CSN Nursing 101 Exam 1--Fundamentals, Communications, Aging Adult

What are the 4 aims of nursing?

To promote health

To prevent illness

To restore health

To facilitate coping with disability or death

How long is a nursing license good for in Nevada (and most states)?

2 years

How many CEUs do you need to renew your nursing license in NV?

30

In the nursing process, what will you always do first?

Assess

Where would you find a nurse's scope of practice?

Nurse Practice Act

NCSBN.org

In health care settings, what are the levels of care and what are their aims?

Primary--promotion and prevention

Secondary--diagnosis and treatment

Tertiary--specialty (like burn center, cancer center)

Which are examples of primary level care health PROMOTION? SATA.

A. Exercise class

B. Immunizations

C. Prenatal care

D. Community and legislative actions

E. Blood pressure or cancer screenings

F. Nutrition classes

A, C, F

Which are examples of primary level care health PREVENTION? SATA.

A. Exercise class

B. Immunizations

C. Prenatal care

D. Community and legislative actions

E. Blood pressure or cancer screenings

F. Nutrition classes

B, D, E

What kind of care do rehabilitation centers provide?

intermediate follow-up care

What is the goal of a rehabilitation center?

Assist the individual to regain maximal functional status

Promote independence

In extended care, which facility provides assistance for ADLs, such as meals?

Assisted living

Who does hospice provide services for?

Dying patients AND their loved ones

In health care plans, which two are managed care organizations?

HMO, Medicare MCO

What are the two focuses of an MCO?

1. health maintenance, health promotion, primary care

2. containing costs

What is the focus of a PPO?

Health maintenance

Medicare part A covers what?

hospital

How are hospital costs for Medicare part A calculated?

DRGs (diagnosis-related groups)

Which Medicare plan is called an advantage plan, and why?

Part C because it includes parts A (hospital) and B (doctors visits) and some include D (meds); advantage because it has comprehensive coverage

Money is taken out of a social security check on a monthly basis for Medicare Part C; who is it paid to? Why?

MCO because they actually manage the healthcare plan

What is the prospective payment system (PPS)?

System for Medicare patients by which a predetermined level of reimbursement is established before services are provided, based on DRGs.

When the PPS was established in 1983, what did it eliminate?

cost-based reimbursement; moved instead to diagnosis-related groups (DRGs) to determine payment

Under the PPS, hospitals are reimbursed a fixed amount for each DRG. What benefit does this have to the patient?

It promotes quality care, since the hospital has no financial incentive to keep a patient longer or run unnecessary tests

HCAHPS tracks patient satisfaction. In what way does this affect the hospital?

Reimbursement--if bad reviews for care, hospital will not be reimbursed the full amount

What are examples of hospital-acquired conditions for which a facility will not be reimbursed?

skin breakdown (e.g. pressure sore)

falls or injuries

infections

What are the roles of a nurse? SATA.

A. Collaborator

B. Educator

C. Manager

D. Researcher

E. Care provider

F. Patient Advocate

G. Producer

A, B, C, E, F

What is the definition of health?

State of well-being

"whole person"

defined by individuals

relative to their values

What are internal variables influencing health? SATA.

A. Developmental stage

B. Educational background

C. Maslow's heirarchy of needs

D. Perception of illness and functioning

E. Emotional factors

F. Biological factors

A, B, D, E

What are external variables influencing health? SATA.

A. Developmental factors

B. Negative or positive thinking

C. Socioeconomic factors

D. Family practices

E. Cultural background

F. Biological factors

C, D, E, F

What factors affecting health and illness make up the base of Maslow's heirarchy of needs? SATA.

A. Sex

B. Money

C. Shelter

D. Elimination

E. Body temperature

F. Physical safety

G. Nutrition

H. Love

I. Fluids

J. Oxygen

K. Self-esteem

A, C, D, E, G, I, J

Where does pain fall in Maslow's heirarchy of needs?

One level above the base, under "Psychological Safety"--it is not an immediate need

What are the four stages of illness behavior?

1. Experiencing symptoms

2. Sick role

3. Dependent role

4. Recovery and rehabilitation

Which risk factors can be modified to help cut back on chances of getting a disease?

A. Genetic and physiological factors

B. Age

C. Environment

D. Lifestyle

C--could change jobs, cities

D--diet, exercise, stopping smoking

What are the levels of PREVENTIVE care and what are their aims?

Primary--promote and PROTECT

Secondary--diagnose and treat

Tertiary--restore and rehabilitate

What are the differences between the levels of PREVENTATIVE care and the HEALTH CARE SETTINGS levels of care?

Primary--promote and prevent (health care); promote and protect (preventative)

Secondary--diagnose and treat (same for both)

Tertiary--Health care: specialized care; Preventative: restore and rehabilitate

In the health care settings level of care, rehabilitation is its own separate category

What are health beliefs?

a person's ideas, convictions, and attitudes about health and illness

The health belief model focuses on the relationship between what?

Beliefs and health behaviors

The three components to convincing someone to change health behaviors

1. Susceptibility

2. Seriousness

3. Preventive action

Match the term to the example.

1. Susceptibility

2. Seriousness

3. Preventive action

A. "This photo is of a person's black and withered lungs after smoking a pack a day for 10 years."

B. "Once you stop smoking, you will likely have more energy, improved lung function, and more years of health."

C. "The fact that you smoke puts you at risk for cancer, COPD, and other ailments."

1. C

2. A

3. B

In communication, who is the encoder? Who is the decoder?

Encoder--the sender of the message

Decoder--the receiver of the message

If you have a language barrier in a health care setting, what are your preferred options for communication? SATA.

A. Interpreter

B. Phone interpreter

C. Family member

A, B

Verbal or nonverbal communication--which is often more truthful?

Non-verbal

In the levels of communication, which are formalized?

Intrapersonal

Interpersonal

Small-Group

Organizational

Small-group (teaching sessions, patient conferences, support groups) and Organizational (employees, staff meeting)

Which communication occurs between two or more people, with a goal to exchange messages?

Interpersonal

What is the goal of communication for women? For men?

Women: Communication leads to compromise and is vital to preserve the relationship.

Men: "Win" the conversation; it is a means of delivering a message

What is the ideal personal space?

4 feet

What does SBAR stand for?

Situation

Background

Assessment

Recommendation

What is the purpose of SBAR?

At shift change: to communicate patient information and reduce med errors due to miscommunication

In a helping relationship, in which phase are goals introduced?

Orientation phase

What is the difference between assertive and aggressive behaviors?

Assertive--respectful confidence; standing up for self

Aggressive--impedes on someone's needs or feelings; force

Which are "good" examples of communication? SATA.

A. "Tell me about your pain."

B. "214 needs a bedpan!"

C. "Did you come in today for a physical?"

D. "I don't know, but I'll find out."

E. "Why did you wait 3 months before coming in?"

F. "It sounds like you're anxious about the procedure. What about this makes you nervous?"

G. "Don't worry, you're going to be fine."

A, D, F

What are examples of subjective data? SATA.

A. Patient rates her pain as 4 out of 10.

B. Patient looks pale.

C. Patient has a fever of 100.5.

D. Patient has difficulty walking.

E. Patient feels depressed.

F. Patient says she drinks alcohol occasionally.

G. Patient has a headache.

A, E, F, G

What are the years of middle adulthood?

40-65

What are the years of older adulthood?

65+

For a middle adult, what are normal changes due to aging? SATA.

A. fragile skin

B. decreased cardiac output

C. decreased peristalsis

D. decreased reflexes

E. loss of calcium from bones

F. decreased muscle mass/ decreased strength

B, E, F

What is the nurse's role with the middle adult?

Promoting and preventing illness through education and role-modeling

What are physical changes in the older adult? SATA.

A. Brittle bones

B. Stiff joints

C. Decreased bladder capacity

D. Decreased blood flow to kidneys

E. Decreased peristalsis

F. Loss of elasticity in blood vessels, lungs

G. Decreased reflexes

H. Decreased sensation in extremeties

A, B, C, D, E, F, G, H

What three changes in the older adult contribute most to risk for injury?

Stiff joints

Decreased reflexes

Decreased sensation in extremities

Why is high blood pressure common in older adults?

Loss of elasticity in blood vessels means that they are stiffer and less flexible; therefore, the blood running through the vessels does so at a higher pressure, like putting your thumb on a hose spout

Why do older adults have decreased blood flow to kidneys?

Decreased cardiac output means decreased blood flow to organs

What are the two main causes of delirium?

UTI

Dehydration

T/F Dementia and delirium can occur at the same time

True

What are the nurse's roles with the older adult? SATA.

A. Promoting health

B. Recommending medications

C. Assessments

D. Planning

E. Investigating home environment

F. Relationship advice

G. Injuries

H. Polypharmacy

A, C, D, G, H