Exam 2 "hints"

Question 1

What does the ANA say about nurses and how they are professional beings?

Answer 1

Speaks to the nurses obligation to: The client, to self, to colleagues, and to the nursing profession
Gives us information like social policy and the nurse practice act
Includes safety, EBP, and quality of care

Question 2

What is non-maleficence?

Answer 2

avoiding actions that bring harm to another person

Question 3

What is the beginning of therapeutic communication?

Answer 3

Introduction
establishment of trust

Question 4

How do you use therapeutic communication?

Answer 4

build rapport with the client
identify clients feelings problems and goals

Question 5

autonomy

Answer 5

the individuals right to self determination

Question 6

beneficience

Answer 6

doing the greatest amount of good and avoiding harm

Question 7

confidentiality

Answer 7

respect for another’s privacy, not divulging info that was given in confidence

Question 8

maleficence

Answer 8

act of committing harm

Question 9

What is HIPPA?

Answer 9

Health Insurance Portability and Accountability Act was designed to protect an individuals health records and info

Question 10

What happens to us as nurses if we do not adhere to HIPPA?

Answer 10

penalties for failure to comply involve a substantial fine, prison term, or both

Question 11

How does communication begin?

Answer 11

the interview process
Phase 1: orientation
Phase 2: Working
Phase 3: Termination

Question 12

What is cultural competence?

Answer 12

a set of cultural behaviors and attitudes integrated into the practice methods of a system, agency, or its professionals that enables them to work effectively in cross cultural situations

Question 13

What are the 8 domains of cultural competence?

Answer 13

governance
leadership
workforce
communication
language assistance
engagement
continuous improvement
accountability

Question 14

How do we understand different cultures and get more awareness about them?

Answer 14

become knowledgable
recognize barriers
develop techniques to foster communication and utilize resources

Question 15

What is QSEN?

Answer 15

Quality and Safety Education for Nurses
prepares future nurses to provide safe, quality, patient centered care and team collaboration in a clinical practice

Question 16

What does client centered care mean and all we do as a nurse?

Answer 16

includes client’s individual preference, values, beliefs and needs
client has right to self determination
advocate for client

Question 17

What did the Joint Commission do in accrediting?

Answer 17

National patient safety goals
TJC also regulates hospitals and evaluates safety fro accredidation
5c’s

Question 18

What are the national patient safety goals?

Answer 18

identify patients correctly
improve effective communication
improve safety of high alert meds
ensure correct site, correct procedure, correct patient surgery
reduce risk of health care associated infections
reduce risk of patient harm from falls

Question 19

What are the 6C’s

Answer 19

clear
concise
complete
concrete
courteous
correct

Question 20

What are the reasons medical errors occur?

Answer 20

miscommunication
errors are usually system problems
due to fatigue or handoff errors
under reporting of med errors

Question 21

What is evidence based practice?

Answer 21

implementing nursing interventions based on sound clinical research and professional judgement in real-time situations

Question 22

Why do we use evidence based practice?

Answer 22

provide the best care to clients by using the best evidence to guide practice

Question 23

What is the IOM to err is human?

Answer 23

a report that expressed not all humans are perfect and will continue to make errors, but it is up to the health care system to identify what leads to errors so that improvements cam be made

Question 24

What is a near miss?

Answer 24

when a patient is exposed to a harmful situation but DOES NOT experience harm (either through luck or early detection)

Question 25

What is a preventable adverse effect?

Answer 25

due to error or failure to apply an accepted strategy or prevention

Question 26

What is an ameliorable adverse event?

Answer 26

while not preventable, could have been less harmful if care had been different

Question 27

how do we start the process of initiating evidence based practice?

Answer 27

asses the patient and identify a clinical problem then ask a question

Question 28

Why don't we like to report errors?

Answer 28

we fear being punished

Question 29

What is TeamSTEPPS?

Answer 29

Team Strategies and Tools to Enhance Performance and Patient Safety is a program that emphasizes improving patient outcomes by improving communication in a health care team using EBP

Question 30

Biases and understanding our own biases

Answer 30

bias: slant toward a particular belief understanding your own biases starts with self-awareness and cultural awareness, understand intrinsic biases

Question 31

Define therapeutic communication

Answer 31

The purposeful use of communication to build and maintain helping relationships with clients' families, and significant others. Therapeutic communication is client-centered, purposeful, planned, and goal directed.

Question 32

What are the most important parts of therapeutic communication?

Answer 32

client-centered partnership professional boundaries involvement/active participation use of self

Question 33

client centered

Answer 33

includes the clients individual preference, values, beliefs, and needs

Question 34

partnership

Answer 34

honors the clients right to self-determination, giving the client and family maximum control over health care decisions advocate for the client and encourage independence

Question 35

professional boundaries

Answer 35

protect functional integrity of alliance between the nurse and client

Question 36

involvement/active participation

Answer 36

degree of the nurse's attachment and active participation on clients care

Question 37

use of self

Answer 37

authenticity: requires admitting mistakes, recognizing vulnerabilities self-awareness: reflective process seeking to understand one's one values, feelings attitude, motivations, strengths and limitations presence: in the moment

Question 38

Define safe, quality care

Answer 38

QSEN definition: the minimization of risk for harm to patients and to providers (doctors and nurses) through both system effective ness and individual performance

Question 39

What do we do to clarify communication?

Answer 39

paraphrase restate reflect explore

Question 40

paraphrase

Answer 40

Restating in fewer words what was said

Question 41

restate

Answer 41

Echoing feelings; saying the same KEY WORDS that the client used

Question 42

reflect

Answer 42

may be a question or mirroring back to the clients feelings

Question 43

explore

Answer 43

A way to elicit more information such as "tell me more, describe, give me an example"

Question 44

Therapeutic vs non therapeutic communication

Answer 44

therapeutic: use of silence, active listening, clarifying techniques, verbal, nonverbal non therapeutic: excessive questioning, giving advice, giving approval or disapproval, asking "why" questions, changing the subject

Question 45

What does "advise" mean from a nursing perspective?

Answer 45

RECOMMEND what a client should do (ex: take a shower or instruction after discharge)

Question 46

Electronic records and what they have to do with nurses. Are they good or bad?

Answer 46

Technology oriented solutions, such as electronic records, barcodes and IDs help nurses perform safer practices when caring for a patient

Question 47

what are some safer practices that nurses can implement?

Answer 47

use of check lists timely documentation standardized tools (SBAR) for better communication technology oriented solutions understanding interdisciplinary roles relationships and nursing role relationship changes EBP research and promotion of safer policies/procedures

Question 48

What are the various theoretical concepts of a person, concepts of illness, concept of environment- nursing etc.?

Answer 48

There external factors that play into a client's condition. The clients view on illness, environment (where they live), previous experiences, nationality, ethnicity, how they were raised, etc. will play a role how a person views their experience in a hospital setting

Question 49

What is SBAR?

Answer 49

SBAR is a standardized communication tool commonly used between two people during handoff. Situation Background Assessment Recommendation

Question 50

Situation

Answer 50

Introduce yourself Patient name, age, room # Attending physician/consulting physician involved in care Diagnosis and admission date Description of patient's current situation

Question 51

Background

Answer 51

Basically a head to toe assessment Pertinent procedures and tests completed Allergies, code status, most recent VS, BS, labs Vascular access, fluids, drip/rate, patency and site- changes due or last changed Oxygen flow if oxygen was ordered Hearing, visual, cognitive, language barriers Patient mobility/fall risk status Isolation/infection control precautions Current medications/relationship to condition Comorbidities affecting client's status Cardiac status

Question 52

Assessment

Answer 52

Any changes in respiratory, physical, or mental status What happened in today's shift Last pain medication given Any medications held and the rationale

Question 53

Recommendation

Answer 53

Suggestions of actions to be taken (plan of care, what does the patient need and when, pending procedures and tests to be scheduled) Recommendations for discharge Ask if receiving nurse has any questions

Question 54

What is Maslow's hierarchy of needs?

Answer 54

1. Physiological needs 2. Safety and Security needs 3. Love and Belonging Needs 4. Self esteem 5. Self actualization Helps nurses prioritize nursing actions

Question 55

infant

Answer 55

totally dependent on caregiver communicate through CRYING OR SMILING provide for infants physical and emotion needs, by 12 months, infants say 3-words with meaning swaddle and hold infant in arms Take time to listen and address caregiver

Question 56

toddler

Answer 56

Regress to infantile behaviors when stressed (they think its safer) LITERAL with interpretation of word (take BP, they think you are actually taking something from them) Use consistency; routines are important, explain using very basic words, approach slowly

Question 57

preschooler

Answer 57

Follow simple commands but only ONE AT A TIME LITERAL with interpretation of words Eye contact, sit down at their level, approach slowly

Question 58

school age

Answer 58

Transition from home to school Use terms understandable to child, give choices, provide encouragement and praise, be honest

Question 59

adolescent

Answer 59

Transitioning from childhood to adulthood -fight for independence -need comfort and security difficult time -demands from family school peers society body changes (puberty need something to feel good about acne difficult time for parents -transition -opposing views

Question 60

adults

Answer 60

Recognize characteristics -working toward career goals -earning a living -establish primary relationships -making a place in their community -raising a family STRESS -info and assistance in parenting and daily living -extended psychological adolescent period -still pursuing education -still living with parents (boomerang generation)

Question 61

older adults

Answer 61

Fewer acute illnesses (chronic illness management) more freedom (empty nest, retirement) final stage (no longer needed, bored, lack of energy to participate in activities, fear off loss) interests in younger years tend to remain the same (active vs non active social vs nonsocial)

Question 62

fidelity

Answer 62

faithfulness; loyalty; obligation to client

Question 63

virtue centric

Answer 63

this theory centers on the CHARACTER of the person acting

Question 64

deontology

Answer 64

this theory asks "what is one obligated to do?" It focuses on the MORAL VALUE MINDEDNESS where everyone has inherit dignity and worth

Question 65

utilitarianism

Answer 65

this theory places emphasis on the OUTCOME of the situation - greatest good for the greatest number

Question 66

advanced directive

Answer 66

document where written instructions are recognized under state law related to the provision of medical care when an individual is incapacitated and unable to state desired care

Question 67

advocate

Answer 67

someone who speaks up for or acts on behalf of clients

Question 68

clients rights

Answer 68

right to autonomy, beneficence, nonmalficience, justice, informed consent

Question 69

informed consent

Answer 69

A person's agreement to allow something to happen based upon a full disclosure and explanation of facts needed fro a client to make an intelligent decision. May include information about procedures, treatments, options and consequences of refusal

Question 70

Statutory vs Common Law

Answer 70

statutory: established through the legislative process common law: established by previous court decisions

Question 71

What can the boards of nursing do?

Answer 71

can only limit to deny a nursing license

Question 72

What are the 6 competencies of QSEN?

Answer 72

patient centered care teamwork & collaboration EBP Quality improvement safety informatics

Question 73

just culture

Answer 73

recognizes human error and faulty systems that causes a mistake and encourages investigation so that the system can be fixed makes workers feel more at ease to report problems

Question 74

Agency for Healthcare Research and Quality (AHRQ)

Answer 74

U.S. Department of Health and Human Services involved in patient safety by FUNDING RESEARCH and complying evidence to publish best evidence based standards of practice

Question 75

young old

Answer 75

65-74

Question 76

old

Answer 76

74-84

Question 77

oldest old

Answer 77

85+

Question 78

centenarians

Answer 78

100+

Question 79

paternalism

Answer 79

a concept where health care providers believe there know more about what is best fir the clients than the clients themselves

Question 80

ethnicity

Answer 80

a membership of a person in a particular cultural group.. common racial, geographic, ancestral, religious of historical bonds

Question 81

ethnocentrism

Answer 81

the belief that ones own culture is superior to another culture

Question 82

cultural relativism

Answer 82

a concept where each culture is determined to be unique and only judged on its own values, standards or beliefs

Question 83

health disparities

Answer 83

can exit where there are margins of society that are undeserved for medical care being given (healthcare may be unavailable or person may not have the awareness)

Question 84

acculturation

Answer 84

where a person from a different culture learns behaviors and values of the dominant culture and adopts the norms and values including language

Question 85

communication principles

Answer 85

Listen carefully Explain what the client needs to understand Acknowledge cultural differences Recommend what the client should do Negotiate mutually agreeable strategies

Question 86

hispanic/latino

Answer 86

strong family loyalty father head of household and primary decision makerreligion: Roman Catholic believe illness id falling out of favor w God high incidence of diabetes not uncommon fro these clients to share meds LOOKING FOR WARMTH RESPECT AND FRIENDLINESS FROM HCP

Question 87

African american

Answer 87

value "caring for ones own"women often head of household, backbone, assume responsibility for parents and children history of oppression , HTN, stroke, diabetes, heart disease history of suffering from health care disparities especially w lower income groups TRUST MUST BE ESTABLISHED so that clients will participate in their own treatment males tend to use recommended preventivce services and suffer more health issues because of it

Question 88

asian American

Answer 88

very hard working and education is high valued metal respect and honesty male with male and female with female nurses smile in agreement even if hey disagreereligion: hinduism, buddhism, muslim- rituals for prayer, modest, dietary restrictions use herbal medicines and treatments like accupunctr eSTOIC less likely to request pain meds DO NOT believing mental health illness, as it brings shame to family and can result in suicide

Question 89

Native American

Answer 89

health practicies are ties into spiritual practices value nature and earth blue respect, story telling and humor direct eye contact is disrespectful private shoe little to no emotion will not participate in teaching back

Question 90

culture of poverty

Answer 90

associated with health disparities DESERVE SAME RESPECT AS OTHERS