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Nursing Fundamental
Test 1
| Question | Answer |
|---|---|
| What is the nursing diagnosis for "state in which a person is at risk to be invaded by an opportunistic or pathogenic agent from endogenous or exogenous sources? | risk for infection |
| What is the nursing diagnosis for state in which an individual is at risk for transferring an opportunistic or pathogenic agent to others? | risk for infection transmission |
| What are four types of microorganisms and an example of each? | bacteria - E coli, virus - herpes, fungus- mold, protozoa - Ghiardia |
| What are the six components of the chain of infection? | infectious agent, reservoir, portal of exit, means of transmission, portal of entry, susceptible host |
| What are some examples of reservoirs (there are seven)? | humans, animals, soil, food water, milk, inanimate objects |
| What types of risk factors influence a host's susceptibility? | non intact skin/mucus membranes, pH, WBC, age, immunizations, general health, stress, invasive procedures, health habits |
| What is an example of a pathophysiological risk factor? What is it due to? | AIDS due to compromised host defense |
| What are two examples of treatment related risk factors? What are they due to? | medications/surgery due to compromised host defense or site for organism invasion |
| What are two examples of situational risk factors? What are they due to? | nosocomial/iatrogenic due to comprised host defense site for organism invasion and/or contact with contagious agent |
| What are two examples of maturational risk factors? What are each due to? | infant - lack of flora/antibodies, older decreased immune response |
| A hospital acquired infection - | nosocomial |
| What are two main reasons why nosocomial infections occur? | poor hand washing or aseptic technique |
| Will Medicare for treatment related to nosocomial infections? | no |
| What are examples of two drugs resistant microorganisms? | MRSA, VRE |
| Activities to prevent or break chain infection - | asepsis |
| Activities that reduce # and transfer of pathogens- | medical asepsis/clean technique |
| Activities that render and keep objects free from microorganisms - | surgical asepsis/sterile technique |
| Disinfection is an example of - | medical asepsis/clean technique |
| Use of a surgical mask/scrub are an example of - | surgical asepsis/sterile technique |
| What three things impact early detection and surveillance? | susceptibility of host, patient signs/symptoms, virulence |
| These types of signs/symptoms of infection include excessive redness, swelling, warmth, pain and loss of function- | localized |
| These types of signs/symptoms include fever, lethargy, anorexia, enlarged lymph nodes- | systemic |
| Laboratory data that can indicate an infection- | lab values |
| What is normal range for WBC? | 5000-10,000//mm3 |
| What does a shift to the left mean? | there are more band cells when there is an infection |
| The rate in which RBCs settle to the bottom of a tube of whole blood- | sedimentation rate |
| A person with an infection would have a ____ sedimentation rate. | elevated |
| Where do we take cultures and where do we grow them? | urine, blood, sputum -- ager plates |
| What is the most effective way to help prevent the spread of microorganisms? | hand washing |
| What type of technique is needed to kill spores? | sterilization |
| What are three examples of diseases spread by air? | chicken pox, rubeola, TB |
| What are two examples of diseases spread by droplet? | mumps, rubella |
| What are two examples of diseases spread by contact? | MRSA, VRE |
| What agency states that employers must provide PPE and HBV? | OSHA |
| Can OSHA fine a hospital for failure to use equipment or devices that reduce risk of needle stick injuries? | yes |
| What are then five medication "rights"? | right drug, dose, patient, route, time |
| Nursing diagnosis for state in which a person is at risk for harm because of perceptual or physiologic deficit, a lack of awareness of hazards or maturational age- | risk of injury |
| What is a related factor for risk for injury that is based on alteration of cerebral function, impaired mobility and/or impaired sensory functions? | pathophysiological |
| What is a related factor for risk for injury that is based on effects of medications, treatments and/or durable meds? | treatment related |
| What is a related factor for risk for injury that is based on personal or environmental factors? | situational |
| What is a related factor for risk for injury that is based on lack of awareness of hazards, cognitive deficits, sedentary lifestyle or loss of muscle strength? | maturational |
| What percent of healthy adults older than 65 will have at least one fall a year? | 35-40 |
| What is one of the most serious types of injuries resulting from a fall? | hip |
| What is the leading cause of injury related deaths in older adults? | falls |
| What are some risk factors for falls for seniors? | history, impaired vision/balance, altered gate/posture, impaired mobility, medications, postural hypotension, slowed reaction time, confusion, disorientation, weakness, new environment |
| Scale used in health care agencies to determine patient risk for falls - | Morris fall scale |
| Who determines the frequency with which the fall scale is used? | the agency |
| What six factors are included in the Morris Fall Scale? | history of falls, secondary diagnosis, ambulatory aids, IV, gait, mental status |
| What is the low risk range for Morris Fall Scale? | 0-24 |
| What is the medium risk range for Morris Fall Scale? | 25-44 |
| What is the high risk range for Morris Fall Scale? | 45 or higher |
| What are some examples of how to prevent falls at home? | lighting, sturdy shoes, non skid bottoms, remove throw rugs, non slip tubs, handgrips, discard or repair broken equipment |
| What are some examples of how we can prevent falls at healthcare facility? | orientation, keep important items within patient reach, keep bed in low position, lock bed on wheels, |
| Restraint: | device/method used to limit movement or immobilize a patient |
| What are three examples of restraints? | side rails, geri chair, Posey |
| When can a drug be considered a restraint? | when in is not a part of the patient's regular medical care |
| Are elderly more likely to die when restrained or unrestrained? | restrained 8x |
| What percent of restrained elders are injured? | 50% |
| What are some examples of the dangers of restraining? | suffocation, entrapment, circulation, altered skin integrity, changes in mental status |
| When can a restraint be used? | last resort with md order |
| How often do we need to access a restrained patient? | every two hours for an adult, every hour for a child |
| If you apply a restraint what five things do you document? | date/time applied, type, alternatives attempted, family notification, nursing interventions ( skin care) |
| What are seven alternatives to restraints? | increased observation, reorientation ,id door of pt room, elec alarm, toilet assist, distractions, exercise |
| A confidential document that objectively describes circumstances of an accident- | incident/occurrence report |
| When, who completes an incident report? | the nurse asap |
| Is an incident report part of a medical record? | NO |
| An unexpected occurrence involving death or serious physical or psychological injury or the risk of death or injury | sentinel event |
| How are the JCAHO Patient Safety Goals determined? | change year to year based on scientific research |
| What are the six 2010 JCAHO Goals? | id patients correctly, improve staff communication, use medicines safely, prevent infection, check patient medicines, id patient safety risks |
| Small living creature not visible to the naked eye, bacteria, viruses, fungi | microorganisms |
| Disease producing microorganism | pathogen |
| Disease state that results from presence of pathogens | infection |
| A microorganisms ability to cause disease | virulence |
| Microorganisms that normally inhabit a given body site without causing disease and that may be beneficial | normal flora |
| Person who harbors an infectious agent but does not exhibit and signs or symptoms of the disease | carrier |
| Non human carriers such as mosquitoes that transmit microorganisms from one host to another | vectors |
| Person or non living creature where microorganisms can live or obtain nourishment | host |
| The degree of resistance a potential host has to the pathogen, the likelihood a person will get sick if exposed to a given pathogen | susceptibility |
| Infection resulting from treatment or diagnostic procedure | iatrogenic infection |
| What are three common causes of hospital fires | careless smoking, faulty electrical equipment, anesthesia gases |
| What does RACE stand for? | rescue, activate, control, evacuate |
| What agency is responsible for developing and enforcing workplace safety and health regulations? | OSHA |
| What four things can workplace injury result in? | lost productivity, lost income, disability, death |
| What are some examples of health care worker safety injuries/conditions? | equipment, chemicals, disease, "sharps" injuries, back injuries, latex allergy |
| What are some examples of workplace violence issues? | working with volatile people, working late, working in high crime area, working in a community based setting |
| What things can employers do to reduce workplace violence? | improve lighting, security, have a "zero tolerance" policy, train staff in conflict resolution |
| Skills and learning commonly possessed by members of the profession which are expected and accepted | standards and care |
| What is the purpose of standards of care? | to protect the consumer and ensure knowledgeable, safe and comprehensive care |
| Who testifies to standards of care in a legal situation? | a nurse |
| What three entities establish standards of care? | the state, professional organization (ANA), federal organization(JCAHO) |
| What does JCAHO stand for? | Joint Commission on Accreditation of Healthcare Organizations |
| Laws established in each state to regulate the practice of nursing | state nurse practice act |
| What are the four steps of the nursing process? | assessment, planning, intervention, evaluation |
| systematic and continual collection and analysis of data about the health status of pt culminating in a nursing diagnosis | assessment |
| developing a nursing plan of care for a pt which includes goals & priorities derived from the nursing diagnosis | planning |
| nursing action to implement the plan of care by admin. care or directing and supervising nursing acts delegated | intervention |
| determination of a pt progress or lack thereof toward goal achievement which may lead to modification of nursing process | evaluation |
| Under what circumstances can an RN delegate? | only when commensurate with the education and demonstrated abilities of the person to whom tasks are being delegated |
| Transferring of authority to perform a selected nursing task to a competent individual in a selected situation | delegation |
| Who retains accountability for the delegation? | the nurse |
| Who can an RN delegate to? | C.N.A., LPN |
| What two things is an RN not to delegate? | assessment and evaluation |
| Can an LPN supervise a CNA? | yes |
| CAN an LPN delegate to a CNA? | no |
| RN/LPN? Provide direction and assistance to those supervised? | RN |
| RN/LPN? Observe and monitor the activities of those supervised? | RN |
| RN/LPN? Evaluate the effectiveness of acts performed under supervision? | RN |
| RN/LPN? Provide BASIC nursing care | LPN |
| RN/LPN? Record care given and report to the appropriate person changes in condition | LPN or RN |
| RN/LPN? Only assist with the collection of data | LPN |
| RN/LPN? Only assist with the development and revision of a nursing care plan | LPN |
| In what situation can an LPN assume a charge nurse position in a nursing home? | only with appropriate education and experience |
| Can an LPN assess or evaluate independently? | NO! |
| Does a C.N.A work under the license of an RN? | NO! |
| Is the RN or the LPN responsible for making sure that the tasks are carried out properly? | RN |
| A legal document to permit a person to offer to the public skills and knowledge in a particular jurisdiction after successfully meeting specified requirements? | licensure |
| How often must a license be renewed? | every two years |
| What is the purpose of the Interstate Compact? | allows RN licensed in one state to be able to work in another state without having to pay an additional fee for a license |
| Name three reasons a license could be suspended? | fraud, deceptive acts, criminal negligence |
| Program that is provided my community nursing program, receive diploma, approx one year in length, work under supervision of MD or RN, provide basic care | Practical Program - LPN |
| Program that is two years, at tech college, focus bedside care, most RNs in WI have this degree, appeals to men, minorities and non-trad students | Associate Degree |
| Program fist founded in hospitals, program three years, focus on clinical experience bedside care, # of programs declining | Diploma Program |
| Program affiliated with colleges and universities, 4 years, emphasis on theory, can work in public health or school nursing, appeal to younger students | Baccalaureate Program |
| Program that is 1.5 to 2 years to complete after BSN, specialty area include nursing ed, nurse NP, nurse specialist, nurse admin, write a thesis | Master's Degree |
| Usual program is three years post MSN Degree, write dissertation, required to teach at major university | Doctoral Program |
| Organization that establishes and maintains code of ethics, promotes usefulness, honor, standards of nursing practice | ANA |
| What is the ANA's publication? | American Journal of Nursing |
| Organization that provides testing services, continuing ed, educational standards | NLN National League for Nursing |
| What is the publication of the NLN? | Nursing Education Perspectives |
| What two types of accreditation does WCTC have? | State and NLNAC |
| Type of accreditation that is mandatory and determines the minimum standards of education with respect to number of credits and curriculum | State Accreditation |
| Name of organization that provides voluntary accreditation for schools that meet certain criteria | NLNAC |
| What are two LPN nursing organizations? | NAPNES, NFLPN |
| LPN organization that sponsors conventions for LPNs and nursing students | NAPNES |
| LPN organization that makes recommendations related to continuing education and standard of care | NFLPN |
| Concern for welfare and wellbeing of others | altruism |
| Protection and support of another's rights | patient advocacy |
| Respect for worth and uniqueness of each individual | human dignity |
| Act within code of ethics, demonstrates accountability for own actions | integrity |
| Equal treatment under the law and equal access to quality health care for all | social justice |
| Arise when attempted adherence to basic principles results in two conflicting courses of action | ethical dilemmas |
| Ethics that give nurse a framework for making decisions and informs society and nurses of goals and values of the profession | nursing code of ethics ANA |
| Rights and responsibilities of patient while receiving care | Patient's Bill of Rights American Hospital Association |
| Who mandates that each hospital have an ethics committee? | JCAHO |
| What four types of things does the ethics committee do? | provides education, policy making, case review and consultation ( makes recommendations not decisions) |
| Standard or rule of conduct established and enforced by the government, protect the rights of the public | laws |
| Voluntary standards developed and implemented by the nursing profession itself, not mandatory | professional standards |
| Standard developed by legislature and are implemented by authority granted by the state to determine minimum standards for the education of nurses | agency standards |
| Failure to do what a reasonable and prudent person would do under same or similar circumstances. | act of omission |
| Doing what a reasonable and prudent person would not do under same or similar circumstances. | act of commission |
| Professional misconduct, improper discharge or professional duties or failure to meet the standard of care which resulted in harm to another | malpractice |
| What are the four elements used to prove that malpractice has occurred? | duty, breach of duty, proximate cause, damages |
| Are student nurses responsible for their own nursing practice? | yes |
| Are nurses held to the standard of care for LPN or RN? | yes |
| A system in which a fee is paid to a provider organization for each person (or “head”) whether or not the person uses any health care services. | capitation |
| A technique that is used in some managed care systems to efficiently move an individual requiring major health services through the system. | case management |
| A component of an insurance plan that requires that the client pay a part of the bill. | co-payment |
| Indicates the amount of money that must be paid by the client prior to payment by the insurance company | deducible |
| A prospective payment system uses diagnostic groups to determine payment. Developed by Medicare as a way to try to contain costs. Many private insurance companies have adapted a similar system. | diagnosis related group |
| The fee that is generated each time a service is provided. Also referred to as retrospective payment. Payment is given after the service has been provided. | fee for service |
| Provides payment with focus is on wellness, health promotion, and illness prevention. Uses prepaid premiums. The client must use HMO facility or group of physicians. Prospective payment system. | health maintenance organization |
| Health care coverage for people age 65 and over. Federal program. | Medicare |
| Refers to any system in which the use of health care services is carefully controlled and monitored to ensure that policies are followed, that neither too much nor too little care is provided, and that costs are minimized. | managed care |
| A system of reimbursement in which third party payers negotiate with providers of health care to provide certain kinds of care at an agreed-upon, usually lower price. Physicians can belong to several PPO’s. Retrospective payment system. | preferred provider organization |
| Reimbursement amount for a procedure or illness that has been determined in advance of the provision of service. Paid at a certain rate without regard for actual cost. | prospective payment |
| 1965 Title 19 of SS act, people of any age, low incomes, blind, elderly, disabled covered by suppl ss benefits | medicaid |
| Degree required for public health nursing | BSN |
| Usually a three year program | Diploma RN |
| Approx one year in length | LPN |
| Majority of RNs in WI have this degree | ADN |
| You need to conduct research and write dissertation | Doctoral |
| Program appeals to men, minorities and no trad students | ADN |
| Number of nursing programs is decreasing | Diploma |
| Degree needed to teach at major university | Doctoral |
| Degree needed to have prescriptive authority | Masters |
| Emphasis on theory coursework | BSN |
| Degree needed to be a clinical nurse specialist | Masters |
| Focus is on bedside care | LPN, Diploma |
| Appeals to younger students out of high school | BSN |
| Graduates need to write thesis | Masters |
| Often provided staffing for hospitals in the past | Diploma |
| What provides for greatest opportunity to contain costs in a nursing department | salaries |
| Care that does not meet the established standards is/is not cost effective. | is not |
| What does Medicare part b cover? | a portion of physician bill, client pays deductible and co pay |
| A person who arrives at an ER and is told to go elsewhere has what right violated? | right to have access to care |
| System where health care services are monitored and controlled so that too much nor too little care is provided and costs are contained | managed care |
| Reducing the number of uninsured and underinsured persons helps to _____. | prevent health care costs from rising |
| What part of medicare pays for inpatient hospital, skilled nursing and home health | Part A |
| What part of medicare pays for eligible physician services, out of pocket hospital services, certain home health services and durable meds | Part B |
| Medicare combination of Part A and Part B. Provided through private insurance companies approved by Medicare. With this program, you may have lower costs and receive extra benefits. | Part C |
| Medicare that is stand-alone prescription drug coverage insurance. Premium for this coverage. All medically necessary drugs are covered. You can choose what drug plan will be best suited to your needs. | Part D |
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anastasia158
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