NURS 138 Exam 1 Questions With Complete Solutions

the nursing process - ANS five-step process; assessment, nursing diagnosis, planning, implentation, evaluation (ADPIE) assessment - ANS -deliberate, systematic/organized, and continuous -collection, analysis, and synthesis of relevant data for purpose of appraising the individual's health status -helps prioritize care -establish baseline data back channeling - ANS includes active listening prompts such as "all right", "go on", or ""uh-huh". Nursing diagnosis - ANS identify problems Planning - ANS -set goals of care and desired outcomes -identify appropriate nursing actions implementing - ANS perform nursing actions identified in planning evaluating - ANS determine if goals met and outcomes achieved patient interview - ANS -establish therapeutic relationship -orientation phase, working phase, and termination phase orientation phase - ANS -introduction -private setting -when the nurse and the patient meet and get to know each other working phase - ANS -when the nurse and the patient work together to solve problems and accomplish goals -collect data -account for time, place, seating arrangement, distance, language -if family members present, must get approval from patient for them to remain and participate termination phase - ANS The final, integral phase of the nurse-patient relationship closed-ended questions - ANS -questions a person must answer by choosing from a limited, predetermined set of responses -helps to clarify, saves time example: are you feeling better today? Trust vs. Mistrust stage - ANS birth to 12 months Autonomy vs. Shame and Doubt - ANS -12 months to 3 years -initiation of self-care activities fetal period (second or third trimester) - ANS -exposure to teratogen causes delays in growth and development of the fetus and disruption of brain development preimplantation period - ANS death of conceptus occurs if exposed to lethal dose of teratogen embryonic period (first trimester) - ANS gross malformations occur if there is exposure to a teratogen ebstein anomaly - ANS -cardiac defects in a newborn -result of taking lithium during pregnancy stillbirth - ANS may occur because of alcohol use shortened limbs - ANS may occur because of thalidomide neural tube defects - ANS due to antiseizure medications neonatal period - ANS first 28 days of life parallel play - ANS -toddlers -play independently but beside other children dramatic play - ANS -preschool age -assume and act out roles cooperative play - ANS -preschool age -learn to share, wait their turn, become sensitive to peers' needs group play - ANS -characteristic of older children associate play - ANS children engage in separate activities but exchange toys and comment on one another's behavior internal variables - ANS emotional factors external variables - ANS family practices, socioeconomic factors, cultural background ethnocentrism - ANS tendency of a person to hold their own beliefs superior to those of other people cultural imposition - ANS occurs when the nurse or provider ignores differences between his or her own culture and others, imposing their beliefs on people of other cultures SPEAKUP acronym - ANS S-Speak up if you have questions or concerns P- Pay attention the care you get E- Educate yourself about your illness A- Ask a trusted family member or friend to be your advocate K- Know the medicines you take and why you take them U- Use a hospital, clinic surgery center or other healthcare facility that has been carefully checked out P- Participate in all the decisions about your treatment