Final Exam Study Guide.docx

Module: Human Growth and Development - **Folic** **acid** supplements taken before and during pregnancy **reduce** the **risk** for **spina** **bifida**. - **Advanced** **maternal** **age** can increase the **risk** **for** chromosomal defects, such as **Down** **syndrome**. - Accor...

Module: Human Growth and Development - **Folic** **acid** supplements taken before and during pregnancy **reduce** the **risk** for **spina** **bifida**. - **Advanced** **maternal** **age** can increase the **risk** **for** chromosomal defects, such as **Down** **syndrome**. - According to **Freud's** **psychosexual** **stages**, failure to resolve the oral stage of development can lead to overeating, smoking, and drinking alcohol. - Children who have **fetal** **alcohol** **spectrum** **disorder** can display **hyperactive** **behavior**, inattentiveness, memory difficulties, and learning disabilities. - - Module: Inclusion, Equity, and Diversity - **Emic** **knowledge** is information about a culture obtained from an **individual who is part of the culture.** - **Etic** **knowledge** is information about a culture obtained from an **outsider** **observing** **cultural** **practices**. - **Implicit cultural bias** in health care can contribute to health care disparities. Nurses who have implicit biases might treat clients differently. Nurses should conduct a self-evaluation regarding self-bias to understand their own cultural views, assumptions, and values. - **Implicit cultural bias** in health care can cause a decrease in therapeutic rapport with clients and can result in inadequate care and potential client injury. Nurses who have implicit biases might treat clients differently. Nurses should conduct a self-evaluation regarding self-bias to understand their own cultural views, assumptions, and values. - A client who lives in a **crowded** apartment building is at **risk of acquiring and spreading infectious diseases.** - The nurse should **face the client** and make eye contact to effectively communicate with the client. - The nurse should **make eye contact** with the client when using a medical interpreter to promote communication with the client. - **Marital** **status** is included in the **kinship** and **social** **factors** **element** of the **sunrise** **enabler** cultural data collection tool. This information assists the nurse in planning care related to family and social support systems. - Module: Collaboration and Teamwork - The nurse should include in the in-service that **efficiency in client-care services and improved access** is a benefit of an interprofessional team. Health care team members working together provides efficiency in client-care services along with improved quality and safety care. - The nurse should **read back** the prescription to the provider to verify they wrote the prescription correctly to prevent error. - When using the **I-SBAR-R** **communication** **tool**. The **background** component includes pertinent background information required to provide effective and prompt care, examples of this are what type of illness or injury, when or how long ago did it occur or begin etc.. Using a structured handoff tool such as I-SBAR-R provides for a detailed exchange of information, decreases communication breakdowns, minimizes medical errors, and ensures client safety. - The nurse should include in the in-service on **incivility**, a nurse rolling their eyes at another nurse after providing report is an example of **horizontal** or **lateral** **violence**. Lateral violence is incivility between peer to peer. Module: Evidence-Based Practice - **Clinical** **practice** **guidelines** are evidence-based guidelines that provide information on medical management and health promotion activities for specific disease processes. Module: Informatics - **Information** **management** **technology** helps nurses and other health care providers **comply** with current **practice** **guidelines**. - The **purpose** **of** **RPM** is the rapid transfer of information and data to the client's health care provider. - **Informatics** is **defined** **as** the use of information and technology to communicate, **manage** **knowledge**, **mitigate** **errors**, and **support** **decision** **making**. Module: Patient-Centered Care - **Being** **with** involves being physically and emotionally present for the client. The nurse should **actively** **listen** to the client by focusing on what the client says, how the client says it, and by asking pertinent questions. - Using the **nursing** **process**, the **first** **action** the nurse should take is to **determine** the **client\'s** **needs**. The nurse should review the client\'s situation and available resources before creating an advocacy plan. - **Advocacy**: the nurse is **advocating** for the client by **communicating** **their** **wishes** to their provider. As a client advocate, the nurse should act on behalf of the client to protect their rights, health, and safety. Module: Quality Improvement - An **unusual** or **unexpected** **event**, such as a **client** **fall** or **medication** **error**, requires **completion** of an **incident** **report**. An **incident** **report** is used to review data about what lead to an event and provide information to prevent the event from recurring. Module: Safety - The nurse should complete an **environmental** **checklist** of the client's room to ensure that all objects that the client could use to cause self-harm to themselves have been removed. - The **acute** **illness** **stage** is the **third** **stage** of infection. The acute illness stage begins when significant manifestations of the infection occur such as sneezing, cough, muscle aches, headache and fever. - According to evidence-based practice, the **recognition** **of harmful stimuli by pattern receptors on cell surfaces** is the **first** **step** in the **inflammatory** **response**. The pattern receptors on the cell surfaces recognize an infectious stimulus, such as a bacteria or virus, or a non-infectious stimulus, such as a burn or foreign body. Module: Infection Control and Isolation - The nurse should **inspect the sterile package for damage** before using it to ensure the sterile package is not contaminated. Module: Complementary and Integrative Health - The **holistic** **nurse** should consider **factors** such as **stress**, **diet**, and **sleep** that might trigger the client\'s headaches. A **holistic** **approach** to nursing **includes** the **mind**, **body**, and **spirit** to relieve pain and promote health. - **Integrative** **health** combines complementary therapies and conventional medicine in an integrative manner to treat illness, relieve pain, and promote health. Example: massage therapy combined with pain medications. - **Chiropractic** medicine uses **spinal** **manipulation** and manual therapy, such as stretching, massage, and pressure to treat musculoskeletal disorders, such as neck and shoulder pain. - **Massage** **therapy** can cause **blood** **clots**, **nerve** **injury**, and **bone** **fractures** in older adult clients. - **Homeopathy** uses **diluted** **substances** to stimulate the **body to heal itself**. It is a medical approach that suggests a substance that can cause a disease can cure the disease. - The nurse determines that a **banana** is the **best** food **source** to recommend because 1 banana contains 326 mg of **potassium**. - **Vitamin** **A** **deficiency** can result in **visual** **changes**, **dry** **skin**, and **impaired** **immunity**. Module: Medication Administration - **Orange** **juice**, or foods containing **vitamin** **C**, can promote **absorption** of **iron** preparations. - **Evidence**-**based** **practice** indicates that medications administered via the **intravenous** **route** have the **fastest** **rate of absorption** because these medications are injected directly into the circulatory system. - The nurse should **shake** the **MDI (metered dose inhaler)** briskly for 2 to 5 seconds to aerosolize the medication particles prior to administering. - For **otic** **medications**, the nurse should **roll the medication between their hands to warm** it to room temperature before administration to promote comfort. Module: Mobility - When **lifting a heavy object**, the nurse should **stand** **close to the object being moved** to reduce reaching and decrease the risk of injury. This action indicates an understanding of the teaching. - **Safe** **ergonomic**-**practice**, breaks provide time for rest and muscle recovery, which reduces the risk for injury. - **When repositioning a client in bed**, according to evidence-based practice, the first action the nurse should take is to **raise the height of the client\'s bed**. This ensures the client is close to the nurse\'s center of gravity and reduces the risk of injury. - The nurse should assign a \"**minimal** **assist**\" activity level to client\'s who require an **assistive** **device**, such as a cane, to stand. Module: Client Education - Observing the client in checking their radial pulse utilizes the development of physical movement and coordination associated with the **psychomotor domain of learning**. - Preoperative teaching, the nurse should **ensure** **privacy** for the client to reduce distractions and **promote** **learning**. - **Teaching** a client with a **visual** **impairment**, the nurse should use reading material written with a large print or printed with braille to promote learning. - **Return** **demonstration** is an active teaching method based on the psychomotor domain of learning. The nurse demonstrates a procedure, and the client returns the demonstration. - **Teach-back** is an active teaching method based on the cognitive domain of learning. During teach-back, the nurse can evaluate the client's understanding of the education and determine whether further instruction is indicated. - The nurse should ask the **client to demonstrate** walking with a cane as part of the **evaluation** **step** of the **teaching** **plan**. Module: Vital Signs - Peripheral Vascular Resistance, a blood pressure of 160/88 mm Hg is greater than the expected reference range of systolic \< 120 mm Hg and diastolic \< 80 mm Hg. The nurse should expect **hypertension** in a client who has increased **peripheral** **vascular** **resistance** due to a decrease in compliance of the arteries and increased vasoconstriction. - A client who has **hypoglycemia** is at risk for **hypotension**. The nurse should monitor the client for hypotension (decreased blood pressure). - The nurse should **auscultate the client's apical pulse for 1 min** to obtain an accurate heart rate. - **Dehydration & hypotension**, the nurse should increase the client's fluid intake to increase circulatory blood volume and blood pressure. - Bearing down and **straining** to have a **bowel** **movement** can stimulate the **vagus** **nerve** and the parasympathetic nervous system and cause **bradycardia** and **hypotension**. Module: Nursing Foundations - **Code of ethics** outlines rules for nurses that include maintaining client confidentiality, protecting client rights, and being accountable for one's actions. - The nurse should identify the client is demonstrating **health literacy** by understanding to take their blood glucose daily. The client is demonstrating **health** **literacy** by being **knowledgeable** about and understanding their health care information and treatments. Module: Health Care Delivery - **Medicare consists of three parts: A, B, and D**. Part D covers prescription medications, Part A covers inpatient care, Part B covers outpatient services such as oxygen, mental health and ambulance services. - **MDS (medium data set) forms** are completed by a registered nurse in a long-term care setting and contain an evaluation of each resident\'s assessment, including their cognitive and physical status. The MDS forms are maintained at the facility for state compliance. Module: Health Promotion, Wellness, and Disease Prevention - A client who has a family history of breast cancer and is scheduled for a mammogram is an example of **secondary prevention**. **Secondary prevention** is early detection of a disease before it progresses. Secondary prevention can include screenings and other forms of diagnostic tests. Module: Health Policy - **Reviewing the policies and procedures manual before performing a skill,** such as IV removal**,** provides the nurse with best practice guidelines that promotes safety. These manuals provide information such as who can perform the procedure, equipment needed, and the steps to follow for the procedure. - **Each state's board of nursing governs or regulates all nursing programs in that state**, including prelicensure programs and advanced practice nursing programs. Nursing programs must be in accordance with the requirements of the board. - **The FDA** is responsible for enforcing medication laws to ensure all medications go through strict testing before being sold to the public. This includes prescriptions, over-the-counter medications, vaccines, and medical devices. Module: Comfort, Rest and Sleep - **Physiology of sleep**, memory is transferred from short-term to long-term during sleep. - **Physiological** **changes** that occur **during sleep** include body temperature, heart rate, blood pressure, and respiratory rate decrease **during non-rapid eye movement** sleep. - Enlarged tonsils can cause **obstructive sleep apnea (OSA).** - **Polysomnography** measures body movements, brain activity, heart rate, snoring activity, and blood pressure to diagnose sleep disorders during sleep. - **Diphenhydramine** **adverse** **reactions** can cause dry mouth, blurred vision, tinnitus, and urinary retention. The client should rinse their mouth out as needed and perform frequent oral hygiene to reduce dry mouth. - To best **promote comfort**, the nurse should present information and **answer questions honestly** to show respect, promote a caring relationship, and provide comfort to the client. - **Allowing** the client an opportunity to **make informed choices regarding their care**, such as types of food the client likes that can be included in their diabetic diet. The nurse is showing respect to the client. Module: End-of-Life Care - **End of life care dyspnea**, the nurse should administer an opioid narcotic as prescribed to promote vasodilation, relieve anxiety, and improve breathing. - End of life **organ donation authorization**, the client or the client\'s surrogate, if the client is unable, can request organ or tissue donation. - **Postmortem care,** the nurse should document the description and the location of the client\'s belongings - **Postmortem care,** the nurse should wash the client\'s body to remove body fluids to provide respect and dignity for the client. Module: Elimination - **Skin care for urinary incontinence**, the nurse should apply a protective barrier cream to clean, dry skin to reduce the risk for irritation and breakdown. - A **neobladder** is an **internal reservoir that stores urine**. It connects to the urethra to facilitate voiding. - A **colonoscopy** is performed to visualize the colon from the cecum to the anus. It is performed to **screen clients for colon or** **rectal cancer**. - The nurse should plan to **warm the enema solution to room temperature to promote comfort** for the client and reduce the risk of abdominal cramping. Module: Fluid, Electrolyte, and Acid-Base Regulation - **Risk of osteoporosis**, the client should **limit** calcium intake to 600 mg per dose day to **promote** **absorption.** - **IV infusion of dextrose 10%,** can increase blood sugars too much therefore the nurse should infuse the IV slowly and monitor the client for hyperglycemia - **Dextrose 5% in water** is an **isotonic** solution administered to clients who have **hypernatremia**. - The nurse should **change the client's IV tubing every 96 hr** to reduce the risk of infection. - Air Embolism, the nurse should **place the client on their left side** with their head down. The nurse should clamp the IV line to contain air in the client's left ventricle. Module: Gas Exchange and Oxygenation - **Mitral Valve Stenosis**, a **murmur** is a swishing or blowing sound is heard when auscultating the heart. It is caused by a backward flow of blood due to an incompetent valve. - **Pleural effusion**, **areas of dullness** percussed over the client\'s lung fields indicates areas of fluid in the lung. This is an expected finding for a client who has a pleural effusion. - The client should repeat the breathing exercise every 1 to 2 hrs to increase lung expansion and **reduce the risk for atelectasis and pneumonia**. - **COPD** (**pursed lip breathing**), the client should inhale through the nose and exhale through the mouth with purse lips to release trapped air, increase resistance, and prevent alveolar collapse. Module: Pain - **Acute Pain,** a surgical incision causes a short-term, anticipated pain that lasts **less than 6 months**. - **Nonverbal manifestations of acute pain** can include **hypertension**, **tachycardia**, **tachypnea**, **dilated pupils, diaphoresis, grimacing,** and **guarding.** - **Prescription for pain**, the nurse should administer the lowest dose first to the client. If the dose is ineffective, the nurse should wait until the medication has peaked before administering another dose, up to the maximum amount in the range prescribed by the provider, or up to 2 mg of morphine in 4 hr. Module: The Surgical Client - **Informed Consent**, the nurse should confirm the client is competent, of legal age, voluntarily giving consent, and has been given adequate information about the procedure. - **Postoperative complications, smoking tobacco** increases the risk for **blood clots, myocardial infarction, pneumonia, tissue necrosis,** and **delayed wound healing.** - Post-Anesthesia Care Unit, the first action the nurse should take using the airway, breathing, circulation approach to client care is to check the client\'s airway. Anesthesia places the client at risk for hypoxia. The nurse should **check the client\'s airway**, reposition the airway if needed, and apply supplemental oxygen. - **Patient unresponsive to verbal commands** is at greater risk for a **pressure injury** because they have a very limited sensory perception. The nurse should monitor the client for a pressure injury Module: Tissue Integrity - **Stage 1 Pressure Injury,** intact skin with localized erythema is a stage 1 pressure injury. Module: Sensory Perception - **Cranial Nerve I** (olfactory nerve), the nurse should have the client **identify specific smells**, such as coffee or peppermint, testing each nostril separately, when checking cranial nerve I