Exam 1: PRN1178/ PRN 1178 (New 2026/ 2027 Update) Client-Centered Care II Review| Questions and Verified Answers| 100% Correct| A Grade - Rasmussen

Exam 1: PRN1178/ PRN 1178 (New 2026/ 2027 Update) Client-Centered Care II Review| Questions and Verified Answers| 100% Correct| A Grade - Rasmussen Q. If an incident report is needed, what is in the report? ANSWER facts not opinions what happen where don't need why or assume Q. Dysuria means ANSWER painful or difficult urination Q. What are complex carbs ANSWER beans, brown rice, whole grain Q. What is a simple carb ANSWER sugar Q. What is appropriate when asking about pain ANSWER when it started how long it has been does anything make it better Q. When food does not test well taste good it could due to what ANSWER oral hygiene Q. What does SBAR stand for ANSWER Situation Background Assessment Recommendation Q. What is common for opioid medication ANSWER respiratory rate is very slow normal rage is 12-20 per minute Q. What does RACE stand for ANSWER rescue, activate, contain, extinguish Q. What is something that is common in an older people with UTI ANSWER confusion Q. Diabetic- what food are low on the glycemic index ANSWER kidney beans lentil Q. Is white rice a carb? ANSWER yes Q. What to tell patient if they are constipated ANSWER eat more fiber Q. Non-pharmacologic technique ANSWER distraction music Q. Analgesia ANSWER inability to feel pain patient controlled pain medication Q. Vegan diet ANSWER Q. What food are on a soft food diet ANSWER mashed potatoes Q. Times period for no bowel movement before being concerned ANSWER 3 days Q. What fat is really really really bad? ANSWER saturated fat Q. What fat is healthier? ANSWER unsaturated Q. Why are they called essential? ANSWER They are called essential because the body cannot synthesize them itself. Diets high in saturated fat are associated with cardiovascular risk. Q. What are the essential fatty acids? ANSWER The essential fatty acids - omega-3 and omega-6 fatty acids - are polyunsaturated fats. Q. What is a polyunsaturated fat? ANSWER are liquid at room temperature and also found in plants Q. What is a monounsaturated fat? ANSWER are soft at room temperature and are usually derived from plant sources. Q. What is saturated fat? ANSWER hard at room temperature and found in animal products. Q. What are the three classifications of lipids? ANSWER Saturated Monounsaturated polyunsaturated. Q. Another name for lipids is ANSWER Fat Q. Breakdown of amino acids itself requires energy, which is why high-protein diets are associated with ANSWER weight loss Q. When carbohydrates are depleted, ANSWER the body can use protein for energy. Q. Protein is rarely used as an ANSWER as an energy source, unless it is needed. Q. Protein :primary function? is to build and repair tissues of the body. Also forms ANSWER Neurotransmitters, hormones, lipoproteins, and other important metabolic substances. Q. 20 amino acids build one protein, Nine must come from food and called ANSWER essential amino Q. Proteins are made up of ANSWER amino acids Q. Examples of dietary fiber include: ANSWER fruits, vegetables, and whole grains. Q. What is another name for non-digestible carbohydrates? ANSWER dietary fiber Q. What do non-digestible carbohydrates do? ANSWER Non-digestible carbohydrates are not absorbed by the digestive tract, and instead help promote regular bowel function Q. What does high glycemic index foods do? ANSWER tend to spike blood glucose. Q. What does low glycemic index foods do? ANSWER better for maintaining blood glucose control. Q. What are amino acids made of? ANSWER which contain the same three elements as carbohydrates plus nitrogen Q. Complex carbohydrates are low on the ANSWER glycemic index. Q. Complex carbohydrates take longer to break down, like ANSWER brown rice Q. Carbohydrates that break down quickly include ANSWER efined grains, such as white bread. Q. Primary function of carbohydrates is what? ANSWER The primary function of carbohydrates is to provide energy to cells. Q. What is another name for polysaccharides? ANSWER also known as complex carbohydrates, Q. What are polysaccharides? ANSWER are made up of many single sugars. Q. What are disaccharides? ANSWER are made up of two monosaccharides. Q. What are monosaccharides? ANSWER are the simplest of the three types, made up of a single sugar. simple sugars What are the 3 main types of carbohydrates? monosaccharides, disaccharides, and polysaccharides. How did carbohydrates get their name By the chemical elements they're composed of which are: - Carbon ( C ) - Hydroden ( H ) - Oxygen ( O ) What factors contribute to poor dietary choices? excessive food intake and some of these factors include: advertisement of high-sugar/high-calorie foods, fast food, vending machines, and large portion sizes What is the typical American diet? consists of high sugar, saturated fat, and energy-dense foods Current healthcare is focused on disease and treatment . Push for more emphasis on preventive care. What can we do to combat poor nutrition? Policies can be developed at the federal, state, and local levels. What is the Solution? Lifestyle and nutrition education should be incorporated throughout all healthcare settings. What is contributing to the diabetes epidemic in the US? Obesity and the typical American diet are also contributing to the current diabetes epidemic in our country Poor diet is associated with chronic diseases, including cardiovascular disease and obesity, and some cancers What is homeostatis? All of these nutrients work together to maintain homeostasis - or a state of dynamic equilibrium within the body Water is used in what part of the body? Water which is vital to life, is utilized in virtually all parts of the body What does fat do? stores energy, Fat supports many essential functions in the body What are proteins? Proteins are made up of amino acids, which contain the same three elements as carbohydrates plus nitrogen Main source of energy is Carbohydrates Explain the function of lipids within the human body also known as fat - perform various functions in the body Explain the function of proteins within the human body. Protein is needed to build and repair tissues. Fat supports many essential functions in the body. Explain the function of carbohydrates within the human body. Carbohydrates are the body's main source of energy. Describe the role of nutrition in promoting health. Proper nutrition is essential to health and wellbeing. People need appropriate amounts of macronutrients and micronutrients in their diets. What are "look-alike / sound-alike" medications? two or more drugs that look similar or have a similar-sounding name. What are the six rights of medication? Right drug Dose Route Time Client Documentation. What can increase medication errors? Clients receiving high-alert medications or more than four medications at the same time are at increased risk of errors. When do most medication errors occur? most errors occur during medication administration When do medication errors occur? Medication mistakes can occur due to system failure or human error, and can happen at all stages of the medication process. What patient education should occur if oxygen is used in the home? Clients and families of clients receiving oxygen therapy must be educated that no smoking is allowed in the home What do you do if you discover a fire? Nurses must be familiar with their institution's fire regulations What are some examples of safety hazards? safety hazards such as rugs, dim lighting, and unsafe tubs or showers. What is a fall risk assessment? Data should be collected for a falls risk assessment, so that additional precautions can be taken if necessary. When should the client be oriented to the room? As soon as clients are admitted to the hospital What are the three most common risk factors for falls? impaired physical mobility altered mental status neurological deficits What is a significant safety issue? Client falls are a significant safety issue, in both the hospital and at home. Nurses are considered what? last line of defense between the client and potential medication errors. Who is first to meet the client and observe the environment for safety hazards? Nurses Every point in the process of client care involves potential safety risks What are the four steps for developing a reporting culture with organizations? establish trust encourage reporting eliminate fear of punishment examine the reports. Are incident reports part of the client's medical record? Incident reports are not part of clients' medical records How do you fill it out? When filing an incident report, the content should consist of facts about the event and not opinions about why it occurred What is the purpose of an incident report? Incident reports allow facilities to identify dangerous patterns and also serve as an immediate recall of an event that may result in litigation What is an incident report? a form that documents the details of an incident such as workplace injury, accident, near miss, property damage, safety issues, health issues, or even security breaches. Whenever you have a question about a procedure, can you look for the procedure in the policy book? yes Should you report errors? Why? Healthcare facilities should have clear procedures for reporting errors. Often, incident reports are used. What is a "reporting culture"? When errors do occur, it is important for organizations to recognize them and learn from them. Who is responsible for client safety? All healthcare professionals are responsible for ensuring client safety throughout the continuum of care. As a licensed practical nurse What do the standards do? The standards help facilities assess, measure, and improve performance. What do the Joint Commission standards do? The Joint Commission standards provide a basis for objective evaluation of health care organizations. Who is the Joint Commission? The Joint Commission enterprise is a global driver of quality improvement and patient safety in health care. Is client safety a global issue? yes How does the World Health Organization define client safety? "the absence of preventable harm to a [client] during the process of healthcare and reduction of risk of unnecessary harm associated with healthcare to an acceptable minimum". What is WHO? World Health Organization Describe safe use of medical equipment. used for the specific purposes of diagnosis and treatment of disease or rehabilitation following disease or injury Reinforce client teaching related to home safety practices. Check the house for hazards including loose rugs, missing steps, cords that pose a risk of tripping and excess clutter Explain national client safety goals. the absence of preventable harm to a [client] during the process of healthcare and reduction of risk of unnecessary harm associated with healthcare to an acceptable minimum". Adverse effects of opioids are: the most serious of which is respiratory depression. Other side effects include sedation and constipation Pain medication classes include: nonsteroidal anti-inflammatory drugs (NSAIDS), COX-2 inhibitors, and narcotic or opioid analgesics. Nonpharmacological pain methods include: biofeedback, distraction, guided imagery, meditation, massage, and other alternative therapies How do you manage acute and chronic pain? Acute and chronic pain are managed with both nonpharmacological and pharmacological methods How do you measure pain? Nurses should measure clients' pain using the most standardized method possible. Methods for measuring pain vary according to client age, cognitive level, and health status. What can LPNs do with pain? monitor pain status, provide nonpharmacological and pharmacological pain management congruent with their scope of practice, and reinforce client teaching related to pain reduction strategies. What is neuropathic pain? Neuropathic pain is pain caused by damage to the nervous system or neurological diseases. Neuropathic pain can occur in the absence of physical or potential tissue damage. Clients with diabetes, stroke, and multiple sclerosis may experience neuropathic pain. What is nociceptive pain? Nociceptive pain is pain caused by physical or potential damage to a part of the body. Nociceptive pain is the most common type of pain, and can occur from injuries, medical procedures, or health conditions like arthritis. What is chronic pain? Chronic pain last longer than acute pain, up to months or even years. It can be mild or severe, and may be constant or intermittent. Client may describe chronic pain as dull, constant, or burning. Vital signs usually return to baseline, as the body's "fight-or-flight" response eventually stops. What is acute pain? Acute pain Is short-lived and often intense. It alerts the person to an actual or potential injury. Acute pain may be described as aching, throbbing, or searing. Changes in vital signs may occur with acute pain, including heart rate blood pressure, and respiratory rate Pain results from an interaction between: nerves, the spinal cord, and the brain. 7. How do you remove a fecal impaction? emoval of fecal impaction may involve an oil-retention enema and digital disimpaction Should you provide privacy? Yes What is the best position to have a stool? Why? sitting position so that gravity and the abdominal muscles can help with bowel elimination stool is normally soft, tubular, and light to dark brown in color What happens to the food we eat? After digestion and absorption of nutrients takes place, indigestible material is removed via the large What does the digestive system do? The digestive system is responsible for the elimination of solid wastes 9. . What could be ordered after a bladder scanner and why? Based on the results of the bladder scan, the healthcare provider may order a straight catheterization or indwelling Foley catheter. Bowel Elimination 8. When should a bladder scanner be used? When a Clients are unable to empty their bladder longer than eight hours they may need a bladder scan What is a bladder scanner? is an ultrasound performed to determine the amount of urine in the bladder Nurses individualize patient care with urinary elimination by using what 4 items? Bathroom, commode, urinal or bedpan How many times do adults usually void a day Normal voiding frequency for adults is between five to 10 times per day, What system eliminates metabolic waste from the blood? urinary system is responsible for eliminating metabolic waste from the blood What cells produce waste? All cells of the body produce waste Is elimination a basic human need? yes If you see fluid deficit or overload, what do you do? LPN must report signs of fluid imbalance to the RN or healthcare provider immediately. What are signs of fluid overload? Signs of fluid overload can include swelling, increased blood pressure, shortness of breath, and Rapid weight gain. What are signs of fluid deficit? Signs of fluid deficit may include dry skin and mucous membranes, decreased urinary output, and weight loss. What 3 things will you do as an LPN related to nutrition and hydration? As an LPN, you will collect nutritional data, assist clients with meals and oral care, and reinforce culturally competent dietary education. What about brushing their teeth? Impaired oral hygiene can also affect taste and appetite. How can food and water intake be affected while in the hospital? Food and water intake can be affected by illness, surgery, and even medications. What is a micronutrient? vitamins and minerals What is a macronutrient? carbohydrates, protein, and fat What are the 4 basic human needs? rest sleep nutrition hydration How can nurses promote rest and sleep? nurses can use flashlights instead of turning on the lights when clients are resting, and offer earplugs if not contraindicated What can cause disturbed rest and sleep in the hospital? inpatient environments are filled with noise and commotion. Sleep is also frequently interrupted by diagnostics tests and vital sign measurements. In what environment is the biggest risk for disturbed rest and sleep? Hospitalized clients are particularly at risk for disturbed rest and sleep. Inadequate rest and sleep negatively affect what? can negatively affect many systems of the body, such as the cardiovascular, respiratory, immune, and neurological systems, as well as metabolism What level are rest and sleep in Maslow's hierarchy of needs? physiological which is the 1 level What is the main difference between the bottom level and top level? Bottom is physiological which is something you need and must have and top is self actualization which is something you want but not need. What are the 5 levels? physiological , safety, love/ belonging, esteem, and self actualization. What is Maslow's hierarchy of needs? physiological Name 4 basic care concepts. basic care concepts are rest, sleep, nutrition, and hydration. Who is the LPN's supervisor when working on a unit? RN LPN stands for licensed practice nurse Nurses deliver client center care How does the ANA define nursing? defines nursing as both a science and an art. In delivering client-centered care, nurses apply principles of the life sciences and perform complex skills. What is the ANA? The American Nurses Association Describe pain classifications. The main 4 types of pain classifations are Acute pain, Chronic pain, Nociceptive pain, and Neuropathic pain. Identify strategies for chronic and acute pain management. Acute and chronic are pain management with both nonpharmanological This includes pain medication physical therapies And pharmacological methode. This includes cognitive behavioural therapy and relaxation techniques such as meditation/ medication. Identify non-pharmacological pain treatment strategies. non-pharmacological pain management methods include music therapy, biofeedbag, guided imagery, medition, relaxation techniques, repositioning, the use of a cold/ heat compress, respiratory and deep breathing exercises, massage, diet, prayer, exercise, distraction and music Describe nursing interventions to promote nutrition and oral hydration. Dim the light/ but airbuds on/ make use you do everything at once so you dont have to wake them up all the time. Describe nursing interventions to promote rest and sleep. Dim the light/ but airbuds on/ make use you do everything at once so you dont have to wake them up all the time. Identify the clients at risk for impaired elimination. Kidney failure Pressure on the urethra Infection 4 main functions of water in the body Act as a vehicle of transportation of substances to and from cells 4 main functions of water in the body Aid heat regulations by providing perspiration which evaporates 4 main functions of water in the body Assist with maintence of hydrogen balance in the body 4 main functions of water in the body To serve as a medium for the enzymatic action for digestion How much of the body is water? More than half - 60% males contain 50% females contain 60% due to fat tissue Lose more fluid through skin than adults Infants - kidneys are not as efficient as adults less fluid absorption Adults - age related decline in total body water Diminished thirst sensations; decrease in urine concentrating abilities of kidneys; decreases the effectiveness of the antidiuretic hormone (ADH) Hypovolemia Abnormal decrease in the volume of blood plasma (occurs with dehydration or bleeding) What is critical in maintaining homeostasis Water Cells can't function without Water - death will occur Electrolytes are Minerals or salt dissolved in body fluid. Major source is from diet Electrolytes are measured MEq/L Electrolytes in A solution breaks into particles known as ions from reactions from hydrogen and electrolyte Ions Develop a positive electrical charge known as citations; for each positive charge in a fluid compartment there must be a negatively charged anion so that the balance is maintained Circulating blood volume 4 to 6 liters Erythrocytes Red cells - carried in plasma Leukocytes White cells - carried in plasma Platelets thrombocytes - carried in plasma Cancer Results from defect in DNA genes; Inherited or caused by mutation; carcinogens is external and internal environment **men and women who are overweight by 40% or more have a 33%-35% greater risk of developing cancer than persons of normal weight** Environmental agents Carcinogen exposure ( x-rays, sun, UV light, lifestyle, tobacco use ) viruses are capable of introducing new genetic material into normal cell and transforming it into a malignant one Cancer warning signs Unusual bleeding; sores that don't heal; change in bowel or bladder habits; lump in breast or other part of the body; nagging cough; dysphangia (difficulting swallowing); change in mole cancer prevention Make early detection; nitrite and food additives - cancer stimulators; moderation in drinking alcohol too much can cause liver damage, vitamin c (bacon) Common problems cancer Anorexia; malnutrition; mucositis; weight loss of 2 or more lbs per week; fatigue; hyperuricemia- elevated uric acids; immunosuppression decreases WBC Biopsy Sample of tissues Radiologic X-Ray; CT ; MRI Endoscopy Scope of throat Laboratory Blood + urine Dietary requirements- malignancies ( cancerous tumors) Foods high in protein and calories, bland, lukewarm; carbonated drinks can be tolerated but not taken with meals 1 hr before or after; ** caffeine, rich or fatty foods AVOID** Mucositis- irritation and inflammation of the mucosa in the mouth Mouth must be moist; swish and spit meds for PAIN RELEIF; maintain oral hygiene Cancer nursing interventions Medications: antiemetic's - monitor for dehydration and electrolyte imbalance Immunosuppression : keep comfortable, encourage oral intake Ineffective coping: be honest, positive approach, psychosocial and spiritual care Palliative care- comfort care : netting the needs of the dying put by providing comfort and maintaining a high quality of life. - allow pain free death - transdermal medications - rectal pain meds End stage symptoms Pain, dyspena, death rattle, delirium Osmolaity Concentration of the solution determined by the # of solutes in it *** normal osmolality of body fluids : 280 to 294 mOsm/kg (millions miles per kilogram) nonelectrolyte solutes Protein, urea, glucose, creatinine, bilirubin Electrolytes contribute to The osmolality of the ICF (intracellular fluid) Potassium maintains The osmolality of the ECF (extracellular fluid) Cations + Anion - For each positively charged cation in a fluid compartment There must be a negatively charge anion so the balance is maintained K+= 3.5-5.0 mEq/L Major intracellular cation NA+= 135-145 mEq/L Major cation of extracellular fluid CA+ = 8.4-10.6 mg/L Calcium - formation of bone and teeth Mg2+=1.3-2.1 mg/dl Magnesium- building bones and teeth PO43-=2.7-4.5 mg/dl Potassium- necessary for formation of ATP CL-=96-106 mEq/L Chlorine - helps maintain acid- base balance HCO3-=22-26 mEq/LA Bicarbonate- buffet that neutralizes excess acids in the body. Helps regulate acid- base balance Diffusion Substances move from an area of HIGH concentration to an area of LOW concentration Ex: capillaries in kings move between alveoli and capillaries Filtration Filtration, water and substances move through a semipermeable due to pushing force- hydrostatic pressure Ex: kidney filter Osmosis Diffusion of liquid across membrane Ex: fluid absorption Active transport requires Cellular energy, uses ATP Potassium/sodium cannot enter. Must be broke from electrolyte. Let's electrolytes move back and forth Hyponatremia Sodium- 135 mEq/L Restrict water intake as ordered for patients with congestive heart failure, kidney failure, and inadequate antidivertic hormone production; liberalize a low sodium diet; closely monitor patient receiving IV solutions to correct hyponatermia; replace water loss with fluids containing sodium Hyperkalemia Potassium- 5.0 mEq/L Decrease intake of foods high in potassium, increase fluid intake, provide adequate carbs to prevent use of body proteins for energy, proper insulin to patients with diabetes, salt substitutes Hypernatremia Sodium - 145 mEq/L Increase fluid intakes, I's and O's, give water between tube feedings, restrict sodium intake, monitor temperature Hypokalemia Potassium - 3.5 mEq/L Cardiac arrest, extra potassium must be given to help correct imbalance Hypocalcemia Calcium- 8.4 mg/dL Blood clotting, nerve condition, muscle contraction, cerpopedal soasm ( trousseau's sign). Hyperactive reflexes (chvostek's sign), laryngospasm may occur if deficit is severe Hypercalcemia Calcium - 10.6 mg/dL Administer diuretics, monitor I's and O's, encourage high fluid intake ( ml/ day) Hypomagnesemia Magnesium- 1.3 mEq/L DNA and protein synthesis, magnesium imbalances and rare Monitor IV infusions Hypermagnesemia Magnesium 2.1 mEq/L Avoid abuse of laxatives and OTC, encourage fluid intake to increase urinary excretion, I's and O's, administer diuretics as ordered Hypophosphatemia Phosphate- 3.0 mg/dL Vitamin D deficiency, overuse of aluminum- containing antacids Hyperphosphatemia Phosphate- 45 mg/dL IV fluid therapy, calculation of IV fluid rates, monitor weight Hypertonic solutions More solute outside the cell than inside the cell. Water molecules leave the cell, this water loss causes the cell to shrink Hypotonic solutions There is more solute inside the cell than outside the cell, causing the cell to expand, as the water volume inside the cell increases Isotonic solutions Same amount of solute of both sides of the cell, it will remain stable, neither shrinking nor swelling Fluid imbalance happens when The body has too much (excess) or too little (deficit) water Fluid imbalances signs and symptoms Dizziness; confusion; cool dry skin; dark concentrated urine; low BP; poor skin turgor; high pulse; flat neck veins when laying down; thirst; weakness fluid overload Cardiac issues; renal shut down; can't move blood through vascular system; edema/pitting; stomach distending too much fluid in the intercellular space fluid volume deficit Dehydration; depleting electrolytes; potassium shift; diabetes