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222 Cards in this Set

  • Front
  • Back
The basic qualities of pain
remain a uniquely individual experience.
The nursing definition of pain is
whatever bodily hurt the client says exists.
Acute pain
usually resolves with healing if there is no permanent damage.
Chronic pain
is constant or intermittent
Cancer-related pain is
generally related to tumor involvement.
The pain threshold is
the least experience of pain that a subject can realize.
Pain tolerance is
the maximum amount and duration of pain that an individual will endure.
Unrelieved acute pain
results in an activation of the stress response.
Asking a client to locate pain
must be phrased at the client's appropriate developmental level.
When documenting the quality of pain, the nurse should
use direct client quotes.
Josie Smith, a sixty-five-year-old woman with metastatic breast cancer, experiences almost constant pain that has been extremely difficult to control despite therapeutic interventions. The client is probably experiencing
intractable pain
Mrs. Smith uses all of the strategies suggested by the medical team and follows her medication regime. She also uses prayer and mediatation to help alleviate the pain. This is an example of
therapeutic coping
On a recent visit, Mrs. Smith confides that she is using reflexology for pain control. She reports positive effects and now plans to discontinue her regular pain medication regime. As her nurse, it is your responsibility to
explore her reasons for discontinuing the conventional medication regime and see if she is willing to talk about combining the two treatments.
Pain impulses travel in
myelinated A-delta fibers and unmyelinated C fibers.
Enkephalins are
One of the endogenous opioids that binds to opiate receptors and is used as a neurotransmitter. They are primarily activated through nociceptor peripheral fibers.
The peripheral nervous system receptors that transmit pain are called
nociceptors.
The gate theory postulates
an unlimited amount of sensory information can reach the brain at any given time.
This psychological view of pain is associated with a more willing acceptance of discomfort is that
Pain is interpreted as having a positive outcome.
Fear of addiction to opioids is the most common myth about analgesics. The fact is that
clients are unlikely to become addicted to opioids if they are used for pain control.
Annie jones is a three-year-old child who just underwent open-heart surgery. Research on pain control in children would suggest that Annie
will be undermedicated for her pain.
The professional responsibility for providing adequate pain control in a PRN analgesic approach rests solely with the
nurse
The goal of pain management is to
relieve the pain.
The placebo effect is
a true physiological response to pain.
The current recommended approach to pain management is
balanced analgesia to maximize pain control and minimize toxic effects.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are
helpful in treatment of arthritis and cancer-related bone pain.
Nonpharmacologic interventions include
cutaneous stimulation and massage.
Age and developmental level influence pain assessment techniques. For an adolescent, it is important to conduct interviews
in private so they feel comfortable admitting discomfort.
A client is from a culture that encourages loud vocalizations and moaning when pain is present. Research has shown that, when a PRN medication schedule is used, the client will
be undermedicated by the nurse.
The most explicit example of an advocacy role for nurses in pain management includes
helping clients interface with providers when using alternative therapies.
In assessing pain, who must initiate questions about pain?
The nurse
Sexuality begins when?
At conception.
The male and female reproductive systems are homologous. This means that they are
fundamentally similar in structure and function.
Puberty refers to
The development of adult characteristics and functioning.
Female breasts are
accessories of the reproductive system and specialized sebaceous glands.
Male menopause
occurs gradually and over a longer period of time than in women.
The female climacteric consists of (3 stages):
premenopausal, menopausal, and postmenopausal stages.
In the United States, emerging sexually transmitted infections (STIs) include
HIV/AIDS and chlamidia.
A sexual dysfunction in males is
erectile dysfunction.
Homophobia refers to
an irrational fear, hatred, or intolerance of people in same-sex relationships.
The following statements are true about female circumcision (3)
It is used to ensure virginity and reduce temptation. It is a criminal offense in the U.S. UNICEF and WHO unanimously recommend that it be abolished.
Joan Smith is a thirty-year old, sexually active woman who presents at the clinic for an evaluation of an unusual vaginal discharge. Research has shown that this client will
prefer for the nurse to initiate a discussion about sexuality.
Ms. Smith requests information on the cervical sponge. Which type of contraceptive method is this?
Barrier method.
Vasectomies and tubal ligations are examples of which kind of contraception?
Sterilization
Bob Jones has a history of a serious anxiety disorder and was recently placed on high levels of antianxiety agents. As his nurse, you should inform Mr. Jones that these medications
may cause problems with his libido and sexual response.
In the United States, there is tremendous pressure on teenagers to
become sexually active during their teen years.
J.C. is fifteen-years old and pregnant with her first child. Research has shown that to prevent pregnancies like this, interventions would need to
address societal problems as well as individiual high-risk behaviors.
As a client advocate, the nurse would
help clients and families interface with the medical team.
Implementing a sensitive sexual assessment history for a male client can be done by
integrating questions into the genitourinary assessment area.
Before asking any questions related to sexuality, the nurse should
determine if the client is sexually active.
A comprehensive sexual history is usually done when a client
receives contraceptive intervention.
The incidence of child sexual abuse over the last decade has
increased significantly.
When an ill client engages in inappropriate sexual behavior, the nurse must
consider the reasons for the behavior before intervening.
Which of the following strategies would help a client maintain a healthy sexual self-concept?
Give appropriate, positive attention to the client's appearance.
The sexual response of an older adult is
fairly consistent with sexual activity experienced in younger years.
Cultural universals are
seen in every culture.
If treatment recommendations are too far removed from acceptable cultural practices, the client will
discount the recommendation.
What is "susto"? What kind of folk belief is "susto"?
In hispanic cultures, this is when a frightening experience leads to the temporary loss of one's spirit from the body. Treatment occurs when a lay healer sweeps the victim with indigenous herbs while praying. This is a neutral folk belief.
If a family decides to use only a healer for epilepsy treatment, the practice would be
dysfunctional
The community health nurse who believes that all Turkish clients believe in the "evil eye" is displaying
stereotyping
The most appropriate initial response when a client shares the fact that a lay healer has treated them would be
asking the reasons the healer was sought and what occurred during the treatment.
An asian child with otitis media is beign treated with penicilin. A major nonemergency consideration in educating the family about the child's condition is
encouraging the parents to complete the entire course of antibiotic therapy.
Race refers to
a classification system based on certain biological characteristics.
Prejudice refers to
preconceived ideas or opinions about a group, individual, or culture that are not based on facts and limit a person's ability to accurately understand the culture or individual.
The Center for Disease control uses race as a
risk marker for health problems caused by social conditions.
Health-care practices are
behaviors that a person or group habitually employ when health or illness are involved.
A person who believes that illness is a sign that life's rhythms are out of balance probably employs which model to explain disease?
Holisitic
Cultural competence refers to
compromising personal beliefs and values.
Ethnocentrism is a
belief that one's approach is the superior way to believe and act.
Cultural universals include
family, work, parenting roles and education.
Functional health practices
facilitate optimal health.
Which of the statements accurately reflects current knowledge about chronic illness?
Most people with chronic illnesses do not consider themselves ill.
The client's symptoms are controlled and managed in which phase of the chronic illness trajectory model?
Stable
Severe or unrelieved symptoms that necessitate rehospitalization occur in which phase of the chronic illness trajectory model?
Acute
Which phase of the chronic illness trajectory model reflects a gradual or rapid shutting down of body processes despite efforts to alter the disorder?
Downward
The parents of a child with a chronic illness ask the nurse how to discipline their child. The nurse's response should be based on knowledge that discipline is
essential for positive growth and development of the child.
Sarah, age seven, has several physical disabilities. Her mother explains that the child is as independent as possible and concentrates on what she can do rather than what she cannot do. The nurse's best interpretation of this is?
The child is using an adaptive coping style.
The nurse is caring for a child who has had a tracheostomy for five years. He has been cared for at home by his mother, who is rooming in at the hospital. The mother insists on providing almost all of the child's care and tells the nurse how to care for the child. The nurse recognizes that this parent is
an expert in her child's care.
The nurse care manager is planning a discharge care conference for a school-age child with complex health-care needs. Who should the nurse invite to the care conference meeting?
Family, key health professionals, and school health and educational professionals.
Which of the following reflects the best practice in the care of children with chronic illnesses or disabilities?
Care is focused on the child's developmental level.
The nurse is providing information to parents who have just learned their child has been diagnosed with a serious chronic illness. The parents keep asking the nurse the same questions over and over. What should the nurse do?
Continue to answer their questions in a patient, kind manner.
For both clients and families, denial is a common reaction to a diagnosis of a chronic illness. As a defense mechanism, denial
is a helpful cushion against disintegration.
When a child is diagnosed with a chronic illness, family members travel through various stages of reactions. After the initial shock, a period of adjustment usually follows that is often characterized by
Guilt and accusation
Which of the following actions is particularly helpful in assessing parental guilt when a chronic condition is diagnosed?
Discuss the feelings of guilt only if the parents bring it up.
A common parental reaction to a child with special needs is overprotection. Which of the following parental behaviors suggests overprotection?
Responding to the child's every desire.
Most parents of special needs children experience what is called "chronic sorrow". In anticipatory guidance, the nurse explains to the parents that they may feel this intensified sorrow
at certain landmarks of the child's development.
The Wilson family has a nine-year old child named Michael. Three years ago, as the result of an accident, Michael developed quadraplegia. The family has adjusted to his injury and takes Michael everywhere with them. These parents
will need anticipatory counseling at developmental milestones.
A chronic condition
has periods of remission and exacerbation.
Respiratory cancers result in
the greatest percentage of disabled Americans.
What is the best example of a nurse advocacy role in chronic illness?
Redirecting the intervention focus from a pathologic model to a developmental model.
Family developmental theory
allows for an analysis of changes in both adults and children.
The most basic attribute of an effective community is
patterned social interactions.
The primary foci of community-based nursing are the
individual and family.
Public health nurses connect at-risk individuals to
the work of the health department.
Home health nursing
provides care to ill individuals in their home environment.
A unique attribute of community health nursing is its
accountability to society for the health of the public.
The American Nurses Association Standards for Community Health Nursing
identifies the level of requirements for excellence in community health nursing.
In a broad sense, prevention involves
everything possible to prevent disease development or progression.
In the United States, the three government tiers of public health are
federal, state and local.
Documentation of home visits in community health is
particularly important, because there are generally no witnesses to the nurse-client interaction.
In the United States, the public health level with primary responsibility for health matters is the
state government
The primary global agency that deals with international health concerns is
World Health Organization
A pandemic
involves populations in widespread geographical areas of the world.
Conducting a colon cancer-screening clinic for healthy older adults is an example of
secondary prevention.
An example of primary prevention is
assisting a sexually active adolescent to receive contraceptive information.
An example of tertiary prevention is
discussing contraceptive options for a pregnant teenager.
The objectives identified in Healthy People 2010 are important because they
allow governments to focus valuable resources in the right places.
The major focus of the Healthy People 2010 objectives is
measurement of progress over time.
Disease causality refers to
the act of relating one event to the effects it produces.
Risk refers to
the probability that an unfavorable event will occur.
Rate refers to
a special form of proportion that includes specification of time.
Three factors involved in risk assessment include
susceptibility, exposure potential, and relative risk ratio.
The mortality rate is an estimation of
proportion of the population that dies during a specified period.
The two rates used to describe morbidity in a community are
prevalence and incidence rates.
Prevalence measures
the total number of cases of a given disease in a specified population at a designated time.
Incidence measures
the newly occurring cases of a disease in a specified population.
Screening coal miners for black lung disease is
secondary prevention
Creating a community support group for substance abuse clients who are in rehabilitation is an example of
tertiary prevention
Primary prevention in a rural community would be
encouraging hearing protection for farmers.
A farmer presents at the clinic with facial edema and shortness of breath. He states he was "stung by a wasp" about twenty minutes ago. After initiating the anaphalaxis protocol, you provide supportive care until the ambulance arrives. This is an example of
secondary prevention
A primary prevention strategy to prevent child abuse is
educating expectant parents on issues related to growth and development.
As a school nurse in an elementary school, legally, you must know to
report the suspicion of child abuse to the local child protection agency.
Pregnancy is divided into
trimesters
Antepartal is defined as the time between
conception to the onset of labor.
The time from the onset of labor to the birth of the infant and placenta is called
intrapartum
The term used for a woman who is pregnant for the first time is
primigravida.
Gravida refers to
any pregnancy, regardless of duration.
The term for a birth after twenty-weeks gestation regardless of whether the infant is born alive or dead is
para
A woman is pregnant for the third time. She lost two babies at fourteen weeks gestation. The woman's obstetrical history would read
gravida 3 para 0 ab 2.
A woman is pregnant for the first time with triplets. Her obstetrical history would read
gravida 1 para 0 ab 0.
The acronym TPAL refers to
a more comprehensive method to collect an obstetric history.
A positive sign of pregnancy is
fetal heartbeat heard with a fetoscope
A presumptive sign of pregnancy is
quickening
A probable sign of pregnancy is
the presence of HCG.
During pregnancy, uterine enlargement is due to
hypertrophy and limited hyperplasia.
Braxton Hicks contractions
assist in placental circulation.
Quickening is
softening of the uterine cervix, a probable sign of pregnancy
Ballottement is
a technique of palpation where the organs are gently bounced and the rebound is felt.
Braxton Hicks contractions
assist in placental circulation
During pregnancy, a woman's blood volume increases by ___% above prepregnancy levels
45%
During pregnancy, cardiac output increases ___% above prepregnancy levels.
30-50%
Teaching the pregnant woman to rest and sleep on her left side is an attempt to prevent
pregnancy-induced hypotensive syndrome.
In pregnant women, the plasma volume increase is greater than the erythrocyte volume increase. Because of this, the hematocrit may decrease slightly. This condition is referred to as
physiologic anemia of pregnancy.
One explanation for the nausea and vomiting associated with pregnancy in the first trimester is
secretion of HCG by the implanted blastocyst.
During the second trimester, the presence of the uterus on the bladder
decreases.
During pregnancy, the respiratory system experiences a ___% increase in the volume of air breathed each minute?
30-40%
A number of hormones are critical to retaining a pregnancy. At the time of conception, these hormonal agents are produced by the
corpus luteum.
In the first trimester of a planned pregnancy, it is not unusual for a woman to experience which of the following feelings about the pregnancy?
Ambivalence
Nagle's Rule is
a method for determining the estimated birth date.
How do you calcluate date of birth using Nagle's Rule
Subtract three months from the first day of the last normal menstrual period, and add 1 year and 7 days.
Caroline began her last menstrual period on March 15 of this year. Her estimated date of birth would be
December 21. (Subtract 3 months and add a year and a week)
In a low-risk, normal pregnancy, the recommended schedule of office visits for second trimester prenatal care is
every four weeks.
Danger signs during pregnancy should be
reviewed with the mother in an educational manner that does not cause alarm.
In an amniocentesis, how much fluid is withdrawn?
15-20 milliliters.
During the third trimester, blurred vision with dizziness and persistent headaches may indicate
Preeclampsia
Measurements of fundal height are
used as an indication of uterine size.
A pregnancy that terminates before twenty weeks is considered
abortion
The only known cure for eclampsia and preeclampsia is
birth of the fetus.
The most common imlpantation site for an ectopic pregnancy is
fallopian tube
A woman has a history of cocaine use and is admitted in active labor. At this point, the nurses priority concern would be
abruptio placenta
The first stage of labor is divided into three phases. These are
latent, active and transitional.
The second stage of labor begins with
complete cervical dilation.
The third stage of labor ends with
placental delivery.
The cardinal movements of labor refer to
the fetal head and body adjusting to the maternal pelvis.
During fetal monitoring, late fetal heart decelerations are considered
an ominous sign.
To perform an amniotomy,
the cervix must be at least two centimeters dilated.
Complete involution of the placental site
occurs within six to seven weeks.
A postpartal woman who uses both a diaphragm and a cervical cap for fertility control should be told to
have the devices refitted after childbirth.
Realistically, a woman should expect to return to her prepregnany weight within
six to eight weeks after postdelivery.
In a multipara woman, the maternal bond is
reestabilshed with each child born.
A nurse would be most alert for signs of postpartum depression in a new mother
one month postpartum.
Lochia rubra that persists longer than two weeks is
highly suggestive of uterine subinvolution.
A primipara woman with an incompetent cervix will
usually be unaware of the problem until it is found on exam.
In a woman with a normal BMI and a normal pregnancy, the Institute of Medicine's recommended weight gain during pregnancy is
11.5kg to 16kg (25-30lbs.)
Folic acid supplementation should be started
one month before pregnancy.
Today, external fetal monitoring is usually accomplished by using
ultrasound
The home use of terbutaline sulfate pumps is recommended for pregnant women who have (3)
risk factors known to increase the incidence of preterm labor, have had multiple pregnancies, have previously delivered preterm infants.
A premonitory sign of labor is
bloody show
If the mother is adequately nourished, infants can be nutritionally supported solely by breast milk for
2-15 months.
The functions of amniotic fluid include (3)
controlling the embryo's temperature, permitting the symmetrical growth of the fetus, maintaining circulatory exchange.
The placenta is involved in
metabolic, transport, and endocrine activities.
A primary purpose of fetal circulation is to
decrease blood flow to the fetal lungs.
One test used to determine fetal lung maturity is
the L/S ratio.
The CDC and the American Academy of Pediatrics recommend that all newborns recieve which vaccine within 12 hours of birth?
Hepatitis B
A small-for-gestational-age newborn is a baby who is below the ______ percentile.
tenth percentile.
Sensory perception refers to
the translation of stimuli into meaningful information.
Examples of external stimuli include (2)
visual and auditory.
What area of the brain is believed responsible for mediating the arousal mechanism?
Reticular activating system.
Sensory deprivation refers to
a decrease of meaningful stimuli.
Clients with reception and perception alternations are at risk for
both sensory deprivation and sensory overload.
A conductive or middle ear hearing loss results from
interference in the transmission of sound to the middle ear.
An older adult presents to the clinic with a complaint of not being able to hear high frequency sounds. One of the first age-related problems to be considered would be
presbycusis
The parents of a newborn are heavy smokers. The nurse would explain that one of the major risk factors they are exposing their baby to is the risk for
acute otitis media.
If pain persists in otitis media, which of the following procedures is performed?
Myringotomy.
Meniere's disease is
a triad of symptoms that includes vertigo, tinnitus and sensorineural loss.
One of the most common causes of medication-related ototoxicity is
IV aminoglycosides.
An older adult has been diagnosed with macular degeneration. To monitor the disease status at home, the client will be given
an Amsler grid.
Miotics cause
pupillary constriction.
Cycloplegics
paralyze the iris sphincter.
Absolute blindness is clinically defined as
absence of light perception.
When a person presents with cataracts, the symptoms would include
painless blurring of vision.
A child presents to the school nurse with bilaterally inflamed eyes. She complains of itching and burning. She adds her eyes were "glued" together when she woke up this morning. This child is most likely suffering from
conjunctivitis.
Initial tests used to evaluate a person's hearing acuity include the
Weber test and Rinne test.
Collecting data to judge whether or not the outcomes have been reached is part of which phase of the nursing process?
Evaluation.
Working with clients who have reproductive disorders requires skill in numerous areas of client care. On an inital interview, one of the most important skill related areas includes
interviewing and teaching.
Initial cancer-related research results on hormone replacement therapy (HRT)
are now considered flawed.
Hot flashes are
directly attributable to hormonal changes.
A woman diagnosed with endometriosis would probably present witih which of the following types of discomfort.
Dull, cramping abdominal pain
An elderly female client has severe itching from vulvitis. The nurse would recommend
sitz baths in tepid water.
Kegel excercises can be used
to prevent uterine prolapse.
The preferred treatment method for recotceles and enteroceles is
laparoscopic surgery.
The purpose of a dilation and curettage includes (3)
removal of endometrial tissue, control of uterine bleeding, theraputic measure for incomplete abortion.
The most common pathologic condition of older men is
benign prostatic hyperplasia
The obstructive and irritative complex of symptoms associated with BPH is called
protatism
An incision made to cure a hydrocele is called a
hydrocelectomy.
When considering toxic environmental factors that impact reproductive health in women, it is important to remember that
the fetus is more susceptible.
Sexual abuse is
considered a type of domestic violence.
A sexual history would include (3)
fertility management, a history of sexual abuse, a history of exposure to medications
An example of secondary prevention as it relates to a man's reproductive health is encouraging the client to
complete regular TSE (testical self examination) exams.
Postoperative care to prevent DVTs would include
use of elastic pressure stockings.
The female's vaginal area is usually protected from infections by
a low pH.
Stress incontinence is associated with
weakened perineal muscles.
With advancing age, hormones
decline in both men and women.