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UTMB Intro Final Exam Review: Nursing History, Ethics, and Patient Care, Exams of Nursing

Cranfield UniversityNursing

A comprehensive review of key concepts for an introductory nursing exam at utmb. It covers essential topics such as nursing history, ethical principles, patient care, and quality improvement. Questions and answers, making it a valuable study resource for nursing students.

Typology: Exams

2024/2025

Available from 11/12/2024

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UTMB Intro Final Exam Review
Questions With Correct Answers
Nightingale - ANSWER- Founder of modern nursing, Implemented during Crimean,
improved sanitation, implemented research
Seacole - ANSWER- Jamaican minority, setup clinics during crimean war
Dix - ANSWER- Asylum movement, reform for mentally ill & prisoners
Barton - ANSWER- first president of American Red Cross
Mahoney - ANSWER- First African American nurse in the US
Wald - ANSWER- Henry Street Settlement, first public health nurse
Ford - ANSWER- started first NP program
Nutting - ANSWER- Graduated from Johns Hopkins, expanded nursing curriculum to 2-
3 yrs, added clinicals, limited hours students could work, established the library there,
and Army Nurse Corps
Richards - ANSWER- The first trained nurse in the United States, started Japanese
nursing program, created pt records & night shift
Patient Abandonment - ANSWER- Terminating the relationship with the patient without
giving reasonable notice or providing a competent replacement, resulting in a lack of
necessary medical care
Assault - ANSWER- threat or attempt to injure
Battery - ANSWER- physical harm
Boundary Crossing - ANSWER- a departure from a commonly accepted practice that
could potentially benefit a client (non-exploitative)
Boundary Violation - ANSWER- a serious breach that results in harm to clients and is
therefore unethical (exploitative)
BON Purpose - ANSWER- To protect and promote welfare of people in Texas ensuring
that each person who holds a license as a nurse is competent to practice safely.
(SAFETY)
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UTMB Intro Final Exam Review

Questions With Correct Answers

Nightingale - ANSWER- Founder of modern nursing, Implemented during Crimean, improved sanitation, implemented research Seacole - ANSWER- Jamaican minority, setup clinics during crimean war Dix - ANSWER- Asylum movement, reform for mentally ill & prisoners Barton - ANSWER- first president of American Red Cross Mahoney - ANSWER- First African American nurse in the US Wald - ANSWER- Henry Street Settlement, first public health nurse Ford - ANSWER- started first NP program Nutting - ANSWER- Graduated from Johns Hopkins, expanded nursing curriculum to 2- 3 yrs, added clinicals, limited hours students could work, established the library there, and Army Nurse Corps Richards - ANSWER- The first trained nurse in the United States, started Japanese nursing program, created pt records & night shift Patient Abandonment - ANSWER- Terminating the relationship with the patient without giving reasonable notice or providing a competent replacement, resulting in a lack of necessary medical care Assault - ANSWER- threat or attempt to injure Battery - ANSWER- physical harm Boundary Crossing - ANSWER- a departure from a commonly accepted practice that could potentially benefit a client (non-exploitative) Boundary Violation - ANSWER- a serious breach that results in harm to clients and is therefore unethical (exploitative) BON Purpose - ANSWER- To protect and promote welfare of people in Texas ensuring that each person who holds a license as a nurse is competent to practice safely. (SAFETY)

Informed Consent - ANSWER- Pt knows Pros AND Cons of procedure, detailed description of its purpose and who is performing the procedure. Surgeon's responsibility to get consent. RNs responsibility to ensure pt understands UTMB honor pledge - ANSWER- On my honor, as a member of the UTMB community, I pledge to act with integrity, compassion, and respect in all my academic and professional endeavors. Professionalism - ANSWER- The quality of performing at a high level and conducting oneself with purpose and pride EBP (evidence based practice) from IOM (institute of Medicine) - ANSWER- Integrating best research with clinical expertise and pt values for optimum care and participating in learning and research activities to the extent flexible Steps in EBP Process - ANSWER- -Cultivating a spirit of inquiry -Asking clinical questions -Searching for the best evidence (literature review) -Critically appraising the evidence -Integrating the evidence with clinical expertise, client preferences, and values* -Evaluating the outcomes of the practice decisions or changes based on evidence -Share EBP results Evidence of Hierarchy Pyramid - ANSWER- - Systematic reviews and metaanalysis of RCTs

  • One well-designed RCT
  • Well-designed controlled trials w/o randomization
  • Well-designed case control studies
  • Systematic reviews of descriptive and qualitative studies
  • Single descriptive or qualitative studies
  • Opinion of authorities or expert committees PICOT format - ANSWER- P - Identify the population or problem (age, gender, ethnicity, disease/disorder) I - Intervention (exposure to disease, risk behavior, education) C - What will you compare the intervention against? (Treatment vs no treatment, Test scores before/after) O - Outcome - What doe you hope to observe/achieve? (higher test scores with tutoring) T - Time it takes for intervention to achieve the outcome Purpose of informed consent - ANSWER- education of the patient and to ensure they are a willing participant Tuskegee Study - ANSWER- an unethical study about syphilis in which subjects were denied treatment so that the effects of the disease could be studied

- PTSD

  • Compassion fatigue
  • Secondary traumatic stress (healthcare providers feel when caring for others suffering)
  • Burnout (excessive/prolonged stress) Anxiety - ANSWER- Worry, nervousness, unease about imminent event with uncertain outcome Anxiety levels - ANSWER- Mild: everyday tension Moderate: perceptual field begins to narrow Severe: perception is impaired, can only focus on one thing Panic: Out of control feeling Effects of stress - ANSWER- Infection, Increased BP, Heart disease, Obesity, Diabetes, Cancer Self-efficacy - ANSWER- Believing you have the power to execute behaviors necessary to produce specific performance attainment. (good predictor of how well that person will actually do)
  • Set goals, believe they can despite setbacks, committed low self-efficacy - ANSWER- No self-esteem, no belief that they can do it, expect failure, avoid challenges What is caring? - ANSWER- practice of looking after those who are unable to care for themselves (sick & elderly) Demonstrate Caring - ANSWER- - Presence
  • Active Listening
  • Touch
  • Know the patient Caring Touch - ANSWER- influences comfort & security, enhances self esteem, increases confidence, improves mental health, Builds pt rapport Protective touch - ANSWER- protects nurse & or patient (bracing pt when falling) Task-oriented touch - ANSWER- Involves the personal contact required when performing nursing procedures (gives security & competence) SBAR - ANSWER- Situation Background Assessment Recommendation CUS - ANSWER- Concerned

Uncomfortable Safety Issue IM SAFE - ANSWER- Illness Medication Stress Alcohol and drugs Fatigue Eating and elimination 2 Step Challenge - ANSWER- assertively voice concerns at least 2 times - then run it up the ladder STEP (progress monitoring) - ANSWER- Status of pt Team members Environment Progress toward goal Call out - ANSWER- inform team member of emergent situation, allows for anticipation of next step, gives person direct responsibility to a person for each task (CPR - "You call 911") Check back - ANSWER- double check what you heard is in fact correct Handoff - ANSWER- The transfer of information (& authority/ responsibility) during transitions in care across the continuum; to include an opportunity to ask questions, clarify, and confirm. (shift change report) Brief (team events) - ANSWER- Before - share the plan, anticipate outcomes, assign roles Huddle (team events) - ANSWER- During - prob solve, ad hoc mtg to address needed changes Debrief (team events) - ANSWER- After - exchange info, what worked/didn't, positive critique, reinforce positives Situational monitoring - ANSWER- individual skill - continually scan & assess Situational awareness - ANSWER- individual outcome - know what is going on around you Shared mental model - ANSWER- Team outcome - team members maintains sit. awareness & are on the same page Cross monitoring - ANSWER- An error reduction strategy that involves:

Ethics Provision 8 - ANSWER- Collaborate to protect human rights, promote health diplomacy, & reduce disparities Ethics Provision 9 - ANSWER- Articulate RN values, maintain integrity, integrate social justice into health policy Ethics Committee - ANSWER- committee made up of individuals who are involved in a patient's care, including health care practitioners, family members, clergy, and others, with the purpose of reviewing ethical issues in difficult cases - Maintain integrity of profession, integrate social justice & RN values moral distress - ANSWER- Pain or anguish of a person who unwillingly participates in perceived moral wrongdoing. (leads to burnout/resignations) Veracity - ANSWER- truthfulness, honesty Beneficence - ANSWER- Doing good - RN obligated to do actions that benefit pt. Justice - ANSWER- Fairness (insurance, healthcare services, organ transplants) Utilitarianism - ANSWER- Value determined by usefulness, focuses on outcome/consequences (sex education & risk of HIV) Accountability - ANSWER- ability to answer for one's own actions autonomy - ANSWER- Self-governance, people have the right to make their own decisions (i.e. surgical consent) Fidelity - ANSWER- faithfulness; loyalty, honoring your word ("I'll be right back") Ethical Nursing Care - ANSWER- - initiate conversation r/t pt wishes

  • Listen more, talk less
  • assess pt understanding of illness/treatment
  • Facilitate communication of pt wishes
  • allow time for pt to explore values Durable medical power of attorney - ANSWER- Identifies who will make decisions regarding future care, extent of treatment, and kinds of treatment if the person is unable to make his or her own decisions. Written while the person is mentally competent. HIPAA - ANSWER- protects health information by requiring verbal or written authorization for release of information Exceptions to HIPAA - ANSWER- - Child or Domestic abuse/neglect
  • Communicable disease
  • Prevent threat to health/safety of pt/public
  • WCI (?)
  • Total of 10 exceptions Patient Rights - ANSWER- -Making decisions regarding their care -Being actively involved in the treatment process -Being treated with dignity and respect -American Hospital Association Patient's Bill of Rights Illness behaviors - ANSWER- actions taken by a person who feels sick and indulges in the behavior for the purpose of defining the state of his or her health and for discovering suitable remedies Internal Variable (illness) - ANSWER- perception of illness/nature/seriousness of illness External Variable (illness) - ANSWER- social groups, cultural/economic background, accessibility to healthcare Primary Prevention - ANSWER- True prevention that lowers the chances that a disease will develop Secondary Prevention - ANSWER- focuses on those who already have the disease or at risk Tertiary Prevention - ANSWER- occurs when a defect/disability is permanent/irreversible, to prevent complications/deterioration Health Belief Model - ANSWER- explains and predicts health behaviors (based on pt perceptions)
  • disease susceptibility
  • disease perception
  • disease prevention Health Promotion Model - ANSWER- Directed at increasing pt level of well-being -Individual characteristics & experiences -Behavior specific knowledge -Behavioral outcomes Holistic Health Model - ANSWER- Pt is the expert on their own health, involved in healing process, use of complimentary & alternative interventions Chronic Illness - ANSWER- persists, usually longer than 6 months, is irreversible, and affects functioning in one or more systems
  • snarky put downs
  • eye roll
  • "eating the young" Cultural awareness - ANSWER- An in-depth self-examination of one's own background, recognizing biases, prejudices, and assumptions about other people Cultural competence - ANSWER- the ability to interact effectively with people of different cultures ESL Communication - ANSWER- Talk slowly, enunciate clearly, observe body language, check frequently for comprehension, and encourage accurate feedback by asking probing questions. interpersonal communication - ANSWER- direct, face-to-face communication between two or more people interprofessional collaboration - ANSWER- promotes sharing of expertise from health care professionals to create a plan of care that will restore and maintain a client's health Maslow's Hierarchy of Needs - ANSWER- physiological, safety, love/belonging, esteem, self-actualization Nursing Process - ANSWER- Assessment Diagnosis Planning Implementation Evaluation ABCs Priority - ANSWER- Airway Breathing Circulation Saftey & Risk Reduction - ANSWER- Safety risk to client --> Greatest risk to pt --> significance of risk compared to others Least restrictive - ANSWER- Protects clients civil and legal rights Unauthorized use of restraints can be: assault and batter, false imprisonment Use least restrictive methods of restraining first Physical restraints only when the client, staff, or others' safety is at risk Survival Potential - ANSWER- -used in mass casualty or disaster triage -priority to clients with reasonable chance of survival with prompt intervention
  • Class I Emergent (Life threatening, survival dependent on tx)
  • Class II Urgent (Survival expected w/ tx)
  • Class III Non-urgent (non life threatening)
  • Class IV Expectant (not expected to live, even w/treatment) Acute vs. Chronic - ANSWER- Acute needs may pose more of a threat Chronic needs usually develop over period of time Attend to alteration in acute phase before they evolve into chronic alteration Urgent vs Nonurgent - ANSWER- TRIAGE Urgent needs pose more threat to client Needs become urgent when related to an intervention needed within a specified time When caring for a group of clients, attend to the client with the most urgent need first Clinical Reasoning - ANSWER- Analyzing clinical situations, then making a decision based on analysis. (Critical thinking) Clinical Judgement - ANSWER- The decision made regarding a course of action based on a critical analysis of data when nursing knowledge is applied to a clinical situation