Exam 5 Fundamentals II
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Questions and Answers

Which domain of learning primarily focuses on the skills needed for physical tasks?

  • Cognitive
  • Psychomotor (correct)
  • Effective
  • Kinesthetic

    • What is the primary focus of the effective domain in learning?

  • Developing technical skills
  • Memorizing facts
  • Applying knowledge in practice
  • Understanding feelings and motivations (correct)

    • Which method is most effective for teaching psychomotor skills?

  • Storytelling
  • Demonstration and return demonstration (correct)
  • Lectures
  • Group discussions

    • What is meant by 'the right context' in patient education?

    <p>The teaching environment is conducive to learning</p> Signup and view all the answers

    Which of the following tools can be effective in the cognitive domain of learning?

    <p>Audiovisual materials</p> Signup and view all the answers

    What is one of the five rights of teaching that involves ensuring the patient is engaged?

    <p>Right goal</p> Signup and view all the answers

    Which teaching method is most likely to encourage personal reflection in the effective domain?

    <p>Journaling</p> Signup and view all the answers

    What is a key indicator that the 'right time' for teaching has been met?

    <p>The patient is free of pain and motivated</p> Signup and view all the answers

    Which factor contributes to skin breakdown in elderly individuals?

    <p>Thinner, more permeable skin</p> Signup and view all the answers

    What is the primary purpose of the subcutaneous layer?

    <p>Insulate the body and cushion organs</p> Signup and view all the answers

    Clients with which condition are more likely to develop pressure injuries?

    <p>Diminished sensation</p> Signup and view all the answers

    How does impaired circulation affect skin integrity?

    <p>It delays wound healing and contributes to tissue damage</p> Signup and view all the answers

    Which nutrient is essential for maintaining skin health?

    <p>Protein</p> Signup and view all the answers

    What type of wound is formed without any break in the skin?

    <p>Closed wound</p> Signup and view all the answers

    What are clean/contaminated wounds?

    <p>Wounds from unsterile surgical incisions into sterile areas</p> Signup and view all the answers

    Which type of wound healing involves little to no tissue loss?

    <p>Primary intention</p> Signup and view all the answers

    What can excessive moisture on the skin lead to?

    <p>Maceration and skin breakdown</p> Signup and view all the answers

    Which of the following describes a chronic wound?

    <p>A wound that exceeds the expected length of recovery</p> Signup and view all the answers

    What type of injury is classified as a superficial wound?

    <p>Injuries involving only the epidermal layer</p> Signup and view all the answers

    Clients with impaired cognition are at higher risk for pressure injuries due to which reason?

    <p>Lack of awareness to reposition themselves</p> Signup and view all the answers

    What can frequently bathing and using drying soaps lead to?

    <p>Compromised skin barrier and function</p> Signup and view all the answers

    What problem can arise from medications that affect skin integrity?

    <p>Skin itching and rashes</p> Signup and view all the answers

    What is the primary characteristic of secondary intention healing?

    <p>Involves extensive tissue loss</p> Signup and view all the answers

    During which phase of wound healing does hemostasis occur?

    <p>Inflammatory phase</p> Signup and view all the answers

    What type of drainage is characterized by a pinkish color due to a mix of fluids?

    <p>Serosanguinous</p> Signup and view all the answers

    Which complication of wound healing occurs most likely during the inflammatory phase?

    <p>Dehiscence</p> Signup and view all the answers

    What is the main purpose of the proliferative phase in wound healing?

    <p>Depositing collagen for strength</p> Signup and view all the answers

    What condition indicates that evisceration has occurred?

    <p>Protrusion of internal organs through the incision</p> Signup and view all the answers

    What type of healing involves delayed primary closure?

    <p>Tertiary intention healing</p> Signup and view all the answers

    What is a common cause of dehiscence in wound healing?

    <p>Poor nutritional status</p> Signup and view all the answers

    Which phase of wound healing is characterized by the presence of macrophages clearing debris?

    <p>Inflammatory phase</p> Signup and view all the answers

    What type of wound drainage is indicative of an infection?

    <p>Purulent</p> Signup and view all the answers

    What must a plaintiff prove to win a malpractice lawsuit?

    <p>Existence of a duty, breach of duty, causation, and damages</p> Signup and view all the answers

    What factor does the Braden Scale NOT assess?

    <p>Pain</p> Signup and view all the answers

    Which of the following is a form of defamation of character?

    <p>Slander</p> Signup and view all the answers

    What complication is characterized by an abnormal passage connecting two body cavities?

    <p>Fistula formation</p> Signup and view all the answers

    What does false imprisonment in nursing refer to?

    <p>Restraining a patient without legal authorization</p> Signup and view all the answers

    How long does the inflammatory phase of wound healing typically last?

    <p>1 to 5 days</p> Signup and view all the answers

    What is the role of fibroblasts during the proliferative phase?

    <p>They form collagen</p> Signup and view all the answers

    What is the primary purpose of Good Samaritan laws?

    <p>To protect those providing emergency care from liability</p> Signup and view all the answers

    Which element is NOT necessary to establish negligence in nursing?

    <p>Proof of intent to harm</p> Signup and view all the answers

    How should a nurse respond if a patient refuses care?

    <p>Document the patient's refusal and ensure they understand the consequences</p> Signup and view all the answers

    What does the failure to assess and diagnose imply in the context of nursing malpractice?

    <p>Failing to conduct an adequate assessment</p> Signup and view all the answers

    Which situation exemplifies invasion of privacy?

    <p>A nurse discussing a patient's condition with another patient</p> Signup and view all the answers

    What is required for a nurse to act in accordance with legal accountability?

    <p>Knowledge of state nursing practice acts</p> Signup and view all the answers

    What constitutes an intentional tort in nursing?

    <p>Restraining a patient without consent</p> Signup and view all the answers

    What is defined as fraud in nursing practice?

    <p>Providing misleading information to patients</p> Signup and view all the answers

    What does the term 'malpractice' primarily refer to in nursing?

    <p>Legal failures in the nursing profession</p> Signup and view all the answers

    Which of the following actions is crucial to minimize malpractice risk in nursing?

    <p>Keep detailed and accurate documentation of care provided</p> Signup and view all the answers

    What is the main purpose of standardized nursing terminology?

    <p>To make nursing care and its outcomes visible</p> Signup and view all the answers

    Which of the following is an advantage of source-oriented documentation systems?

    <p>Allows for easy identification of care by discipline</p> Signup and view all the answers

    What is one disadvantage of charting by exception?

    <p>Potential omissions of important information</p> Signup and view all the answers

    What does the minimum data set (MDS) process entail?

    <p>Comprehensive assessments of functional capabilities and health needs</p> Signup and view all the answers

    In the S-bar format of reporting, what does 'B' stand for?

    <p>Background</p> Signup and view all the answers

    What should be included when writing a prescription based on a verbal order?

    <p>Provider's name and your signature</p> Signup and view all the answers

    Which layer of the skin is responsible for producing new cells?

    <p>Stratum germinativum</p> Signup and view all the answers

    What is one of the main issues with problem-oriented documentation systems?

    <p>They centralize too much information</p> Signup and view all the answers

    Why is standardized terminology particularly important in EHR systems?

    <p>It allows for conversion into numerical codes</p> Signup and view all the answers

    Which statement correctly describes charting by exception?

    <p>Only significant findings are documented</p> Signup and view all the answers

    What document is critical for long-term care facilities to ensure compliance?

    <p>Minimum data set assessments</p> Signup and view all the answers

    In the context of nursing documentation, which is a benefit of problem-oriented systems?

    <p>Ease of monitoring the client’s progress</p> Signup and view all the answers

    Which of the following statements is true about the epidermis?

    <p>It lacks blood vessels</p> Signup and view all the answers

    What is a key characteristic of verbal orders during emergencies?

    <p>They must be confirmed for accuracy</p> Signup and view all the answers

    What is indicated by a Norton scale score of 18 or less for hospitalized patients?

    <p>High risk of pressure injuries</p> Signup and view all the answers

    Which stage of a pressure ulcer involves non-blanchable erythema of intact skin?

    <p>Stage 1</p> Signup and view all the answers

    What is a key characteristic of Stage 3 pressure ulcers?

    <p>Loss of the epidermis and dermis</p> Signup and view all the answers

    Which of the following accurately describes a deep tissue injury?

    <p>It is characterized by purple or maroon discoloration</p> Signup and view all the answers

    What type of errors occur when the wrong action is taken, such as administering the incorrect medication?

    <p>Errors of commission</p> Signup and view all the answers

    Which of the following is NOT a nursing intervention for preventing pressure injuries?

    <p>Limiting nutritional intake</p> Signup and view all the answers

    What defines wisdom in the context of nursing informatics?

    <p>Applying knowledge appropriately to solve complex problems</p> Signup and view all the answers

    Which component of nursing informatics aids in reducing errors related to handwriting in prescriptions?

    <p>Electronic health records (EHRs)</p> Signup and view all the answers

    Which of the following categories was suggested to be added to the Norton scale?

    <p>Skin appearance</p> Signup and view all the answers

    What does inadequate nutrition negatively impact in relation to pressure injuries?

    <p>Skin integrity and wound healing</p> Signup and view all the answers

    What is a defining feature of unstageable pressure ulcers?

    <p>Covered with eschar preventing depth determination</p> Signup and view all the answers

    What role does computer technology play in nursing informatics?

    <p>Facilitates data processing and enhances information accessibility</p> Signup and view all the answers

    What is the primary purpose of frequent repositioning for patients at risk of pressure injuries?

    <p>To reduce prolonged pressure on bony prominences</p> Signup and view all the answers

    What is the primary function of the underlying data in nursing informatics?

    <p>To provide context to isolated numbers</p> Signup and view all the answers

    What does the process of 'Information Processing' include regarding computers?

    <p>Input, process, output, and storage</p> Signup and view all the answers

    What is the role of nurses in ensuring proper patient care through delegation?

    <p>Nurses must understand delegation and the scope of practice of those they delegate to.</p> Signup and view all the answers

    Which ethical principle emphasizes the duty to do no harm?

    <p>Non-maleficence</p> Signup and view all the answers

    What is the primary focus of the code of ethics in nursing?

    <p>To inform the public about minimum standards and ethical considerations.</p> Signup and view all the answers

    What should a nurse do if there is an immediate threat to health or safety?

    <p>Report it immediately.</p> Signup and view all the answers

    Which ethical principle is concerned with fairness and equal treatment?

    <p>Justice</p> Signup and view all the answers

    What does the THINK mnemonic help with in ethical decision-making processes?

    <p>It assists with evaluating potential harm to patients.</p> Signup and view all the answers

    In which model does the nurse assess the patient's capability to make decisions?

    <p>Autonomy model</p> Signup and view all the answers

    What is an ethical dilemma?

    <p>A scenario where two ethical principles conflict.</p> Signup and view all the answers

    What is a nursing responsibility regarding continuing education?

    <p>Nurses must remain current in practice through ongoing education and training.</p> Signup and view all the answers

    What is the role of a whistleblower in healthcare?

    <p>To reveal information about corrupt practices.</p> Signup and view all the answers

    Which element is NOT part of the THINK mnemonic?

    <p>Knowledge of ethical guidelines.</p> Signup and view all the answers

    What does the Patient Care Partnership emphasize?

    <p>Patient expectations and responsibilities in ethical treatment.</p> Signup and view all the answers

    What is the duty of fidelity in nursing?

    <p>Being faithful and keeping promises made to patients.</p> Signup and view all the answers

    How are ethical principles often described in nursing practice?

    <p>In a continuum of obligations.</p> Signup and view all the answers

    Study Notes

    Patient Education

    • Patient education is crucial for nursing care, equipping patients with health management skills.
    • Three learning domains exist: cognitive, affective, and psychomotor.
    • Cognitive: Focuses on intellectual skills (recall, application). Includes thinking, problem-solving, and remembering. Taught via lectures, readings, discussions, and visuals.
    • Psychomotor: Involves physical skills and procedures (e.g., taking vitals, administering medications, ADLs). Learned through hands-on practice, demonstrations, return demonstrations, simulation, journaling, and reflection.
    • Affective: Deals with feelings, motivation, and engagement with new information. Influenced by student values, beliefs, and attitudes. Encourages personal reflection, empathy, and growth. Supported by role modeling, group discussions, storytelling, one-on-one teaching, and visuals.
    • Five rights of teaching:
      • Right time: Patient readiness, motivation, pain-free, trust established, sufficient time.
      • Right context: Quiet, distraction-free environment.
      • Right goal: Patient actively involved in planning, realistic and valued goals.
      • Right content: Appropriate to patient needs, new information or reinforcement, patient level, relevance.
      • Right method: Teaching strategy matches patient learning style and ability, varied methods.

    Documenting and Reporting

    • Standardized language enhances nursing visibility and demonstrable value, making outcomes more transparent.
    • Standardized terminology supports nursing research, EHR systems (numerical codes), and evidence-based practices.
    • Standardized nursing languages (NIC, NOC, NANDA) are used in documentation.
    • Source-oriented systems: Disciplines document in separate sections (history, labs, notes). Advantages: easy access to each discipline's care. Disadvantages: fragmented data, scattered throughout record; requires review of multiple sections for full understanding.
    • Problem-oriented systems: Database, problems, plan of care, progress notes. Advantages: common problem list, centralized information, easier progress monitoring, and enhanced team collaboration.
    • Charting by exception: Documents significant findings and exceptions to norms. Advantages: reduced time spent documenting routine care, highlights variations, easily read and understood. Disadvantages: potential omissions of important information.
    • Home Healthcare Documentation: Includes assessments, interventions, client responses, caregiver/provider interactions.
    • Long-Term Care Documentation: Comprehensive assessments, minimum data set (MDS) required for Medicare/Medicaid facilities. Updates necessary with condition changes. Includes SBAR (situation, background, assessment, recommendation).
    • Verbal/telephone orders: Less common due to CPOE. Require confirmation, repetition, spelling out terms, separate digit pronouncements. Must be countersigned within 24 hours.

    Skin Integrity and Wound Healing

    • Skin is the body's largest organ, composed of epidermis, dermis, and subcutaneous layers.
    • Epidermis: Protective barrier; stratum germinativum (basal layer) continuously produces new cells.
    • Dermis: Connective tissue, blood vessels, glands, nerves, hair follicles.
    • Subcutaneous: Insulation and cushioning.
    • Factors affecting skin integrity include:
      • Age: Thin, permeable skin in infants/children and older adults.
      • Nutrition: Adequate protein, vitamins (C, zinc, copper) for collagen formation.
      • Sensation Level: Impaired sensation increases risk of injury.
      • LOC (Level of Consciousness): Impaired cognition causes repositioning issues.
      • Impaired Circulation: Delays healing.
      • Medications: Skin reactions (itching, rashes).
      • Moisture: Maceration (softening) increases breakdown risk.
      • Fever: Sweating leading to maceration.
      • Infection: Impairs healing.
      • Lifestyle: Tanning, drying soaps, infrequent cleansing.
    • Wound Classification:
      • Closed: No skin break (e.g., contusion).
      • Open: Skin or mucous membrane break (e.g., abrasion, laceration).
      • Acute: Short-duration healing.
      • Chronic: Delayed healing.
      • Clean, Clean/contaminated, Contaminated, Infected, Superficial, Partial-thickness, Full-thickness.
    • Wound Healing Processes (Primary, Secondary, Tertiary).
    • Phases of Wound Healing (Inflammatory, Proliferative, Maturation).
    • Types of wound drainage (serosanguinous, purulent, sanguinous, puro-sanguinous)
    • Wound Healing Complications (Hemorrhage, Infection, Dehiscence, Evisceration, Fistula formation).
    • Nursing Assessments: Focused skin assessments, Braden Scale, Norton scale.
    • Pressure Injuries: Types (Stage 1-4, deep tissue, unstageable) Nursing Interventions.

    Nursing Informatics

    • Data: Unprocessed numbers, symbols, or words.
    • Information: Groups of data with context.
    • Knowledge: Meaningful information from groups of data.
    • Wisdom: Appropriate use of knowledge to solve complex problems.
    • Computer Functions: Input, process, output, storage.
    • Error Types: Commission (incorrect action), omission (missed action), planning, execution.
    • Benefits of EHRs: Efficiency, productivity, continuity, accessibility, reduced errors, privacy.
    • Informatics enhancing nursing: Evidence-based practice, literature databases, evidence-based practice databases (e.g., journals, organizations).

    Legal Accountability/Leading & Managing

    • State laws guiding nursing: Mandatory reporting, good Samaritan, nurse practice acts.
    • Torts in nursing practice:
      • Intentional torts: Assault, battery, false imprisonment, invasion of privacy, fraud, defamation.
      • Negligence, malpractice (duty, breach of duty, causation, damages).
      • Strategies to Minimize Malpractice Risk: Documentation, use of the nursing process, guidelines, delegation, continuing education, adherence to the legal and ethical framework.

    Ethics and Values

    • Ethical dilemmas arise when ethical principles conflict.
    • Whistleblower actions (THINK pneumatic).
    • Ethical Principles (Autonomy, Non-maleficence, Beneficence, Fidelity, Veracity, Justice).
    • Code of ethics (ANA, guidelines for professional behavior).
    • Patient care partnerships (focus on patient expectations), The Joint Commission Standards.
    • Ethics models (autonomy, patient benefit, social justice).

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    Description

    This quiz explores the essential aspects of patient education within nursing, emphasizing the three learning domains: cognitive, psychomotor, and affective. Learn how these domains impact health management and patient engagement. Additionally, discover the five rights of teaching to enhance patient readiness and motivation.

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