nurs 406 test 1 Study Guide Rated A+
cardiac
neuro
behavioral health
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 i...
4). 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
Ans: 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
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, 5). Maslows hierarchy of needs
Ans: 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)
6). Double bind messages
Ans: 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.
7). The "miracle" question
Ans: 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?"
8). The backbone of a nurse-client relationship is
Ans: patient centered care (gold standard)
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, -dignity and respect
-information sharing
-pt and family participation
-collaboration in policy and program development
9). Social relationship
Ans: 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
10). Therapeutic relationship
Ans: 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
11). Morally, legally, and ethically trained nurses and nursing students do not have ______________
relationships with patients
Ans: intimate
these are forbidden among nurses/students with patients/clients
12). 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
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, Ans: •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.
13). Peplau's model of nurse patient relationship
Ans: POWT
Phases:
Preorientation
orientation
working
termination
14). 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?
Ans: •Countertransference
Countertransference occurs when the nurse unconsciously displaces feelings related to
significant figures in the nurse's past onto the patient.
15). 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."
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