NUR3196 Exam 1 LOs With Actual Questions And Verified Detailed
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Describe the CJMM and its relationship to patient care and the nursing process.
-Answer The Clinical Judgment Measurement Model that the National Council of State
Boards of Nursing developed is designed to assess a nurse's clinical judgment in a way
that is congruent with the delivery of safe and effective care. The CJMM describes the
cognitive processes that nurses use to make decisions regarding patient needs,
emphasizing that clinical judgment has a direct impact on the care provided. It relates to
the nursing process by exemplifying those critical thinking skills needed in order for a
nurse to assess, analyze, plan, implement, and then evaluate patient-centered care
appropriately. The CJMM is intended to assist nursing students and nurses in enhancing
their competence in clinical judgment through repeated application with increasing
amounts of clinical experience.
Distinguish the six cognitive skills in the CJMM 1. Perceive Cues: Information pertinent
to a patient's situation is identified.
2. Analyze Cues: Interpreting the information gathered.
3. Prioritize Hypothesis: Hypotheses are analyzed and prioritized based on the analyses.
4. Generate Solutions: Identifying possible solutions for the situation.
5. Take Action: Applying the selected action.
6. Evaluate Outcomes: The consequences of the executed actions are evaluated.
Describe the basic ethical principles underlying informed consent and the concept of
the risk-benefit ratio. -Answer 1. Respect for Persons: Individuals must be treated as
autonomous agents, capable of making their own decisions. This constitutes the
premise on which the requirement for informed consent is based.
2. Beneficence: Researchers must maximize prospective benefit while minimizing risks
of harm to research participants. This relates to careful assessment of the risk-benefit
ratio.
3. Justice: The risks and benefits of research should fall fairly on all groups and not
disproportionately burden any one population.
,Describe the purpose of state nurse practice acts -Answer 1. To define the legal scope
of nursing practice for each state. 2. To have provisions to protect the public health,
safety, and welfare from unqualified or unsafe nurses.
3. Provide for state boards of nursing to oversee licensure, standards of education, and
discipline.
4. Define the requirements and process for licensure and license renewal
5. Explain the roles and responsibilities of practicing at different levels of nursing such
as RN and APRN
6. Deal with specific topics such as medication administration by registered nurses
7. Allow specific acts of nurses permitted under general practice acts.
Describe the four processes of pharmacokinetics -Answer 1. Absorption: The process
by which, following administration, the drug enters the bloodstream.
2. Distribution: The movement of the drug from the blood into the tissues and cells of the
body.
3. Metabolism-biotransformation: Chemical alteration of the drug into metabolites,
usually to aid excretion.
4. Excretion (Elimination): The removal of the drug and related metabolites from the
body, mainly via the kidneys and liver.
Name the four major families of receptors -Answer 1. Cell membrane-embedded
enzymes: These are enzymes embedded in the cell membrane that catalyze chemical
reactions upon being bound by a drug or ligand.
2. Ligand-gated ion channels: These are receptors that span the cell membrane and,
upon the binding of specific ligands, either open or close the pore and thus allow the
flow of ions across the membrane. 3. G protein-coupled receptor systems: These are
receptors spanning the cell membrane that interact with G proteins inside the cell. Upon
being bound by a ligand, they initiate a cascade in the signaling pathway.
4. Transcription factors Receptors that are proteins and that bind to specific DNA
sequences, regulating gene transcription when bound by a ligand.
Describe the effect of protein binding on drug bioavailability -Answer The fraction of a
drug that is bound to plasma proteins such as albumin is inactive and cannot exert a
pharmacological effect. Only the unbound or free fraction of the drug is available to the
, tissue receptors to elicit a therapeutic response. The more highly protein-bound a drug
is, the less free, active drug is available. Diseases that cause a decline in the levels of
plasma proteins, such as liver disease, kidney disease, malnutrition, or old age, result in
an increase in the free drug available, which may lead to drug accumulation and toxicity.
When two highly protein-bound drugs are administered together, they may displace
each other from binding sites, increasing free drug levels of one or both drugs.
factors that can affect bioavailability:
Form of drug
Route of drug administration
Gastric mucosa and motility
Administration of food and other drugs with the medication
Alterations in liver metabolism
Define Terms in-class presentation List terms- answer Pharmacokinetics- Movement of
drug through the body and what body does to the drug
Pharmacodynamics-What the drug does to the body as drug moves throughout the body
Drug absorption -Answer Drug movement from GI tract into bloodstream•
Disintegration - Breakdown of oral drug form into smallparticles•
Dissolution - Combining small drug particles with liquidto form a solution
Drug Absoption Methods -Answer Passive transport: The movement of substances
across a cell membrane from an area of higher concentration to an area of lower
concentration, without requiring energy input. Diffusion is an example of passive
transport.
Active transport: The movement of material across a cell membrane from a region of low
concentration to a region of high concentration requires energy provided by ATP.
Sodium-potassium pump is an example of active transport.
Pinocytosis: This is a type of endocytosis wherein cells internalize particles and
substances by forming vesicles around them.
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