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Published by stuffednurse
=) more reviewers and notes available at http://stuffednurse.blogspot.com
=) more reviewers and notes available at http://stuffednurse.blogspot.com

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Published by: stuffednurse on Nov 13, 2008
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NURSING PRACTICE 5Situation 1 - Jimmy developed his goal for hospitalization. "To get a handle on mynervousness." The nurse is going to collaborate with him to reach his goal. Jimmywas admitted to the hospital because he called his therapist that he planned toasphyxiate himself with exhaust from his car but frightened instead. He realizedhe needed help.1. The nurse recognized that Jimmy had conceptualized his problem and the nextpriority goal in the care plan is:a. help the client find meaning in his experienceb. help the client to plan alternativesc. help the client cope with present problemd. help the client to communicateCORRECT ANSWER: CRATIONALE: Crisis Intervention is an active but temporary entry into the lifesituation of an individual, a family or a group during a period of stress. Itincludes assessment, planning of therapeutic intervention, implementation oftherapeutic intervention and evaluation. Since the client has alreadyconceptualized his own problem, there is no need for assessment anymore. Helpinghim cope with present problem is already planning of therapeutic intervention.OPTION A- There is no need helping the client find meaning in his experiencebecause as stated, he is already aware of his own problemOption B- Planning of alternatives is wrong because the client hasn’t cope withhis problem yet. He hasn’t developed any coping strategies yet.Option D- There is no need to let the client verbalize and/or communicate becausehe has already verbalized that he needs to handle his nervousness.SOURCE: Shives, Psychiatric-Mental health Nursing, 5th ed, pp166-1682. The nurse is guided that Jimmy is aware of his concerns of the "here andnow" when he crossed out which item from his "list of what to know"a. anxiety laden unconscious conflictsb. subjective idea of the range of mild to severe anxietyc. early signs of anxietyd. physiological indices of anxietyCORRECT ANSWER: CRATIONALE: Crisis Intervention deals with the “here and now”, Gestalt therapy. Itemphasizes identifying the person’s feelings and thoughts in the here and now.Therapist’s often use gestalt therapy to increase client’s self-awareness,focusing on the present. Early signs of anxiety don’t deal with the here and nowbecause the client is already manifesting signs of anxiety. An early sign ofanxiety is a part of assessment process.SOURCE: Videbeck, Psychiatric Mental Health Nursing, 3rd ed, p 593. While Jimmy was discussing the signs and symptoms of anxiety with his nurse,he recognized that complete disruption of the ability to perceive occurs in:a. panic state of anxietyb. severe anxietyc. moderate anxietyd. mild anxietyCORRECT ANSWER: BRATIONALE: A severely anxious person has trouble thinking and reasoning. Theycan’t complete a task. The range of perception is reduced, anxiety interferes witheffective functioning.
OPTION A- In panic the ability to concentrate is disrupted, the individual mayexperience terror or confusion or unable to speak or move. They can’t communicateverbally and may be suicidal.OPTION C-In Moderate Anxiety, the perception becomes narrower; concentration isincreased and able to ignore distractions in dealing with problems. Moderatelyanxious person has difficulty concentrating independently.OPTION D- In Mild anxiety, the client is more alert, more aware of environment. Ithelps the person focus attention to learn, solve problems, think, act, feel andprotect himself.SOURCE: Videbeck, Psychiatric Mental health Nursing, 3rd ed,4. Jimmy initiates independence and takes an active part in his self care withthe following EXCEPT:a. agreeing to contact the staff when he is anxiousb. becoming aware of the conscious feelingc. assessing need for medication and medicating himselfd. writing out a list of behaviors that he identifies as anxiousCORRECT ANSWER: ARATIONALE: Contacting the staff every time he feels anxious is still beingdependent to the staff nurses of his self-careOPTION B, C, and D—implies independence5. The nurse notes effectiveness of Interventions in using subjective andobjective data in the:a. initial plans or orderb. databasec. problem listd. progress notesCORRECT ANSWER: DRATIONALE: A progress note is a chart entry made by all health professionalsinvolved in a client’s care. It is in the progress notes that the nurse notes theeffectiveness of interventions.OPTION A-OPTION B- includes the nursing assessment, the physician’s history, social andfamily data and the results of the physical examination and baseline diagnostictests.OPTION C- derived from database. It is usually kept at the front of the chart andserves as an index to the numbered entries in the progress notes.SOURCE: Kozier, Fundamentals of Nursing, 7th ed, pp 331-332Situation 2 - A research study was undertaken in order to identify and analyze adisabled boy's coping reaction pattern during stress.6. This study which is a depth study of one boy is a:a. case studyb. longitudinal studyc. cross-sectional studyd. evaluative studyCORRECT ANSWER: ARATIONALE: Case study involves an in-depth, longitudinal examination of a singleinstance or event: a case, rather than using large samples and following a rigidprotocol to examine a limited number of variables.OPTION B- Longitudinal study is a correlational research that involves repeatedstudies observations of the same items over a long period of time. It studiesdevelopmental ternds over a long period of time. OPTION C-Cross-sectional study is
a study design in which data are collected at one point in time; sometimes used toinfer change over time when data are collected from different age or developmentalgroupsOPTION D- Evaluative study is a research that investigates how well a program,practice or policy is workingSOURCE: Polit and Beck, Nursing Research, 7th ed, pp 712, 715 717, 7237. The process recording was the principal tool for data collection. Which ofthe following is NOT a part of a process recording?a. Non verbal narrative accountb. Audio and interpretationc. Audio-visual recordingd. Verbal narrative accountCORRECT ANSWER: CRATIONALE: Process recordings are written records of segment from the nurse-clientsession that reflects closely as possible the verbal and non-verbal behaviors ofboth client and nurse. It is usually best of the student can write notes verbatimin a private area immediately after the interaction has taken place. Nurses recordtheir words and client’s words, identify whether the responses are therapeutic,and recall their emotions at that time.OPTIONS A, B & D- all are part of process recordingSOURCE: Varcarolis, Foundations of Psychiatric Mental Health Nursing, 4th ed, p2458. Which of these does NOT happen in a descriptive study?a. Describing relationship among variablesb. Exploration of relationships between two or more phenomenac. Manipulation of phenomenon in real life contextd. Manipulation of a variableCORRECT ANSWER: DRATIONALE: Descriptive research is a nonexperimental study. The purpose of it isto observe, describe, and document aspects of a situation as it naturally occursand sometimes to serve as a starting point for hypothesis generation or theorydevelopment. The aim of this study is to describe relationship among variables.Neither of the variables could be experimentally manipulated.OPTIONS A, B, C- all happens in a descriptive studySOURCE: Polit and Beck, Nursing Research, 7th ed, pp 192, 1959. The investigator also provided the nursing care of the subject. Theinvestigator is referred to as a/an.a. Participant-observerb. Observer researcherc. Caregiverd. AdvocateCORRECT ANSWER: CRATIONALE: The primary role of caregiver is the primary role of the nurse. Theprovision of care to patients that combines both the art and the science ofnursing in meeting all the aspect of well being.OPTION A- the researcher participates as a member of the group and observes thegroup at the same time in data collectionOPTION B-the researcher observes a particular group and records behaviors oractivitiesOPTION D- in advocate role, the nurse informs the client and then supports him orher in whatever decision he or she makes. Advocacy is the process of acting in theclient’s behalf when he or she cannot do so.

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