Final

Question 1

Blood Pressure Ranges

Answer 1

Normal: less 120 and less 80
Elevated: 120-129 and less 80
I: 130-139 or 80-89
II: greater or equal to 140 or greater and equal to 90
Crisis: Greater 180 and/or greater or equal t 120

Question 2

Vital Sign Ranges

Answer 2

Temperature: 35.9-38C (96.7-100.5F)
Pulse: 60-100 bpm
RR: 12-20 bpm
BP: less than 120 / less than 80

Question 3

Temperature Range

Answer 3

35.9-38C or 96.7-100.5F

Question 4

Pulse Deficit

Answer 4

2 nurse check:
apical - radial pulse

Question 5

MAP and Pulse Pressure

Answer 5

MAP = (DP+ (1/3(SP-DP))

PP: SBP - DBP

Question 6

PERRLA

Answer 6

CN 3
Pupils are equally round, reactive to light, and accommodation

Question 7

Physical Assessment Techniques Order

Answer 7

Inspection
Palpation
Percussion
Auscultation

Question 8

GCS

Answer 8

Max: 15
Eye Open: 4
Verbal Response: 5
Motor Response: 6

Less than 8 = comatose

Question 9

Positioning

Answer 9

Fowler’s position: breathing
Trendelenburg: fluid

Question 10

Program Learning Outcomes

Answer 10

Leadership
Teamwork and Collaboration
Professional
Communication
Evidence-Based Practice
Informatics
Patient-Centered Care
Quality Improvement
Safety
Systems-Based Practice

Question 11

Medicare

Answer 11

65 and older

A: inpatient hospital cost with no premium
B: outpatient preventative; premium
C: A+B including vision, hearing, and gym; premium
D: outpatient and drug coverage; premium

Question 12

Levels of Healthcare

Answer 12

Primary: clinic with PCP or NP
treat common health problems and provide preventative measures
e.g. sore throat, HTN, DM, vaccinations, mammograms

Secondary: community centers with specialized physicians
Diagnose disease and disease management
e.g. hospital care for MI or stroke

Tertiary: medical centers with subspecialized like pediatric hematologist
Rare and complex disease management
e.g. pituitary tumor

Question 13

Delegations to LPN Only

Answer 13

Apical Pulse
Oxygen Administration
Nasal Swab and NP Collections
Sputum Specimen Collection
Wound Culturing
IM, ID, SubQ
Medications
Enemas
Bladder Scanner
Change stoma appliance
Collect data

Question 14

What can you not delegate to LPN

Answer 14

U EAT
Unstable patient: new admission, post-op, sudden changes
Evaluation: trending or interpreting data
Assessment: initial, first, primary
Teaching: initial, first, primary education

Question 15

Informatic Terms: Data, Information, Knowledge, Wisdom

Answer 15

Data: discrete entities described without interpretation
Information: data interpret, organized, structured
Knowledge: synthesized information to identify relationships
Wisdom: appropriate use of knowledge to manage and solve human problems

Question 16

Research Journal Article

Answer 16

Abstract: summary of article and purpose
Intro: specific purpose and lit review
Method: subject, research design, data collected and how it was analyzed
Results
Discussion/Conclusion: what results mean in regard to purpose of study and lit review including suggestions for future research and application to nursing practice

Question 17

EBP Steps

Answer 17

1. PICOT format question
2. search and collect most relevant best evidence
3. analyze previous research
4. implement practice
5. evaluate outcome
6. disseminate outcomes

Question 18

System Dev Lifecycle

Answer 18

1. Analyze and Plan
2. Design and Dev
3. Test
4. Train - superuser
5. Implement
6. Maintain
7. Evaluate - stage nurses are needed

Question 19

PICOT

Answer 19

P: patient, population, problem of interest
I: intervention of interest (independent var)
C: comparison of interest (control)
O: outcome of interest
T: time

Question 20

Hierarchy of Evidence

Answer 20

Level I: systematic review
Level II: randomized controlled trials
Level III: controlled cohort studies
Level IV: uncontrolled cohort studies
Level V: case studies, qualitative, EBP implementation
Level VI: expert opinion

Question 21

Quantitative

Answer 21

Number; Objective

Descriptive: describe relationships
Correlation: relationship between two variables
Quasi-experimental: clinical setting
Experimental: lab setting

Independent: manipulating
Dependent: variable being studied

Question 22

Quantitative Research Process (Scientific Method)

Answer 22

1. research problem usually a question
2. define the study purpose
3. review literature
4. hypothesis and variables
5. research design
6. population and sample
7. collect data
8. analyze data
9. communicate findings

Question 23

Qualitative

Answer 23

words and narrative; subjective
perception, experience, views

Phenomenology: description of experience of subject

Grounded theory: how people describe their own realities

Ethnography: cultural issues

Historical: examine past events

Question 24

Medicare 4 Parts

Answer 24

65 and older

A: inpatient hospital cost; no premium

B: outpatient: voluntary and monthly premium

C: Advantage Plus (A+B) also includes vision, hearing and gym. Premium

D: outpatient and drug coverage; premium

Question 25

Levels of Healthcare

Answer 25

Facilities Primary: clinic (PCP & NP) treat common health problems and preventative measure Sore throat, HTN, DM, vaccination, screenings Secondary: community centers (specialties like peds; neuro) diagnose dz and management hospital care for MI or stroke Tertiary: medical centers subspecialities like pediatric hematologist rare and complex dz management pituitary tumor

Question 26

AZBoN

Answer 26

apply to take NCLEX to become RN apply for licensure scope of practice for RN, LPN, CNA Nurse Practice Act

Question 27

Prioritization

Answer 27

Safety first ABC: airway, breathing/brain, circulation (heart) acute > chronic actual > potential least invasive first Maslow's: physiological needs first

Question 28

Source of Law: Administrative and Statutory

Answer 28

Administrative: enforcing - Board of Nursing Statutory: Nurse Practice Act safe nursing practice disciplinary process professionalism scope of practice delegation board responsibilities

Question 29

Levels of Preventive Care

Answer 29

Primary: promoting health Secondary: early detection screening Tertiary: know the disease and rx

Question 30

Health, Wellness, Illness, Dz

Answer 30

Health: holistic - physical, mental, social Wellness: promotion of holistic health Illness: response to dz Dz: pathologic change

Question 31

Care Based Approach Bioethics

Answer 31

nurse-patient relationship is the center promotion of dignity and respect for patient attention to ind pt virtues: kindness, attentiveness, empathy, compassion, reliability

Question 32

Principle-Based Approach Bioethics

Answer 32

Autonomy: respect patient rights Nonmaleficence: do no harm Beneficence: benefit outweigh risk Justice: act fairly Fidelity: keep promises Veracity: truth and fact Accountability, Privacy, Confidentiality: HIPPA

Question 33

Common Nursing Malpractice

Answer 33

failure to ensure safety improper treatment failure to monitor and report med errors and reactions failure to follow facility procedure failure to document equipment use adverse incident not reported lawsuit with HIV patients

Question 34

Beliefs and Values

Answer 34

Beliefs about worth of something that act as standard to guide behaviors creating a value system (code of conduct) Professional values: altruism: concern well being of others autonomy: respect pt rights human dignity: value and respect others integrity: honest and ethical framework social justice: equal rights and rx

Question 35

Signs of Impending Death

Answer 35

Difficulty talking or swallowing Nausea, flatus, and abdominal distention Urinary or bowel incontinence or constipation Loss of movement, sensation, reflexes Decreasing body temperature with cold or clammy skin Weak, slow, irregular pulse Decreasing BP Noise, irregular or Cheyne-Stokes respiration Restlessness or agitation Cooling, mottling, cyanosis of extremities and dependent areas

Question 36

Five Stages of Dying

Answer 36

Denial: deny reality of death Anger: rage and hostility and adopt why me attitude Bargaining: barter for more time Depression: period of grief before death Acceptance: accepted reality of death and prepared to die

Question 37

Concepts of death and dying

Answer 37

irreversible cessation of circulatory and respiratory functions (cardiac death) irreversible cessation of all functions of the entire brain, including the brainstem (brain death) Most protocols require two separate clinical examinations. The medical criteria used to certify a death are as follows: ○ Breathing cessation ○ No response to deep painful stimuli ○ Lack of reflexes (such as the gag or corneal reflex) and spontaneous movement ○ Flat encephalogram (brain waves)

Question 38

Concepts of Spirituality

Answer 38

Spirituality: relationship with nonmaterial life force or higher power Faith: confident belief where there is no proof or evidence Religion: organized system of beliefs about higher power Hope: ingredient in life responsible for positive outlook Love: connectedness with others Suffering: specific state of distress

Question 39

Five Models of Health: Health Belief Model Health promotion Health Illness Continuum Agent-Host-Environment Model Stages of Change Model

Answer 39

Health Belief Model: personal perception of their health perceived susceptibility to dz perceived seriousness of dz perceived benefits of actions Health promotion: what they do to promote healthy behaviors Health Illness Continuum: health is constantly changing state with high level of wellness and death on opposite sides Agent-Host-Environment Model: external agent, susceptible host, and environment as causes of dz Stages of Change Model: addiction to change their behavior

Question 40

Diagnosis Related Groups (DRGs) were instituted by the federal government mainly to reduce

Answer 40

Cost of health care

Question 41

Isotonic, Isometric, Isokinetic

Answer 41

Isotonic: muscle shortening and active movement Isometric: muscle contraction without shortening Isokinetic: muscle contraction with resistance

Question 42

Stages of Pressure Injuries

Answer 42

Stage 1: nonblanchable erythema of intact skin Stage 2: partial-thickness of skin loss with exposed dermis Stage 3: full-thickness skin loss not involving underlying fascia Stage 4: full-thickness skin and tissue loss Unstageable: obscured full-thickness skin and tissue loss Deep tissue pressure injury: persistent nonblanchable deep red, marron, or purple discoloration