Which would the nurse consider to be the center of decision-making when providing client care?

Brooker D. Person-centred dementia care.London: Jessica Kingsley; 2007

Centre for Policy on Ageing. The effectiveness of care pathways in health and social care. 2014. https://tinyurl.com/3t835kfd (accessed 1 November 2021)

Department of Health. Refocusing the Care Programme Approach. Policy and positive practice guidance. 2008. https://tinyurl.com/anyrzhy6 (accessed 3 November 2021)

Department of Health. Personalised care planning: improving care for people with Long term conditions. 2011. https://tinyurl.com/uc3u3tkh (accessed 1 November 2021)

Department of Health. Care planning in the treatment of long term conditions: final report of the CAPITOL Project. 2013a. https://tinyurl.com/7399vphc

Foundations of nursing practice: making the difference, 2nd edn. In: Hogston R, Simpson PM (eds). London: Palgrave Macmillan; 2002

Kozier B, Erb G, Berman A, Snyder S, Lake R, Harvey S. Fundamentals of nursing: concepts, process and practice, 8th edn. Harlow: Pearson Education; 2008

Leach M. Clinical decision making in complementary & alternative medicine.Chatswood (NSW, Australia): Elsevier; 2010

Lloyd M. A practical guide to care planning in health and social care.Maidenhead: Open University Press; 2010

Matthews E. Nursing care planning made incredibly easy!.Philadelphia (PA): Lippincott Williams and Wilkins; 2010

Monitor. Delivering better integrated care: A summary of what delivering better integrated care means and how Monitor is supporting the sector. 2015. https://tinyurl.com/825k8kd6 (accessed 1 November 2021)

NHS website. NHS launches accredited suppliers for electronic patient records. 2019. https://tinyurl.com/4fzs4up5 (accessed 1 November 2021)

National Institute for Clinical Excellence. What to expect during assessment and care planning. 2021. https://tinyurl.com/63hm5vvp (accessed 1 November 2021)

NHS England. Personalised care and support planning handbook: the journey to person-centred care: Core information. 2016a. https://tinyurl.com/9fyrtw45 (accessed 1 November 2021)

Nursing and Midwifery Council. Future nurse: standards of proficiency for registered nurses. 2018a. http://tinyurl.com/yddpadva (accessed 1 November 2021)

Nursing and Midwifery Council. The code: professional standards of practice and behaviour for nurses, midwives and nursing associates. 2018b. https://tinyurl.com/gozgmtm (accessed 1 November 2021)

Revello K, Fields W. An educational intervention to increase nurse adherence in eliciting patient daily goals. Rehabil Nurs. 2015; 40:(5)320-326 https://doi.org/10.1002/rnj.201

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Terms in this set (48)

A client with asthma and depression is admitted to the hospital. Which tasks delegated by the delegator would indicate the task is applicable for the registered nurse?

"Teach the client how to use a meter dose inhaler."

According to Gardner's tasks of leading/managing, a behavior of the executive position is to assist corporate leaders with planning and priority setting. Leading inspires client/families to achieve their vision. A behavior of the management position is to inspire the staff to achieve the mission of the organization. A behavior of the clinical position is to ensure that the organizational systems work on the client's behalf.

Which behavior would the nurse consider suitable for an executive position according to Gardner's tasks of leading/managing?

To assist corporate leaders with planning and priority setting

According to Gardner's tasks of leading/managing, a behavior of the executive position is to assist corporate leaders with planning and priority setting. Leading inspires client/families to achieve their vision. A behavior of the management position is to inspire the staff to achieve the mission of the organization. A behavior of the clinical position is to ensure that the organizational systems work on the client's behalf.

According to Gardner's tasks of leading/managing, a behavior of the executive position is to assist corporate leaders with planning and priority setting. Leading inspires client/families to achieve their vision. A behavior of the management position is to inspire the staff to achieve the mission of the organization. A behavior of the clinical position is to ensure that the organizational systems work on the client's behalf.

Critical analysis

Critical analysis by the registered nurse serves as a guide for delegation in the nursing process. It is applied in assessment, planning, implementation, and evaluation for safe and effective client care. Leadership is a role in which a nurse has charge of the personnel as they perform their tasks. Psychomotor tasks are the common characteristics and essential components that a nurse should possess to provide client care. Time management is essential in performing tasks within specified deadlines during delegacy.

According to Gardner's tasks of leading/managing, a behavior of the executive position is to assist corporate leaders with planning and priority setting. Leading inspires client/families to achieve their vision. A behavior of the management position is to inspire the staff to achieve the mission of the organization. A behavior of the clinical position is to ensure that the organizational systems work on the client's behalf.

Occasionally offering derogatory comments

This registered nurse who has limited clinical experience should make an attempt to adapt delegation decisions to organization policies. The nurse should not offer derogatory or offensive comments, which can detract from a collaborative and productive work environment. Asking open-ended questions allows the registered nurse to gain pertinent information from the nursing assistant delegated to perform client care. The registered nurse should provide feedback about behavior that will best shape performance. Maintaining an open line of communication with the nursing assistant yields a collaborative and productive work environment.

The professional obligation of a nurse to assume responsibility for actions is referred to as what?

Accountability

What qualities does the professional nurse require to lead, manage, and follow in a team? Select all that apply.

Exercising self-awareness
Managing emotions in self and others
Motivating self and others

Who functions as a liaison between team leaders and other healthcare providers?

Charge nurse

The nurse leader mentors the staff on types of conflict. Which statement of the leader describes intrapersonal conflict?

It arises due to imbalances between the nurse's personal and professional priorities.

A nurse is caring for a client with a diagnosis of polycythemia vera. The client asks, "Why do I have an increased tendency to develop blood clots?" Which effect of the polycythemia vera should the nurse include in the teaching session?

Increased blood viscosity

A nurse is evaluating the practice of a home health aide who is caring for a client who has paraplegia. Which behavior indicates understanding about the nursing team's responsibility in relation to pressure ulcers?

Inspecting the skin daily

The registered nurse is organizing a community health care program for administering tetanus vaccinations. Which member of the health care team is most suitable for delegating the task of administering vaccinations?

Licensed practical nurse

The nurse leader is teaching the staff that the health care provider continuously strives to work effectively within the cultural context of a client. Which cultural principle is the nurse leader explaining?

Cultural competence

Which activity indicates improper follow-through on the part of the delegatee?

Failure to report results

While auditing unit documents, a nurse finds some omissions. Which term best describes when the nurse meets with the staff to discuss the findings and communicates ways to achieve the desired goals?

Management

The registered nurse (RN) is caring for an older client who has been admitted to the hospital. The RN allocates several tasks to the unlicensed nursing personnel (UNP). In order to evaluate the understanding of the UNP, the RN asks the UNP to describe which tasks have been allocated. Which responses given by the UNP indicate effective understanding of the tasks? Select all that apply

I must assist the client with oral care.

"I must give a sponge bath to the client every morning."

"I must monitor the blood pressure of the client at regular intervals.

What does the nurse understand is the collaborative definition of delegation according to the American Nurses Association (ANA) and the National Council of State Boards of Nursing (NCSBN)?

"Delegation is the process for the nurse to direct another person to perform nursing tasks."

Which role does a nurse play when helping clients to identify and clarify health problems and to choose appropriate courses of action to solve those problems?

Counselor

As a part of informed consent, a surgeon explains to the client who is scheduled for surgery the details of the surgery and the related care. The nurse as a leader witnesses the complete procedure. What information does the nurse leader ensure was provided to the client? Select all that apply.

Surgery procedures
Name of surgeon
Description of the risk

What does the professional nurse consider to be the center of decision-making when providing client care?

Ethics of care

A female nurse has been caring for a depressed 75-year-old woman who reminds her of her grandmother. The nurse spends extra time with her every day and brings her home-baked cookies. What does the nurse's behavior reflect?

Countertransference

What is the function of the Professional Standards Review Organizations (PSROs) set up by the federal government?

To review the quality, quantity, and cost of hospital care

The emergency department nurses are caring for a group of clients injured in a community disaster. Which action of the nurse needs correction?

Removing people from danger

Before effectively responding to a sexually abused victim on the phone, it is essential that the nurse in the rape crisis center do what?

Be aware of any personal bias about sexual assault

Which skills would be essential for an effective nurse manager to develop and improve collaboration with others? Select all that apply.

Ability to share information and ideas
Flexibility
Ability to listen to others

A nurse providing care in a hospital witnesses a client's spouse shaking the client vigorously because the client has had an episode of incontinence. Because of the suspicion of physical abuse, legally the nurse should discuss the concerns with which party?

Adult protective services

A nursing assistant is frequently late for work and often tells the nurse manager that although he leaves his apartment early, he is delayed by heavy traffic. What defense mechanism is being used by the nursing assistant?

Rationalization

What factors are most important for the nurse to consider when delegating responsibilities?

Staff member's level of education and expertise

Mr. Perry Burke is a 51-year-old African-American patient on the medical-surgical unit for management of chronic bronchitis that has turned into pneumonia. He works in a paper mill factory where he inhales sawdust and chemicals on a daily basis. Working in an industrial environment causes his lungs to be constantly irritated and inflamed.
Cyrus is the nursing student assigned to Mr. Burke. After reviewing his care plan, the health care provider's orders, and the nursing notes from the previous shift, Cyrus enters Mr. Burke's room.

...

1. Cyrus finds Mr. Burke restless, agitated, and confused. His pulse is 102 beats/min, and respirations are 42 breaths/min and shallow. He is sitting up in bed grasping the side rails and trying to catch his breath. He is most likely experiencing which of the following conditions?
A. Hyperventilation
B. Hypoventilation
C. Hypoxia
D. Dysrhythmia

Answer: C
Rationale: Hypoxia is the decreased diffusion of oxygen from the alveoli to the blood, as in pneumonia. Signs and symptoms of hypoxia include apprehension, restlessness, inability to concentrate, decreased level of consciousness, dizziness, and behavioral changes. Vital sign changes include increased pulse rate and rate and depth of respiration.

2. Mr. Burke's condition is causing the clinical sign of shortness of breath. Shortness of breath is referred to as _______________.

Answer: Dyspnea
Rationale: Dyspnea is shortness of breath often found in hypoxia.

3. Mr. Burke's respiratory rate as determined by Cyrus is 42 breaths/min. This means that he is experiencing apnea.
A. True
B. False

Answer: B
Rationale: Apnea is the absence of breath sounds. Tachypnea is more than 20 breaths/min.

4. Mr. Burke coughs up bloody sputum that Cyrus sends to the laboratory. Bloody sputum is referred to as ____________.

Answer: Hemoptysis
Rationale: Hemoptysis is bloody sputum that often accompanies respiratory illnesses such as pneumonia.

Acculturation

the adoption of the behavior patterns of the surrounding culture

Enculturation

the process by which culture is learned and transmitted across the generations

Assimilation

Process by which a person gives up his or her original Identity by becoming absorbed into the dominant culture group

Bicuturalism

Duel pattern of identification

Culture

Is a pattern of shared attitudes beliefs, self-definition, norms, roles, and values that can occur among those who speak a particular language or live in the defined geographic region

3 Requirements from nurses over competency

•Expected component of nursing education and professional nursing practice
•Requires underlying acceptance of patient's health beliefs
•Requires adapting care to meet unique needs and perspectives of individual

8 questions associated with the RESPECT Model when working with patients

1.What do you call the problem?
2.What do you think has caused the problem?
3.Why do you think it started when it did?
4.What do you think the sickness does? How does it work?
5.How severe is the sickness? Will it have a long or short course?
6.What kind of treatment do you think the patient should receive?
7.What are the chief problems the sickness has caused?
8.What do you fear most about the sickness?

Ethnocentrism

Belief in the superiority of one's nation or ethnic group.

Multiculturalism

A perspective recognizing the cultural diversity of the United States and promoting equal standing for all cultural traditions

Cultural imposition

tendency of some to impose their beliefs, practices, and values on another culture because they believe that their ideas are superior to those of another person or group

Regarding the past experiences of clients who have immigrated, which consideration would the nurse incorporate when planning care?

3
Past experiences are important and must be recognized because they help set the individual's values and beliefs throughout life. Past experiences enrich our lives; acculturation does not have to come at the expense of memories and personal history. The amount of influence of inherited traits versus past experiences is difficult to quantify; any person would be affected by both factors. Although past experiences play an important role in an individual's life, new experiences influence current and future interactions.STUDY TIP: A word of warning: Do not expect to achieve the maximum benefits of this review tool by cramming a few days before the examination. It doesn't work! Instead, organize planned study sessions in an environment that you find relaxing, free of stress, and supportive of the learning process.

The nurse manager works on a unit where the nursing staff members are uncomfortable taking care of clients from cultures that are different from their own. Which action would the nurse manager take to address this problem?
1
Assign articles about various cultures so that the nurses can become more knowledgeable.
2
Relocate the nurses to units where they will not have to care for clients from a variety of cultures.
3
Rotate the nurses' assignments so they have an equal opportunity to care for clients from other cultures.
4
Plan a workshop that offers opportunities to learn about the cultures the nurses might encounter while at work.

4
A workshop provides an opportunity to discuss cultural diversity; this should include identification of one's own feelings. Also, it provides an opportunity for participants to ask questions. Although articles provide information, they do not promote a discussion about the topic. Relocation is not feasible or desirable; clients from other cultures are found in all settings. Rotating the nurses' assignments probably will increase tension on the unit.Test-Taking Tip: You have at least a 25% chance of selecting the correct response in multiple-choice items. If you are uncertain about a question, eliminate the choices that you believe are wrong and then call on your knowledge, skills, and abilities to choose from the remaining responses.

Which of these cultural groups adopts a combination of dietary, herbal, and other naturalistic therapies to prevent and treat illness?
1
East Asian
2
Hispanic

Asian Indian
4
Native American

3
Asian Indians rely on a combination of dietary, herbal, and other naturalistic therapies to prevent and treat illness. East Asians use yin treatment (which uses needles to restore balance and flow of qi) and yang treatment (which uses moxibustion or heat with acupuncture to restore the yin/yang balance). Hispanics use a combination of prayers, herbs, and other rituals to treat traditional illnesses. Native Americans rely on a combination of prayers, chanting, and herbs to treat illnesses caused by supernatural, psychological, and physical factors.

Which culturally based behavior would the nurse expect to observe in an Asian client who has symptoms of anxiety and panic?
1
Reluctance to take medication
2
Minimal eye contact
3
Desire to have an Asian nurse
4
Offense at being touched

2
As a show of respect, people in Asian cultures tend to make little eye contact, particularly with people perceived as authority figures. People from Asian cultures are accustomed to taking medication, herbs, and other complementary therapies, so the nurse would assess before administering medication. Health care professionals with the same cultural background may be preferred, but the nurse would assess if language barriers are the chief concern. If a client is highly anxious or having symptoms of a panic attack, the nurse would not use touch, regardless of the cultural background or ethnicity.

Which key factor assists the nurse in assessing how a client will cope with the body image change after an above-the-knee amputation?
1
Extent of the change
2
Suddenness of the change
3
Obviousness of the change
4
Personal perception of the change

4
The reality of a situation is not the important issue at this time, but the client's feelings or perceptions about the change are the most important determinant of the client's ability to cope. The extent of change is not relevant; what is relevant is whether the client perceives the change as enormous or less important. Although suddenness of the change may influence a person's coping ability, this is not the primary factor influencing a client's coping mechanisms with body image changes. Although obviousness of the change may influence a person's coping ability, this is not the primary factor influencing coping mechanisms with body image changes.Test-Taking Tip: Have confidence in your initial response to an item because it more than likely is the correct answer.

1
Enjoyment of specific foods is inherited.
2
There are familial influences on childhood eating habits.
3
Childhood obesity is usually not a predictor of adult obesity.
4
Children with obese parents are destined to become obese themselves.

2
Studies have demonstrated that culture and family eating habits have an effect on a child's eating habits. Inheritance is not known to influence eating habits, although it is believed that other hereditary factors are associated with obesity. Childhood obesity is a known predictor of adult obesity. Children with obese parents are not necessarily destined to become obese themselves.

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