Podcast
Questions and Answers
An unstable client requires a change in care. Which healthcare provider is MOST appropriate to assume responsibility?
An unstable client requires a change in care. Which healthcare provider is MOST appropriate to assume responsibility?
A nurse is delegating tasks to assistive personnel. Which factor is MOST crucial for the nurse to consider before delegating?
A nurse is delegating tasks to assistive personnel. Which factor is MOST crucial for the nurse to consider before delegating?
Which of the following components is LEAST important when communicating delegated tasks?
Which of the following components is LEAST important when communicating delegated tasks?
Which of the following is the MOST appropriate description of health promotion according to the provided information?
Which of the following is the MOST appropriate description of health promotion according to the provided information?
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Which of the following is an example of a modifiable risk factor for illness or injury?
Which of the following is an example of a modifiable risk factor for illness or injury?
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A 45-year-old woman with no family history of breast cancer asks about breast cancer screening guidelines. What should the nurse recommend regarding clinical breast exams?
A 45-year-old woman with no family history of breast cancer asks about breast cancer screening guidelines. What should the nurse recommend regarding clinical breast exams?
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A client reports finding a lump in their breast during a self-exam. What characteristics of the lump would be most concerning?
A client reports finding a lump in their breast during a self-exam. What characteristics of the lump would be most concerning?
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A 52-year-old man is scheduled for his first colonoscopy. What pre-procedure instruction is MOST important for the nurse to emphasize?
A 52-year-old man is scheduled for his first colonoscopy. What pre-procedure instruction is MOST important for the nurse to emphasize?
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Which of the following statements BEST describes current recommendations for mammogram screening in women?
Which of the following statements BEST describes current recommendations for mammogram screening in women?
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According to the information provided, when should screening for uterine cancer typically begin?
According to the information provided, when should screening for uterine cancer typically begin?
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When prioritizing patient care using the C.U.R.E. framework, which of the following examples would fall under 'Urgent' needs?
When prioritizing patient care using the C.U.R.E. framework, which of the following examples would fall under 'Urgent' needs?
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According to Maslow's hierarchy of needs, which level is primarily addressed when attending to 'Routine' needs in the C.U.R.E. prioritization framework?
According to Maslow's hierarchy of needs, which level is primarily addressed when attending to 'Routine' needs in the C.U.R.E. prioritization framework?
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A patient experiencing an anaphylactic reaction, difficulty breathing, and a rapidly dropping blood pressure requires immediate intervention. According to the C.U.R.E. framework, this situation falls under which category?
A patient experiencing an anaphylactic reaction, difficulty breathing, and a rapidly dropping blood pressure requires immediate intervention. According to the C.U.R.E. framework, this situation falls under which category?
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A nurse is delegating tasks to a patient care assistant (PCA). Which of the following tasks is most appropriate for the nurse to delegate to the PCA?
A nurse is delegating tasks to a patient care assistant (PCA). Which of the following tasks is most appropriate for the nurse to delegate to the PCA?
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A nurse discovers a fire in a patient's trash can. After moving the patient to safety, what is the next appropriate intervention?
A nurse discovers a fire in a patient's trash can. After moving the patient to safety, what is the next appropriate intervention?
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Consider a scenario of escalating care levels. Which action needs to be taken FIRST?
Consider a scenario of escalating care levels. Which action needs to be taken FIRST?
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A patient is scheduled to receive multiple medications at the same time. Which of the following actions demonstrates appropriate medication administration and patient safety?
A patient is scheduled to receive multiple medications at the same time. Which of the following actions demonstrates appropriate medication administration and patient safety?
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When working with a patient who speaks a different language, what is the most appropriate nursing intervention to ensure effective communication?
When working with a patient who speaks a different language, what is the most appropriate nursing intervention to ensure effective communication?
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You are caring for a patient who is exhibiting early signs of sepsis. What is the priority nursing intervention?
You are caring for a patient who is exhibiting early signs of sepsis. What is the priority nursing intervention?
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A patient with COPD is experiencing increased shortness of breath and wheezing. Which of the following interventions should the nurse implement first?
A patient with COPD is experiencing increased shortness of breath and wheezing. Which of the following interventions should the nurse implement first?
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An otherwise stable patient begins to exhibit subtle signs of declining neurological function. According to the guidelines given, which healthcare provider MUST assume the patient's care?
An otherwise stable patient begins to exhibit subtle signs of declining neurological function. According to the guidelines given, which healthcare provider MUST assume the patient's care?
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What is the expected frequency and best practice for breast self-exams in alignment with recommended cancer screening guidelines?
What is the expected frequency and best practice for breast self-exams in alignment with recommended cancer screening guidelines?
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A nurse delegates the task of ambulating a stable post-operative patient to an Unlicensed Assistive Personnel (UAP). Which of the following considerations is MOST critical before delegation?
A nurse delegates the task of ambulating a stable post-operative patient to an Unlicensed Assistive Personnel (UAP). Which of the following considerations is MOST critical before delegation?
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According to the principle of health promotion, what is the PRIMARY aim of interventions?
According to the principle of health promotion, what is the PRIMARY aim of interventions?
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A patient with a family history of colon cancer is discussing screening options with a nurse. What is the MOST appropriate recommendation considering the patient’s increased risk?
A patient with a family history of colon cancer is discussing screening options with a nurse. What is the MOST appropriate recommendation considering the patient’s increased risk?
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Which of the following factors is considered a non-modifiable risk factor?
Which of the following factors is considered a non-modifiable risk factor?
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A nurse preparing to delegate a task to an LPN understands which of the following to be TRUE regarding LPN scope of practice based on the provided context?
A nurse preparing to delegate a task to an LPN understands which of the following to be TRUE regarding LPN scope of practice based on the provided context?
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A 42-year-old patient asks about the recommended frequency of mammograms. What is the MOST appropriate response based on the provided guidelines?
A 42-year-old patient asks about the recommended frequency of mammograms. What is the MOST appropriate response based on the provided guidelines?
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Communication of a delegated task by the RN or LPN to assistive personnel MUST include which of the following elements for maximum effectiveness?
Communication of a delegated task by the RN or LPN to assistive personnel MUST include which of the following elements for maximum effectiveness?
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When does the provided cancer screening guidelines state Uterine Cancer screenings should start?
When does the provided cancer screening guidelines state Uterine Cancer screenings should start?
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Which of the following scenarios represents a 'Critical' need according to the C.U.R.E. prioritization framework?
Which of the following scenarios represents a 'Critical' need according to the C.U.R.E. prioritization framework?
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A patient reports feeling isolated and expresses a desire to reconnect with their community. According to Maslow's hierarchy of needs and the C.U.R.E. framework, which category does this fall into?
A patient reports feeling isolated and expresses a desire to reconnect with their community. According to Maslow's hierarchy of needs and the C.U.R.E. framework, which category does this fall into?
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Which nursing action demonstrates the least effective application of critical thinking principles?
Which nursing action demonstrates the least effective application of critical thinking principles?
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A Registered Nurse (RN) is delegating tasks on a busy medical-surgical unit. Which task is least appropriate to delegate to a Licensed Practical Nurse (LPN)?
A Registered Nurse (RN) is delegating tasks on a busy medical-surgical unit. Which task is least appropriate to delegate to a Licensed Practical Nurse (LPN)?
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A patient requiring assistance with feeding and hygiene but is otherwise stable would be classified under which level of priority using the C.U.R.E method?
A patient requiring assistance with feeding and hygiene but is otherwise stable would be classified under which level of priority using the C.U.R.E method?
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Applying C.U.R.E with Maslow's Hierarchy would be beneficial for all the reasons, except:
Applying C.U.R.E with Maslow's Hierarchy would be beneficial for all the reasons, except:
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Within the delegation process, which step is least likely to be part of it?
Within the delegation process, which step is least likely to be part of it?
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A patient is admitted with chest pain, shortness of breath, and dizziness. Considering both the C.U.R.E framework and Maslow's hierarchy of needs, what is the most appropriate initial nursing intervention?
A patient is admitted with chest pain, shortness of breath, and dizziness. Considering both the C.U.R.E framework and Maslow's hierarchy of needs, what is the most appropriate initial nursing intervention?
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Which of the following situations best demonstrates a nurse effectively utilizing the nursing process in a patient's care?
Which of the following situations best demonstrates a nurse effectively utilizing the nursing process in a patient's care?
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Study Notes
Coordination of Care
- Care is team-based, sharing information among healthcare providers and patient care teams.
- Utilize information literacy to identify, evaluate and apply information sources.
- Use evidence-based practice, integrating nursing research, clinical expertise and patient preferences.
- Four steps of care coordination:
- Establish responsibility by clarifying who is accountable for specific aspects of care.
- Communicate effectively by sharing patient information clearly and promptly.
- Assist with transitions, facilitating care changes (e.g., case management).
- Assess patient needs and goals to tailor care to each patient's unique situation.
- Chain of command for problem-solving:
- Nursing hierarchical order: Administrator → DON → Assistant DON → Nursing Staff
- School hierarchical order: Instructor → Course Coordinator → Division Chair → Directors
- Prioritize communication and systematically escalate issues.
- Prioritization in Nursing:
- Address life-threatening needs first (ABCDE): -Airway, Breathing, Circulation, Safety, Discomfort, Education, Feelings. -Critical, Urgent, Routine, Extras
- Consider Maslow's hierarchy to prioritize care.
Critical Needs
- Definition: Immediate life-threatening situations requiring urgent attention to save a life.
- Maslow's Level: Physiological Needs (Airway, Breathing, Circulation)
- Medical Examples:
- Airway Obstruction: Clear the airway immediately (e.g., suctioning, Heimlich maneuver).
- Severe Hypoglycemia: Administer 15g of oral glucose or IV dextrose immediately.
- Cardiac Arrest: Begin CPR and call for a defibrillator immediately.
Urgent Needs
- Definition: High-priority tasks that, while not immediately life-threatening, could become critical if delayed.
- Maslow's Level: Physiological needs (e.g., oxygenation, hydration) and Safety needs.
- Medical Examples:
- Oxygen Saturation decline: Increase oxygen flow or adjust delivery method
- Post-Operative Pain Management: Administer prescribed pain medication.
- Wound Care for a Patient with Diabetes: Clean the wound and apply prescribed antibiotics.
Routine Needs
- Definition: Tasks contributing to daily care but without immediate urgency.
- Maslow's Level: Physiological Needs (e.g., food, hygiene) and Safety needs (e.g., preventing discomfort).
- Medical Examples:
- Feeding a Stable Patient: Assist with feeding after addressing critical and urgent needs.
- Hygiene for Bedridden Patients: Schedule hygiene care as routine.
- Ambulation Assistance: Prioritize ambulation after critical and urgent needs met.
Extras
- Definition: Tasks delaying without negatively affecting patient outcomes.
- Maslow's Level: Love and Belonging, Esteem and Self-Actualization.
- Medical Examples
- Social Interactions: Provide attention and conversation once higher-priority needs met.
- Patient Education on Lifestyle Changes: Provide education once immediate care needs addressed.
- Room Comfort Adjustments: Make room adjustments after critical, urgent, and routine needs satisfied.
Comprehensive Scenario
- Patient: 65-year-old male with COPD, diabetes, and post-operative pain.
- Critical: Oxygen saturation drops to 85%, struggling to breathe.
- Urgent: Severe post-operative pain (8/10).
- Routine: Requests lunch assistance.
- Extra: Asks for information about new diabetes medication.
- Prioritization of tasks using CURE framework.
Delegation
- RNs can delegate tasks to LPNs or CNAs.
- LPNs can delegate tasks to CNAs.
- Delegate when the patient is stable, task is within scope, and teaching, monitoring, evaluation is feasible.
- 5 rights of delegation:
- Right Task
- Right Circumstances
- Right Person
- Right Direction
- Right Supervision
Critical Thinking in Nursing
- Steps to critical thinking:
- Recognize problems.
- Gather clinical data.
- Analyze and act based on evidence.
Nursing Process
- 5 Steps in the Nursing Process
- Assessment
- Diagnosis
- Planning
- Implementation
- Evaluation
Nursing Roles
- Registered Nurse (RN): Initiates teaching, develops POCs, assesses unstable patients, administers IV medications, and delegates tasks.
- Licensed Practical Nurse (LPN): Reinforces teaching, assists in POC development, administers non-IV medications and cares for stable patients.
- Patient Care Assistant (PCA): Assists with ADLs, vital signs, and patient mobility.
Sample Questions for Review
- Delegation: RN delegates vital signs to the nursing assistant except for a patient with post-op complications.
- Prioritization: Assess a patient with asthma and shortness of breath first.
- Communication chain: Follow the hierarchical structure.
Health Promotion
- Process of enabling people to control and improve their heath.
- Cultural influences: Differing attitudes and practices regarding childbirth, death, pain, suffering, hygiene, and life transitions.
Cultural Influences
- Attitudes and practices differ among cultures, including childbirth and death practices, responses to pain, personal hygiene, and adjusting to life changes.
Key Illness Terms
- Acute Illness: Sudden onset, quick resolution (e.g., cold).
- Chronic Illness: Develops over a long period (e.g., heart disease, COPD), persists longer than 6 months.
- Terminal Illness: Incurable illness leading to death
- Primary illness: Not caused by another condition.
- Secondary illness: Infection
- Idiopathic Illness: Cause unknown.
- Exacerbation: Worsening of symptoms.
- Remission: Reduction or disappearance of symptoms.
- Asymptomatic: No noticeable symptoms.
Levels of Prevention
- Primary Prevention: Health education, immunizations, and screenings (e.g., teaching handwashing)
- Secondary Prevention: Early detection and treatment (e.g., mammograms)
- Tertiary Prevention: Rehabilitation and preventing further complications (permanent defect)
Risk Factors for Illness or Injury
- Genetic and physiological factors, Age, Environment, Lifestyle, and Gender
Cancer Screenings
- Breast Cancer (most common): Monthly self-exams, clinical exams every 3 years (ages 20-39), annually after 39, mammograms every 2 years (ages 40-74).
- Cervical Cancer: Pap smears starting at age 21 (or when sexually active), every 3 years (ages 21–29), Pap and HPV every 5 years (ages 30–65).
- Prostate Cancer: Annual digital rectal exams and PSA testing annually from age 50.
- Colorectal Cancer: Colonoscopy every 10 years from age 50; or earlier as advised.
Immunizations
- Various immunization schedules and contraindications are described, including those for infants, children, and adults.
Communication in Nursing
- Definition: Exchange of information through verbal, nonverbal, or written means.
- Verbal communication includes spoken, written, and electronic formats.
- Nonverbal communication includes body language, facial expressions, and gestures. Most communication is nonverbal; nurses must observe for cues.
Providing Information
- Clarifying, focusing, paraphrasing, and validating the relevant questions of a patient. Summarizing and self-disclosure are parts of the process.
- Confrontation.
Nurse-Patient Relationships
- Build trust, demonstrate empathy, establish boundaries, respecting cultural influences, developing comprehensive care plans. (Phases: Introduction, working, and termination.)
- Therapeutic Techniques:
- Empathy: Show understanding.
- Silence: Allow patient time to think.
- Clarifying: Ensure understanding.
- Nonverbal Communication Examples: Gentle touch to alert blind patients; maintaining eye contact; therapeutic touch to provide comfort
Special Considerations for Communication
- Hearing-impaired patients: Use clear lighting, minimize noise, speak clearly, use simple language, consider using a sign language interpreter.
- Cognitively impaired patients: Use simple language, watch for nonverbal cues, maintain a calm, and supportive tone, use non-verbal communication
Documentation Guidelines
- Serves as a vital record, tracks patient care and progresses, ensures care continuity.
- Practice the 4 "C's" of documentation: CLEAR, CONCISE, CORRECT, and COMPLETE.
- Includes patient data, care provided, and patient responses.
- Common formats: Narrative chartting, SOAP notes; PIE charting ,DAR charting, and Charting by exception.
- Avoid common errors (omitting important information, illegible handwriting, using inappropriate abbreviations, not documenting actions, errors in recording medications, failing to document discontinued medications, poor charting technique, etc.)
Incident Reports
- Documents events not typical of routine care.
- Important for legal and administrative reasons.
- Objective information and avoid liability issues.
HIPAA
- HIPAA Privacy Rule: Limits use and disclosure of protected health information (PHI).
- PHI includes patient identifiers, medical conditions, and payment information. Penalties for violation are significant.
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Description
This quiz explores the principles of care coordination within nursing practice. It covers team-based care, effective communication, and the integration of evidence-based practices while highlighting the roles in the healthcare hierarchy. Test your knowledge on how to assess patient needs and facilitate transitions in care.
