Week 6: 13, 16, 17, 31, 36 and 39 Epilopoulos ch 15, 33 Ch 13 1. Discuss the fol

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Week 6: 13, 16, 17, 31, 36 and 39 Epilopoulos ch 15, 33 Ch 13 1. Discuss the following factors that may affect clients’ self concept: Gender Developmental level Socioeconomic status Family Peer relationships Internal locus of control 2. The elder client’s daughter is vice president of a large company. She is experiencing great conflict in trying to care for her mother while managing her work-related responsibilities. In planning to help the daughter, the nurse focuses on which component of the daughter’s self-concept? a. Body-image b. Role performance c. Personal identity d. Self-esteem 3. Discuss what areas should be included in the psychosocial assessment of a client 4. In assessing clients who may be experiencing a depressive disorder, the nurse’s top priority is to determine which of the following? a. Onset and severity of symptoms b. Risk of self-harm c. Previous history of depression d. Family and community supports 5. A client with anxiety is completely focused on himself and the need to relieve his problem. He is in which stage of anxiety? a. Panic anxiety b. Mild anxiety c. Moderate anxiety d. Severe anxiety Chapter 16 1. The nurse notes on the admission form that the client has indicated “no religious preference.” He understands that a.. The client does not follow the tenets of a specific faith b. The client is in denial about his religious beliefs c. The client does not believe in God or a “higher power” d. The client will not want to pray or visit with the chaplain 2. It would be most important for the nurse to instruct the NAP to assist clients of which faith to wash their hands before meals? a. Christian b. Jewish c. Mormon d. Muslim 3. Would this statement by the nurse would be correct? “We should pray to God that your cancer goes into remission.” a. Yes b. No Chapter 31: Comfort/pain 1. Differentiate between phantom pain and psychogenic pain 2. Differentiate between acute, chronic and intractable pain and provide examples of medical conditions that may cause each type. 3. It is most important for the nurse to understand the various ways in which pain is classified A. so that he can document the client’s pain using accurate terms B. so that he can be clear in his communication with the physician C. so that he can develop an effective pain management plan D. so that he can educate the client thoroughly 4. Discuss how the following factors influence pain for clients: Past experience with pain Emotions Developmental stage Sociocultural factors Communication skills Cognitive impairment 5. Discuss the following pain scales: Visual Analogue Scale (VAS) Numeric Rating Scale (NRS) Wong-Baker Faces Pain Rating Scale 6. The nurse is assessing the confused client. In trying to determine the client’s level of pain, the nurse should a. be aware that confused clients don’t feel as much pain due to their confusion b. observe the client carefully for changes in behavior or vital signs c. ask the client’s family how much pain the client normally has d. use only pain scales that feature numbers or “faces” the client can point to 7. Discuss Pharmacological Measures to Manage Pain Nonopioid analgesics •NSAIDs •Acetaminophen Opioid analgesics •Includes IV, IM, transdermal, and epidural forms •Client-controlled analgesia pumps 8. Mr. Zenobia's chronic cancer pain has recently increased, and he asks the home health nurse what can be done. In relationship to his long-acting morphine, which of the following is an appropriate response by the nurse? a. "If you take more morphine, it will not change your pain relief." b. "I'll call the physician and ask for an increased dose." c. "The amount you are taking now is all I can give you." d. "I'm worried if we increase your dose that you will stop breathing.” Chapter 36 1. Which diagnostic test/exam would best measure a client’s level of hypoxemia? a. chest x-ray b. pulse oximeter reading c. ABG d. peak expiratory flow rate 2. Describe two ways in which breathing is controlled 3. What are the major risks to oxygenation for children and adults? 4. What areas should you include in a nursing history for a patient with oxygenation concerns who is undergoing a comprehensive assessment? 5. When is a cough significant? What aspects of a cough should be assessed? 6. In caring for a client with a tracheostomy, the nurse would give priority to the nursing diagnosis of: a. Risk for ineffective airway clearance b. Anxiety related to suctioning c. Social isolation related to altered body image d. Impaired tissue integrity Chapter 13: 1. Discuss the following factors that may affect clients’ self concept: Gender Developmental level Socioeconomic status Family Peer relationships Internal locus of control 2. The elder client’s daughter is vice president of a large company. She is experiencing great conflict in trying to care for her mother while managing her work-related responsibilities. In planning to help the daughter, the nurse focuses on which component of the daughter’s self-concept? a. Body-image b. Role performance c. Personal identity d. Self-esteem 3. Discuss what areas should be included in the psychosocial assessment of a client 4. In assessing clients who may be experiencing a depressive disorder, the nurse’s top priority is to determine which of the following? a. Onset and severity of symptoms b. Risk of self-harm c. Previous history of depression d. Family and community supports 5. A client with anxiety is completely focused on himself and the need to relieve his problem. He is in which stage of anxiety? a. Panic anxiety b. Mild anxiety c. Moderate anxiety d. Severe anxiety Chapter 39 1. Provide examples of a ‘Never Event’ 2. Discuss how surgeries can be classified. 3. Discuss factors affecting surgical risk 4. An elderly woman fell at home and fractured her hip. After being admitted to the hospital, the nurse knows that the patient is to be “stabilized” prior to having surgery. This surgery would be classified as a. urgent b. elective c. emergency d. palliative 5. The nurse is completing a preoperative patient assessment. Which finding indicates the greatest risk for the development of a postoperative complication? a. the patient is 60 years old b. the patient’s blood pressure is 130/88 c. the patient does not understand the surgery d. the patient has early stage Alzheimer’s 6. Discuss what should be included in a clients’ preoperative teaching plan 7. Describe how to prepare a client physically for surgery 8. Discuss intraoperative safety measures 9. Describe postoperative nursing care including: the initial physical assessment, postoperative teaching, incentive spirometry, pain control and deep vein thrombosis prevention. 10. The nurse knows that the most important reason for controlling postoperative nausea/vomiting in the PACU is a. to prevent the patient from becoming dehydrated b. to prevent potential airway issues c. to prevent the surgical dressing from becoming soiled d. to prevent the patient from becoming upset

Explanation / Answer

Chapter 13:

2. ANS: B. Role performance

3. ANS: In the psychological assessment several components can be included such as interview information, observational data, informal tests and surveys, school or medical records, medical evaluation and norm-referenced psychological tests.

4. ANS: B. Risk of self-harm

5. ANS: D. Severe

Chapter 16:

1. ANS: A. The client does not follow the tenets of a specific faith.

2. ANS: D. Muslim

3. ANS: B. NO.(The client should do that, but the nurse should not be stating the intent of the prayer session).

Chapter 31:

1. ANS: Phantom pain: this kind of sensation perceptions are defined as an individual experiences related to an organ or limb which may not physically part of the body.

Ex: Limb loss (amputation or congenital limb deficiency).

Psychogenic pain: This kind of pain can defines a psychological disorder, in which the pain was arisen due to the evidence of psychological disturbances.
2. ANS:

Acute pain: It is generally arisen suddenly and it is caused by something specific. Acute pain usually does not last longer than 6 months and it was sharp in quality. Surgery, Dental work, broken bones, Labor and childbirth are included under acute pain.

Chronic pain: Even after the injury this type of pain will continue. It is generally lasts longer than six months. Headache, Cancer, Nerve pain, Arthritis and Back pain are included in this

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