Fundamentals of Nursing Spring 2025 Concept Review Exam 1 PDF

**This exam covers chapters 1, 20, 17, 24, 25 & 27. Although you are responsible for all covered material, here are some concepts of focus.** **Chapter 1** Discuss how nurses have developed more independent practice during the last 50 years. - nurses have developed more independent practice...

**This exam covers chapters 1, 20, 17, 24, 25 & 27. Although you are responsible for all covered material, here are some concepts of focus.** **Chapter 1** Discuss how nurses have developed more independent practice during the last 50 years. - nurses have developed more independent practice through significantly increased educational attainment, particularly with the rise of advanced practice nursing roles like Nurse Practitioners (NPs), allowing them to diagnose, treat, and prescribe medication in certain situations, alongside a stronger emphasis on evidence-based practice, leading to greater autonomy in decision-making and patient care management within their scope of practice. Discuss the influence of nursing's historical development on contemporary views of professional nursing. - emphasized focus on patient advocacy, holistic care, and a strong emphasis on ethical conduct, with nurses now recognized as vital members of the healthcare team with a wide range of specialized skills and advanced practice capabilities. Identify distinct pathways for entrance into and continuation of professional nursing practice. - CNA, LPN, ADN, BSN, Identify the different levels of nursing education and scope of practice. - CNA -- entry level role under supervision of RN's - LPN -- role requiring 1 year of school - RN -- Involves assessing, monitoring, and treating patients - ASN -- associates degree preparing students to become RN's - BSN -- degree preparing students for comprehensive nursing roles - NP - A role that requires a master\'s or doctoral degree in nursing and a license from an approved national licensing body Identify roles and responsibilities of professional nurses within the healthcare delivery system. - RN roles and responsibilities - Assessing, observing, and speaking to patients. Recording details and symptoms of patient medical history and current health. Preparing patients for exams and treatment. Administering medications and treatments, and then monitoring patients for side effects and reactions. Describe the purpose and function of professional nursing organizations. - Professional nursing organizations aim to promote and protect the interests of nurses by setting standards for nursing practice, providing education and training opportunities, advocating for healthcare policies that benefit nurses and patients, offering support and guidance to members, and ultimately improving the quality of patient care through professional development and policy influence Recognize major nursing theories and their relevance to nursing practice. Theories of Florence Nightingale. - Environmental theory - Pure air and water, cleanliness, effective drainage, and light Describe the aspects of holistic nursing. - Holistic nursing is an approach to patient care that considers the patient as a whole being. Holistic care in nursing addresses all aspects of a patient's being, including their emotional, mental, spiritual, social, and physical needs. Identify the four major concepts of nursing theories. - Person, environment, health, and nursing Explain the relationship of functional health pattern typology to nursing. Review the levels of Maslow's hierarchy of needs and how it pertains to patient care. **Chapter 20** Identify the six components of the chain of infection. - **Infectious agent**: A microorganism, such as a virus, parasite, fungus, or bacterium, that causes disease - **Reservoir**: The environment where the microorganism lives and multiplies - **Portal of exit**: How the microorganism leaves the reservoir - **Mode of transmission**: How the microorganism spreads from one person to another - **Portal of entry**: How the microorganism enters a new person\'s body - **Susceptible host**: A person who is at risk of infection Identify ways that infection may occur (mode of transmission) - Vehicle, direct, indirect, vector, droplet, and airborne Describe factors that increase the risk of infection in various settings. - compromised immune systems, invasive procedures, open wounds, long hospital stays, improper hand hygiene practices by healthcare workers, shared medical equipment, contaminated environments, overuse of antibiotics leading to resistant bacteria, and high-risk patient care areas like intensive care units. Discuss the role of healthcare personnel and health agencies in infection control. - Healthcare personnel play a critical role in infection control by actively implementing practices like hand hygiene, proper use of personal protective equipment (PPE), patient isolation when necessary, and adhering to standard and transmission-based precautions, while health agencies establish guidelines, monitor compliance, and provide education to ensure effective infection prevention strategies across all healthcare settings, protecting both patients and healthcare workers from the spread of infections Identify ways that caregivers can increase their protection against infectious exposure. - Caregivers can increase their protection against infectious exposure by consistently practicing good hand hygiene, wearing appropriate personal protective equipment (PPE) when necessary, following respiratory hygiene etiquette, properly cleaning and disinfecting surfaces, and being aware of when to use isolation precautions, all while adhering to standard infection control practices. Explain ways that caregivers can decrease the transmission of infection to patients. - consistently practicing good hand hygiene, wearing appropriate personal protective equipment (PPE) when necessary, following respiratory hygiene guidelines, properly cleaning and disinfecting patient care equipment and the environment, and adhering to standard precautions for all patient interactions, including isolating patients with highly contagious infections when required. Differentiate between medical and surgical asepsis. - Medical asepsis, also known as clean technique, is used to control microorganisms in all patient care. Surgical asepsis, also known as sterile technique, is used to eliminate microorganisms in surgical procedures Demonstrate good hand hygiene technique and identify key occasions and reasons for incorporating it as an integral part of practice. - before eating, after using the toilet, before and after patient contact (in healthcare settings), after coughing or sneezing Describe appropriate situations for using cleaning, disinfection, and sterilization. - Cleaning is appropriate for everyday surface maintenance, removing visible dirt and debris, while disinfection is used when you need to kill most germs on a surface, like high-touch areas in a public space, and sterilization is reserved for medical equipment that comes into contact with sterile tissues, requiring the complete elimination of all microorganisms. Describe proper use of barriers also known as personal protective equipment (PPE). - wearing the appropriate barrier items, like gowns, gloves, masks, and eye protection, based on the potential exposure to bodily fluids or infectious agents, ensuring a proper fit, putting them on correctly before patient contact, and carefully removing and disposing of them afterwards to prevent self-contamination and the spread of infection Discuss the two-tier system of isolation. - Standard precautions - These are basic infection control practices applied to every patient, including hand hygiene, wearing gloves when appropriate, and proper disposal of sharps.  - Transmission-based precautions - Airborne, droplet, contact, etc. Standard precautions & transmission-based precautions\ Identify age-related and cultural considerations in preventing the transmission of infectious diseases. **Chapter 27** Name the major components of the body's normal resistance to infection and the role of each. - physical barriers like skin and mucous membranes, innate immune cells (like neutrophils and macrophages), the complement system, and the adaptive immune system with B cells producing antibodies and T cells directly attacking infected cells Differentiate between cellular and humoral immunity and between active and passive immunity. - Humoral immunity and cellular immunity are two types of immune responses that work together to protect the body from pathogens. Humoral immunity is antibody-mediated, while cellular immunity involves cell-to-cell contact. - Active immunity is when your body\'s immune system protects you from a pathogen, while passive immunity is when you receive antibodies from another source Identify possible risk factors for infection or infectious diseases. - Weakened immune system, age, underlying health conditions, travel, hygiene, unvaccinated, healthcare workers, and environment Discuss five common healthcare-associated infections (HAIs). - MRSA, C. Dificile, Catheter-associated urinary tract infection (CAUTI), Central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia Recognize common manifestations of infection. - Fever, chills, headache, cough, sore throat, shortness of breath, skin changes, diarrhea, vomiting, pain, urination(burning or pain), vaginal discharge, weight loss, fatigue Identify common diagnostic and laboratory tests used to identify or confirm an infectious process. - Common diagnostic tests for infectious diseases include blood tests, urine tests, and cultures of bodily fluids.  Describe major consequences of an infectious process. - Sepsis, meningitis, pneumonia, dehydration Describe nursing measures that strengthen defense mechanisms against infection. - good nutrition, ensuring adequate hydration, encouraging regular exercise, monitoring immunization status, practicing proper hand hygiene, using appropriate personal protective equipment (PPE), educating patients on hygiene practices, managing stress levels, and providing supportive care for patients with compromised immune systems **Chapter 17** Identify factors that affect safety & common manifestations of altered safety. - environmental hazards like poor lighting, slippery surfaces, unsafe equipment, as well as individual factors like patient acuity, communication breakdowns, medication errors, inadequate staff training, and a poor safety culture Recognize the importance of safety in the home & healthcare environments. - it protects the well-being of patients, caregivers, and the environment Identify patients at risk for injury through assessment. - impaired mobility, poor balance, visual impairments, cognitive decline (dementia), recent falls, use of multiple medications with side effects like dizziness, orthostatic hypotension, incontinence, pain affecting gait, and neurological conditions that impact coordination or awareness, particularly in older adults Identify necessary interventions to promote safety - provide strong, clear, and visible attention to safety Preventing falls - conducting regular fall risk assessments for each patient, creating individualized fall prevention plans, implementing exercise interventions to improve balance and strength, maintaining a clutter-free environment, using assistive devices when needed, educating staff on fall prevention techniques, and monitoring fall rates to identify areas for improvement Identify alternatives to using restraints and guidelines when using restraints. - frequent monitoring, providing regular toileting assistance, environmental modifications like lower beds, using bed/chair alarms, offering distractions and activities, providing a sitter, implementing personalized care plans, and utilizing assistive devices like walkers or canes Filing an Adverse Event/Incident Report & documentation - documenting a detailed account of an unexpected or harmful event that occurs during patient care, including the circumstances surrounding the incident, the actions taken in response, and any potential contributing factors, with the primary goal of learning from the event and preventing similar occurrences in the future Fire safety and RACE/PASS - \'Remove, Alarm, Confine and Extinguish or Evacuate - Pull, aim, squeeze, and sweep Barriers to reporting events. - fear of blame or punishment, lack of time to report, a culture of blame and shame, inadequate reporting systems, lack of awareness about reporting procedures, concerns about legal ramifications, not trusting that reports will be acted upon, and a lack of support from leadership **Chapter 24** Factors affecting personal hygiene - cultural practices, socioeconomic status, and developmental level General skin care principles - Clean, moisturizing, and protecting skin Safety concerns when providing care - medication errors, diagnostic errors, patient falls, healthcare-associated infections, bloodborne pathogens, workplace violence, sharps injuries, improper handling of medical devices, ergonomic hazards from lifting patients, and potential exposure to hazardous chemicals or radiation Discuss the importance of self-care and hygiene in health and illness. - helps manage stress, lowers risk of illness, and increases energy Describe the effects of health and illness on the ability to perform self-care. - physical limitations, cognitive impairments, pain, fatigue, and emotional distress caused by illness can directly hinder one\'s capacity to manage their own health through activities like medication adherence, diet management, exercise, and monitoring symptoms Discuss important subjective and objective areas of assessment when identifying self-care deficits and individualizing a plan for self-care. - key subjective areas include the individual\'s reported feelings about their ability to manage daily activities, motivation levels, stress levels, and perceived barriers to self-care, while objective areas include physical appearance, hygiene, nutritional intake, sleep patterns, and ability to perform basic activities of daily living (ADLs) like bathing, dressing, and eating Demonstrate basic hygiene skills such as bathing, shampooing hair, perineal care, foot care, back massage, toileting, and bed making. - N/A Demonstrate proper care of eyes, ears, and teeth, including aids such as dentures, eyeglasses, contact lenses, and hearing aids. - N/A List beneficial patient teaching for each of the four areas of selfcare. - physical, emotional, mental, and spiritual **Chapter 25** Explain normal functions of the musculoskeletal system and characteristics of normal movement. Identify factors, including lifespan considerations, that can affect or alter mobility. - Age-related physical changes like muscle weakness, joint degeneration, decreased balance, chronic diseases such as arthritis, Parkinson\'s disease, or stroke, neurological conditions, injuries, lifestyle choices like exercise habits and diet, mental health, environmental factors like accessibility of surroundings, socioeconomic status, and access to healthcare Describe the impact of immobility on physiologic and psychological functioning. - immobility can cause degradation of cardiovascular, respiratory, gastrointestinal, and musculoskeletal functioning - feeling trapped or immobile is used as a metaphor to describe feelings and experiences often connected to depression and anxiety  Discuss appropriate subjective and objective data to collect to assess mobility status. - subjective data includes asking about their self-reported pain, difficulty with daily activities, history of injuries or medical conditions affecting movement, and perceived limitations, while objective data would involve observing their gait, posture, range of motion in joints, muscle strength, and performing standardized tests like the Timed Up and Go test to measure their functional ability Demonstrate nursing interventions such as positioning, ambulating, transferring, providing range of motion, and using assistive devices. - N/A Plan strategies to avoid musculoskeletal injury to the nurse and patient during patient care. - prioritize proper body mechanics, utilizing assistive devices when needed, patient positioning techniques, regular breaks, and awareness of personal limitations, alongside educating patients on how to assist with movements where appropriate. Develop appropriate community-based nursing interventions for preventing and managing mobility problems. - performing repositioning activities, completing range of motion exercises, and assisting the patient to dangle on the edge of a bed