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Nursing Basics Q's
Questions from Mod 1&2
| Question | Answer |
|---|---|
| What does the 14 Basic Needs Theory look like in practice? | Assess the 14 basic needs and promote patient independence. |
| What does the Self-Care Deficit theory look like in practice? | Identify patients' capacity and deficits, and teach, support, and compensate their care as needed. |
| What does the Human Caring Theory look like in practice? | Being fully present and paying attention to the patient and protecting their dignity and meaning. |
| What do health care systems include? | The clients (or patients) who participate, the setting in which health care takes place, the agencies that regulate health care, and the mechanisms that provide financial support. |
| What is a challenge with nursing today? | Retaining health care's caring values while practicing within a cost-containment structure as health care systems become more business driven and less service oriented. |
| What are the SDOH categories? | Neighborhood and built environment, social and community context, economic stability, health care access and quality, and education access and quality. |
| What are the aspects of Neighborhood and Built Environment in SODH? | Geographical layout, crime rate, air and water quality, living arrangements, accessible outdoor spaces |
| What are the aspects of Social and Community Context in SODH? | Relationships and interactions with others, transportation systems, availability of food and nutrients, access to healthy food options, sources of food |
| What are the aspects of Economic Stability in SODH? | Ability to seek health care, employment status, child-care opportunities |
| What are the aspects of Health Care Access and Quality in SODH? | Availability of health care services, health insurance, availability of screening services |
| What are the aspects of Education Access and Quality in SODH? | Level of education, quality of the educational system, presence of social descrimination |
| What is the goal of primary health services? | To make comprehensive health care available and in close proximity to those who need it, with flexible cost to accomodate income variations for those who use services. |
| What problem does lack of health insurance cause? | Individuals with no insurance or using a state or federal based coverage program may experience a lack of access due to the cost of seeking health care. |
| What has the Patient Protection and Affordable Care Act done? | Allowed more individuals to obtain access to health insurance coverage while controlling costs of health care. |
| What are benefits of having health insurance? | Better health care outcomes and a predictable pattern of health care. |
| What are the barriers to Health Care? | Inadequate health care insurance, inability to pay for health care services, language barriers, cultural barriers, lack of health care providers in a community, geographic isolation, lack of transportation, distance of travel, and provider office wait times. |
| What are the QSEN Competencies? | Safety, Patient Centered Care, Evidence Based Practice, Informatics, Quality Improvement, Teamwork and Collaboration |
| What is QSEN Safety? | The minimization of risk factors that could cause injury or harm while promoting high quality care and maintaining a secure environment for patients, self, and others. |
| What is QSEN Patient Centered Care? | The provision of caring and compassionate, culturally sensitive care that addresses patients' physiological, psychological, sociological, spiritual, and cultural needs, preferences, and values. The patient is included in the decision making process. |
| What is QSEN Evidence Based Practice? | The use of current knowledge from research and other credible sources on which to base clinical judgement and patient care. |
| What is QSEN Informatics? | The use of information technology as a communication and information gathering tool that supports clinical decision making and scientifically based nursing practice. |
| What is QSEN Quality Improvement? | Care related and organizational processes that involve the development and implementation of a plan to improve health care services and better meet patients' needs. |
| What is QSEN Teamwork and Collaboration? | The delivery of patient care in partnership with inter-professional members of the health care team to achieve continuity of care and positive patient outcomes. |
| A nurse is discussing the purpose of regulatory agencies during a staff meeting. What task should the nurse identify as the responsibility of state licensing boards? | State licensing boards are responsible for ensuring that health care providers and agencies comply with state regulations. |
| A nurse is explaining the various health care coverage patients might have to a group of nurses. What health care financing mechanisms should the nurse include as federally funded? | Medicare and Medicaid. |
| A nurse manager is developing strategies to care for the increasing number of clients who have obesity. What actions should the nurse include as a primary health care strategy? | Collaborating with providers to perform obesity screenings during routine office visits. Primary health care emphasizes health promotion and disease control, and is often delivered during office visits. |
| A nurse is explaining the various levels of health care services to a group of newly licensed nurses. What are examples she could give of tertiary care? | Intensive care units, oncology treatment centers, and burn centers, as they involve the provision of specialized and highly technical care. |
| A nurse is discussing restorative health care with a newly licensed nurse. What examples could the nurse include in the teaching? | Home health care, rehab centers, and skilled nursing facilities, as they involve intermediate follow up care for restoring health and promoting self care. |
| What are an RN's role and responsibilities? | Perform assessments, establish nursing diagnoses, goals, and interventions, and conduct ongoing assessments. They develop interprofessional plans of patient care. And they share appropriate information with the team. They initiate referrals and identify community resources for patients. |
| What are a PN's Roles and Responsibilities? | Collaborate within the nursing process, assist with the plan of care, consult with other team members, and recognize the need for referrals to assist with actual or potential problems. They participate in the delivery of nursing care. |
| What are an AP's Roles and Responsibilities? | Tasks can include feeding patients, preparing supplements, lifting, basic care like grooming, bathing, and transferring, taking vitals, and ambulating patients. |
| A patient with rheumatoid arthritis needs to use adaptive devices because he has difficulty feeding himself. Who on the interprofessional team should the nurse refer him to? | The occupational therapist is the personnel responsible for helping patients with physical challenges who need adaptive devices. |
| Who can help a patient who is concerned about the adverse effects of a medication they were prescribed? | The provider, who must be knowledgable any medications the patient is prescribed, the pharmacist, who must be knowledgable about the medications they dispense to a patient, and the RN, who must be knowledgable about medications administered. |
| What can RNs do that LPNs can't? | Pronounce a patient dead, assess and educate patients, care for unstable patients, and hang blood. |
| What do you do when you come into a patient's room to provide care? | Provide privacy, introduce yourself, perform hand hygiene, verify the patient using name and DOB, explain why you're seeing them. |
| What do you do before starting care of a patient? | Ask them how they're feeling/doing. |
| What steps need to be completed before starting a bed bath? | Bring the patient to a supine position, raise the bed to a comfortable working position, put a bath blanket over the patient, remove the bed linens and leave them folded at the end of the bed if you plan to reuse them. |
| How do you begin a bed bath? | Remove the patient's gown, remove their pillow and place a towel under their head, and place a towel over the bath blanket. |
| How do you remove a patient's gown? | Remove the gown from the patient's unaffected side of the body, then remove it from the affected side. This provides better manipulation of the garment on the affected side. |
| Which part of the body do you start with during a bed bath? | The face. |
| What are the steps of washing the face? | Remove contacts if the patient is wearing them. Ask if they prefer washing their face with soap and water or just water. Clean the eyes starting from the inner eye and moving outward. Dry the eyes. Clean the rest of the face. Shave if the patient requests. |
| What do you want to do throughout the bed bath? | Explain what you are doing to the patient, rinse areas cleaned with soap, dry the parts you've cleaned, and examine the body for skin integrity. |
| How do you preserve a patient's privacy while giving them a bed bath? | You only expose the body part you're working on and cover the rest of the body with the bed blanket and towel. |
| What do you wash after the face? | The upper extremities (arms). |
| How do you wash the arms? | Expose the extremity you're cleaning and cover the rest of the body with the towel and bath blanket. Put a towel under the extremity to keep the bed from getting wet. Clean from the fingers to the axilla (armpit). Use long, firm strokes on the arms. Apply deodorant after cleaning the axilla. Remember to rinse and dry. |
| In what "direction" do you clean the body? | From the least dirty area to the most dirty area. |
| What area does the "clean from least dirty to most dirty" rule not apply to? | The perineal area. |
| What do you wash after the arms? | The chest. |
| How do you wash the chest? | Use long firm strokes for the chest and abdomen. Lift the breasts if necessary. Clean between skin folds if necessary. Don't forget to clean the belly button. Rinse and dry as you go. |
| What do you wash after the chest? | The lower extremities. |
| How do you preserve the patient's privacy when cleaning the lower extremities? | In addition to only exposing the body parts you're cleaning, keep the perineal area covered. |
| How do you clean the lower extremities? | Place a towel under the extremity. Clean the legs first using long, firm strokes, moving from the lower leg to the upper leg. Then clean the feet and don't forget to clean in between the toes. |
| How should you clean a patient who has a risk of thrombosis? | Use light, short strokes instead of long, firm strokes. |
| What do you clean after the lower extremities? | The back. |
| How do you clean the back? | Turn the patient to their side. Cover the body with the bath blanket, leaving the back exposed. Place the towel under the back. Use long firm strokes. Rinse and dry. Return the patient to supine position. |
| What do you do when you've finished a bed bath? | Remove the body and head towels. Replace the pillow under the patient's head. Put a new gown on their affected side before their unaffected side to better manipulate the gown around their affected side. Remove the bath blanket and fix up the gown. Put the patient in a comfortable position. Document and clean/remove the supplies you've used. |
| Do you need to give a complete bed bath every day? | No, the frequency you'll perform the bed bath depends on the patient's comfort levels, their hygiene, and their care plan. |
| Who do you give a bed bath to? | You give them to patients who are totally dependent and immobile. However, you still want them to participate in everything they are able to. |
| Who do you give a partial bed bath to? | You give them to dependent, immobile patients who don't need as much cleaning, or to self sufficient patients who can't reach certain spots. |
| What are the tasks of hair hygiene? | Shampooing and detangling. |
| What are the tasks of nail hygiene? | Trimming (usually reserved for podiatrists), cleaning underneath the nails, and nail filing. |
| What are the tasks of oral hygiene? | Have the patient open their mouth and inspect for any health concerns. For independent patients, observe their brush, flossing, and mouthwash technique and provide education where needed. |
| What is an extra consideration important for perineal care? | It is extra important to consider cultural issues. |
| How do you clean the vagina? | Bring the linens to the knees. Have the patient open their knees slightly. Wash the labia, the outer part of the vagina before washing the vulva, the inner part. Move the patient into the Sim's position. Clean the inner buttocks, then clean the outer buttocks. Bring them back to a supine position. |
| How do you clean the penis? | Bring the linens to the knees. Wash the tip of the penis, then clean the shaft from the top to the base. Clean the scrotum, including any folds. Move the patient to Sim's position. Wash the inner buttocks, then the outer buttocks. Return them to a supine position. |
| What tends to make perineal care go more smoothly? | The nurse providing the care being the same sex as the patient. |
| What extra steps are included in providing oral care to a dependent patient? | Have suction on hand for when necessary. Brush their teeth. When you finish, brush their tongue as well. |
| What extra steps are included in providing oral care to an unconscious patient? | Turn the patient onto their side. Keep suction on hand. Place a towel on their pillow under their mouth and an emesis basin under their chin. Use a tongue blade and/or a bite clock to keep their mouth open. Rinse their mouth by injecting water into the side of their mouth with a syringe. |
| Which patient need patient hygiene more than anyone? | Patients at risk of infection. |
| How do you clean dentures? | Take out the upper denture, then the lower one. Bring them to the sink. Place a towel on the bottom of the sink and fill it with some water to prevent damage if you drop them. Clean all over the dentures, both sides and bottoms of the teeth and the mouth piece. Inspect them for damage. If the patient wants them back in, put the top one in first, then the lower one. Otherwise, put them in a cup with a lid in cleaning solution. |
| What are factors you need to consider when picking what razor to use for shaving a patient? | Patients on anticoagulants, have a low platelet count, or have a bleeding disorder need to be shaved with an electric razor. |
| When are bed linens changed? | After a bath, or when they're soiled. |
| What do you need to document after giving a bed bath? | The date and time, the type of procedure (the hygiene care provided), the patient's level of participation, the condition of the areas and any abnormal findings, interventions implemented, the patient's response to the care, and teaching you provided, referrals if necessary, and any odor or discharge (especially with the perineal area). |
| When does a nursing certificate expire? | After 2 years, until you renew it. Renewal can be done online. |
| What are your legal and ethical roles as a nurse? | Follow state, ANA, and faculty policies; notice inequity in patient treatment; document outcomes of care; and advocate for change. |
| What does autonomy in practice look like? | Respecting patient's informed choice. |
| What does beneficence in practice look like? | Acting for the benefit of the patient. |
| What does nonmaleficence in practice look like? | Avoiding preventable harm. The driving force behind medicine. |
| What does veracity in practice look like? | Telling the patient the truth. Telling your supervisors about errors made immediately. |
| What does fidelity in practice look like? | Following through on your commitments. Not making promises you can't keep. |
| What does justice in practice look like? | Treating all patients fairly and allocating equitably. |
| The Decision Making Process Broken Down | 1. Define the issue and immediate risks; 2. Listen to the stakeholders, facts, and client wishes; 3. Look at the standards, law, policy, and bias; 4. Choose the safest, least harmful option; 5. Document care and outcomes, evaluate, and prevent recurrence. |
| The main legal question to ask | What is required and what is prohibited? |
| The main ethical question to ask | What should we do to protect the patient's dignity, rights, and well-being? |
| What are common breaches? | Practicing beyond your scope, medication or documentation errors, privacy or social media disclosure, abuse, boundary violation, or diversion, and failure to report of intervene. |
| What are the potential consequences of breaches? | Harm, delay of treatment, and/or loss of trust of the patient; remediation, suspension, and/or termination by employer; reprimanding, probation, restriction, suspension, and/or revocation from the board; civil damages and/or criminal penalties from the government. |
| Showing Professionalism | Be prepared, know your assignment, policy, and limits; Protect privacy, boundaries, and patient rights; Follow through, complete tasks, document care, nd escalate when necessary; Communicate clearly and listen intentionally; Respect roles when collaborating, ask for help early; Reflect, seek feedback, and learn. |
| Nurses' Role in Ethical Decision Making | Being an agent for patients facing an ethical decision (ex. discussing options with the patient and caring for them while they're considering their options), and being a decision maker for health care delivery (ex. witnessing medical misconduct) |
| A patient deciding not to have a life saving surgery is an example of... | ...the patient is exercising autonomy. |
| Offering pain medication to a post op patient is an example of... | ...exercising beneficence. |
| All patient waiting for a transplant having to meet the same criteria is an example of... | ...justice in the health care process. |
| A nurse questioning a medication as too extreme for an elderly patient is an example of... | ...nonmaleficence in decision making. |
| Negligence that can lead to a malpractice lawsuit | Failure to: follow professional and facility established standard of care, use equipment in a responsible and knowledgeable manner, communicate effectively with patients, document care, notify the provider of changes in a patient's condition, and complete a prescribed procedure. |
| When do nursing students face liability? | If they harm patients as a result of their direct action or inaction. |
| Who faces liability if a student harms patients? | The student, their instructor, the educational institution, and the facility. |
| Nursing role in clients' rights | Ensuring the patient understands their rights and protecting the patients' rights. |
| Nursing role in informed consent | Witnessing the patient signing the informed consent form and ensuring the provider has obtained the informed consent responsibly. |
| A health care worker reprimanding a patient for not using the urinal correctly and telling the patient they will use diapers next time the urinal is used improperly is an example of which legal breach? | Saying diapers will be used is a threat, so they are committing assault. |
| What should you do if you notice a nurse smells of alcohol? | Notify your supervisor. |
| What kind of patient statement would indicate they understand what an advanced directive is? | A statement of the kind of care they would prefer in the event they need end-of-life care. |
| Where can a patient file a privacy violation complaint that isn't the medical facility? | The OCR appointed Privacy Officer. This person works for the OCR, not the medical facility they are assigned to. This is the first point of contact for privacy concerns. Their job is to investigate HIPAA violations at their designated medical facility. |
| How are psychotherapy notes treated under HIPAA? | They are held to a higher standard, as they are not part of a patient's medical record and are never supposed to be shared with anyone else. |
| What kinds of treatments can minors consent to without parental consent? | Emergency, natal, sexual, substance abuse, and mental health care. |
| When does the disclosure of PHI not need authorization from the patient? | When the PHI pertains to public health services, compliance oversight, and when there is reasonable concern for abuse, neglect, or domestic violence. |
| Can PHI be used in research? | Yes, but the information has to be de-identified so it can't be traced back to the patient. |
| How do nurses contribute to accurate billing? | By documenting everything. |
| What should documentation of infection control include? | Measures used to treat and contain, if clean or sterile gloves were used, if the patient has a latex allergy or sensitivity, response to care, specimens and cultures collected for testing, disposal methods used, and isolation protocols used. |
| How do you prevent the completion of the infection chain? | You interrupt any one link. |
| What are reservoirs pathogens exploit? | People, animals, insects, water, food, and equipment. |
| What are portals of exits pathogens exploit? | Respiratory secretions, blood, urine, stool, skin. |
| What are points of entry pathogens exploit? | Mucosa, broken skin, respiratory system, urinary system, GI tracts. |
| When does exposure become an infection? | When the body's defenses cannot contain the agent. |
| Host Susceptibility Factors | Age, chronic illness, devices or wounds, nutrition, medications, stress or fatigue. |
| Why does age impact risk of infection? | Immature or declining immune defenses. |
| Why does chronic illness impact risk of infection? | These diseases can alter normal defenses. |
| Why do devices and wounds impact risk of infection? | They create new portals of entry. |
| Why does nutrition impact risk of infection? | Gives the body resources to defend and repair the body. Insufficiency leads to breakdown of these systems. |
| Why does medication impact risk of infection? | Can cause immunosuppression or flora suppression. |
| Why does stress and fatigue impact risk of infection? | Reduced resilience and self care. |
| What is the purpose of inflammation? | Isolate the threat introduced to the body, remove damaged material, and repair the affected areas. |
| Boundaries that maintain sterile field integrity | Only sterile items touch sterile items, keep the field in view, moisture carries organisms, edges and uncertain items are contaminated. |
| What material shields radiation? | Lead |
| What is a non-oral benefit of oral care? | It also protects the respiratory system. It reduces aspiration and VAP. |
| How long should you wash your hands? | 20 seconds |
| What should you do when you wash your hands (that isn't actually washing them)? | Inspect your hands for breaks or cuts to dress before seeing patients. |
| When should you wash your hands? | Before and after caring for a patient, after contact with the environment, after touching bodily fluids and/or contaminated items, and between some tasks when caring for the same patient. |
| How do you put on a mask? | Put the mask over the nose and mouth, then adjust the ear straps. |
| How do you know your mask fits? | It should collapse when you inhale and there should be no air leakage when you exhale. |
| What should you do when taking off a gown? | Don't touch the outside. Fold it in on itself and roll it into a bundle with the inside outward. |
| When should you take off goggles when removing PPE? | After you've taken off your gloves. |
| What is something you shouldn't do once you've applied goggles or faceshields? | Adjust or reapply. |
| When should you put on goggles when applying PPE? | Before you put on your gloves. |
| What is the difference between respirators and masks? | Respirators provide more protection than masks, and they need to be fit tested before using as PPE. |
| When do you need a respirator instead of a mask? | When you are caring for an airborne precaution patient. |
| Who is more at risk of having a latex allergy? | Anyone who is also allergic to kiwis, papayas, avocados, bananas, potatoes, and tomatoes. |
| What are standard precautions? | Hang hygiene (washing hands or hand sanitizer), respiratory hygiene, and injection safety. |
| What PPE is needed when caring for patients on contact precautions? | Gloves, gown, private room. |
| What infections require contact precaution? | VRE, MRSA, C. difficile, wound infections, herpes |
| What PPE is needed when caring for patients on droplet precautions? | A surgical mask, hand hygiene, and dedicated care equipment. |
| What infections require droplet precaution? | The flu, mycoplasma pneumonia |
| What PPE is needed when caring for patients on airborne precautions? | Negative airflow HEPA filter, private room, N95 respirator before entering the room |
| What infections require airborne precaution? | TB, Covid |
| What PPE is required when caring for transplant and gene therapy patients? | Private room, positive airflow HEPA filter, client wears a mask outside their room when construction is going on, no plants in their room. |
| How long does the body take to produce urine? | About 6-8 hours. |
| Why can LPNs not take care of post-op patients? | Because they are considered unstable for a period of time. |
| What is the bare minimum amount of urine that should be produced per hour? | 30mL |
| Why do you need a prescription to give a patient oxygen? | Because pure oxygen is considered a medication and oxygen therapy is a treatment. |
Created by:
marinareagankhan