NR 222 Week 2 Questions

Chapter 16 Nursing Assessment/Nursing Process - Standards P/P

Mr. Chuck Rhodes is admitted to the medical-surgical unit for unrelenting abdominal pain. Mr. Rhodes is a 37-year-old fireman. He has been intermittently vomiting for the past 2 days. His wife has accompanied him to the hospital. Mr. Rhodes has never been hospitalized. Crystal is the student nurse who has been assigned to admit Mr. Rhodes. Crystal is in her first clinical rotation. Crystal goes into Mr. Rhodes’ room, introduces herself, and explains that she will be collecting information that is needed for his admission. Mr. Rhodes is agreeable and asks Crystal to call him Chuck.

1. Crystal starts the data collection. What would she want to accomplish during the interview? (Select all that apply.)
2. During the initial interview, Crystal notices that Chuck is grimacing and will not make eye contact with her. She wants to get more information. Which question is most appropriate to help Crystal in her assessment?
3. Crystal is assessing Chuck using Gordon’s functional health patterns. This is an example of which approach to comprehensive assessment?

Answer the following:

1. Which of the following examples are steps of nursing assessment? (Select all that apply.)
2. Determining which medications to administer based on a patient’s assessment data
3. A nurse assesses a patient who comes to the pulmonary clinic. “I see that it's been over 6 months since you've been here, but your appointment was for every 2 months. Tell me about that. Also I see from your last visit that the doctor recommended routine exercise. Can you tell me how successful you've been in following his plan?” The nurse's assessment covers which of Gordon's functional health patterns?
4. When a nurse conducts an assessment, data about a patient often comes from which of the following sources? (Select all that apply.)
5. The nurse observes a patient walking down the hall with a shuffling gait. When the patient returns to bed, the nurse checks the strength in both of the patient's legs. The nurse applies the information gained to suspect that the patient has a mobility problem. This conclusion is an example of:
6. A 72-year-old male patient comes to the health clinic for an annual follow-up. The nurse enters the patient's room and notices him to be diaphoretic, holding his chest and breathing with difficulty. The nurse immediately checks the patient's heart rate and blood pressure and asks him, “Tell me where your pain is.” Which of the following assessment approaches does this scenario describe?
7. The nurse asks a patient, “Describe for me a typical night's sleep. What do you do to fall asleep? Do you have difficulty falling or staying asleep? This series of questions would likely occur during which phase of a patient-centered interview?
8. A nurse is assigned to a 42-year-old mother of 4 who weighs 136.2 kg (300 lbs), has diabetes, and works part time in the kitchen of a restaurant. The patient is facing surgery for gallbladder disease. Which of the following approaches demonstrates the nurse's cultural competence in assessing the patient's health care problems?
9. Which type of interview question does the nurse first use when assessing the reason for a patient seeking health care?
10. A nurse gathers the following assessment data. Which of the following cues together form(s) a pattern suggesting a problem? (Select all that apply.)
11. A nurse is checking a patient's intravenous line and, while doing so, notices how the patient bathes himself and then sits on the side of the bed independently to put on a new gown. This observation is an example of assessing:
12. A nurse makes the following statement during a change-of-shift report to another nurse. “I assessed Mr. Diaz, my 61-year-old patient from Chile. He fell at home and hurt his back 3 days ago. He has some difficulty turning in bed, and he says that he has pain that radiates down his leg. He rates his pain at a 6, and he moves slowly as he transfers to a chair.” What can the nurse who is beginning a shift do to validate the previous nurse's assessment findings when she conducts rounds on the patient? (Select all that apply.)
13. A patient who visits the surgery clinic 4 weeks after a traumatic amputation of his right leg tells the nurse practitioner that he is worried about his ability to continue to support his family. He tells the nurse he feels that he has let his family down after having an auto accident that led to the loss of his left leg. The nurse listens and then asks the
14. patient, “How do you see yourself now?” On the basis of Gordon's functional health patterns, which pattern does the nurse assess?
15. A nurse is conducting a patient-centered interview. Place the statements from the interview in the correct order, beginning with the first statement a nurse would ask.
16. During a visit to the clinic, a patient tells the nurse that he has been having headaches on and off for a week. The headaches sometimes make him feel nauseated. Which of the following responses by the nurse is an example of probing?
17. The nurse enters the room of an 82-year-old patient for whom she has not cared previously. The nurse notices that the patient wears a hearing aid. The patient looks up as the nurse approaches the bedside. Which of the following approaches are likely to be effective with an older adult? (Select all that apply.)

Chapter 22 Ethics and Values P/P

Mary Gardner is a 58-year-old patient who is divorced with four grown children. Mrs. Gardner has amyotrophic lateral sclerosis (ALS), a serious neurologic disease that causes muscle weakness, disability, and eventually death. She has become debilitated and is not able to communicate. She is in the hospital for a urinary tract infection. Her primary care physician (PCP) is out of town, and a hospitalist is seeing her while her PCP is gone. She is also seeing a neurologist and a pulmonologist. Lee Harris is a nursing student who is caring for Mrs. Gardner today.

1. Mrs. Gardner’s oldest daughter tells Lee that her mother had indicated earlier in her illness that she did not want to be resuscitated. Although this is the case, the children disagree and want everything done for her. Lee tells the physician about this conversation. The physician writes a DNR order and tells Lee not to tell the family. Should Lee consider this an ethical dilemma? Why or why not?
2. Lee tells his instructor about this issue. His instructor advises him that the ethics committee would be a good place to share this issue. What is the purpose of the ethics committee within a health care organization? (Select all that apply.)
3. Lee refers to the Code of Ethics for Nursing for more guidance. Which of the following statements are true about the American Nurses Association (ANA) Code of Ethics? (Select all that apply.)

Chapter 22 Ethics and Values P/P

You are caring for a 17-year-old female patient with sickle cell disease who has been admitted for treatment of sickle cell crisis. Sickle cell disease is a genetic abnormality that affects hemoglobin in the red blood cells. In a sickle cell crisis weakened red blood cells clump together and impede blood flow, causing extreme pain. To prevent stroke and manage the pain of the crisis, your patient needs aggressive fluid and comfort management. At the change-of-shift report, you learn that, even though she is receiving pain medication around the clock, she continues to report acute pain at a level of 10 on a scale of 0 to 10. She complains about almost everything: her roommate, the food, even the intravenous line that delivers the fluids and pain medications. Her home is far from the hospital, and her family and friends are not able to visit.

During shift report the nurse from the past shift describes the patient as manipulative. On the basis of her concern about a risk for addiction, she has declined to increase the dose of pain medication.

1. Describe this case in terms of the ethical principles that it raises. Refer to the nursing code of ethics to compose your response.
2. How could a values clarification exercise promote an ethical response to this case?
3. In trying to better understand sickle cell disease, you join a chat room online where people with sickle cell disease discuss their problems. Hoping to protect patient privacy, you use only your first name and the patient's first name. You mention the name of the hospital where you work. On the basis of your reading of the ANA White Paper on Social Media, describe benefits and risks of participating in social media in this situation.

NR222 Week 2 Activity 7 Key Ethical Principles of Nursing

Nursing ethics refers to moral judgment and standards of conduct. There are specific principles of health care ethics that have to be adhered to in every situation:

1. Nonmaleficence-competence in their field. Reporting any suspected abuse. Avoid injury to patient by following scope of practice.
2. Beneficence- Patient Advocate.
3. Autonomy- Patient’s right of self-determination, independence, and self-direction. Respect of patient wishes.
4. Justice-Treated fairly and equally.
5. Fidelity- Being loyal, truthful, fair and advocate.
6. Paternalism-What care is best for your patient when considering diagnosis, plan of care or therapy.
7. Principles of totality and integrity- taking the entire person’s needs into consideration before plan of care is established