State/Professional study, Five Rights of Delegation, Legal and ethical considerations, Five Rights + 3, State Exam Nursing New Zealand, immunisation schedule, Nursing Professionalism State Revision, Mock STATE Exam, Practice Questions + Answers Nursi...

State/Professional study, Five Rights of Delegation, Legal and ethical considerations, Five Rights + 3, State Exam Nursing New Zealand, immunisation schedule, Nursing Professionalism State Revision, Mock STATE Exam, Practice Questions + Answers Nursi... Jeremy has a long history of explosive outburst, these have included actual assaults on others and damage to property When assessing his current potential for agression and violence the nurse needs to identify ? Presence of disorder perception Jeremy has a long history of explosive outburst, these have included actual assaults on others and damage to property When attempting to understand agression and violence within the situational model, the nurse is aware that the behaviour ? Is an interaction between internal and external factors and should be considered multi-dimentional Jeremy has a long history of explosive outburst, these have included actual assaults on others and damage to property When talking with jeremy in the dayroom, the nurse becomes aware that an explosive episodes is imminent. What should the nurse do? Remove other patients and speak in a calm tone. Gerald is an elderly man with a history of general anxiety disorder of which he has been experiencing increased severity in symptoms over the past 12 months. He has begun to drink heavily in order to cope with these experiencies. His use of alcohol would be interpreted as what dual diagnosis? Primary mental illness with subsequent substance abuse. Gerald is an elderly man with a history of general anxiety disorder of which he has been experiencing increased severity in symptoms over the past 12 months. He has begun to drink heavily in order to cope with these experiencies. If you were to engage in behavioral therapy with him, your focus would primarily be on? Behaviour change. Gerald is an elderly man with a history of general anxiety disorder of which he has been experiencing increased severity in symptoms over the past 12 months. He has begun to drink heavily in order to cope with these experiencies. The use of psychopharmacological agents in the treatment of elderly patients with anxiety can be problematic due to? Increased susceptibility of side effects and other drug interactions. Gerald is an elderly man with a history of general anxiety disorder of which he has been experiencing increased severity in symptoms over the past 12 months. He has begun to drink heavily in order to cope with these experiencies. When assessing Gerald an MMSE can support the nurse's assessment by screening Cognitive functioning including TPP, short term memory, language and function registrations Gerald is an elderly man with a history of general anxiety disorder of which he has been experiencing increased severity in symptoms over the past 12 months. He has begun to drink heavily in order to cope with these experiencies. When assessing whether his ideas are logical and coherent, they are examining what? thought process. A client has been prescribed oral clopixol for the past 6 months and is complaining of side effects. What examination is used to assess doe EXTRAPYRAMIDAL SIDE EFFECTS (EPSE)? Abnormal involuntary movements scale EPSE include what four types of reactions? EPSE (drug-induced movement disorder) Akathisia, dystonia, psuedoparkinsonism and trardive dyskinesia. What is the treatment for acute cases of dystonia ? IMI benzotropine. A 32-year-old mother of three pre school aged children, see the nurse at the public health clinic because of fatigue and dizziness. She has a history of iron deficiency anemia but has not taken supplemental iron for the past 2 years. Which lab result would the nurse expect based on her symptoms? Haemoglobin!!!! 60g/L A 32-year-old mother of three pre school aged children, see the nurse at the public health clinic because of fatigue and dizziness. She has a history of iron deficiency anemia but has not taken supplemental iron for the past 2 years. The nurse discusses diet with her. An appropriate goal is to increase her intake of? Meat & Fish. A 32-year-old mother of three pre school aged children, see the nurse at the public health clinic because of fatigue and dizziness. She has a history of iron deficiency anemia but has not taken supplemental iron for the past 2 years. The nurse has taught her about taking oral iron supplements. Which statement indicates a need for additional education? " I will watch my stools for signs of bright red blood" A 32-year-old mother of three pre school aged children, see the nurse at the public health clinic because of fatigue and dizziness. She has a history of iron deficiency anemia but has not taken supplemental iron for the past 2 years. Before leaving the clinic the client ask when she should perform a breast self-examination having established that her period is regulary the nurse best response would be At the same time each month. Immunisations has been the mainstay of preventative care for decades. Recent concerns are around low immunisations rates in NZ What would be a factor leading to low level? Cost to family. Immunisations has been the mainstay of preventative care for decades. Recent concerns are around low immunisations rates in NZ Immunizations are often given at specified intervals with week or month in between each injection because? TO STIMULATE THE BEST IMMUNE RESPONSE.! A child is suspected of meningococcal meningittis. What is the FIRST responsibility of the public health nurse in this situation? Seek immediate medical treatment Why is immunization against rubella recommended when rubella is a mild illness? Rubella can cause deformity in the developing fetus if the mother contracts it. What is a live vaccine? Live attenuated virus. The resurgence in TB due to the emergence of a multidrug-resistant strain of M TB is primarily the result of? Poor compliance with drug therapy in patients with TB A patient with TB class 3. is admitted with chest pain & MI the nurse knows that? Respiratory isolation is required. What do you do with someone with hypothermia? Wrap in warm blanket. Rangitihi has been diagnosed with T2DM. He has little knowledge of this condition and will need good education in order to manage. What is the primary cause of t2dm? Failure of the pancreas to produce enough insulin. Rangitihi will need good information about the importance of what factors? Exercise lowers BSL and increases the need for glucose. When teaching Rangitihi to check her BSL what is the most helpful way? Discussion and equipment demonstration First line of treatment for hypoglycaemia?? Simple Carbohydrates The most common signs of hypoglycaemia? Perspiration, nervousness, weakness. A young married woman tells you that she is going to have tubal ligation because there are two people with intellectual disabilities in her husbands family and she is afraid this problem with surface in her children. The nursing diagnosis that best applied to this couple? Knowledge deficit of genetically inherited disorders. When an infant is born with a genetic disorders the parents need to know? Not all genie disorders are inherited True statement in regards to down syndrome? The frequency increase over 35 years. Down syndrome may occur because of translocation defect. This means? An additional chromosome is attached to a normal chromosome. Children and family services offer assessment and treatment of childhood disorders. The nurse working in these areas need to have a good understanding of developmental delay and disorder in order to assist families A 6-year-old is seen in a mental health clinic for possible attention deficit hyperactivity disorder. His mothers reports that he is "ALLBOY" When evaluating his behavior it is important to assess. The pattern of the boys typical day. What is a sign of ADHD? A lack of concentration You are involved in the assessment of a child with possible autism. In the history from his mother you expect to hear? States at a roaring well on his crib mobile. James has been recently diagnosed with CHD. When assessing James the nurse finds he recently made diet changes and stopped smoking. An appropriare intervention in educating James at this time is to? Develop a plan to support James in maintaining changes in his life to prevent relapse in dieting behavior. Before introducing further education when working with James it is important to ask? What type of environmental or activities help him learn best Appropriate teaching straggly to promote smoking cessation is ? Group teaching Rowena has been diagnosed with breast cancer following needle biopsy of a lump. She has no family HX od this and little knowledge of the condition. She is to have R) Mastectomy and is to receive radiotherapy. The nurse managing overall care of Rowena should plan teaching session on? Understanding and managing surgery and treatment options Rowena is now facing imminent surgery. She states she is fearful of the surgery and its outcome. What is the best response? Encourage Rowena to express her concerns. Rowena post op has a red arm, warm at touch and swollen what do you do? CALL Doctor STAT Gravida (woman who has been pregnant or is currently pregnant) Para (babies alive or dead only if over 20 weeks) Two normal infants. 1 miscarriage at 12 weeks gestation. How would you record Obstetric history? Gravida 3, Para 2 Miriam is now late in pregnancy and is having trouble sleeping what is the best sleeping position? Side with her abdomen on a pillow Miriam ask what Placental praevia means you tell her? Low placenta implantation Normal neontal HR 120/160 Miriam, states her water has broken what do you do? Asses the foetal heart rate pattern When caring for Miriam during labour, identify one sign that would indicate a possible complication of labor. Meconium stained amniotic fluid Gerald is 75 years old he is admitted to the day stay ward with emphysema, he is awaiting a bronchoscopy. Adminstering high concentrations of 02 to a person with C.O.R.D could cause? Respiratory arrest Jocelyn, a 57 year old woman, is admitted to hospital in a distressed state, diagnosied with CHF. Dyspnoea is CHF results from. Fluid accumulation in the interstitial spaces and alveoil of the lungs The feeling that parents often manifest when they are told their child will have a permanent disability is DENIAL (Kublur Ross) Suzette states that she stopped taking her antidepressants medications, AN SSRI because of the side effects. It is important for the nurse to assess these effects in order to provide appropriate guidance to the patient. When commencing on an SSRI the nurse should ensure the client is aware that. A weekly blood test is required for first 18 weeks of treatment. A common complaint of SSRI's is Gi effects such as nausea. Which advice would be the most helpful. Suggest to take medication with food. Depressive symptoms can be helped with Electroconvulsive therapy. in the DSM 1V, Where would you expect to find the diagnosis of major depression? Axis 1 When assessing a patient for possible risk factors for psychiatric mental health disorder you know that which of the following cannot be modified? Genetic if the Iv infiltrates, the nurse should? STOP Infusion The Nursing Council of New Zealand is the statutory body in charge of professional nursing and educational matters. In order to the practice legally the provisions of the HPCA Act, 2003 a RN is required to? Obtain an annual practicing certificate The Nursing Council of New Zealand is the statutory body in charge of professional nursing and educational matters. In order to the HPCA Disciplinary Tribunal to find a RN guilty, of malpractice following an assault on a patient it would have to prove that the nurse? Intended to cause harm to the patient In order for the HPCA disciplinary tribunal to find a nurse guilty of negligence, it would have to prove that the nurse? Failed to do what another prudent RN would have done in a similar situation. Nursing malpractice occurs when An injury occrrued but was not caused by mistake The nursing profession has a code of ethics to ensure that? There are accepted principles that serve to guide nursing practice. you are working as a community health nurse. Your work involves varied and interesting roles which include community education, health promotion, monitoring and contact tracing. There has been several cases of HEP B in the district. What is important to state Not to share drink bottles. What is Most effective approaches to prevent obeisty in children Teaching nutrition in primary schools What are the five rights of delegation? Right activity, right circumstances, right person, right communication, right direction Right activity An activity that the RN judges as appropriate for a specific health consumer Right circumstances Appropriate health consumer group, available resources and other relevant factors considered Right person Right person is delegating the right activity to the person with the right skills and knowledge to assist the right health consumer Right communication Clear, concise description of the activity to be undertaken, including the objective, and expected outcomes Right direction Appropriate monitoring, evaluation, intervention, as needed, and feedback What is delegation? The transfer of responsibility for the performance of an activity from one person to another with the former retaining accountability for the outcome What is direction? Direction is provided directly when the registered nurse is actually present, observes, works with and directs the person; direction is provided indirectly when the registered nurse works in the same facility or organisation as the supervised person but does not constantly observe his/her activities What should the professional judgement of the RN include? the health status of the health consumer, complexity of the delegated activity, the context of care, and the level of knowledge, skill and experience of the HCA to perform the delegated activity The RN must ensure the HCA who has been delegated the activity... understands the delegated activity, has received clear direction, knows who and under what circumstances they should ask for assistance, knows when and to whom they should report DAMHS Director of Areas Mental Health Services What do DAMHS do? Have clinical oversight of the mental health service DI Someone appointed in accordance to section 94 to be a district inspector Who can be a DI? solicitor or barrister What does a DI do? An appointed lawyer who will monitor the persons rights DAO responsible for procedural requirements necessary to facilitate compulsory treatment. Ensures the purpose of assessment and notice of assessment are explained to a person in the presence of a support person What is stated in section 2 of the MHA? The definitions of people involved in the mental health act What is stated in section 4 of the MHA? The basis for which treatment should not occur Treatment does not occur because of a person's... political, religious or cultural beliefs, sexual preferences, their criminal or delinquint behaviour, substance abuse or intellectual disability What is stated in section 5 of the MHA? Recognition of the importance and significance of the person's whānau, hapū, iwi and family group. Also, respect the culture, language and beliefs What is stated in section 8-13 of the MHA? the process of compulsory treatment What is stated in section 111 of the MHA? powers of the nurse What does right one under the MHA state? patients right to information What does right two state? respect for cultural identity What does right three state? Right to an interpreter What does right four state? To treatment What does right five state? To be informed about treatment What does right six state? To refuse video recording What does right seven state? To independent psychiatric advice What does right eight state? To legal advice What does right nine state? To company What does right ten state? To have visitors and make telephone calls What does right eleven state? To send and receive mail What does section 8a state? The application for assessment. The applicant must be over 18 years old, and has seen the client in the last three days. What does section 8b state? Certificate to accompany assessment Section 28? Compulsory treatment orders Section 29? Community orders: the responsible clinician can state that the person can no longer be treated as an outpatient, can be placed as an inpatient for up to 14 days. Section 31? Leave for inpatients: may be granted leave by the responsible clinician for a period not exceeding three months. Responsible clinician may extend leave period as they see appropriate Section 32? Absence without leave: Any patient whom section 31 applies to who becomes absent without leave from the hospital may be retaken by any person. Any patient who is retaken may be taken back to the hospital to which they were detained in 1. Right patient 2. Right medication 3. Right dose