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Fundamentals of Nurs
| Question | Answer |
|---|---|
| What is pain? | individual pain perception & response |
| What is the only intervention for pain? | relieve the pain |
| T/F Currently pain is under managed and yet over medicated. | T |
| This kind of pain varies in intensity & duration, & is protective in nature. Acute or Chronic | Acute |
| This kind of pain is limited, intermittent or persistent and contains periods of remission or exacerbation. Acute or Chronic | Chronic |
| This kind of pain is diffuse or scattered & originates in the tendons, ligaments, bones, blood vessels, & nerves. a. cutaneous b. visceral c. deep somatic pain d. referred pain | deep somatic pain |
| this kind of pain involves the skin or subcutaneous tissue. a. deep somatic pain b. visceral pain c. referred pain d. superficial pain | Superficial or Cutaneous |
| _____________ pain is when the cause of pain can be identified. | physical pain |
| ______________ pain is when the cause cannot be identified. | psychogenic pain |
| _____________ pain perceived in an area distant from its point of origin. | referred pain |
| ________________ pain is from an injury to an or abnormal functioning of peripheral nerves or the central nervous system; exact cause unknown. Can be short duration or linger. | Neurogenic pain |
| _____________ pain is resistant to pain therapy & affects quality of life that is difficult to treat. | intractable pain |
| _____________ pain is when pain receptors and nerves are absent but pain is real | phantom pain |
| _____________ pain is when the pain has no real cause but pain can be found. | psychogenic pain |
| What are the 4 processes in the pain process? | Transduction, transmission, modulation, & perception of pain |
| Which step in the pain process is described as activation of pain receptors | transduction (first step) |
| Which step in the pain process is described as conduction along pathways (a delta & c delta fibers via noireceptors) | transmission (2nd step) |
| Which step in the pain process is described as initiation o the protective reflex response. | modulation (3rd Step) |
| Which step in the pain process is described as awareness of the characteristics of pain. | perception of pain (4th Step) |
| _______________ releases histamine; and produces inflammation. | bradykinin vasodilators |
| ______________ excite or inhibit nere cells. Two types are... _________ & _________. | Neurotransmitters. Prostaglandins & substance p |
| This theory is described as the relationship between pain and emotions. A mechanism determines impulses that reach the brain located in the dorsal horn of the spain. Small and Large nerve fibers conduct & inhibit pain stimuli. | Gate Control Theory |
| _______________ is the lowest intensity of stimulus that causes the patient to recognize pain. | pain threshold |
| What is the 5th vital sign? | Pain |
| What are 7 factors that affect the pain experience? | 1. Culture 2. Ethnicity 3. family/gender/age 4. Religion 5. Environment/support people 6. anxiety/stress 7. past pain experience |
| What are 10 assessments we should make of pain? | 1. Quality 2. Quantity 3. Chronology 4. Location 5. Duration 6. Description 7. Aggravating/Alleviating factors 8. Physiologic indicators 9. Behavioral responses 10. effect on life |
| Name 3 assessment tools for pain. | wong-baker faces, FLACC Scale, WILDA Scale |
| What ist he FLACC Pain scale | Faces, legs, activity, cry consolability |
| What is the WILDA Scale | Words that describe it, intensity, location, duration, aggravating or alleviating factors |
| List 10 nonpharmacologic pain relief measures. | 1. Distraction 2. Humor 3. Music 4. Imagery 5. Relaxation 6. Cutaneous Stimulation 7. Acupuncture 8. Hypnosis 9. Biofeedback 10. Therapeutic Touch |
| Describe the Numerica Sedation Scale. | 1. awake & alert 2. occasionally drowsy but easy to arouse 3. Frequently drowsy, drifts off to sleep during conversation; reduce dosage 4. Somnolent with minimal/no response to stimuli; discontinue and try something else |
| As you age, what happens to your total body water? | It decreases by 20% |
| As you age what happens to your lean body mass and body fat/adipose tissue? | body mass is decreased by adipose/fat is increased |
| As you age what happens to your SI absorption. | You absorb less B12, D, Ca+, & folate |
| What are the calcium requirements for people over the age of 51? | 1200 mg/day |
| This is described as unintentional weight loss of greater than 10% of body weight associated with serum albumin < 3.5 g/dL | Malnutrition |
| THis is protein energy malnutrition characterized by severe tissue wasting, excessive loss of lean body mass & fat sotres, dehydration,w eight loss. | Marasmus |
| This is just protein malnutrition characterized by retarded growth, changes in hair and skin pigmentation, edema, & low serum albumin. | Kwashiorkor |
| How does the body adapt to starvation? | energy metabolism decreases, vital signs are reduced, protein metabolism begins |
| What is refeeding syndrome? | when previously malnourished patients are fed with high carb loads they result in a fall in phosphate, magnesium, potassium, and increasing ECF volume |
| How is body fat measured? | anthropometric assessment |
| A nurse assesses a terminally ill patient with a DNR order, with findings of decreased blood pressure, urinary and bowel incontinence, loss of reflexes, and Cheyne-Stokes respirations. Based on these findings, the nurse recognizes which of the following? | These are signs of impending death. |
| During a health history interview, a male patient tells the nurse that he does not feel that he completely empties his bladder when he voids. He has been diagnosed with an enlarged prostate. What is the name of this symptom? | urinary retention |
| Which are considered to be physiological needs of the dying patient? | Hygiene, Pain Control, Nutritional Needs |
| What is the last stage of the healing process? | Remodeling |
| This is defined as the opposite effect by a medication than originally intended or prescribed for. a. adverse effect b. idiosyncratic effect | idiosyncratic effect |
| What psychological effects can a patient experience with the presence of a wound? | Pain, anxiety, fear, change in body image |
| A nurse has administered an intramuscular injection. What will the nurse do with the syringe & needle? | DO NOT recap the needle, and place it in a puncture-resistant container. |
| A nurse attempts to integrate complementary & alternative therapies (CAT) into the nursing practice. Which are basic principles of CAT? | Healing is a natural, slow process that involves the body, mind, and spirit. Health is a state characterized by a dynamic balance of mind, body, and spirit. Illness is a manifestation of imbalance or disharmony and is a process. |
| While caring for a patient near end of life, a student talks to her. Another student asks why she is talking to someone who is dying. Which response would be accurate? | I believe the patient can hear me as long as she is alive." |
| A home care nurse makes the following assessments of a wound: increased drainage and pain, increased body temperature, red and swollen wound, and purulent wound drainage. What wound complication do these assessments indicate? | INFECTION |
| A man is diagnosed with terminal kidney failure. His wife demonstrates loss and grief behaviors. What type of loss is the wife experiencing? | anticipatory loss |
| A nurse is assessing the stoma of a patient with an ostomy. What would the nurse assess in a normal, healthy stoma? | dark, red, & moist |
| Which of the following is NOT involved in postmortem care of a hospice patient? | Prepare the body for an autopsy |
| A nurse is conducting a health history and asks the patient about use of complementary and alternative therapies (CAT) to treat her chronic headaches. What response would require further questions? | "I take herbs to treat my headaches." |
| What are the clinical signs of impending death? | Inability to swallow, Pitting edema, Decreased GI & urinary activity, incontinence, Lose motion, sensation, reflexes, fever, cold clammy skin, cyanosis, hypotension Noisy or irregular respiration (death rattle) Cheyne-Stokes respirations Mottling |
| A dying patient and family have requested that no attempts be made to resuscitate the patient in the event of death. A doctor has written a DNR order. What is the nurse's responsibility if the patient dies? | Make no attempt to resuscitate the patient. |
| Confusion and dizziness are two common signs/symptoms of adverse reactions due to polypharmacy in the elderly. T/F | T |
| A nurse documents a closed wound on a patient chart. Which of the following is an example of a closed wound? a. abrasion b. ecchymosis c. incision | ecchymosis |
| A nurse working in long-term care is assessing residents at risk for the development of a decubitus ulcer. Which one would be most at risk? | an 86-year-old who is bedfast |
| A nurse is teaching an older adult at home about taking newly prescribed medications. Which of the following would be included? | "I have written the names of your drugs with times to take them." |
| A male patient who has had outpatient surgery is unable to void while lying supine. What can the nurse do to facilitate his voiding? | Assist him to a standing position. |
| What must a nurse do each time medications are administered to ensure that medication errors do not occur? | Observe the three checks and six rights. |
| What is the most consistent risk factor for a patient to experience adverse drug reactions related to polypharmacy? | the number of drugs being taken |
| What is not a drug that needs to be double-checked by another nurse? | Tylenol |
| A _________________ is described as a wound with new onset that heals well. | acute wound |
| Kübler-Ross defines five stages of psychosocial responses to dying and death. Which of the following statements is characteristic of the bargaining stage? | "Just let me live to see my grandson born." |
| Which of the following are functions of the skin? | protection psychosocial, sensation immunological temperature regulation |
| A nurse is administering an intramuscular injection of a viscous medication using the appropriate-gauge needle. What does the nurse need to know about needle gauges? Gauges range from 18 to 30, with 18 being the largest. | Gauges range from 18 to 30, with 18 being the largest. |
| A nurse is practicing imagery to relieve stress. What might accompany the imagery to even further promote relaxation? | listening to music |
| For a patient to be considered for Hospice care they must meet the following requirements. | Physician determines patient has six months or less to live. No curative measures are being taken. Patient's condition continues to deteriorate. |
| A home health nurse has a caseload of several postoperative patients. Which one would be most likely to require a longer period of care? | an older adult |
| A nurse is applying healing touch to a postoperative patient's wound. What benefits of healing touch would the nurse tell the patient's family? | It will help the wound heal. |
| A patient interested in acupuncture asks a nurse, "Just exactly what does it do?" What would the nurse explain? | "It changes the flow of energy and helps healing." |
| A nurse assessing a patient's wound documents the finding of purulent drainage. What is the composition of this type of drainage? | white blood cells, debris, bacteria |
| A patient is having difficulty having a bowel movement on the bedpan. What is the physiologic reason for this problem? | The position does not facilitate downward pressure. |
| The presence of undermining, tunneling, or a sinus tract in a wound indicates _________________. | infection |
| A hospitalized patient asks the nurse for "some aspirin for my headache." There is no order for aspirin for this patient. What will the nurse do? | State that an order from the doctor is legally required and check with the doctor. |
| A patient tells the nurse, "Every time I sneeze, I wet my pants." What is this type of involuntary escape of urine called? | urinary incontinence |
| Family members of a dying patient are in the room with the patient. As the patient nears death, what should the nurse tell the family? | "Please stay with your loved one and talk to him." |
| A patient who is taking an oral narcotic for pain relief tells the nurse he is constipated. What is this common response to narcotics called? | adverse effect |
| A nurse is conducting an interview for a health history. In addition to asking the patient about medications being taken, what else should be asked to assess the risk for drug interactions? | use of herbal supplements |
| The following factors affect wound healing (select all that apply): | Correct Answers: Wound condition Circulation & Oxygenation Age Health Status |
| A nurse is assessing a patient with a stage IV pressure ulcer. What assessment of the ulcer would be expected? | full-thickness skin loss |
| A nurse has auscultated the abdomen in all four quadrants for 5 minutes and has not heard any bowel sounds. How would this be documented? | "All four abdominal quadrants auscultated. Inaudible bowel sounds." |
| A nurse caring for elderly patients in an assisted-living facility encourages patients to eat a diet high in fiber to avoid which of the following developmental risk factors for this group? | constipation |
| There are ___________ stages of pressure ulcers. | 4 |
| Wounds left open to heal from inside to outside are called: | tertiary |
| During a dressing change, the nurse assesses protrusion of intestines through an opened wound. What would the nurse do after covering the wound with towels moistened with sterile 0.9% sodium chloride solution? | Notify the physician and prepare for surgery. |
| A patient who is taking Tylenol for a fever asks a nurse if there is a generic form that is less expensive. What would the nurse tell him? | "Yes, and it is acetaminophen." |
| What are scientologists strongly against? | mild-altering drugs |
| Nurses provide care to meet needs in all the human dimensions. What is one intervention nurses can implement to meet spiritual needs? | Offer a compassionate presence. |
| In general, what is the focus of care for nurses who work with older adults? | assisting patients to function as independently as possible |
| Which of the following are spiritual needs underlying all religious traditions that are common to all people? (Select all that apply.) | Correct Answers: need for forgiveness need for love and relatedness need for meaning and purpose |
| Pressure ulcers can be categorized in how many different stages? | 4 |
| What causes depression in older adults? | All of above? -look this up |
| Circumcision is performed on the 8th day of life in Judaism. T/F | True |
| Which of the following are increased risks of inadequate nutrition in the elderly? (Select all that apply.) medication use inability to chew walking with a walker/cane social isolation | medication use inability to chew social isolation |
| Protestants believe in reincarnation. T/F | False |
| Which of the following are signs and symptoms of neglect? (Select all that apply.) bruising use of chemical restraints malnutrition uncleanliness dehydration | use of chemical restraints malnutrition uncleanliness dehydration |
| Pneumonia is a/an ________________ of the lungs. | inflammation |
| What statement by a patient would indicate that a nurse had successfully implemented a teaching/learning strategy to prevent injury in the home? | "I am going to remove all those throw rugs on the floor." |
| Elders are likely to report if they are experiencing abuse. T/F | False |
| Which religion is associated with teh carrying of a rosary? | Catholicism |
| A nurse is caring for a hospitalized patient. What intervention can the nurse use to help the patient continue normal spiritual practices? | Request dietary consultation for the patient's dietary restrictions. |
| Jewish people do not believe in surgeries or other medical appointments scheduled on: | Sabbath |
| There are many physiological changes associated with nutrition in the older adult. Which of the following are some of the physiological changes that occur? (Select all that apply.) | decrease in gastric motility sleep changes decrease in total body water by 20% |
| Pregnant or menstruating woman of Islamic faith have the exception of eating and rinking during daylight if it is a time of fasting. T/F | True |
| What dietary restriction do followers of Hinduism follow? | Vegetarian |
| Islamics fast in a period called: | ramadan |
| What are the Basic Sacraments of the Roman Catholic Faith? Baptism Confirmation Holy Communion | All of the above? |
| While conducting a health assessment with an older adult, the nurse notices it takes the person longer to answer questions than is usual with younger patients. What should the nurse do? | Slow the pace and allow extra time for answers. |
| If a Native American needs an amputation, they believe that the limb should be put back on after death. T/F | True |
| T/F Most older adults are functional, benefitting from health-oriented interventions. | True |
| T/F Native Americans may want a medicine man to pray with when ill or hospitalized. | True |
| A nurse is feeding a patient. Which of the following statements would help a person maintain dignity while being fed? | "What part of your dinner would you like to eat first?" |
| Which of the following is NOT considered a sign of sexual abuse in the elderly? | Hazardous or unsafe living conditions |
| Wiccan believe that when they lost a limb, they do not want it reattached. T/F | True |
| By the time a person is 50 years old, they have a 65% chance of developing some form of hemorrhoids. T/F | True |
| What are the three classifications of osteoporosis? | postmenopausal, premenopausal, senile |
| Some religious beliefs may conflict with prevalent healthcare practices. For example, what type of treatment is prohibited by the doctrine of Jehovah's Witnesses? | administering blood transfusions |
| The number one person/people responsiblt for abuse of the elderly are: | The Family |
| Mrs. Ash, an 88-year-old woman who lives alone, has deficits in vision and hearing. Her blood pressure medicine is making her dizzy. What response to these health probles would the home health nurse identify? | risk for accidental injury |
| Which is most important to the Mormon faith? | marriage and family |
| Income and economic status can affect a person's nutritional status. T/F | True |
| Buddhism follows the teachings of who? | Buddha |
| What is the most common bacteria that causes pneumonia? | Streptococcus |
| Sensory changes impact an older adult's safety. T/F | True |
| Which of the following is NOT a risk for developing a pressure ulcer? | Race |
| Cerumen impaction is not common in the older adult and will not impair hearing. | False |
| Nurses provide many interventions to prevent falls in healthcare settings. Which of the following would be an appropriate fall-prevention intervention? | Lock wheels on beds and wheelchairs. |
| A patient tells a nurse that he does not think he can have the recommended heart surgery because transfusions are against his religion. What is the best response of the nurse in this situation? | Obtain all the information needed for the patient to make an informed decision. |
| ________________________ is the most likely cause of suicide in the elderly. | Untreated depression |
| Hindiusm followers prefer natrual medicine over traditional medications. T/F | True |
| While caring for an elderly man, the nurse observes that his skin is dry and wrinkled, his hair is gray, and he needs glasses to read. Based on these observations, what would the nurse conclude? | These are normal physiologic changes of aging. |
| A patient with type 1 diabetes has impaired sensation in her lower extremities. What teaching would be necessary to reduce her risk of injury? | "Always test the temperature of bath water before stepping in." |
| Which of the following is considered a Protestant religion? | Lutheran |
| Which special senses have the most dramatic change when it comes to aging? | vision and hearing |
| Males are twice as likely to develop irritable bowel syndrome as females. T/F | False |
| 1. Circumcision is performed on the 8th day of life in Judaism. T/F | True |
| 3. Where does elderly abuse usually occur? A. At the grocery store B. Long-term care facilities C. In their own home D. At the mall E. All of the above | E. |
| If a Native American needs an amputation, they believe that the limb should be put back on after death. True or false | T |
| What is not a sign & symptom of sexual abuse? 1. Unexplained STD 2. Bruising around breasts or genitals 3. Hazardous or unsafe living conditions 4. Torn, stained, or blood undergarments | 3 |
| 1. The number one people responsible for abuse of the elderly are __________. a. their family b. the elderly c. the nurse d. the nurses aids | a |
| Which religion is associated with the carrying of a rosary? a. Hinduism b. Islam c. Catholicism d. Wiccan | c |
| What is the most common bacteria that causes Pneumonia? A. Streptococcus B. Fungi C. Chlamydia D. Mycoplasma | A |
| Pneumonia is a/an _____________________ of the lungs. A. Deterioration B. Inflammation C. Restoration | B |
| Best prevention of illness includes A. Wear gloves B. Get the flu shot C. Wash hands D. Keep nails short | A, B, C |
| 1. Arthritis is a ___________disorder. a) genetic b) pulmonary c) autoimmune | C |
| 2. Which of the following is not a home remedy of multiple sclerosis? a) plenty of rest b) exercise c) eating junk food d) cool down | C |
| 3. What are teh 3 classifications of osteoporosis? a) Menopause, Brittle, Calcification B) postmenopausal, senile, premenopausal C) Premenopausal, senile, disorption D) Senile, Brittle, postmenopausal | B |
| Gout is the result of: a)inflammation b) acute trauma c) high levels of uric acid d) fluid build up around the joint | C |
| Males are twice more likely to get Irritable bowel syndrome than female | F |
| Colon can be easily removed during colonoscopy and they are not life threatening. T/F | F |
| By the time a person is 50, they will have 65% chance of developing some form of Hemorrhoids | T |
| The following physiological changes occur in adult nutrition except what? Total body water increases by 20% Sleep changes Decrease in taste/smell sensation Decrease in gastric secretion and motility | Answer is total body water increases by 20 % |
| Scientology focuses only on the spirit of a person and not on relationships? T/F | F |
| which of the following is part of the protestant religion? a. lutheran b. wiccan c. muslim d. judaism | a |
| Elder Abuse is described as: A) only physical abuse B) only emotional abuse C) only neglect D) only by the caregiver E) only sexual F) all of the above are true of elder abuse | F |
| Where does abuse most commonly occur? | in their own home |
| 1. Which special senses have the most dramatic change when it comes to aging? A. Smell and Taste B. Hearing and Smell C. Vision and Hearing D. Vision and Taste | C |
| 2. True or False. Cerumen impaction is not common and will not impair hearing. T/F | F |
| 3.True or False. Sensory changes impact an older adult's safety and quality of life. T/F | T |
| In Buddhism, males need to be taken care of before females. T/F | F |
| 2) Which of the following Is NOT a risk factor for developing a pressure ulcer ? A. Age B. Immobility C. Loss of sensation D. Race E. Smoking | D |
| 5) T/F Hinduism prefer natural medicine over medical medicine. | T |
| T/F--In general, wounds on children heal slower than wounds on adult | F |
| T/F Purulent drainage is very thick, often has a musty odor, and is yellow/green | F |
| The first stage of wound healing is: A) Proliferative Inflammatory C) Remodeling D) Drainage | B |
| Wounds left open and heal from inside to outside are called: a) Primary b) Secondary c) Tertiary d) Exudates | C |
| t/f stage 1 pressure ulcers are blanchable | F |
| t/f the skin is the first line of defence | T |
| What are some interventions that nurses can do to help with wound care for a patient? Select all that apply. a. maintain hydration b. monitor vital signs c. monitor s/s of infection d.administer medications e. let patient sleep all day | A,B,C,D |
| What psychological effects that a patient can have with wounds? a. pain b. anxiety c. fear d. change in body image e. all of the above | E |
| What factors affect wound healing? A. Age B. Circulation & Oxygenation C. Health Status D. Wound Condition E. All of the abovE | E |
| A ______ is described as a wound with new onset that heals well. a. acute wound b. chronic wound c. long-lasting wound | A |
| The presence of undermining, tunneling, or sinus tract in a wound indicates what? | Infection |
| Which of the following is not a function of the skin? A) Sensation B) Protection C) Vitamin E production and absorption D) Body Temperature Regulation | C |
| The final stage in wound healing is | Remodeling |
| Which colostomy has to the loosest stools A) Desending Colostomy B) Sigmoid Colostomy C) Illeostomy D) Ascending Colostomy | C |
| What is the primary pharmacologic treatment for constipation? a- increase fluid intake b-laxatives c-increased intake of dietary fiber d-increase in exercise | B |
| How can nurses help their patients maintain normal urination? (Select all that apply) a. Help them maintain proper hygiene b. Keep them on a regular schedule c. If bedridden, keep them lying down d. Give them privacy | a,b,d |
| 1)Types of Urinary Incontinence A) Stress b)Functional c)overflow D) all or the above | D |
| Which of the following are considered constipating foods? (Select all that apply) A. Cheese B. Pasta C. Eggs D. Alcohol E. Lean Meats | a, b, c, e |
| Depending on the patient, what is considered the norm for having bowel movements within a 24 hour period? a. 1 to 3 b. 1 to 4 c. 5 to 6 d. 4 to 5 | B |
| 1. What are the two common diuretics we see in the nursing home? A. Lasix & Fureosemides B. Lasix & estrogen C. Lasix & Morphine D. Citalopram & Fureosemides | A |
| If a patient, med w/ constipation, what is the nursing concern that you do NOT want to take in this situation? a. increase fluids b. tell the dr. to order a laxative c. take the patient off of the medication giving the side effect | C |
| Which of the following types of urinary incontinence is caused by factors outside the urinary tract? A) Overflow Functional C) Total D) Urge | B |
| What is the act of micturition? A. process of emptying the bladder B. process of having a bowel movement C. process of taking diuretics D. process of having green or blue-green urine | B |
| T/FPostmenopausal and sexual active woman are a risk of UTI | T |
| How to diuretics effect the urinary system? A. Increased urine production B. Prevent reabsorption of water C. Increased urine frequency D. All of the abov | E |
| Which is the longest phase of wound healing? A. Inflammatory phase B. Proliferative phase C. Remodeling phase D. Healing phase | C |
| Select all of the following that are causes of constipation: A. immobility B. too much fiber C. being lazy D. medications E. too much water | A, B, D |
| What are some of the factors contributing to polypharmacy? Select all that apply a-underrepsonding symptoms b- less chance for adverse reactions and side effects c- use of multiple providers d- use of others’ medications | a, c, d |
| All medicines, even over-the-counter, have adverse effects. T/F | T |
| One of the ways a drug is classified is by it's chemical composition T or F | T |
| When do you sign off on a medication administration? A-before you give the drug B-after you give the drug C-while you're administering the drug D-After the shift is over | B |
| Generic name is: A) identifies the drug’s active ingredient assigned by the manufacturer who develops the drug B)name selected by drug company; may be several trade names for one drug when produced by several manufacturers C)Both A and B | A |
| In which ways are drugs classified. Select all that apply. a. absorption b. excretion c. chemical composition d. therapeutic action e. clinical indications f. effect on body systems | c,d,e,f |
| What is not a drug that has to be checked by another nurse Tylenol Blood products Insulin Narcotics | a |
| medication order has all of the following except: a. Pt name b. Name of drug c. No signiture of MD/NP d. Dosage of drug | C |
| What factors affect the mechanism of action of the medication? a. lipid solubility b. pH c. blood flow d. route of administration e. all of the above | E |
| Which of the following are considered to be physiological needs of the dying pt? (select all that apply) a- Hygiene b- Pain control c- Loss of dignity d- Nutritional needs e-Isolation | a, b, d |
| What is included in advanced directive? a. decide how patient will be treated b. decide the kind of medical tx patient wants c. decide type of clothes the patient will wear. d. decide who will make decisions for the patient in case he or she is unabl | a, b, d |
| which is NOT involved in postmortem care of a hospice patient? A. Prepare the body for an autopsy B. Make sure the death certificate is issued and signed C. Review organ donation arrangements if applicable D. Remove any tubes and replace dressings | A |
| Which of the following is a clinical sign of impending death? a. inability to swallow b. pitting edema c. mottling d. incontinence e. all of the above | e |
| What are the needs of a dying patient? Select All that apply. A. Physiologic Needs B. Psychological Needs C. Sexual Needs D. Environmental Needs E. Spiritual Needs F. Self-Actualization needs | a, b, c, e |
| Which of the following are clinical Signs of Impending Death ? A.Inability to swallow B.Pitting edema C Decreased gastrointestinal and urinary tract activity D.Bowel and bladder incontinence E.All of the above | e |
| When a person has passed away, the nurse is required to do the end-of-life cares before the body is taken away. | T |
| For patient to be considered for Hospice they must meet the following requirements. A. Physician determines pt will die w/in 6 months B. no improvement in the pts condition C. No curative measures taken D. Can only be taken care of in the pts | A, B, C |
| 1. _________________ is loss that has not yet taken place. a. perceived loss b. anticipatory loss c. Maturation loss d. situational loss | b |
| Which is NOT apart of hospice? 1. do not have to be 6 months or less, only terminal 2. Care to give support in final phase of a terminal illness 3. occur in any setting 4. Physician must sign that the patient has 6 months or less. | 1 |
| Qi Gong is all except for the following? a. System of posture b. Exercise c. Breathing techniques d. All of the above | d |
| Pressure ulcer risk factors consist the following? Name all that applies. a. Aging skin b. Immobility c. Smoking d. Malnutrition | a, b, d |
| At least yearly, we should ask elderly patients to bring what medications that they have at home? Name that all applies. a. Prescription b. Vitamins c. Over the counter d. Herbal preparation | a, c, d |
| What type of loss is characterized as a loss that has not yet taken place? A. Actual Loss B. Anticipatory Loss C. Maturational Loss D. Situational Loss | B |
| How can a nurse develop a trusting relationship during end of life and hospice? A. Explain the patient’s condition and treatment B. Meet the needs of dying patient C. Teach family members to assist in care D. Meet family needs E. All of the above | e |
| Which of the following is not a clinical sign of impending death? A. Death Rattle B. Diaphoresis C. Pitting Edema D. Dysphagia | B |
| What is included in advanced directive? a. decide how pt will be treated by others b. decide kind of medical tx the pt wants c. decide type of clothes the patient will wear d. decide who will make decisions for the patient in case he or she is unab | a, b, d |
| Bereavement means? a. acceptance of loss; person learns to deal with loss b. state of grieving; person goes through grief reaction c.emotional reaction to loss d.all of the above | B |
| What are some examples of healthy stress management techniques? Select all that apply. a. Relaxation b. Drinking alcohol c. Anticipitory guidance d. Using drugs e. Meditation | a, c, e |
| What are the three most common anxiety responses to stress? A. Mild, Average, Severe b. mild, moderate, severe C. Okay, Anxious, Panic D. Stage 1, Stage 2, Stage 3 | b. |
| What could be a coping mechanism for stress? a) Crying b) Laughing c)Physical activity d) None of the above e) All of the above | e |
| What are the three most common stressors (select all that apply)? a. Depression b. Suicide c. Anger d. Anxiety | a, c, d |
| which of the following is not an emotional response to stress? A. Depression B. Anger C. Exercising D. Anxiety | C |
| Which of the following is a factor affecting sleep? a. motivation b. culture c. illness d. medications e. all of the above | e |
| T/F Long Term Stress can compromise recovery and the return to normal function | T |
| Which of the following are ways to reduce burnout? a. prevent stress b. accept stress c. stress reduction techniques d. all of the above | d |
| What three terms describes the way the body responds to stress? a. resistance, shock, flight or fight b. alarm, resistance, exhaustion c. alarm, repression, regression d. all of the above | C |
| Some factors that affect sleep include: Select all that apply a. motivation b. culture c. lifestyle and habits d. dietary habits e. illness f. medications | a,b, c, d, e, f |
| What illnesses are associated with sleep disturbances? a. epilepsy b. liver failure c. peptic ulcers d. hypothyroidism e. all of the above | e |
| Which of the following is NOT a nursing intervention to help a patient get restful sleep. A. Promote Bedtime Rituals B. Go into patients room to check on them often C. Respect normal sleep wake patterns D. Use medications to produce sleep | b |
| What is an example of cutaneous pain? a. Stubbing your toe b. Liver damage leading to edema c. Heart attack d. Sore muscles after an intense workou | a |
| T/F Psychogenic pain is when pain receptors are absent, but pain is real. | F |
| This type of pain is resistant to pain therapy and affects the quality of the patient's life and very difficult to treat. a. psychogenic b. phantom c. intractable d. neuropathic | C |
| Which kind of pain is perceived in an area that's distant from its point of origin? a. referred pain b. deep somatic pain c. psychogenic pain d. neuropathic pain | a |
| How many levels are on the Numeric Sedation Scale | 4 |
| A patient comes in with lower back pain, list 2 nonpharmacologic pain relief measures that can be used to relieve the patients pain while waiting for the doctors order. | 1. Distraction 2. Humor 3. Music 4. Imagery 5. Relaxation 6. cutaneous stimulation 7. acupuncture 8. hypnosis 9 biofeedback 10. therapeutic touch |
| What factors are used to diagnose pain? Select all that apply. A. Types of pain B. Etiologic factors C. Behavioral, physiologic, affective response D. Other contributing factors | A, B, C, D |
| Which of the following is NOT considered part of the pain process? A. Transduction B. Transmission C. Modulation D. Intractable | D |
| What are three general responses to stress? A. Resistance, Exhaustion & Fight-or-Flight B. Alarm Reaction, Resistance & Exhaustion C. Coping, Rationalization & Exhaustion D. Alarm Reaction, Adaption & Resistance | B |
| What coping mechanism is used most often by children but a very successful type for anyone? A. Crying B. Laughing C. Cursing D. smoking | B |
| What factors affect the experience of pain? huh huh huh? a. religious beliefs b. environment c. past pain experiences d. gender e. all of the above | e |
| What type of pain is resistant to pain therapy, affects quality of life and difficult to treat a)Psychogenic pain b)Neuropathic pain c)Phantom pain d)Intractable pain | D |
| There are three origins of pain. They are: (SELECT ALL THAT APPLY) A. Physical B. Psychogenic C. Referred D. Acute E. Deep Somatic | A, B, C |
| sources of pain include a. deep somatic b. cutaneous c. viceral d. refered e. all of the above | e |
| Which of the following is NOT true about pain? A. Pain is different for each person. B. Pain is over managed and under medicated. C. Pain is a body's defense mechanism. D. Pain is the 5th vital sign. | B |
| The body’s general response to stress is in what order? A. Exhaustion, alarm reaction, resistance B. Resistance, alarm reaction, exhaustion C. Alarm reaction, resistance, exhaustion D. None of the above | c |
| factors affecting pain experience except what? A. Culture B. Ethnic variables C. Family, gender, and age variables D. Religious beliefs E. All are factors affecting pain experience | E |
| which of the following could benefit from a FACES pain rating scale? a. blind people b. children c. def people d. all of teh above e. both b and c | e |
| T or F: Anxiety is most common stress | T |
| T or F: Epilepsy is one of the thing that can effect sleep. | T |
| what are the effects of aging on bowel & bladder? | nocturia, increased frequency, retention & stasis |
| The following medications turn the urine what color? Anticoagulants Diuretics yridium Elavil Levodopa | Anticoagulants: red Diuretics: yellow Pyridium: orange Elavil: green/blue Levodopa: brown/black |
| What are 5 risk factors for UTI's? | Sexual activity, postmenopause, catheters, DM, eldery |
| Incontinence w/ increased pressure is.. | stress |
| Incontinence due to abrupt strong desire to go is.. | urge |
| Incontinence with stress and urge s/s is.. | mixed |
| Incontinence with overdistention & overflow of bladder is.. | overflow |
| Incontinence caused by factors outside the UT is | functional |
| Incontinence w/ out sensation of need to void is.. | reflex |
| T/F for older adults constipation is often a chronic problem. | T |
| Normal elimination is every.. __ to __ days | 1 to 3 |
| What are 5 ways to promote regular bowel elimination habbits? | Timing, positioning, privacy, nutrition, exercise |
| Who is at risk for constipation? | bedrest patients, patients with reduced fluids or bulk in their diet, patients who are depressed, and patients with CNS dz |
| Patients with an ostomy should avoid what kind of foods? | Foods high in fiber and foods that cause diarrhea |
| Patients with an ostomy should drink how much fluid a day? | 2 quarts |
| What kind of food makes ostomy patients fluids smell terrible? | dark green vegetables |
| What is the healthcare definition of constipation? | discomfort, less than 3 bowel movements per week. |
| define primary constipation. | Slow transit, trouble with expulsion, difficult/hard stools |
| Define secondary constipation. | lifestyle influences, neurological d/o, metabolic/endocrine d/o, CT dz, Medications |
| medications associated w/ constipation are.. | estrolgens, calcium channel blockers, antihypertensives, antidepressants, & pain medications |
| Nonpharmacologic treatment of constipation is.. | increase intake of fiber and fluids and increase exercise |
| Pharmacologic treatment of constipation is.. | laxatives, stool softeners, |
| ______________ is anythin that pertains to person's relationship with nonmaterial life force or a higher power. | spirituality |
| ______________ is a confident belief in something for which there is no proof or evidence. | faith |
| ______________ is a term to describe cultural or institutional religion | religion |
| ______________ is an ingredient in life responsible for a positive outlook | hope |
| What are 3 spiritual needs? | a need for meaning/purpose, love & relatedness, and forgiveness |
| the study that deals with chemicals that affect the body’s functioning | pharmacology |
| identifies the drug’s active ingredient assigned by the manufacturer who develops the drug | generic name |
| how drug is identified in the official publications (also the generic name) | official name |
| name selected by drug company; may be several trade names for one drug when produced by several manufacturers | trade name/brand |
| THE EFFECT OF THE BODY ON THE DRUG. | pharmacokinetics |
| PROCESS BY WHICH A DRUG IS TRANSFERRED FROM ITS SITE OF ENTRY INTO THE BODY TO THE BLOODSTREAM. INFLUENCED BY SEVERAL FACTORS | absorption |
| HIGHEST PLASMA CONCENTRATION SHOULD BE MEASURE WHEN ABSORPTION IS COMPLETE | peak level |
| THE POINT WHEN THE DRUG IS AT ITS LOWEST CONCENTRATION, USUALLY DRAWN 30 MINUTES PRIOR TO THE NEXT DOSE | trough level |
| AMOUNT OF TIME IT TAKES FOR 50% OF THE BLOOD CONCENTRATION OF THE DRUG TO BE ELIMINATED FROM THE BODY | half-life |
| the ability of the drug to alter cell physiology and affect the body | pharmacodynamis: |
| life-threatening allergic effect and results in respiratory arrest | anaphylactic rxn |
| the body becomes accustomed to the effects of a drug | drug tolerance |
| the risk for permanent damage or death | toxic effects |
| unusal or peculiar response to a drug; different with each of us. | idiosyncratic effect |
| single order is a.. | one time medication |
| a standing order is | certain medications that can be given for a specific length of time without calling a MD/NP |
| 6 Rights are.. | Medication Dosage Client Route Time documentation |
| Polypharmacy is __ or __ + drugs | 5 or 7 |
| What are 6 functions of the skin? | protection, body temp, sensation, excretion of toxins, water electrolyte balance, vitamin D production/absorption |
| What are 8 risk factors for presure ulcers | aging, immobility, illness, malnutrition, incontinence, altered consciousness, SC/brain injury, neuro d/o |
| What pressure ulcer stage is described as nonblanchable erythyema of intact skin (red/warm) | Stage I |
| What pressure ulcer stage is described as partial-thickness skin loss presentas a blister/abrasion | Stage II |
| What pressure ulcer stage is described as full-thickness skin loss not involving underlying fascia. | Stage III |
| What pressure ulcer stage is described as full thickness loss w/ extensive destruction | Stage IV |
| This is described as plasma and blood leaking into the injured tissue in a wound. | exudate |
| this is described as dehydration dry cells leads to death of cell and tissues | desiccation |
| This is described as over hydration that leads to impaired skin integrity & overgrowth of bacteria. | Maceration |
| This phase of wounding healing.. Begins at time of injury; leukocytes and macrophages enter site. Macrophages eat debris and release growth factors Prepares wound for healing (blood clotting), inflammation, pain, heat, redness, swelling | inflammatory phase |
| Phase begins 2 to 3 days of injury and last up to 2 to 3 weeks New tissue is built to fill wound space through action of fibroblasts Capillaries grow, layer of epithelial cells forms across wound Granulation tissue forms for scar tissue development | proliferative phase of wound healing |
| Final stage of healing begins about 3 weeks after injury to possibly 6 months Collagen is remodeled New collagen tissue is deposited Scar becomes a flat, thin, white line | Remodeling phase of wound healing |
| this wound drainage is.. composed of clear serous portion of blood; clear and watery | serous |
| this wound drainage contains..: large numbers of red blood cells. Bright red drainage indicates fresh bleeding; dark red indicates older bleeding (think of GI bleeding upper versus lower) | Sanguineous |
| this wound drainage is most often is light pink to blood tinged | serosanguineous |
| this wound drainage is cream or off white | alba |
| this wound drainage is.. thick, often has musty or foul odor varies in color, but most often is yellow or green | purulent |
| this is described as an emotional reaction to loss | grief |
| this is described as a state of grieving | bereavement |
| this is described as acceptance of loss | mourning |
| This type of loss can be recognized by others | actual loss |
| this type of loss is felt by a person but is intangible to others | perceived loss |
| this type of loss is experienced as a result of natural developmental process | maturational loss |
| this type of loss is described as a result of an unpredictable event | situational loss |
| this type of loss is described as one that has not yet taken place. | anticipatory loss |
| What are the 5 stages of grief. | denial/isolation, anger, bargaining, depression, acceptance |
| this type of care is an approach that improves quality of life of patients & families facing the problem associated with life-threatening illness. It focuses on PREVENTION & relief of suffering. It can occur in any setting. | Palliative Care |
| Define stress | a condition in which human system responds to changes in normal balanced state. It results from a change in the environment that is perceived as a challenge, threat, or danger. It can have both positive and negative effects. |
| anything that is perceived as challenging, threatening or demanding | stressor |
| hange that takes place as a result of the response to a stressor; ongoing process is necessary for normal growth and development, ability to respond to changing situations and to respond to physical and emotional stressors | adaptation |
| maintain relative constancy in your own environment | homeostasis |
| This is a biochemical model of stress used to describe the body's general response to stress. What are it's 3 characteristics and what is it called? | General Adaptation Syndrome and it is Alarm Reaction, Resistance, Exhaustion |
| This is a reaction to stress that lasts minutes to hours. It is when defense mechanisms are activated. Hormone levels rise and the body goes through shock and counter shock phases. | alarm reaction |
| this is a reaction to stress in which the body attempts to adapt to the stressor. Vital signs, hormone levels, and energy production return to normal. Body regains homeostasis | Resistance |
| This is a reaction to stress that results when adaptive mechanisms are exhausted. The body either rests and mobilizes its defenses to return to normal | exhaustion |
| What are three emotional responses to stress? | Depression, Anger, Anxiety |
| HOW DO PEOPLE COPE WITH STRESS? | crying laughing, sleeping, cursing, exercise, drinking, smoking, withdrawal, limiting relationships |
| What are 5 effects of burnout? | exhaustion, overachievers, withdraw, drug/alcohol, leave nursing |
| What are 5 ways to reduce burnout? | prevent stress, accept stress, reduce stress, accept we are not infallible, take care of self first |
| 5 teaching points about stress. | Exercise, rest/sleep, nutrition, support system, stress management |
| What are 6 stress management techniques? | Relaxation, meditation, anticipatory guidance, imagery, biofeedback, crisis intervention |
| What is crisis intervention? | ID problem, list alternatives, choose from alternatives, implement plan, evaluate outcome |
| What is the control center for sleeping/waking? | hypothalamus |
| What is the reticular activating system? | facilities reflex/voluntary movements and controls activities related to alertness |
| What is NREM? | non rapid eye movement 4 stages 1 & 2 is a light sleep and 3 and 4 is a deep sleep |
| What is REM? | Rapid Eye Movement |
| Describe the sleep cycle. | A person passes through 4 stages of NREM then reverses and returns from stage 4, 3, 2, and then lastly enters REM sleep. |
| What are 5 illnesses associated w/ sleep disturbances? | peptic ulcers, CAD, epilepsy, liver failure, & Encephalitis, and Hypothyroidism |
| What characteristics of sleep do nurses assess? | restlessness, sleep postures, sleep activities, snoring, leg jerking. |
| This sleep d/o is characterized by.. insomnia or excessive sleepiness | dyssomnias |
| This sleep d/o is characterized by.. patterns of waking behavior that papear during sleep | Parasomnias |
| What are 6 dyssomnias? | insomnia, hypersomnia, narcolepsy, sleep apnea, restless leg syndrome, sleep deprivation |
| What are 6 times of parasomnias? | somnambulism, sleep talking, nocturnal erections, bruxism, enuresis, sleep-related eating d/o |
| What are some treatment options for dyssomnias? | sedatives/hypnotics, stimulus control, sleep restriction, sleep hygiene, cognitive therapy, multicomponent therapy, & relaxation therapy |
Created by:
Kelly Hempeck