Exam (elaborations)

Nurs 406 Test 1 Questions And Answers Latest Top Score.

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nurs 406 test 1 questions and answers latest top

Institution Nurs 406
Course Nurs 406

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Nurs 406 Test 1 Questions And Answers Latest
Top Score.

cardiac - correct answer. ...

neuro - correct answer. .....

behavioral health - correct answer.

Patient is receiving an IV infusion of heparin and was started on warfarin therapy the
night before. which statement is most correct?

A. the patient is receiving a double dose of anticoagulants
B. the heparin therapy was ineffective, so the warfarin was started.
C. the heparin provides anticoagulation until therapeutic levels of warfarin are reached.
D. the heparin and warfarin work together synergistically to provide anticoagulation -
correct answer. C. the heparin provides anticoagulation until therapeutic levels of
warfarin are reached.

coumadin (warfarin) takes a few days for therapeutic levels to be reached. we may end
up putting a pt on both of these initially to get the anticoagulation under control, and
then once the coumadin levels are okay, the pt will come off of heparin

MASLOWS hierarchy of needs - correct answer. 5 levels

1 is ultimate priority
1 - physiological: oxygen, fluids, nutrition, body temperature, elimination, shelter, sex
2 - safety and security: physical and psychological safety
3 - love and belonging needs
4 - self esteem
5 - self actualization (dreams, hopes, goals)

double bind messages - correct answer. Bateson and colleagues (1956) coined the
term double-bind messages.

They are characterized by two or more mutually contradictory messages given by a
person in power or someone attempting to gain or maintain power.

,Opting for either choice will result in displeasure of the person in power.
Example: Dr. Shepard asks Dr. Onori to teach one of the topics in nursing research
because she knows Dr. Onori teaches that topic very well. On the day of the lecture, Dr.
Onori just informs Dr. Shepard that he is going to the beach with his family and thus
can't teach the topic. Dr. Shepard looks into the eyes of Dr. Onori and says, okay, that's
fine, enjoy your vacation knowing very well that she has not prepared to teach the
research topic for that day. The content from Dr. Shepard becomes contradictory to Dr.
Onori.

the "miracle" question - correct answer. a clarifying technique (along with
paraphrasing, restating, reflecting, exploring, and projective questions)

The miracle question is a goal-setting question that helps patients to see what the future
would look like if a particular problem were to vanish.

The question should be asked deliberately and dramatically

Example: "Now, I want to ask you a strange question. Suppose that while you are
sleeping tonight...a miracle happens. The miracle is that the problem that brought you
here is solved... When you wake up tomorrow morning, what will be different that will tell
you that a miracle has happened?"

the backbone of a nurse-client relationship is - correct answer. patient centered care
(gold standard)

-dignity and respect
-information sharing
-pt and family participation
-collaboration in policy and program development

social relationship - correct answer. primarily initiated for the purpose of friendship,
socialization, companionship, or accomplishment of a task

•Participants share ideas, feelings, and experiences during SRs to facilitate meeting of
mutual needs
•There is little emphasis on the evaluation of the interaction during SRs
•SRs do not benefit patients because the nurse unconsciously ignores the concerns of
patients

therapeutic relationship - correct answer. In a TR, the nurse maximizes
communication skills, understanding of human behaviors, and personal strengths to
enhance the client's growth

•Clients are more likely to engage in a relationship when the clinician's interactions
address their concerns, respect clients as partners in decision making, and use easy-to-
understand language

,•In a TR, the focus should be on the client's ideas, needs, problems, experiences, and
feelings. It's all about the welfare of the client

Morally, legally, and ethically trained nurses and nursing students do not have
______________ relationships with patients - correct answer. intimate

these are forbidden among nurses/students with patients/clients

You are about to initiate your first contact with Becky. Which is the most suitable goal in
establishing the therapeutic relationship?

•Establish friendship and a sense of fun
•Ensure that mutual needs will be met
•Establish clear boundaries while identifying patient needs
•Ensure two-way communication to give or ask for help - correct answer. •Establish
clear boundaries while identifying patient needs

A therapeutic relationship demonstrates the following qualities:
Needs of patient identified and explored
Clear boundaries established
Problem-solving approaches taken
New coping skills developed
Behavioral change encouraged

The other choices listed here are more appropriate to a social relationship.

Peplau's model of nurse patient relationship - correct answer. POWT

Phases:
Preorientation
orientation
working
termination

You notice that you look forward to talking to Becky because her dark sense of humor
reminds you of your best friend in high school. You also begin to make little cynical
jokes, hoping to have a good laugh together. What is this relationship showing early
signs of?

•Accountability
•Self-reflection
•Transference
•Countertransference - correct answer. •Countertransference
Countertransference occurs when the nurse unconsciously displaces feelings related to
significant figures in the nurse's past onto the patient.

, After your first conversation, Becky withdraws from you again before you've even really
begun. Which statement will contribute most to establishing Becky's trust?

A."Weren't you complying with your medication regimen?"
B."It must be discouraging to be readmitted to the hospital so soon."
C."Everyone with bipolar disorder ends up in the hospital occasionally."
D."You must take your drugs as prescribed or you will be rehospitalized." - correct
answer. ANS: B

When the nurse shows genuine concern for another's circumstances (has positive
regard and empathy), even a short encounter can have a powerful effect.

Case study:
As you prepare for the initial interview with 15-year-old Noah, you learn that he has a
history of cutting himself. His parents have separated and are getting a divorce; his
father has left and Noah is living with his mother. Noah has been smoking for about a
year and a half and his mother suspects that he has come home smelling of marijuana
twice now. All three behaviors were ongoing before the father left.

Which behavior from Noah would be considered a double-bind message?
A.He winks at you and says, "Do you date 15-year-old guys?"
B.He puts his head in his hands, shakes it, and snaps, "I don't want to do this. Just get
me out of here!"
C.He sneers at you and almost purrs as he says, "Oh yes. I will tell you anything you
want to know, of course, I will."
D.He cries and shakes, jiggling one leg, as he says softly, "Please, let's just not talk
about Dad, okay? - correct answer. C. He sneers at you and almost purrs as he
says, "Oh yes. I will tell you anything you want to know, of course, I will."

A double-bind message is a mutually contradictory message given by a person in power
or attempting to gain or maintain power.

In example C, Noah is in a frightening or uncomfortable position and attempts to gain or
maintain some control or power. You, the nurse, want information from him. You want
his cooperation, and he doesn't want to give it. So his nonverbal language—sneering
and a rather mocking purr—contradicts the verbal message, or content: that of a
promise to cooperate and answer "anything." In examples B and D, his actions match
his verbal message. They do in "A" as well. He is trying to deflect you from the serious
nature of the interview, but he's not using a double-bind message. His wink does match
his words.

Noah has made it clear he doesn't want to talk about his dad. But the truth is, as the
interview proceeds, he becomes anxious and tries to evade all questions about why he
is here. Which type of communication might be most appropriate right now?
A.Stop questioning so much and just give him some good advice so he'll trust you.

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