Mix it up
In what age group are screenings for scoliosis, hearing, and vision expected to be performed?
1.Preschoolers
2.Infants
3.Adolescence
4.School-aged child
Answer: 4
School-age child are recommended to receive screenings for scoliosis, hearing, and vision, often performed by the school nurse.
Give 5 tips to communicate with adults with hearing loss.
Equipment
•Hearing aids, glasses, provide a sign language interpreter if needed, or other adaptive equipment
Clear, concise communication
•Face the client at eye level, be sure that your face/mouth is visible, and do not chew gum
•Speak at a normal, clear volume (do not exaggerate lip movements, do not shout)
•Speak a little more slowly but not excessively slowly
Environment
•Choose a quiet, well-lit environment with minimal distractions.
Time
•Allow time for the client to respond
•Give the client a chance to ask question
•Keep communication short and to the point, ask one question at a time
A nurse is caring for a client with a new diagnosis of cancer when the client states “I’m so nervous about the upcoming surgery. What if I don’t make it?” What is the best response by the nurse?
1.“Why do you believe you won’t make it?”
2.“Everyone get a little nervous before big procedures”
3.“There is nothing to worry about you’ll be fine”
4.“It sounds like you have some concerns about the surgery”
•Option 4 is the best response because it is a therapeutic technique. 4 shows paraphrasing.
•Paraphrasing is restating another’s message more briefly using one’s own words. Through paraphrasing you send feedback that lets patients know that they are actively involved in the search for understanding and clarity.
1. Why question judgemental
2. Generalizing
3 False reasurance
Erikson's stage for a school-age child.
What age is school age?
Industry versus inferiority.
6-12
What age is the older adult?
What Erikson's stage is the older adult in?
What activity will help the older adult with bone and muscle strength?
65 and older
Erikson: Integrity vs Despair
Strength training improves muscle tone, bone density, and stamina.
What does the Nurse Practice Act do?
The Nurse Practice Act, regulates the scope of nursing practice and protects public health, safety, and welfare.
Give 4 tips to communicate with adults with vision loss.
Assess the use of glasses or contact lenses.
Identify when you are entering and exiting the room.
Speak in a normal tone of voice.
Do not use gestures or nonverbal communication.
Use indirect lighting.
Use at least 14-point print on written materials. Braille may be necessary.
Which stage of Piaget is represented by learning to think with use of symbols, mental images, and magical thinking?
1.Sensorimotor
2.Preoperational
3.Concrete operations
4.Formal operations
Answer: 2, preoperational
•Preoperational: During this period, children learn to think through the use of symbols and mental images. Thinking is strongly influenced by fantasy or magical thinking. Play is the primary means to foster cognitive development.
•Sensorimotor explores the world using the five senses.
•Concrete operations is making rational judgments based on what they can observe and reason, such as mentally picture a series of steps and reverse the steps to get back to the starting point and classify objects
•Formal operations is learned self-consciousness that eventually leads to abstract and theoretical thinking.
Erikson's Generativity vs Stagnation Stage: What ages?
This stage is known as the sandwich generation; why?
36 to 65
Gererativity vs stagnation - Retirement, trying to give back to the next generation
Taking care of both parents and children
What does Spices mean in the Fulmer SPICES Framework?
Sleep disorders
Problems with Eating or Feeding,
Incontinence,
Confusion,
Evidence of Falls,
Skin Breakdown
A nurse is caring for a 52-year-old client. What are examples of this client meeting the developmental tasks appropriate for this group? Select all that apply.
1.Seek meaningful friendships
2.Creating an identity
3.Mentoring coworkers and training new hires
4.Reflect and review their life
5.Volunteering at the community center
Caring for children and parents
3, 5, and 6 are all expected tasks in Erikson’s generativity vs stagnation. The middle adult focuses on supporting future generations through parenthood, teaching, mentoring, and community involvement.
•1 is Erikson’s Intimacy vs. isolation (young adult)
•2 is Erikson’s Identity vs. role confusion (adolescence)
4 is Erikson’s Integrity vs. despair (older adults)
Give a brief discription of what the "S" in ISBAR stands for. Give an example of the "S" in ISBAR.
Situation - What is new that you whis to report? Is there a change in status, lab report or an injury. What is the main reason for the call.
Example:
I was preparing to administer medications to Mr. Smith when I noticed the medication prescription route in the chart is listed as PO (by mouth) with an additional order that the client is NPO (nothing by mouth).
Kohlbergs Developmental Theory which stage deals with good boy nice girl?
Conventional
An adult client is talking with a nurse about establishing a career and building intimate relationships with others. This would be during which of Erikson’s stages of development?
1.Initiative versus guilt
2.Industry versus inferiority
3.Identity versus role confusion
4.Intimacy versus isolation
•Answer: 4. Young adults must establish close relationships/partnerships. Young adults take on adult commitments and responsibilities and make occupational choices. They also establish independent living and develop close friendships and intimate relationships.
•
•Preschoolers must establish initiative versus guilt where they learn to cooperate with others
•Industry versus inferiority is school-aged (Without proper support for learning new skills or if skills are too difficult, they develop a sense of inadequacy and inferiority. Children at this age need to be able to experience real achievement to develop a sense of competency),
•Identity versus role confusion is adolescence. At this stage, adolescents are trying to find out who they are, and connecting with their peers
Name 3 changes the older is adjusting to.
Older Adults 65 and up
adapting to changes in family structure, approaching death, living environments, decrease functional ability, decreased visual acuity.
A nurse is providing community education for a group of middle adults. What are health risks for middle adults that the nurse should include in the health promotion education? Select all that apply.
1.Suffocation and sleep position
2.Cancer
3.Drownings and poisonings
4.Cardiovascular disease
5.Anxiety and depression
6.Diabetes mellitus type 2
Answers: 2, 4, 5, 6
Middle adults are at risk for:
•diabetes mellitus type 2
•obesity
•cardiovascular disease
•cancer
•substance use disorder
•psychosocial stressors (anxiety, depression)
Suffocation and sleep position is a health risk for infants
drownings and poisonings are high risk for young children (especially infants/toddlers).
Which of the responses by the new graduate nurse is nontherapeutic? Select all that apply
1.“My advice would be to try aromatherapy.”
2.“Why are you crying?”
3.“Do you want to talk about it?”
4.“You seem frustrated.”
5.“No one here would lie to you.”
6. “You’re overreacting, it wasn’t that big of a deal
1. “My advice would be to try aromatherapy - Giving Adivce
2.“Why are you crying?”
Why question (considered judgy)
5."No one here would lie to you.”
Defensive
6.You’re overreacting, it wasn’t that big of a deal.”
Belittling
Which statement(s) require clarification about nutrition for a 7-month-old infant? Select all that apply.
1.I can switch to low-fat milk at 12 months
2.I should offer new foods one at a time
3.I should offer fruit juice twice a day
4.I should introduce iron-fortified rice cereal
5. I should offer grapes and popcorn as snacks
Answers: 1, 3, 5 are incorrect and require clarification
•Switching to full fat/regular milk at 12 months is recommended, not low fat.
•Parents should not offer fruit juice which is high in sugar.
•Grapes and popcorns are a choking hazard and should be avoided
•I should offer new foods one at a time and I should introduce iron-fortified rice cereal is correct nutrition education for this age group
At what age does moral development begin?
What theorist is associated with moral development?
Kholbers,
4
What is Medicare?
What is Medicaid?
Medicare - Medicare is public health insurance that supports older adults or senior citizens of the community and those with chronic health problems or disabilities.
Medicaid- is public insurance but for individuals who belong to a particular economic level
A 15-year-old client tells the nurse that she is sexually active. What is the best action by the nurse?
1.Contact her parents to alert them of her need for birth control.
2.Explain that having sex is not appropriate for her age-group.
3.Counsel her on safe sex practices and on minimizing health risks.
4.Ask her to have her partner come to the clinic for STI testing.
●
Answer: 3.
Sexual health is an important topic for adolescents. Educating about safe sex practices is important for those who are sexually active. Nurses need to be sensitive to the emotional cues from adolescents before initiating health teaching to know when they are ready to discuss concerns.
In addition, discussions with adolescents need to be private and confidential.
A charge nurse is mentoring a new graduate nurse about therapeutic communication techniques. Which response by the new graduate nurse demonstrates sharing observations?
1.“This must be frustrating for you”
2.“You look tired today.”
3.“Everyone feels overwhelmed sometimes”
4.“We talked about your friends, let’s talk about discharge planning”
•2. "You look tired today" is sharing observations.
•1 is sharing empathy, 3 is belittling, and 4 is focusing
"I see you haven't eaten anything" is an iexample of which communiation technique?
1. Summarizing
2. Sharing observations
3. Focusing
4. Clarifying
2. Sharing observations
Which stage of Kohlberg’s development theory is represented by the statement “I must follow the rules; otherwise, I will be punished”?
1.Preconventional reasoning
2.Conventional reasoning
3.Postconventional reasoning
4.Abstract reasoning
●
Answer: 1 Preconventional reasoning
•Preconventional reasoning behavior is guided by punishment or reward. The question becomes, “What is in it for me?” There are two stages in this level of development.
•
•Conventional reasoning is based on the internalization of societal and others’ expectations. The individual wants others to approve of their behavior. The question becomes, “How will this behavior affect my relationships with others?” There are two stages in this level of development., aka good girl/bad girl
•Postconventional reasoning occurs when an individual finds a balance between basic human rights and an obligation to societal rules, aka challenging laws that are not moral or ethical
Your client is hearing impaired. How does the nurse communicate with this client?
Reduce background noise,
Turn off electronics,
Sit in front of the client
Use active listening during the interview