Caring
Which is the primary emphasis of person centered care?
1. Putting the organization at the center of health care delivery
2. Putting the health care worker at the center of health care delivery
3. Putting individual preferences and needs at the center of health care delivery
4. Putting curing disease at the center of health care delivery
3
1. The nurse is planning spiritual care interventions for an 8-year-old patient. Based on the patient’s age, which growth and development factor must the nurse consider when planning spiritual care?
1. This age-group’s concept of spirituality is provided by parents, and love and affection promote spirituality.
2. This age-group begins to ask about God or a Supreme Being and is influenced by spiritual and religious stories.
3. This age-group is fascinated with magic and mystery and often believes illness is related to bad behavior.
4. This age group has a clear concept of a higher spiritual being and is interested in learning about spirituality.
4
True or False :The following statement is considered Therapeutic
"Don’t worry; everything will be all right.”
False. When a patient is seriously ill or distressed, you may be tempted to offer hope with statements such as “You’ll be fine” or “There’s nothing to worry about.” When a patient is reaching for understanding, false reassurance discourages open communication. Offering reassurance not supported by facts does more harm than good. Although you are trying to be kind, it has the secondary effect of helping you avoid the other person’s distress, and it tends to block conversation and discourage further expression of feelings. To use a more facilitative response you can say “It must be difficult not to know what the surgeon will find. What can I do to help?”
1. The public health nurse is working with the local city/county health department during a pandemic that has created a crisis within the community. What are the responsibilities of the public health nurse during the pandemic? Select all that apply.
1. Educate the public on disease prevention.
2. Serve as liaison between patients and health care services and providers.
3. Investigate cases as they arise.
4. Monitor trends of the disease outbreak.
5. Assist with testing for identification of the disease.
6. Diagnose patients with the disease
1, 2, 3, 4, 5
1. A nurse is seeing all of the patients in the community health clinic. The nurse identifies which patient(s) as having a health disparity? Select all that apply.
1. A patient who has a homosexual sexual preference
2. A patient who is unable to access primary care services
3. A patient living with chronic schizophrenia
4. A family who relies on a family member for transportation
5. A patient who has a history of hypertension
1 2 3
In a Value-Based Care model, health care is designed and organized around:
1. Service providers
2. People with shared health needs
3. Geographic location
4. Cost of care
2
2. A 44-year-old male patient has just been told that his wife and child were killed in an automobile accident while coming to visit him in the hospital. After analyzing the assessment findings, the nurse recognizes which statements made by the patient support a nursing diagnosis of Spiritual Distress related to loss of family members? Select all that apply.
1. “I need to call my sister for support.”
2. “I have nothing to live for now.”
3. “Why would my God do this to me?”
4. “I need to pray for a miracle.”
5. “I want to be more involved in my church.”
2 and 3
What type of Response is the nurse giving in the following statement:
"Things are bad, and there is nothing I can do about it.” “Things are falling apart, and it is all your fault.”
Passive responses serve to avoid conflict or sidestep issues. They reflect feelings of sadness, depression, anxiety, powerlessness, and hopelessness.
2. A community health nurse is working in a clinic with a focus on asthma and allergies. What is the primary focus of the community health nurse in this clinic setting? Select all that apply.
1. Decrease the incidence of asthma attacks in the community.
2. Increase patients’ ability to self-manage their asthma.
3. Treat acute asthma in the hospital.
4. Provide asthma education programs for the teachers in the local schools.
5. Provide scheduled immunizations to people who come to the clinic.
1 2 4
2. A 35-year-old female patient has Medicaid coverage for herself and two young children. She missed an appointment at the local health clinic to get an annual mammogram because she has no transportation. She gets the annual screening because her mother had breast cancer. Which of the following are social determinants of this patient’s health? Select all that apply.
1. Medicaid insurance
2. Annual screening
3. Mother’s history of breast cancer
4. Lack of transportation
5. Patient’s age
1 4 5
Which is NOT part of the role of the nurse in delivery of nursing care in a person-centered care model?
1.Relational lens
2. Cost of care
3. Care coordination
4. Care delivery
2
3. A nurse is preparing to teach an older adult patient who has chronic arthritis how to practice meditation. Which of the following teaching strategies are appropriate? Select all that apply.
1. Encourage family members to participate in this exercise.
2. Have the patient identify a quiet room in the home that has minimal interruptions.
3. Suggest running a quiet fan in the room.
4. Explain that it is best to meditate about 5 minutes 4 times a day.
5. Show the patient how to sit comfortably with the limitation of arthritis and focus on a prayer.
2 and 3
EHR is a requirement in today’s healthcare environment.
Name at least one
Epic, Georgia Health Information Network (GaHIN) and the Georgia Department of Public Health (GDPH)
3. The nurse caring for a refugee community identifies that the children are undervaccinated and the community is unaware of resources. The nurse assesses the community and determines that there is a health clinic within a 5-mile radius. The nurse meets with the community leaders and explains the need for immunizations, the location of the clinic, and the process of accessing health care resources. Which of the following practices is the nurse providing? Select all that apply.
1. Raising awareness about community resources for the children
2. Teaching the community about health promotion and illness prevention
3. Promoting autonomy in decision making about health practices
4. Improving the health care of the community’s children
1 2 4
3. A nurse is conducting a nursing history and physical assessment on a patient. Which findings alert the nurse to assess for health literacy needs? Select all that apply.
1. Patient has difficulty completing a registration form at a medical office
2. Patient asks for written information about a health topic
3. Patient speaks Spanish as a primary language
4. Patient states unfamiliarity with a newly ordered medicine
1 and 3
A nurse is caring for a patient recently diagnosed with metastatic liver cancer who just transferred from an intensive care unit following extensive surgery. Because of the complexity of this patient’s care, the family is feeling overwhelmed and expresses concern they do not feel as though they are a part of the care team. Which interventions will most likely demonstrate the nurse’s care for the patient and the family? Select all that apply.
1. Have the family provide the patient’s bath and change the sheets on the patient’s bed.
2. Ask the family what activities (e.g., praying, reading, listening to music) are comforting to the patient.
3. Make all the decisions about the patient’s care without consulting with the patient or the family to reduce their stress.
4. Explore the family’s concerns and fears.
5. Request a social worker consult when the patient and family state they would like to discuss advance directives.
2, 4, 5
4. A nursing student is developing a plan of care for a 74-year-old female patient who has spiritual distress over losing a spouse. As the nurse develops appropriate interventions, which characteristics of older adults should be considered? Select all that apply.
1. Older adults do not routinely use complementary medicine to cope with illness.
2. Older adults dislike discussing the afterlife and what might have happened to people who have passed on.
3. Older adults achieve spiritual resilience through frequent expressions of gratitude.
4. Leaving a legacy of a loved one behind can help maintain a connection between the person left behind and the lost loved one.
5. Older adults frequently use rituals or exercise to cope with illness and pain.
3 , 4 ,5
Name Out SBAR
4. What factor results in medically underserved populations being more likely to develop health problems?
1. The ability to use available resources to find housing
2. Adequate transportation to the grocery store and community clinics
3. Availability of others to help provide care
4. Limited access to health care services
4
4. A nurse desires to communicate with a young female patient who is from a culture different from the nurse’s. The patient has limited experience with being in a hospital. The nurse has 10 years of experience caring for patients from this culture. The patient was admitted for a serious pregnancy complication. Apply the LEARN model, and match the nurse’s behaviors with each step of the model.
____ 1. L
a. The nurse learned that fathers can visit mothers at any time in the patient’s own country and the United States.
____ 2. E
b. The nurse shares own perception of the woman’s experiences as a patient.
____ 3. A
c. The nurse asks the patient to explain how to maintain bed rest upon returning home.
____ 4. R
d. The nurse actively listens to the patient’s explanations about hospitals in the patient’s country.
____ 5. N
e. The nurse involves the patient in a discussion of the treatment options available for the patient’s condition.
1d, 2b, 3a, 4e, 5c
Match the following caring behaviors with a nursing action.
___1. Knowing
a. Encouraging a patient or family to use resources and trust previous decisions that have helped resolve issues
___2. Being with
b. Asking a patient to talk about what the loss of a loved one means for the patient and family
___3. Doing for
c. Telling a family that you understand their anger about the side effects of chemotherapy
___4. Maintaining belief
d. Providing an opportunity for a patient’s specific religious practice as the patient would do it
1b, 2c, 3d, 4a.
5. The nurse is caring for a 50-year-old female patient visiting the outpatient medicine clinic. The patient has had type 1 diabetes mellitus since 13 years of age. She has numerous complications from her disease, including heart disease, severe numbness and tingling of the extremities, and reduced vision. Knowing that spirituality helps patients cope with chronic illness, which of the following principles should the nurse apply in practice? Select all that apply.
1. Pay attention to the patient’s spiritual well-being throughout the course of her illness.
2. Select standard interventions that you know scientifically support spiritual well-being.
3. Listen to the patient’s story during each visit to the clinic, and offer a compassionate presence.
4. When the patient questions the reason for her longtime suffering, try to provide answers.
5. Consult with a spiritual care adviser and have the adviser recommend useful interventions.
1,3
What does the ABC mnemonic of communication stand for?
1. Attend mindfully: Reflect on how you typically communicate and align your nonverbal communication with your spoken message.
2. Behave calmly: Ensure that you convey respect when communicating with your patients by approaching them from the front, respecting your patient’s personal space, putting yourself at the patient’s eye level, avoiding making sudden movements, and projecting a calm and positive attitude. Ensure that your body language does not convey frustration, anger, or impatience.
3. Communicate clearly: Use short and simple questions and gestures to help underline your words. Allow your patient time to respond to your questions.
5. The nurse in a new community-based clinic is requested to complete a community assessment. Place the following steps in the correct order for completing this assessment.
1. Structure or locale
2. Social systems
3. Population
1 3 2
5. The nurse educator is working with a group of nurses on continuing education. Which statements made by a nurse about the teach-back technique show understanding of the technique? Select all that apply.
1. “After teaching a patient how to use an inhaler, I need to use the teach-back technique to evaluate my patient’s ability to use the inhaler correctly.”
2. “The teach-back technique is an ongoing process of asking patients for feedback.”
3. “Using teach-back will help me identify explanations and communication strategies that my patients will most commonly understand.”
4. “Using pictures, drawings, and models can enhance the effectiveness of the teach-back technique.”
5. “When doing my patient teaching, I will use plain language to make the material easier to understand for the patient.”
1, 2, 3, 4, 5.