theory is organized into 14 basic needs of the whole person and includes phenomena from the following domains of the client: physiological, psychological, sociocultural, spiritual, and developmental

henderson’s

Mishel’s theory of uncertainty in illness is not an example of a grand theory; it is a middle-range theory. Neuman’s systems model is a grand theory. Grand theories require further specification through research. Grand theories are systematic and broad in scope and complexity. Grand theories do not provide guidance for specific nursing interventions; instead they provide the structural framework for broad and abstract ideas about nursing.

room

room

state-operated program that provides long-term care to low-income families and disabled older clients

medicaid

The nurse suspects that the client is in the stage of contemplation. This stage of health behavior is characterized by the client’s attitude toward a change and the client is most likely to accept that change over the next 6 months. In the preparation stage, the client believes that a change in behavior will be advantageous. The client may need assistance to bring about the change in behavior. During the maintenance stage, changes need to be implemented in the client’s lifestyle. In the precontemplation stage, the client is not willing to receive any information about changes in behavior and may become defensive and confrontational.

what model views the client as an adaptive system – the need for care occurs when a client cannot adapt to internal and external environmental demands
-goal of nursing is ot help a person adapt

roy adaptation model

<b>types of children?</b>
(1) adapts slowly with frequent communication and reacts to novelty with mild but passive resistance
(2) highly active, irritable, irregular habits
(3) regular and predictable habits
(4) reacts negatively with mild intensity to new stimuli

slow to warm up difficult easy slow to warm up

what type of questioning is asking a pt to rate pain on scale of 0 to 10?

close ended

question type?
-asking whether anything else is bothering the client

probing

"all right" and "go on" are examples of? encourages client to give more details

back channeling

a standardized survey developed to measure client perceptions of their hospital experience. The survey asks 27 questions about the client’s hospital experience. The survey is taken by clients who were discharged from the hospital between 48 hours and six weeks ago.

HCAHPS

a data-driven approach to process improvement that reduces variation in the process

six sigma

focuses on the improvement of processes. It studies each step of a process to determine if that step adds value to that process. It also determines if the process reduces the organization’s time, cost, and resources

value stream analysis

created HEDIS to collect various data to measure the quality of care and services provided by different health plans. It is the database of choice for the Centers for Medicare and Medicaid Services.

NCQA (national committee for quality assurance)

content vs feedback vs output?
(1) data or info from client’s assessment
(2) serves to inform a system about how it functions
(3) product and info obtained from the system
(4) end product of a system

input feedback content output

model of primacy of caring is the basis of _____ – focuses on client’s need for caring as a means of coping with stresses of illness

benner and wrubel’s theory

what theory defines the outcome of nursing activity in regard to the HUMANISTIC aspects of life and promotes health, restoring the client to health, and preventing illness

watson’s theory of transpersonal caring

what theory is based on stress ann the client’s reaction to the stressor?

neuman’s theory

(1) an inaccurate match b/w clinical cues and the nursing diagnosis, using insufficient number of cues, using unreliable cues
(2) failure to validate data
(3) includes inaccurate data, missing data, disorganization
(4) includes insufficient cluster of cues, premature or early closure, or incorrect clustering

interpreting error labeling error collecting errors errors at clustering level

(1) 0-18 inches is distance, example is changing perineum dressing
(2) lecturing students
(3) client’s bedside taking history or teaching client individually
(4) special care needed

intimate zone public zone personal zone vulnerable zone

what theory is action-oriented?

prescriptive

(1) refers to analysis of the client’s biological and psychosocial data to find out the relevant issues and problems
(2) the procedure of assessing the desired outcomes of treatment. (3) done at the very beginning when the nurse collects the data about the client to make an accurate diagnosis.
(4) giving a shot

diagnosis evaluation assessment implementation

what are the three levels of critical thinking in nursing judgment?

basic critical thinking (nurse has faith that expert has right answer), complex critical thinking (nurse analyzes info from expert), commitment (make decisions without help from others)

(1) reviews the quality, quantity, and cost of hospital care
(2) defined a list of 28 "Never Events" in health care. Death or injury due to medication error is an example of a "Never Event."
(3) a group of 28 organizations from a variety of health care disciplines that work together to transform health care on a national level.
(4) have utilization review committees to review admissions and identify and eliminate overuse of diagnostic and treatment services for clients on Medicare.

PSROs national quality forum national priorities partnership medicare-qualified hospitals

(1) comprises 14 basic needs of the whole person and includes phenomena from the following domains of the client: physiological, psychological, sociocultural, spiritual, and developmental
(2) focuses on the client’s self-care needs
(3) based on stress and the client’s reaction to the stressor.
(4) includes the suggestion that nurses do not need to know all about the disease process differentiated nursing from medicine.

henderson’s theory orem’s self care deficit theory neuman’s systems model nightingale’s concept of the environment

health belief model?

The first component is an individual’s perception of susceptibility to an illness. The second component is an individual’s perception of seriousness of an illness. The third component is the preventive actions taken by a person. The health promotion model focuses on behavioral outcomes, behavior-specific knowledge and affect, and individual characteristics and experience.

_____ has the ability to establish an appropriate care plan based on the assessment of clients and families

case manager

________ theories describe a phenomenon such as grief or caring

descriptive

Providing short-term relief to the family caregiver aka?

respite care, used with hospice

Neuman systems model is an example of a grand theory that provides a comprehensive foundation for scientific nursing practice, education, and research. Theories related to growth and development are descriptive theories. Prescriptive theories address nursing interventions for a phenomenon, describe the condition under which the prescription occurs, and predict the consequences. Mishel’s theory of uncertainty is a prescriptive theory. Middle-range theories tend to focus on a specific field of nursing. Mishel’s theory of uncertainty in illness is a middle-range theory.

Mishel’s theory of uncertainty in illness is not an example of a grand theory; it is a middle-range theory. Neuman’s systems model is a grand theory. Grand theories require further specification through research. Grand theories are systematic and broad in scope and complexity. Grand theories do not provide guidance for specific nursing interventions; instead they provide the structural framework for broad and abstract ideas about nursing.

Assessment involves the collection of comprehensive data pertinent to the client’s health. During the planning level of nursing care, the nurse develops a plan that prescribes strategies and alternatives to attain expected outcomes. The nurse analyzes the assessment data to determine the diagnoses during the diagnosis level of nursing practice. The nurse implements the health care plan identified for the client during the implementation level of the standards of nursing practice. This level may include administering prescribed medications or healthcare procedures.

The Roy adaptation model views the client as an adaptive system. The need for nursing care occurs when a client cannot adapt to internal and external environmental demands. Roy’s model believes the goal of nursing is to help a person adapt to changes in physiological needs, self-concept, role function, and interdependent relations during health and illness. All individuals must adapt to the following demands: meeting basic physiological needs, developing a positive self-concept, performing social roles, and achieving a balance between dependence and independence.

The nurse is exercising the preinteraction phase when he or she collects medical data from the client’s caregivers. During the working phase, the nurse motivates the client to exercise self-exploration about his or her own health condition and the nurse uses appropriate self=disclosure and confrontation. The nurse tries to form a healthy relationship with the client during the orientation phase. The termination phase is when the nurse winds up the conversation and evaluates goal achievements with the client.

which phase of erikson’s includes self-care like feeding/dressing

autonomy vs shame/doubt

The program on caring for the elderly with dementia offered by a university is an example of a continuing education program. Such programs are formal, organized educational programs offered by universities, hospitals, or professional nursing organizations. An in-service education program is held in the institution or health care agency to increase the competencies of the nurses employed there. Therefore the programs on culturally sensitive approaches in health care, use of computers, and safe principles for administering chemotherapy are in-service educational programs.

In the preoperational stage, the infant may learn to think with the use of symbols and mental images. In the sensorimotor stage, the individual may learn about the environment through motor and reflex actions. In the sensorimotor stage, the individual may develop schema or action patterns in order to deal with the environment. In the concrete operations stage, the individual may develop the ability to mentally classify objects according to their quantitative dimensions.

The nurse practices autonomy by initiating independent nursing interventions without medical orders. Autonomy is an essential element of professional responsibility. The nurse explains concepts and facts related to health, but does not advise the client. The nurse acts as a client’s advocate by speaking for the client and protecting the client’s health care rights. As a caregiver, the nurse helps the client to improve physical, emotional, spiritual, and social well-being.

The major concept of Leininger’s theory is cultural diversity, where the goal is to provide a client with culturally specific nursing care. S

After asking the clinical question, the nurse should gather the most relevant and best evidence. The nurse may perform a critical appraisal after gathering all the necessary evidence. Sharing the outcomes of the evidence-based practice changes with others is the last step of the decision-making process. After gathering relevant evidence and appraising the same, the nurse should integrate it with clinical expertise and client preferences.

(1) _______ research studies are initial studies that are conducted to develop or refine dimensions of phenomena or to develop a hypothesis about the relationships among phenomena.
(2) _______ research focuses on determining the effectiveness of a program, practice, or policy.
(3) _______ research focuses on measuring the characteristics of people, situations, or groups and the frequency with which certain events or characteristics occur.
(4) _______ research aims to explore variables of interest without any active intervention by the researcher.

exploratory evaluation descriptive correlational

The client receives restorative care during rehabilitation. This care helps to restore the client to the fullest physical, mental, social, vocational, and economic potential. Immunization is an example of preventive care. The focus is on reducing and controlling risk factors for disease. Adult day care centers are an example of continuing care. The nurses in these centers provide continuity between care delivered in the home and the center. Tertiary health care is provided to acutely ill hospitalized clients who need comprehensive and specialized health care.

kohlberg’s theory of moral development stages

<b>helping relationships phases:</b>
(1) when the nurse collects medical data from the client’s caregivers
(2) when the nurse motivates the client to exercise self-exploration about his or her own health condition
(3) when nurse tries to form a healthy relationship with the client
(4) when the nurse winds up the conversation and evaluates goal achievements with the client

preinteraction phase working phase orientation phase termination phase

A registered nurse is teaching a nursing student about evidence-based practice. Which statements should the nurse include in the teaching?

"The funding source is usually external, such as a grant."

"Evidence-based practice is conducted by practicing nurses and other healthcare team members."

"Institutional review board approval is not needed to implement evidence-based practice."

"Evidence-based practice uses information drawn from research to determine safe and effective nursing care."

"Evidence is generated to find the answers for questions that are unknown about nursing practice."

2, 3, 4

read over: ^^

Evidence-based practice is conducted by practicing nurses and other members of the healthcare team. Institutional review board (IRB) approval is not needed to implement evidence-based practice. However, approval is required to conduct research. Evidence-based practice uses information from research, professional experts, and personal experience to determine safe and effective nursing care with a goal of improving the patient care and outcomes. The funding source is internal (from a healthcare agency) for evidence-based practice. An external funding source, such as a grant, is required for research. Evidence-based practice focuses on the implementation of evidence already known in practice. However, in case of research study, evidence is generated to find answers for questions that are not known about nursing practice.

maslow’s hierarchy of needs levels

FREUD’S PSYCHOANALYTIC STAGES:
In the oral stage, the infant realizes that he or she is a separate individual. In the Oedipal stage, the infant develops an Electra complex feeling where the child fantasizes about the parent of the opposite sex as his or her first love interest. In the anal stage, the infant changes the pleasure focus to the anal zone. In the anal stage, the infant delays gratification to meet parental and societal expectations.

Kohlbergs theory of moral development:
In the "social contract orientation" stage, an individual recognizes that the law needs to be changed in order to improve society. In the Society-Maintaining Orientation stage, an individual understands that certain actions are not done not because it can lead to punishment, but because the act is not right. In the Instrumental Relativist Orientation stage, a child understands that punishment is not a proof of being wrong, but is an action that one wants to prevent. In the Punishment and Obedience Orientation stage, a child thinks that he or she may get punished if he or she does not adhere to the rules and regulations.

Telemedicine uses advanced technology to connect rural hospitals to specialists for consultation. Many big-city health care systems are branching out and merging with rural hospitals to provide better health care. Medicare is a federally administered health insurance program for people 65 years of age or older. Medicaid is a federally funded, state-operated program that provides health insurance to low-income families. Critical access hospitals are rural hospitals with no more than 25 inpatient beds. These hospitals provide emergency care to stabilize clients before they are transferred to a larger hospital.

The stage of designing the study is when the nurse chooses the instrumentation for conducting the study. In this stage, the nurse prepares questionnaires and selects physiological measures, interviews, and treatments necessary for the study. The first stage of the research process involves identifying of the problem. At this stage the nurse may gather all relevant articles and review literature for the purpose of conducting the research. The stage of conducting the study involves the nurse obtaining approval from the appropriate authorities and enlisting research subjects. The nurse also monitors whether all investigators are following the appropriate study protocol in order to ensure accuracy of the findings.

Narrative documentation is the use of a story-like format to document information specific to the client’s conditions and nursing care. Acuity records are not part of a client’s medical record; they are used to determine the hours of care and staff required for a given group of clients. Source records have a separate section for each discipline such as an admission sheet, nursing records, and medications. These are used for recording information from a client’s admission until discharge. This documentation is not done in a story-like format. Hand-off reports are reports that get transferred from one healthcare provider to another. The purpose of hand-off reports is to provide better continuity and individualized care for clients.

During the sensorimotor stage, the child learns that objects continue to exist even when they cannot be seen, heard, or touched. This is called object permanence. During the preoperational stage, the child learns to think with the use of symbols and mental images. In the formal operations stage, the child’s egocentric thoughts would be prevalent and the child believes that his or her actions and appearance are constantly being scrutinized. In the concrete operations stage, the child is able to perform mental operations.

piaget’s stages

-theory focused on the prescribed medication under particular circumstances
-nursing-intervention specific

prescriptive theory

The nurse is using cultural desire as a part of cultural competence. This component is related to motivation and commitment towards the care of an individual. Through this, an immigrant may become open to cultural differences and accept them. Cultural awareness is an in-depth self-examination of backgrounds and recognizing biases and prejudices. Cultural knowledge is a comparative study about the beliefs and care practices of other cultures. Cultural encounter is about transcultural interactions for effective communication and development.

Input is the data or information that comes from a client’s assessment, such as how the client interacts with the environment and the client’s physiological function. Output is the end product of a system. The content is the information about nursing interventions for clients with specific healthcare problems. Feedback involves the assessment of how a system functions.

A difficult child is highly active, irritable, and irregular in habits. A difficult child displays an intense and primarily negative mood and adapts slowly to new routines, people, or situations. An easy child displays a mild-to-moderately intense mood that is typically positive. A slow-to-warm up child responds with mild but passive resistance to novelty or changes in routine.

According to Maslow’s hierarchy of needs, the fifth level of needs include self-actualization needs. At this level, the individual wishes to reach his or her maximum potential while coping realistically with the situations of life. A client who wants to become the best swimmer in the world, become a successful engineer, or achieve maximum mobility after being bedridden is displaying self-actualization needs. Feeling the urge to urinate every 10 minutes is a physiological health problem that belongs to the first level of needs. A client who feels like a failure for not being able to complete college education may have a lack of self-worth and achievement. This situation belongs to the fourth level of needs.

In exploratory research, the initial study is designed to develop or refine the dimensions of phenomena or to develop or refine a hypothesis about the relationships among phenomena. Therefore the pilot study conducted to improve or refine the study design before performing the full-scale study comes under exploratory research. In historical research, studies are designed to establish facts and relationships concerning past events. In evaluation research, the study tests how well a program, practice, or policy is working. In descriptive research, the study measures characteristics of persons, situations, or groups, and the frequency with which certain events or characteristics occur.

A registered nurse is teaching a nursing student about nursing research. Which points mentioned by the nursing student post-teaching are accurate?

"Research means to search again or to examine carefully."

"Research is a theoretical process that only asks questions to generate knowledge."

"Nursing research improves professional education and practice but does not lead to the effective use of resources."

"Nursing research is a way to identify new knowledge, improve professional education and practice, and use resources effectively."

"The knowledge that is generated provides a scientific basis for nursing practice and validates the effectiveness of nursing interventions."

1, 4, 5

According to Piaget’s theory of cognitive development, in the preoperational stage, the child demonstrates animism. Animism is defined as the humanization of non-living things. During this stage, the child believes that inanimate objects have lifelike thoughts, wishes, and feelings. He or she brushes the doll’s hair and teeth to foster cognitive development. In the sensorimotor stage, the child learns that he or she is separate from the environment. During the formal operations stage, an individual demonstrates feelings and behaviors characterized by self-consciousness. During the concrete operations stage, the child is able to perform mental operations.

If the client complains and often directs anger toward the nurse or others, the nurse should not argue with the client. Instead, the nurse should listen to the client’s concerns carefully. The nurse should also reassure the family or significant others of the client’s normalcy. If the client shows interest in changing his or her lifestyle to live a better life, then the nurse should continue to introduce only the reality of the situation. If the client realizes the effects of illness, the nurse should begin to share information needed for future. If the client denies any discussion about the illness, the nurse should be supportive and let the client know that the nurse is available for discussion.

How should a nurse handle a client who blames and directs anger toward the nurse or others? .

By listening to the client’s concerns

By continuing to speak of the reality of the situation

By beginning to share information needed for the future

By letting the client know that the nurse is available for discussion

By reassuring family and significant others of the client’s normalcy

1, 5

An 8-year-old child is unable to identify the plate with a greater number of chocolates when a second plate with a different amount of chocolates is placed in front of him or her. Which stage of cognitive development has the child failed to attain?

Sensorimotor

Preoperational

Formal operations

Concrete operations
Eugene off target
So close!
The ability to mentally classify objects according to their quantitative dimensions is known as seriation, which is achieved during the concrete operations stage of cognitive development (7 to 11 years). If the child who is 7 to 11 years old is unable to recognize the quantitative dimensions, it is indicative that the child has failed to reach the concrete operations stage. If a child (birth to 2 years) does not develop object permanence, it indicates that the infant failed to attain the sensorimotor stage. If a child who is 2 to 7 years old is unable to think using symbols and mental images, it indicates that the child failed to attain the preoperational stage. If an adolescent is unable to demonstrate feelings and behaviors characterized by self-consciousness, it indicates a failure to attain the formal operations stage.

space

Havinghurst’s theory does not include four periods that are related to age and does not demonstrate specific categories of knowing and understanding; this statement is associated with Piaget’s theory of cognitive development. Havinghurst’s theory states that the number of tasks differs in each age level for individuals. Havinghurst theory consists of six stages and six-to-ten developmental tasks for each stage. Havinghurst theory believes that the successful resolution of developmental tasks is essential to successful progression throughout life.

A nursing student is recalling the Stage-Crisis Theory of Robert Havinghurst. Which step listed by the nursing student needs correction according to Havinghurst theory?

The number of tasks differs in each age level for individuals.

There are six stages and six-to-ten developmental tasks for each stage.

Successful resolution of the developmental task is essential to successful progression throughout life.

This theory includes four periods that are related to age and demonstrates specific categories of knowing and understanding.

4

The nurse practices autonomy by initiating independent nursing interventions without medical orders. Autonomy is an essential element of professional responsibility. The nurse explains concepts and facts related to health, but does not advise the client. The nurse acts as a client’s advocate by speaking for the client and protecting the client’s health care rights. As a caregiver, the nurse helps the client to improve physical, emotional, spiritual, and social well-being.

The nurse decides to teach deep-breathing exercises to a client recovering from a surgery. Which professional responsibility does the nurse display?

Advisory

Advocacy

Autonomy

Caregiving

autonomy

Research-based practice uses knowledge based only on research studies. Evidence-based practice is a problem-solving approach to clinical practice. It involves the conscientious use of current best practice based on research findings. The nurse combines clinical expertise with client preferences and values to make health care decisions when implementing evidence-based practice.

evidence-based care = ?

problem-solving approach

Which points about nursing care and nursing practice have been accurately stated?

Nursing theories help to describe, explain, predict, and/or prescribe nursing care measures.

Expertise in nursing is a result of clinical experience and substantial knowledge is not required.

The scientific work used in developing theories expands the scientific knowledge of the profession.

Nursing theories offer inadequate rationales for how and why nurses perform specific interventions and for predicting client behaviors and outcomes.

The expertise required to interpret clinical situations and make clinical judgments is the essence of nursing care and the basis for advancing nursing practice and nursing science.

1, 3, 5

According to Piaget’s theory of cognitive development, the sensorimotor period is the time when the child learns that he or she is separate from his or her parents or favorite toy. In addition, the child develops a schema or action pattern for dealing with the environment by hitting, looking, grasping, and kicking. The child also learns about himself or herself and the environment through motor and reflex actions. In the preoperational stage, the child believes that non-living objects have realistic thoughts, wishes, and feelings. The child also promotes his or her cognitive development and learns about the world by playing.

A nursing student notes the characteristics of middle-range theories. Which points noted by the nursing student are accurate?

Middle-range theories are systematic and broad in scope and complexity.

Middle-range theories provide a basis to help nurses understand how clients cope with uncertainty and the illness response.

Middle-range theories do not address a specific phenomenon and do not reflect practices such as administration, clinical, or teaching.

Middle-range theories include Mishel’s theory of uncertainty in illness, which focuses on a client’s experiences with cancer while living with continual uncertainty.

Middle-range theories tend to focus on a specific field of nursing (such as uncertainty, incontinence, social support, quality of life, and caring) rather than reflect on a wide variety of nursing care situations.

2, 4, 5

Tertiary care given by a nurse includes restoration and rehabilitation of clients. The nurse provides work therapy in hospitals, helping clients be more productive. The nurse also makes provisions in hospitals and facilities for client retraining and education to maximize clients’ capabilities. Specific immunizations, such as the influenza vaccine, are provided as part of primary prevention. Attention to personal hygiene is a part of primary prevention. Selective examination of clients for the cure and prevention of disease is part of secondary prevention.

any stimuli that can produce tension and cause instability within the system

stressor

Health care organizations that apply for Magnet status must demonstrate innovations in professional practice. One of the forces of magnetism that impacts the structural empowerment of the organization is its personnel policies and programs. Personnel policies of an organization should provide an innovative environment in which the staff are developed and empowered. Empirical quality outcomes are reviewed by assessing the quality of care. New knowledge, innovations, and improvements are reviewed by assessing the quality improvement of the health care organization. Interdisciplinary relationships are assessed to review exemplary professional practice.

Moral development theory attempts to define how moral reasoning matures in an individual. Developmental theory provides a basis for nurses to assess and understand a client’s responses. Cognitive development focuses on rational thinking processes that include the changes in children, adolescents, and adults to perform intellectual operations. Biophysical development explores theories of why individuals age from a biological standpoint as well as why development follows a predictable sequence. Psychosocial theories describe human development from the perspectives of personality, thinking, and behavior.

Information is defined as the organization and interpretation of data or pieces of reality. Datum is an individual piece of reality. When data are combined and relationships among data are identified, the nurse obtains knowledge.Information is defined as the organization and interpretation of data or pieces of reality. Datum is an individual piece of reality. When data are combined and relationships among data are identified, the nurse obtains knowledge.ore

According to Kohlberg’s development of moral reasoning, in the middle childhood stage, the child is in the conventional level and develops a good boy-nice girl orientation. The child is in the post-conventional level and develops a social contract orientation in the adolescence developmental stage. The child develops punishment-obedience orientation in the toddler stage.According to Kohlberg’s development of moral reasoning, in the middle childhood stage, the child is in the conventional level and develops a good boy-nice girl orientation. The child is in the post-conventional level and develops a social contract orientation in the adolescence developmental stage. The child develops punishment-obedience orientation in the toddler stage

theory that involves assisting client sin attaining health, maintaining health, and dying peacefully

watson’s theory

According to Watson’s theory, the nurse should always provide care to the client before curing the disease.

In the "family as context" approach, the primary focus is the health and development of an individual in a specific environment. The relationship and family processes are the primary focus when the family is viewed as client. When the family is viewed as context, the focus is the ability of the family to meet the basic needs of the individual, not their own needs. The process followed by the family when caring for the sick family member is assessed when family is viewed as client.

What makes a crisis access hospital (CAH) different from an intensive care unit (ICU)?

It offers 24-hour emergency care.

It offers health care to acutely ill people.

It provides temporary care for 96 hours or less.

It provides the most expensive health care delivery.

3

A nursing student is learning about the nursing process, which consists of four components. Which scenarios should the nursing student consider as the ‘input’ component?

"The nurse checks the client’s health history for allergy to iodine before inserting a urinary catheter."

"The nurse finds that the client’s urine has presence of blood after the urinary catheter is removed."

"The nurse checks if the client has a history of substance abuse before administering nasal medications."

"The nurse finds that the client’s skin color has changed to bluish purple after cold therapy is applied to reduce swelling."

"The nurse checks the medical records of the client to know if he/she has had a rectal surgery in the past year before placing an internal fecal catheter."

1, 3, 5

The nurse should know that an easy child is open and adaptable to changes. A difficult child requires a more structured environment and shows an intense and primarily negative mood. An easy child displays a mild-to-moderately intense mood. A ‘slow-to-warm up child’ reacts negatively and with mild intensity to new stimuli.

stages of swanson’s theory

In which process of Swanson’s theory is the nurse engaging when explaining neonatal care to a parent?

Enabling

Knowing

Doing for

Being with

enabling

According to Erikson’s theory, between the ages of 18 months and 3 years, a child develops self-control and independence. At the age of 3 to 6 years old, a child is highly imaginative. At the age of 6 to 12 years old, a child is engaged in tasks and activities. Between the ages of 12 and 19 years of age, a child can differentiate between identity and role confusion.

Block nursing involves the services of nurses living within a neighborhood. The nurse generally provides services for older clients or those who are unable to leave their homes. Therefore running errands is one of the services offered by the block nurse.

The nurse acts as a caregiver by encouraging the client to exercise daily. The nurse’s role as a caregiver involves helping the client to maintain and regain health. As a caregiver, the nurse also sets goals and helps the client and family to achieve them. The duties of a caregiver involve restoring a client’s emotional, spiritual, and social well-being. Therefore the nurse arranges for the client to meet a spiritual advisor to meet the client’s spiritual needs. The nurse as an educator evaluates the client’s understanding of prescribed diet. As an educator, the nurse demonstrates the procedure for administering insulin injection. The nurse also reinforces and evaluates learning.

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