Nursing Regulation

Core Competen cies in Nursing
Nursing Education NOVICE Nursing Service

I.

GUIDE FOR 100 Items (in 20 Situations) PCC – 80% 60% - 12 Situations in SQC 2 Situations in 10% Communications & Collaboration 10% 2 Situations in Health

Management of resources and environment; And Records Management

Research Quality Improveme nt (5%)

ha En

(5 % )

(5%)

SQC (60%) Communication and Collaboration (10%)

II.

Education EMPOWERING – 10% 1 Situation in Ethico5% Moral / Legal Responsibilities 5% 1 Situation in Personal & Professional Dev’t.’ ENABLING – 5% 1 Situation in

En ab lin g

Health Education
(10%)

N E W V E R S I O N

Patient Care Competencies
(80%)

nc in g
) (5%

III.

Empowering
(10%)
items)

(20% or 100

• Legal responsibilities (3%)

Management of 5% Resources & Environment and Records

• Ethico-moral responsibilities (2%) • Personal and Professional development (5%)

Competency-Based Test

HORIZONTAL INTEGRATION

VERTICAL STREAM

VERTICAL STREAM
NURSING PROCESS
NP I NP II NP III NP IV NP V

Basic Nursin g Funda Manag e-ment Leadership

Comm u-nity Health Nursin g

Nursing Care of the Mothe r and Child

Nursing Care of the Adult and the Elderly with Medical Surgica l Conditions

Nursin g Care of the Client with a Psychi a-tric Disord er

Anatomy, Physiology, Pathophysiology, Assessment

INTEGRATION

HORIZONTAL

Developmental Changes in the Lifespan Safety, Comfort, Reduction of Risk Potential, Infection Control Diagnostic Examinations, Nutrition, Pharmacology Bioethics, Jurisprudence, Delegation Coordination, Collaboration, Communication, Patient Advocacy Socio-cultural Issues Prioritization and Decision-making

TEST TAKING TEST TAKING STRATEGIES STRATEGIES .

Lesson 1 Lesson 1 .

You are assigned to take care of the client. 2. 3. Mr.EXAMPLE • A 61 yr old man. Regalado. When doing an initial assessment. is admitted to the private ward for observation after complaints of severe chest pain. the best way for you to identify the client’s priority problem is to: 1. 4. Interview the client for chief complaints and other symptoms Talk to the relatives to gather data about history of illness Do auscultation to check for chest congestion Do a physical examination while asking the client relevant questions .

– . which comes before implementation. you can immediately eliminate options that aren’t assessment options.Test taking strategies • Consider the nursing process – Remember that assessment comes before analysis. which comes before evaluation If the question asks you to assess. which comes before planning.

Give cotrimoxazole tablet or syrup 2.EXAMPLE • Josie brought her 3 month old child to your clinic because of cough and colds. Teach the mother how to count her child’s breathing . Assess the patient using the chart on management of children with cough 3. Refer to the doctor 4. Which of the following is your primary action? 1.

Lesson 2 Lesson 2 .

4.EXAMPLE • Wendy is admitted to the hospital with signs and symptoms of stroke. Prevent skin breakdown Preserve muscle function Promote urinary elimination Maintain a patent airway . A Central venous catheter was inserted and an IV infusion was started. 3. Her Glasgow Coma Scale is 6 on admission. 2. As a nurse assigned to Wendy. what will be your priority goal? 1.

Test taking strategies • – – – • Apply Maslow’s hierarchy of needs Physiologic needs are the most basic and the first need to be met Second needs to be met are safety and security Always satisfy the lowest-level need first Apply the ABCs .

4. 3.EXAMPLE • When caring for Larry after an exploratory chest surgery and pneumonectomy. Supplemental oxygen Ventilation exchange Chest tube drainage Blood replacement . priority would be to maintain: 1. 2.

16 yrs old comes to the ER with acute asthmatic attack and in acute respiratory distress. Which of the ff nursing actions should be initiated first? 1.EXAMPLE • Carlo. Provide emotional support Administer oxygen at 8lpm Suction the client every 30 min Administer bronchodilator by nebulizer . 2. 4. 3.

Lesson 3 Lesson 3 .

Position Conrad with his head turned toward the side of the tumor 3. Provide sensory stimulation 4. Which intervention should you include in your plan to reduce ICP? 1. Encourage coughing and deep breathing . Administer bowel softener 2.EXAMPLE • You are caring for Conrad who has a brain tumor and increased ICP.

Test taking strategies • Consider patient safety .

Hemodialysis is ordered that an A-V shunt was surgically created. 2.Rudy was diagnosed to have chronic renal failure. Change the dressing of the shunt daily Test taking strategies . Instruct the client not to exercise the arm with the shunt 3. Avoid taking BP or blood sample from the arm with the shunt. Which of the following actions would be of highest priority with regards to the external shunt? 1. Heparinize the shunt daily 4.

except 1. Assess and periodically reassess individual client’s risk for falling . will implement the ff.EXAMPLE • You and the you identified a potential risk of a pre postoperative clients. Take action to address any identified risk 3. Assess potential risk of fall 2. To reduce risk of patient’s harm from fall. Allow client to walk with relative to OR 4.

Lesson 4 Lesson 4 .

3.• 1. That pill you were given last night is effective isn’t it? Regina. During the morning endorsement. the nurse read the observation of the night nurse. the outgoing nurse informed the nursing staff that Regina. Which of the following approaches of the nurse validates the data gathered? EXAMPLE 2. 35 yrs old was given Flurazepam (Dalmane) 15 mg at 10 pm because she had trouble sleeping. 4. how are you? . did you sleep well? Regina. You look like you had a very sound sleep.. Before approaching Regina. I learned that you were up till ten last night. Tell me what happened before you were finally able to sleep and how was your sleep? Hmm.

Test taking strategies • Consider verbal and nonverbal therapeutic communication – – – Listen to the client Try to understand the client’s needs Promote clarification and insight about the client’s condition .

.” A therapeutic response of the nurse is: 1. you have the right to invoke confidentiality of our interaction. Yes. “I want to tell you something but promise me that you will keep this a secret. 3. Of course yes. Yes.EXAMPLE • The client says. it is my principle to uphold my client’s rights 4. our interaction is confidential provided that information you tell me is not detrimental to your safety 2. This is between you and me. Yes.

Lesson 5 Lesson 5 .

Test taking strategies • Avoid reading into the question – – This means that you are considering issues beyond the information presented in the question Strategies to prevent this from happening include: » » » » » » Identify parts of a question Read carefully Look for keywords or key phrases Identify the issue Use the process of elimination Avoid asking yourself “What if” .

Ambulate more C. (Question stem) To increase the chance of passing the stones. you instructed her to force fluids and do which of the following? A. Strain all urine D. She was advised to undergo IVP by her physician. The IVP reveals that Fe has small renal calculus that can be passed out spontaneously.Parts of a question: • Case situation • Question stem Options • Example: Test taking strategies (Case situation) Fe is experiencing left sharp pain and occasional hematuria. Bed rest . Balanced diet B.

Lesson 6 Lesson 6 .

Key words or key phrases: • Focus your attention on the critical and specific points • May indicate there is only one option • May indicate that you need to prioritize • May indicate a true response or a false response question Test taking strategies .

Common keywords or key phrases that indicate there is only one correct option: • • • • Early sign Late sign Understands Goal has been achieved • • • • Avoid Ineffective Inadequate Unable to tolerate .

It eliminates toxic waste products due to vasodilation . the nurse applies cold compress to the swollen ankle as ordered by the physician. Cold compress prevents edema and reduces pain. 3. Cold compress reduces blood viscosity in the affected area. This statement shows that the nurse has correct understanding of the use of cold compress: 1. It is safer to apply than hot compress. 2.EXAMPLE • After cleaning the abrasions and applying antiseptic. 4.

Lesson 7 Lesson 7 .

Common keywords or key phrases that indicate the need to prioritize • • • • • • Best First Initial Immediately Most likely or least likely Most appropriate or least appropriate • Highest or lowest priority • Most effective or least effective • Order of priority • At highest risk • At lowest risk • Best understanding .

Assess level of consciousness 2. manicure and dentures . gown.EXAMPLE • Which of the following should be given highest priority when receiving patient in the OR? 1. Assess vital signs 4. Verify patient identification and informed consent 3. Check for jewelry.

You now feel that Irma’s family could be helpful if they knew what Irma has told you. she speaks to you in confidence. Tell the physician who in turn could tell the family B. Tell Irma that she has to tell her family what she told you D.• Irma is terminally ill. Obtain Irma’s permission to share the information with the family C. Make an appointment to discuss the situation with the family . What should you do first? EXAMPLE A.

Lesson 8 Lesson 8 .

effective care environment • Health promotion and maintenance • Psychosocial integrity Test taking strategies .Identify issues of the question: • The specific subject content that the question is asking about • Will assist in eliminating the incorrect and direct you to selecting the correct option Issues can include: • Physiologic integrity • Safe.

Read the labels on food items to determine fat content c. Eat only foods that have less than 1% fat content d. Example: A nurse is providing dietary instructions to a client about low-fat diet. never. Never use butter for cooking b. The nurse tells the client to: a.• Eliminate options that contain absolute words such as all. always. Drink fluids only if they are fat free Test taking strategies .

Lesson 9 Lesson 9 .

d. c. You instructed the family to include more vegetables in the diet and Increase fluid intake Barium enema Cleansing enema Gastric lavage a.EXAMPLE • Post IVP. the patient should excrete the contrast medium. b. .

Places the client in high-Fowler’s position c. Obtain Furosemide and a syringe b. Obtains a dose of morphine sulfate d. Inserts a foley catheter • Test taking strategies . Nurse suspects pulmonary edema and would immediately: a.Eliminate options that contain medical rather than nursing interventions Example: A nurse is caring for a client with CHF who suddenly experiences dyspnea.

Lesson 10 Lesson 10 .

A child should be immunized in the health center before referral. . There is no contraindication to immunization if the child is well enough to go home and should be immunized in the health center before referral are both correct. Test taking strategies b.Which of the following statements about immunization is NOT true a. d. A child with diarrhea due for OPV should receive the OPV and make extra dose on the next visit There is no contraindication to immunization if the child is well enough to go home. c.

Test taking strategies • Ensuring that all parts of an option are correct .

Lesson 11 Lesson 11 .

Chest pain that worsens on inspiration b. Which manifestation differentiates pericarditis from other cardiopulmonary problems? a. Anterior chest pain d. Weakness and irritability . Pericardial friction rub c.Test taking strategies A client is admitted to the hospital with a diagnosis of pericarditis.

Test taking strategies • Look for similar concepts in the question and in one of the options .

except: Is there any fever? Ear discharge How long ear discharge is present? Ear pain .EXAMPLE • a. c. b. A child with ear problem should be assessed for the following. d.

reread them. Choices that involve notifying the physician are usually incorrect .More Test taking tips • • • Read each question and all options carefully before making your selection If 2 options seem equally correct. They may differ in some way.

. Pay no attention to other candidates or the time they take to complete their tests.More Test taking tips • • • Memorize common laboratory values so you can make an informed decision Take necessary time for each question without spending excessive time on any one item.

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