Class notes
NR509 MIDTERM EXAM STUDY GUIDE .
- Course
- Institution
NR509 MIDTERM EXAM STUDY GUIDE .
[Show more]
Content preview
lOMoAR cPSD| 22896205NR509 MIDTERM EXAM STUDY GUIDE 2024-2025
NR 509 Midterm Study Guide
General Study Tips and Recommendations
✓ Topics and content on guides are intended to focus student attention when reading/studying and some topics
may be repeated in multiple chapters.
✓ Multiple test items are derived from the same topic areas to encourage deeper comprehension.
✓ Students must have a broad understanding of content and not simply memorize passages in textbooks or articles.
✓ Information in red letters in the chapters as well as tables and appendices at the end of the chapters may
include test items.
✓ Exam questions represent various levels of cognitive learning. You are expected to analyze, synthesis, and evaluate
patient
scenarios in order to answer the questions.
✓ Read all of the answers BEFORE reading the stem of the question. This will help you focus on the key content
and not get distracted by extraneous information.
✓ Be familiar with “Techniques of Examination” and “Recording Your Findings” for all body system chapters in t
textbook.
After completing an initial assessment of a patient, the nurse has charted that his respirations are eupneic and his pulse
is 58 beats per minute. These types of data would be
Chapter 1 Approach to the Clinical Encounter
NR 509 MIDTERM EXAM STUDY GUIDE 11.30.21
, lOMoAR cPSD| 22896205
• The interviewing process
o Slide 1: Initiate Encounter
▪ Review the clinical record AKA setting the stage/preparation.
▪ Ensure the client is comfortable; greeting patient
▪ Clarify the goals/agenda for the encounter; balance provider and client goals
▪ Establish rapport
▪ Identify the client’s preferred title, name, and gender pronouns
▪ Use “people first” language (i.e., a person with hearing loss, a person who uses a wheelchair)
o Slide 2: Gather Information
▪ Identify the client’s chief complaint or reason for seeking care; information gathering.
▪ Invite the client’s story using an open-ended approach
▪ Gather information about the client’s perspective of the illness using the mnemonic FIFE;
Exploring patient’s perspective of illness.
▪ Conduct the health history interview
▪ Gather information about past medical history, medications and allergies, family history, personal an
social history, and review of systems, Exploring biomedical perspective of disease including relevan
background and context.
• Interviewing techniques
o Active Listening: Active listening involves closely attending to what the client is communicating,
connecting to the client's emotional state, and using verbal and nonverbal skills to encourage the client to
expand on their feelings and concerns.
NR 509 MIDTERM EXAM STUDY GUIDE 11.30.21
, lOMoAR cPSD| 22896205
o Empathy: Empathy encompasses identifying with the client and feeling their pain as one’s own, then
responding to them in a supportive manner.
▪ “I understand this has been difficult for you. Let’s talk about what we can do to help this situation.”
o Guided Questioning: Guided questions help to elicit more information, while still showing a continued
interest in the client’s feelings and story. Some techniques of guided questioning include moving from
open-ended to more focused questions; clarifying what the client means; encouraging with continuers
such as “go on”; using a series of questions one at a time; and using questions that require a graded
response (i.e., how many stairs can you climb before feeling short of breath?).
▪ “Tell me about your abdominal pain. Where else do you feel it? What makes it worse?”
o Validating: Validation is affirming the legitimacy of the client's emotional experience. Examples
include: “That must have been a difficult experience. It’s very common to feel the way you are
feeling.”
▪ “That must have been very scary. It is normal to feel this way after an event like that.”
o Empowerment: Empowering clients to ask questions and express their concerns increases the chances
that they will adopt your advice, make lifestyle changes, or take medications as prescribed.
o Partnering: Partnering involves expressing commitment to an ongoing relationship with the
clients to build rapport.
▪ “Thank you for sharing about your anxiety. I think we can come up with a plan together to help you
feel
better.”
o Reassuring: Reassurance is an appropriate way to help the client feel that problems have been fully
understood and are being addressed.
o Summarizing: Giving a summary of the client's story during the interview helps to communicate that
they have been carefully listening
▪ “You have told me a lot of things. Let me restate what you have shared so you canverify
that I have heard you correctly.”
o Transitions: “Now I would like to ask you some questions about your previous health.”
NR 509 MIDTERM EXAM STUDY GUIDE 11.30.21
, lOMoAR cPSD| 22896205
o Nonverbal Communication: Nonverbal communication includes eye contact, facial expression,
posture, head position, and movement such as shaking or nodding, interpersonal distance, and
placement of the arms or legs (i.e., crossed, neutral, or open).
• Setting the stage for the examination
o Occurs in state 1: Initiating the Encounter – building relationship building with patient via respect,
trust, and rapport.
▪ Preparing for the interview, check appearance. Make sure patient is comfortable to create a safe-
feeling
environment. Follow the rhythm/sequence and implement societal dimensions. Be aware of
biases and create a therapeutic experience.
▪ See discussion of bias in health care on pp. 19–20.
• Implicit bias is a set of unconscious beliefs or associations that lead to a negative evaluation
of a
person on the basis of their perceived group identity can lead to a structural system of privile
(institutional bias) that leads to a misallocation of care
• Explicit bias is the conscious or deliberate decisions or preferences founded on beliefs,
stereotypes or associations on the basis of a perceived group identity. Ex. Patient not
wanting to see a colored doctor because they want a “qualified doctor” or a clinician who
thinks all gays have HIV.
• Box 1-12. Skills and Practices to Mitigate Bias in Your Clinical Encounters–
o Reflect on patterns of emotion and behavior. Pay attention to how you feel and
how you behave around patients of different identities. The patterns you recognize
may reflect biases that impact your interactions with patients as well as your
clinical reasoning. Being aware of these biases is the first step in reducing their
impact on patient care.
o Pause before starting an encounter and prepare for potential triggers of bias. Once
you are aware of your potential biases, pay attention to situations that may trigger
them. Simply being aware of a bias can help minimize its effect. You may take
NR 509 MIDTERM EXAM STUDY GUIDE 11.30.21
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller lennyjast. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $13.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
83100 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now