What is the human genome project?
A National Institutes of Health-funded research was able to identify how types of human behavior may be traced to certain strands of DNA located on specific chromosomes.
What is the study of aging of individuals across the lifespan including the study of physical, mental, and social changes in people as they age?
gerontology
What is the name of cultural assessment tool that provides a visual portrayal of elements within her larger theory to assist nurses and other health care providers in providing culturally congruent care that enhances the health and well-being of all clients at all stages of life?
Leininger's Sunrise Enabler
What is informatics?
The use of information and technology to communicate, manage knowledge, mitigate error, and support decision-making
What are some benefits of EBP?
Client outcomes improve.
Nurses’ experience increased professional satisfaction.
The cost of quality health care is often lowered.
Provides nurses a framework to execute clinical judgment based on research and quality improvement.
What is quantitative research?
Quantitative research uses numerical data to evaluate the outcomes of interventions.
What are EHRs?
Systemic, digitized documentation system used to improve medical records. A computerized, real-time form of a client's paper chart that can be shared between members of the interprofessional team; includes information such as the medical history, diagnosis, allergies, and diagnostic testing results.
A client who was recently discharged from the hospital following a surgical procedure requests a return to work release from the health care provider. The provider indicates the diagnosis and surgical procedure performed on the client’s work release. Is there anything inappropriate about the actions of the health care provider?
Listing a client’s diagnosis on a work excuse is a violation of HIPAA. No one should know the reason for the hospitalization. The employer should be informed only that the employee is authorized to return to work with or without restrictions.
What are the three periods of the prenatal development?
zygote, embryo, and fetus
Which theorist proposed that the adult personality is the result of moving successfully from one psychosexual stage to the next and that failure to resolve conflicts or being fixed in any stages results in personality problems?
Freudian
This is the integration of human behaviors including communication, language, actions, beliefs, values, customs, and institutions of racial, religious, social, and ethnic groups.
culture
What is the term described as 'A method used to create a situation that mimics a real experience and is used for practice, assessment, education, or to acquire knowledge of a system's or a person's actions?'
simulation
Spirit of Inquiry
The desire to clarify complex issues through research and trends that influence client outcomes.
What is qualitative research?
Qualitative research seeks to explain value-laden experiences through narratives collected from participants.
True or False: RNs are the only professionals responsible for documentation.
False:
Documentation is not the sole responsibility of the registered nurse. Licensed practical nurses and assistive personnel (AP) as well as other providers are also responsible for documenting in the EHR.
Adult blood pressure expected reference range
systolic 90 to 119;
diastolic 60 to 79mm Hg
This principle is when the spine develops first, followed by extremities, then fingers, then toes.
proximodistal principle
Which theory consists of eight stages of psychosocial development and that successful resolutions of the crisis at each stage leads to psychosocial growth and development?
Erikson's Theory of Psychosocial Development
This involves being able and willing to investigate and understand differences between perceptions, beliefs, traditions, and values within the nurse's own culture, as well as cultures different from their own.
cultural awareness
What is HIPAA?
HIPAA is a federal law enacted to safeguard clients’ medical health information and contains several regulations. Breach of these regulations can lead to disciplinary actions against an individual or organization, including monetary fines.
What is a nursing process tool for EBP?
Assessment
Analysis
Planning
Implementation
Evaluation
What is the nursing process?
The nursing process can be applied to research in the development of EBP.
(1) Assessment involves identification of the problem
(2) analysis focuses on formulating the research question
(3) planning entails designing the research method
(4) implementation seeks to recruit participants and collect data
(5) evaluation carries out analysis of the data collected and disseminates the results
Nurse Lesley locks the computer before she leaves to enter the client’s room with nurse Amy to adjust the heparin IV infusion. Which of the following is the correct rationale for this action?
A. To ensure the confidentiality of the information
B. To allow the computer to reset itself
C. To indicate that the prescription is being implemented
A. To ensure the confidentiality of the information
Adults pulse expected reference range
60 to 100 beats/minute
What are the 5 indicators of the Apagar score?
1. appearance
2. pulse
3. grimace
4. activity
5. respirations
What are the three levels of Kohlberg's Theory of Moral Development and what do they mean?
Preconventional reasoning: control by rewards and punishments
Conventional reasoning: conformity with law and order
Postconventional reasoning: personal moral code
What are some variables of cultural diversity?
Age
Sexual orientation
Culture
Ethnicity
Socioeconomic status
A student nurse is participating in a simulation experience. Which of the following statements about simulation is true?
A. Participating in simulation has little effect on student performance.
B. Simulations are conducted only at designated clinical sites.
C. Simulation allows students to make errors without causing harm.
C. Simulation allows students to make errors without causing harm.
The Scientific Method
A systematic research process whereby new knowledge is applied to nursing practice and outcomes are re-evaluated.
What is a scholarly database?
An ordered, searchable assortment of articles and research studies that have been published in professional or peer-reviewed journals.
What is the PIE model?
Type of documentation that omits the plan of care and utilizes flow sheets and progress notes.
adult body temperature expected reference range
36 C to 38 C (96.8 F to 100.4 F)
What is the principle when infants gain control over their neck and head before extremities?
cephalocaudal principle
Theory on cognitive development is based on how an individual acquires knowledge, intellect, and cognition over time.
Piaget's
Implicit bias vs. Explicit bias
Implicit bias- unconscious bias that affects our perceptions, actions, decisions, and interactions with others.
Explain what a Clinical Information System (CIS) is and give 3 examples of how nurses use it when caring for clients.
A CIS is a computer system that allows for instant retrieval of client information either directly or from data networks that is used primarily by nurses, providers, and other members of the interprofessional team at the clinical point of care site.
Examples: scanning client armbands for confirming client identification; scanning medication barcodes during medication administration; documenting vital signs; documenting nursing interventions; documenting intake and output;
Essential Elements of Evidence-Based Practice
What is an abstract?
A brief summary of the paper which includes the purpose of the study, the basic study design, the findings and researcher s conclusions.
What does PIE stand for?
Problem–intervention–evaluation charting
A nurse is discussing computerized provider order entry (CPOE) systems with staff. Which of the following statements from a staff member indicates an understanding of a CPOE system?
"CPOE systems can increase the speed of care delivery."
CPOE systems allow provider prescriptions to be transmitted more quickly from one department to another, which can increase the speed of care delivery for clients.
This stage of life involves the transitional period between the onset of sexual maturity and ending with the cessation of growth and movement toward emotional maturity.
Theory that children progressively develop moral reasoning as they gain the ability to think logically and contended that moral development continued throughout the lifespan.
Kohlberg
Broad range of individuals, population, and social characteristics.
What does the Breach Notification Rule mandate?
It mandates the reporting to clients of a breach of unsecured PHI. This rule requires that a facility notify a client of a potential breach via mail.
What is PICOT?
An acronym that stands for Population, Intervention, Comparison, Outcome, and Time.
Domain Name or Web Address Suffixes
What does SOAP stand for?
Subjective, objective, assessment, and plan charting (SOAP notes)
A nurse is preparing an in-service about HIPAA. Which of the following information should the nurse plan to include?
"Personnel can be terminated for breaching a client's confidentiality."
The nurse should plan to inform the group that strong penalties exist for HIPAA violations, which include breaching client confidentiality. Penalties include termination from the facility, imprisonment, loss of professional licensure, or fines.
This stage of life when all body systems are fully developed and matured; however brain development conintues until approximately age 25
Young adulthood
What are some health promotion strategies for individuals in late adulthood?
Maintaining and increasing functional capacity
Improving self-care
Increasing social network
What is cultural competence?
The ability to incorporate effective nursing care with emic and etic knowledge.
What does the security rule establish?
Establishes safeguards for electronic PHI.
What is the Theory-Practice Gap?
The gap between the obtainment of theoretical knowledge from research into its practical application in nursing.
Examples of NON-credible sources
blog, podcast, personal website, or wiki
PIE model example
A nurse is discussing problem-oriented medical records with a group of newly licensed nurses. Which of the following information should the nurse include?
A problem-oriented medical record promotes information sharing among members of the interdisciplinary team.
A problem-oriented medical record uses progress notes, which promotes information sharing among members of the interdisciplinary team.
Identify the following life stage: "Adjusting to new family and work responsibilities, establishing economic stability for the present and future, and maintaining healthy lifestyles and physical well-being."
Middle Adulthood
What is Emic and etic?
EMIC - a cultural insider's viewpoint of a culture
ETIC - an outsider's viewpoint of a culture
What does the privacy rule establish?
Establishes the standards under which PHI in any form could be used and disclosed
Clinical Practice Guidelines
These are statements of evidence-based recommendations to be used as guidelines in the medical management of disease processes and in the area of preventative care.
Critical Appraisal
The process of reviewing a research study to determine validity, reliability and applicability to the investigators search for evidence.
What is focus charting?
Focus charting documents a client’s specific health care problem by focusing on the nursing diagnosis as well as changes in the client’s condition, events, and concerns.
A staff nurse is evaluating a newly licensed nurse's understanding of telephone prescriptions. Which of the following statements by the newly licensed nurse indicates an understanding of the information?
"I can take a telephone prescription if a provider is directing a code for an unresponsive client."
Telephone prescriptions should be reserved for use only in emergency situations, because there is a risk for misunderstanding details about the prescription during verbal communication. An unresponsive client is an emergency, so it is appropriate for a nurse to receive a telephone prescription in this situation.
Climacteric in females is also referred to as ____________ which marks the cessation of menses.
menopause
A school nurse asks a first grader about rules at school. The child responds, "We need to wash our hands before lunch, be respectful to the teacher, and pay attention in class. If we don't, we'll get into big trouble." The nurse should recognize that the child is in which of the following of Kohlberg's stages of moral development?
Punishment and Obedience
The Punishment and Obedience stage is a part of the first level of Kohlberg's moral development theory, referred to as the preconventional reasoning level, and occurs in children between the ages of 4 and 10 years. During the Punishment and Obedience stage, rules are viewed in terms of positive or negative consequences to action. In the punishment and obedience stage, rules are obeyed to avoid punishment. A child who is in the first grade would be in this stage.
Groups of people at higher risk for poor outcomes from barriers to social, economic, and environmental resources, including limitations due to illness or disability.
Which of the following actions can nurses and providers use to prevent the accidental disclosure of an adolescent client’s PHI to their parents?
A. Share information with adolescent's parents in private
B. Use a personal code to protect adolescent clients' PHI
C. Text the adolescent's test results to their cell phone
B. Use a personal code to protect adolescent clients’ PHI
Critical Pathways
Clinical tools used within a health care organization that help nurses manage the delivery of client care for a specific circumstance, category, or disorder.
A rating system for research findings based upon the quality of the research design, the validity of the results and the applicability of the information.
With focus charting what three items must be documented?
data
action
response
A charge nurse is reviewing SOAP documentation with a group of newly licensed nurses. Which of the following chart entries should the nurse include as an example of objective data?
Rebound tenderness noted in RLQ of the abdomen.
Objective data is information the nurse gathers when collecting data about the client, such as through physical assessment or diagnostic testing.
Complete the following sentence:
Individuals over age ____ comprise the fastest-growing age demographic in the U.S.
Individuals over age 65 comprise the fastest-growing age demographic in the U.S.
Erickson's Stages of Development
Trust vs. Mistrust
Autonomy vs. Shame
Trust vs Mistrust – infancy; safety/security/comfort are critical
Autonomy vs. Shame/Doubt – toddler; developing self-reliance
Name six factors related to Health Disparities.
Access to transportation
Accessibility to health care
Health insurance
Religion
Geographic location
Sensory deficits
Physical disabilities
Mental health
Cognitive disabilities
Socioeconomic status
Race
Ethnicity
Gender
Sexual Orientation
Limited education
A nurse is scheduling a Telehealth appointment for a client. Which of the following statements by the client indicates an understanding of the format for the appointment?
A. I will use my computer for videoconferencing for my appointment.
B. I will talk to my provider on my home phone for my appointment.
C. I will need to come into my provider's office for my appointment.
A. I will use my computer for videoconferencing for my appointment.
Standards of Care
Evidence-based interventions that are typically implemented when caring for a client with a specific disorder.
What is meta-analysis?
The utilization of statistics to combine research samples, methods, and findings from many studies regarding the same phenomenon.
What is FACT charting?
Acronym used to help nurses with proper documentation practices.
FACT stands for factual, accurate, complete, and timely.
A nurse is reviewing the documentation of a newly licensed nurse. Which of the following entries should the nurse identify as meeting the American Nurses Association (ANA) standards for documentation?
"The client vomited 240 mL of clear emesis but denies pain or nausea."
According to ANA standards, documentation should be factual and complete. Information charted here includes measurements, visual observations, and client data.
A nurse is caring for a 10-year-old child who is newly diagnosed with diabetes mellitus. Which of the following actions by the child should the nurse recognize as characteristic of Erikson's stage of industry versus inferiority?
Expresses confidence in their ability to self-administer insulin
Industry vs. Inferiority is Erikson's stage of development occurring during the school-age years. During this stage, children work at learning complex skills, problem-solving, and gaining a sense of self. Successes in these areas, along with support from those around them, promotes a sense of accomplishment and confidence in their endeavors.
In what stage in Erikson's theory is the child preschool age and balancing between exploring/serving self and cooperating?
Initiative vs Guilt
A nurse is caring for an adolescent client who has recently shared that they are bisexual. Which of the following factors is the client at increased risk for? (Select all that apply.)
- Being bullied at school
- Sexually transmitted infections
- Use of illicit drugs
- Depression
- Suicide
What are electronic health records?
Systemic, digitized documentation system used to improve medical records. A computerized, real-time form of a client's paper chart that can be shared between members of the interprofessional team; includes information such as the medical history, diagnosis, allergies, and diagnostic testing results.
Example of a critical pathway
Facility-specific tool that utilizes algorithims to convey evidence-based interventions and inform collaboration among health care team members for the treatment of clients with specific disorders.
How do nurses find credible evidence?
Nurses can find credible evidence by referring to scholarly databases, peer-reviewed journals, and websites developed and maintained by the government, non-profit organizations, and academic institutions.
Examples of abbreviations
BID means Twice a day
HOB means Head of bed
Stat means at once
PO means By mouth
Rx means prescription
A nurse manager is reviewing the documentation of four newly licensed nurses. Which of the following medication entries should the nurse identify as being written correctly?
Synthroid 100 mcg PO every morning ac
This medication entry is written correctly because both PO and ac are commonly used abbreviations and do not appear on The Joint Commission's Do Not Use list.
A nurse is assessing an adolescent who reports feeling "very depressed." The nurse should recognize that which of the following are signs of increased risk for suicide?
Expressing feelings of gloom and helplessness
Expressing loss of interest in activities once considered important
Making threats of self-harm
Having access to weapons
In which stage of Erikson's Theory is concerned with childhood and learning to be productive/punishment or failure creates a sense of incompetence?
Industry vs. inferiority
What is a cultural health assessment?
Assessments that can be conducted to gather information regarding the client's culture and how it can affect their health.
Benefits of Informatics
Provides immediate access to client information by the client’s care team
Allows all members of the client’s care team to access information simultaneously Increases speed of clinical decision-making
Decreases medication errors
Integrates evidence-based practice into treatment plans
Example of clinical practice guidelines
Nationally published recommendations for client care developed by physician groups and based on systematic review of evidence
A nurse is collecting data from a group of clients regarding their feelings and experiences of living with congestive heart failure. In which of the following types of research studies is the nurse participating?
Qualitative
In what situation is it acceptable to repeat a verbal prescription without writing it down first?
A. When the provider is with another client
B. In a sterile enviornment
C. When a provider lacks the ability to use the computer software
B. In a sterile environment
A nurse is taking an admission history from a client who is concerned about the facility using an electronic documentation system. Which of the following information should the nurse include as a benefit of electronic documentation?
The system alerts providers of possible actions that could cause client harm.
Many electronic documentation systems contain clinical alerts, which can prompt providers regarding potential errors, such as a medication error or duplicate tests.
A nurse is discussing climacteric changes that occur during middle adulthood with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the concept?
"Both males and females experience a change of life referred to as climacteric."
"Climacteric in females is referred to as menopause"
"Climacteric changes in males occur gradually, over a number of years"
"Climacteric in females can manifest as heart palpitations,"
In what stage of Erickson's theory is in adolescence is about finding place in society?
Identity vs. Role Confusion
A nurse is caring for client who has hearing loss. Which of the following actions should the nurse?
Face the client when speaking.
Adverse Drug Event (ADE)
An injury caused from a medical intervention that is linked to a medication.
Example of standards of care.
Evidence-based interventions implemented when caring for clients with a specific disorder
A nurse has created a table of evidence to organize findings from a literature search. Which of the following components of the table provides information for implementing a change in practice?
Recommendations
Which of the following actions is a step in receiving a verbal prescription?
A. Ask the provider to spell any words that are unclear.
B. Write the information on spare paper before recording it in the client’s record.
C. Resolve questions about prescriptions after implementing client care
A. Ask the provider to spell any words that are unclear.
A nurse is caring for a client following a stroke. The nurse should recognize that which of the following individuals is allowed access to the client's medical record without obtaining special consent from the client first?
The admitting provider
The charge nurse on the unit
The client
What can happen to an aging person's cardiac health?
Changes in the aging cardiovascular system occur as heart valves thicken and become more rigid.
In what stage of Erikson's theory is concerned with middle adulthood and raising a family, mentoring, and caring for others?
G vs S
Generativity vs Stagnation
What supports the need for a medical interpreter?
Family members, significant others, or client friends should not be used as interpreters. This can be a violation of the client’s right to confidentiality. Family members are also at an increased risk for errors in translation due to the lack of knowledge of medical terminology.
Medication Error
Preventable error capable of causing harm or death to a client under the care of a health care provider.
What is a peer-reviewed journal?
Publication which contains articles that have been reviewed by other professionals with similar licensure, education and expertise to ensure quality and promote client safety.
A nurse is using evidence-based practice to develop a PICOT question. Which of the following describes the "O" in PICOT?
The desired result of the intervention to the problem
This describes "O," or outcome, which is the desired result or outcome following an intervention.
Examples of components of the client’s prescriptions that require further clarification.
Acetaminophen use
Ceftriaxone dose
Reason for acetaminophen administration
PCXR abbreviation
A nurse is preparing to administer morphine 15 mg PO every 4 hr PRN pain for a client who has a new prescription. By which of the following routes should the nurse plan to administer the medication?
By mouth
The nurse should identify that "PO" is the abbreviation for "by mouth." It is included in the list of common medical abbreviations. The nurse should plan to administer the morphine by mouth.
A nurse is preparing an educational session about school-age children to a group of caregivers. Which of the following characteristics should the nurse include in the teaching?
Egocentrism decreases.
Begins to understand reversibility
Understands events can be interpreted in different ways
Erickson's theory of Integrity vs. Despair is concerned with ______ _________; contemplating/reflecting on life.
late adulthood
A nurse is caring for a client who speaks a different language than the nurse. Which of the following actions should the nurse take when providing discharge instructions to the client?
Consult the certified medical interpreter who speaks the client’s language.
Medication errors are a common problem in the United States. Which of the following statements is true regarding mortality related to these errors?
A. Medication errors are comparable to heart disease, the leading cause of death.
B. Medication errors are comparable to chronic lower respiratory disease, the third leading cause of death.
C. Medication errors are comparable to cancer, the second leading cause of death.
B. Medication errors are comparable to chronic lower respiratory disease, the third leading cause of death.
What is considered the strongest evidence among all types of nursing research?
systemic review
A nurse is teaching a newly licensed nurse about using credible databases for research studies. Which of the following sources should the nurse include?
A peer-reviewed journal
What are some benefits of this form of a prescription entry through a CPOE system?
1. Transcription errors are reduced
2. Medications can be more quickly administered
A nurse is discussing legal regulations regarding medical records with a newly hired assistive personnel (AP). Which of the following information should the nurse include?
Facilities can establish their own rules for documentation methods.
The nurse should inform the AP that each facility can establish rules for documentation and use of medical records.