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CUMULATIVE 3280 FINAL - WPUNJ (
QUESTIONS AND ANSWERS) 2024
GRADED A+
An 18-year-old woman is in the emergency department with fever and cough. The nurse obtains her vital signs, listens to her lung and heart sounds, determines her level of comfort, and collects blood and sputum samples for analysis. Which standard of practice is performed?
- Diagnosis
- Evaluation
- Assessment
- Implementation - SOLUTION 3 A nurse is caring for a patient with end-stage lung disease. The patient wants to go home on oxygen and be comfortable. The family wants the patient to have a new surgical procedure. The nurse explains the risk and benefits of the surgery to the family and discusses the patient's wishes with them. The nurse is acting as the patient's:
- Educator.
- Advocate.
- Caregiver.
- Case manager. - SOLUTION 2. Contemporary nursing requires that the nurse has knowledge and skills for a variety of professional roles and responsibilities. Which of the following are examples? (Select all that apply.)
- Caregiver
- Autonomy and accountability
- Patient advocate
- Health promotion
- Lobbyist - SOLUTION 1,2,3, A nurse meets with the registered dietitian and physical therapist to develop a plan of care that focuses on improving nutrition and mobility for a patient. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency?
- Patient-centered care
- Safety
- Teamwork and collaboration
- Informatics - SOLUTION 3. A critical care nurse is using a computerized decision support system to correctly position her ventilated patients to reduce pneumonia caused by accumulated respiratory secretions. This is an example of which Quality and Safety in the Education of Nurses (QSEN) competency?
- Patient-centered care
- Safety
- Teamwork and collaboration
- Informatics - SOLUTION 4 What are 3 importances of nursing history? - SOLUTION 1.perspective
- context
- past is not repeated 4, Pride
- enlightening Which nurse was part of the crimean war and pioneer for modern medicine? - SOLUTION Florence Nightingale This person opened the nursing program at St. Thomas Hospital - SOLUTION Florence Nightingale This person founded the American Red Cross - SOLUTION Clara Barton This person founded the American journal of nursing, was the chair of Columbia university and was a big advocate for higher nursing education. - SOLUTION Mary Nutting This person was the pioneer for public health nursing - SOLUTION Lilian Wald This person founded the national association for colored graduate nurses - SOLUTION Mary Mahoney This person founded planned parenthood - SOLUTION Margaret Sanger
- Beneficence
- Nonmaleficence
- Respect for autonomy - SOLUTION 1. Fidelity A patient is admitted to a medical unit. The patient is fearful of hospitals. The nurse carefully assesses the patient to determine the exact fears and then establishes interventions designed to reduce these fears. In this setting how is the nurse practicing patient advocacy
- Seeking out the nursing supervisor to talk with the patient
- Documenting patient fears in the medical record in a timely manner
- Working to change the hospital environment
- Assessing the patient's point of view and preparing to articulate it - SOLUTION 4. The application of utilitarianism does not always resolve an ethical dilemma. Which of the following statements best explains why?
- Utilitarianism refers to usefulness and therefore eliminates the need to talk about spiritual values
- In a diverse community it can be difficult to find agreement on a definition of usefulness, the focus of utilitarianism.
- Even when agreement about a definition of usefulness exists in a community, laws prohibit an application of utilitarianism.
- Difficult ethical decisions cannot be resolved by talking about the usefulness of a procedure. - SOLUTION 2. In most ethical dilemmas in health care, the solution to the dilemma requires negotiation among members of the health care team. Why is the nurse's point of view valuable?
- Nurses understand the principle of autonomy to guide respect for a patient's self-worth
- Nurses have a scope of practice that encourages their presence during ethical discussions.
- Nurses develop a relationship with the patient that is unique among all professional health care providers.
- The nurse's code of ethics recommends that a nurse be present at any ethical discussion about patient care - SOLUTION 3. What is ethics? - SOLUTION The study or examination of morality through a variety of different approaches
What are societal ethics? - SOLUTION These are simply laws and regulations that are mandated by the state/ country, that requires all persons at the minimum to follow. What are some of the societal ethics? (name 2 ) - SOLUTION 1. Negligence
- Liability
- malpractice
- Standard of care Choices made at the bedside are an example of what type of ethics? A. Bio ethics B. Professional ethics C. Personal ethics D. Clinical Ethics - SOLUTION D. Clinical Ethics This translates the high standards that are expected because of the privileged role held in society. A. Bio ethics B. Professional ethics C. Personal ethics D. Clinical Ethics - SOLUTION B. This ethics often overlaps with other types of ethics and may have to be put aside to ensure internalized views are not being projected A. Bio ethics B. Professional ethics C. Personal ethics D. Clinical Ethics - SOLUTION C. All of the following are ethical principles except: A. Justice B. Fidelity C. Nonmaleficence D. Respect for self E. Beneficence - SOLUTION D. should be autonomy Select the correct principle of ethics that is being depicted:
Cindy has promised to grab new batteries for a patient before she leaves for work. Cindy has a very exhausting shift working 14 hours for the day. Upon packing her things to go, she realized that she forgot the batteries. Cindy should get the patient the battery as this demonstrates: A. Justice B. Beneficence C. Fidelity D. Respect for others - SOLUTION C. Fidelity - In the role of a nurse, such action includes keeping your promises, doing what is expected of you, performing your duties, and being trustworthy The responsibility to do the right thing Is:
- Ethics of duty
- Ethics of consequences
- Ethics of Character
- Ethics of relationship - SOLUTION 1. Ethics of duty The responsibility to do offer the option that best serve the greater good is:
- Ethics of duty
- Ethics of consequences
- Ethics of Character
- Ethics of relationship - SOLUTION 2. Ethics of consequences (This basically means, we make decisions that are better for a larger group of people over just an individual, when you see ethic of consequence, think of the consequence of saving one person over a group of people!!) Willingness to reflect on our past action and base decision on our life experiences is:
- Ethics of duty
- Ethics of consequences
- Ethics of Character
- Ethics of relationship - SOLUTION 3. Ethics of Character (think, of it as, our character makes us who we are). True or false: Whistle blowers are protected when they file legitimate claims about clinical safety? - SOLUTION True True or False:
Understaffing isn't an ethical issue because many hospitals are charity funded and often falls under the budget of what can be afforded. - SOLUTION False. Understaffing IS AN ETHICAL ISSUE! IT ENDANGERS PATIENTS! REGARDLESS OF THE REASON. True or false An impaired colleague is a perfect example of an ethical issue - SOLUTION True true or false: Nurses are responsible for their actions and the actions of those to whom they delegate tasks - SOLUTION True! (sorry, but if your UAP fks up, you basically fked up too) What are the three types of patient education/ teaching types? - SOLUTION Self directed. Educational classes, patient-nurse learning encounters. A patient needs to learn to use a walker. Which domain is required for learning this skill?
- Affective domain
- Cognitive domain
- Attentional domain
- Psychomotor domain - SOLUTION 4. The nurse is planning to teach a patient about the importance of exercise. When is the best time for teaching to occur? (Select all that apply.)
- When there are visitors in the room
- When the patient states that he or she is pain free
- Just before lunch, when the patient is most awake and alert
- When the patient is talking about current stressors in his or her life
- When the patient is being transported for a procedure - SOLUTION 2, 3 A patient newly diagnosed with cervical cancer is going home. The patient is avoiding discussion of her illness and postoperative orders. What is the nurse's best plan in teaching this patient?
- Teach the patient's spouse
- Focus on knowledge the patient will need in a few weeks
- Provide only the information that the patient needs to go home
- Where to purchase a medical alert bracelet that says she has asthma
- The importance of maintaining a healthy diet and exercising regularly - SOLUTION 1. A nurse is teaching a group of young college-age women the importance of using sunscreen when going out in the sun. Which type of content is the nurse providing?
- Simulation
- Restoring health
- Coping with impaired function
- Health promotion and illness prevention - SOLUTION 4 A nurse is planning a teaching session about healthy nutrition with a group of children who are in first grade. The nurse determines that after the teaching session the children will be able to name three examples of foods that are fruits. This is an example of:
- A teaching plan.
- A learning objective.
- Reinforcement of content.
- Enhancing the children's self-efficacy. - SOLUTION 2 A nurse is instructing a patient who has decreased leg strength on the left side how to use a cane. Which action indicates proper cane use by the patient?
- The patient keeps the cane on the left side of the body.
- The patient slightly leans to one side while walking.
- The patient keeps two points of support on the floor at all times.
- After the patient places the cane forward, he or she then moves the right leg forward to the cane. - SOLUTION 3 A patient is experiencing some problems with joint stability. The doctor has prescribed crutches for the patient to use while still being allowed to bear weight on both legs. Which of the following gaits should the patient be taught to use?
- Four-point
- Three-point
- Two-point
- Swing-through - SOLUTION 1.
A patient with a right knee replacement is prescribed no weight bearing on the right leg. You reinforce crutch walking knowing that which of the following crutch gaits is most appropriate for this patient?
- Two-point gait
- Three-point gait
- Four-point gait
- Swing-through gait - SOLUTION 2 Which of the following indicates that additional assistance is needed to transfer the patient from the bed to the stretcher?
- The patient is 5 feet 6 inches and weighs 120 lbs.
- The patient speaks and understands English.
- The patient is returning to unit from recovery room after a procedure requiring conscious sedation.
- The patient received analgesia for pain 30 minutes ago. - SOLUTION 3 What is moral distress? - SOLUTION A person who is unable to take action that they believe is morally appropriate or is contradicting to their belief What are the three types of patient teaching? - SOLUTION Formal patient education self directed patient-nurse learning What is patient education - SOLUTION assisting people learn health related behaviors so they can incorporate in in their everyday lives What are the three learning domains? - SOLUTION cognitive, psychomotor, affective What are the three attributes necessary for patient education and learning?
- SOLUTION Patient will be motivated outcomes should be goal oriented planning is involved These three things often motivate patient's to change their lifestyle to adhere or start treatment: - SOLUTION perception of disease susceptibility to disease severity of the disease
activities outcomes and follow up Tell the type of care model being expressed: Nurse Becky arranges for a pick up for Ms. Gloria after her laparoscopic hysterectomy surgery, she also ensures that her disability paperwork is completed upon discharge. - SOLUTION Social care model. Deals with non-medical stuff such as food services, housing, transportation and disability Tell the type of care model being expressed: Nurse Becky arranged to administer all the medication needed for Janet at 11 pm. She also prepared a care plan to help her feel better. - SOLUTION Medical care model include treatment, medication, and focuses on provider driven care. Name three main populations that need care co-ordination: - SOLUTION elderly pediatric persons with multiple morbid conditions What is a very important characteristic of implementation of care co- ordination that must be considered? - SOLUTION The length of time. It should be adjusted to accommodate the priorities of the patient What are common ways that an evaluation can be made of the teaching plan? - SOLUTION Questionnaires, surveys, teach-backs and demonstrations. Teach when patient is alert and rested, keep teaching short and slow paced. This sounds applicable to which age group? A. Elderly B. Adolescent C. School Age D. Infant - SOLUTION A. Elderly Teach using a book that describes the story, this kind of teaching seems appropriate for which age group? A. Elderly
B. Adolescent C. School Age D. Infant E. Toddler - SOLUTION E. Toddler Teach using role play and short stories. Which age group would this teaching method be appropriate for? A. Preschooler B. Adolescent C. School Age D. Infant - SOLUTION A. Preschooler What is deconditioned? - SOLUTION A state of lost physical fitness, which may include muscle imbalances, decreased flexibility, and a lack of core and joint stability. Or, being fat and out of shape. can be caused by immobility The body has this many bones - SOLUTION 206 A. The skull is this type of joint: B. The knee is this kind of joint: C. The spinal column has this kind of joint - SOLUTION A. Syntharthoses B. Diarthroses C. Amphiarthroses A patient is asked to close his eyes. He is then asked to alternate his left and right index finger in touching in his nose. This is a demonstration of what cognitive function? - SOLUTION fine motor skills Name two adverse effects of immobility on the following bodily systems:
- Elimination
- Integument
- Lungs - SOLUTION 1. Infection, renal calculi
- Pressure ulcers, Ischemia
- Atelectasis, stasis pneumonia What are the three fall tools discussed in class? - SOLUTION John hopkins Morse fall Hendricks fall tool
Nurse Mary secures a restraint to Mr. Curry who is vey combative while he is sedative because last time he woke up earlier than scheduled and attacked the UAP. The nurses's action are A. appropriate in protecting staff B. Inappropriate - SOLUTION B. Patient's who are sedated should not be restrained. What can you recommend for atelectasis prevention for a patient on bed rest - SOLUTION Deep breathing, coughing, use of incentive spirometer What can be done to prevent muscle atrophy and loss of ROM in joints to someone on bed rest? - SOLUTION bed excercises What is urinary frequency? - SOLUTION abnormally frequent voiding What is urinary hesitancy? - SOLUTION A delay and difficulty in initiating voiding What is dysuria? - SOLUTION painful urination What is urinary urge? - SOLUTION leaking a large amount of urine What is transient incontinence? - SOLUTION urinary incontinence resulting from a temporary condition eg. medication or infection. What is impaction? - SOLUTION results from unrelieved constipation; a collection of hardened feces wedged in the rectum that a person cannot expel What are hemorrhoids? - SOLUTION varicose veins in rectum For Elimination, Remember: - SOLUTION Ileostomy = small intestines Colostomy = large intestines (because colost sounds like collosal which means large!) With a walker, does a person move forward with the affected or unaffected leg? - SOLUTION affected leg What three factors do you assess when looking at a urine sample? - SOLUTION COC - Color, Odor, Clarity
Is a urinary cauterization a closed or open system? - SOLUTION Closed to prevent back flow and subsequent UTI A nurse is cleaning a patient's bed after she ambulates to use the restroom. The nurse notices that the patient wet her bed. this is called: A. presbyopia B. Enuresis C. Stress incontinence D. Negligence - SOLUTION b. This is another name for bed wetting What is functional incontinence? - SOLUTION Caused by problems that prevent you from getting to the bathroom in time to avoid an accident (trouble walking from arthritis). What is the maximum the bladder should hold? - SOLUTION 500 cc What position for enema administration? - SOLUTION left side lying with right leg flexed For elimination remember, Elimination: - SOLUTION High Fiber Privacy Fluids Physical Activity Medication What is the number 1 best way to prevent infection and spread of disease?
- SOLUTION Hand Hygiene What is the normal range for the follow:
- PH
- PA
- SaO
- HCO
- RR - SOLUTION 1. 7.35- 7.
- 80 MM HG - 100 MM HG
- 95%- 100%
- 22- 266 Meq/ L
- 12 -20 bpm
how should you position a patient that is hypoxemic? - SOLUTION lay them horizontally. True or false:
- UAP can provide suctioning to a patient with a permanent trach - SOLUTION True. They can also suction oropharyngeal in a stable patient. What is a mnemonic for melanoma? - SOLUTION ABCDE A- Asymmetry B- Border C- Color D- Diameter E- Evolving / Edges What are the percentages of air for:
- simple mask
- non rebreather
- nasal cannula - SOLUTION 1. 35-50%
- 60 -90%
- 24 - 44% what is important to do before suctioning a patient and why? - SOLUTION Hypervetillating helps to decrease icp what is the maximum amount of liters can you give a COPD patient? - SOLUTION 2l What is HCT? - SOLUTION the amount (percentage) RBC in your body compared to the total amount of blood in your body temporary leakage due to some underlying factor eg. coughing due to cold etc. What is this? - SOLUTION Transient incontinence Name the pressure ulcer: unblancheable - SOLUTION stage 1 For a stage 2 pressure ulcer select all that applies:
A. Blistering B. full thickness C. Partial thickness D. open E. closed - SOLUTION A,C,D,E, it is partial thickness, has blistering and can be open or closed For a stage 3 pressure ulcer select all that applies : a. Partial thickness b. Full thickness c. Tunnelling d. adipose tissue exposed e. underlying bone exposed f. depth unknown - SOLUTION B,D in STAGE 3 - no muscle or bone is seen. it is full thickness and doesn't usually have tunelling and the depth IS KNOWN. Name the pressure ulcer: necrotic tissue must be removed before staging - SOLUTION UNSTAGEABLE what are the three phases of wound healing? - SOLUTION inflammation, granulation, maturation What is the normal range of WBC? - SOLUTION 5,000-10, Which of the following violates ascetic technique: Select all that apply A. Use for broken skin B. All objects must C. Hands down and scrub well for 20 seconds D. objects must remain in view - SOLUTION A,B,D. Hold hands up when scrubbing. What are the 6 common risk factors of compromised tissue integrity? - SOLUTION Sensory perception
