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NUR 1290 FINAL EXAM QUESTIONS
AND ANSWERS RATED A+
personal morality ✔✔The set of beliefs about the standards of right and wrong that help a person determine the correct or permissible action in a given situation
personal values ✔✔-ideas or beliefs a person considers important and feels strongly about
- values are rooted to unique experience, family, religion, friends and education
Ethical Principles ✔✔Beneficence: doing good
Nonmaleficence: avoiding negative
Autonomy
Justice
Veracity: telling the truth when you know the truth will cause harm
Fidelity:
distributive Justice
privacy
confidentiality
factors that influence ethical decisions ✔✔- code for nursing (standards)
- patients right
- social and cultural attitudes
- science and technology
- legislation
- judicial decision
- funding
- personal religious and philosophic viewpoints
self-care ✔✔patients self-diagnosing and determining their own treatment needs
Model for ethical decision making ✔✔1. identifying and clarifying the problem
- gathering data
- identifying options
- making decisions
- acting and assessing
specific ethical issues related to nursing practice ✔✔- commitment to patient, employer, colleagues, excellence, nursing profession
Karen Ann Quinlan ✔✔First "right to die" case - 1975
The 21-year-old girl combined Valium, alcohol, and dieting, she slipped into what had recently been labeled "persistent vegetative state"
the courts decided that "the proposed removal from the respiratory machine was acceptable" (225). Religious Beliefs supported this case
Terry Shiavo Case ✔✔-27 became comatose after cardiac arrest
-husband won right to discontinue feeding tube but it was put back in two weeks later
- husband won to remove feeding tube
Bioethics ✔✔The study of ethics related to issues that arise in health care. (scientific advances)
issues in bioethics ✔✔- beginning of life
-end of life
-universal access to health care
-insurance for all
- rationing of health care (allocation)m cost and quality
- where and how federal dollars should be spent
-obligation of others to assist homeless
-biomedical research
beginning of life issues ✔✔- family planning
-amniocentesis
-sterilization
-in vitro sterilization
-artificial insemination
-surrogate pregnancies
boundary issues professional ✔✔-patient safety and welfare first
-professional distance
- respect for patient and family
- professional behavior
boundary issues non-professional ✔✔-over involvement with patient
- exploitation
- excessive self-disclosure
- abuse of power
ethical challenges ✔✔- Veracity:accuracy,truth
- Paternalism
- Autonomy
- Accountability:responsible,obedient
moral disengagement ✔✔process that allows an individual to justify their unethical action by altering their moral perception of action
Quality Improvement (QI) ✔✔A continuous process that identifies problems in health-care delivery, examines solutions to those problems, and regularly monitors the solutions for improvement.
institute of health care wants to ✔✔-improve the health of the population
- enhance the patient experience of care
-reduce or control the per capita cost of care
Quality and Safety Education for Nurses (QSEN) ✔✔addresses the challenge to prepare nurses with the competencies needed to continuously improve the quality of care in their work environments
QSEN addresses ✔✔- patient centered care
- teamwork and collaboration
- evidence based practice
-quality improvement
-safety
-informatics
healthcare financial issues ✔✔- macro= national or state perspective
-micro= specific healthcare organization and its budget
Who pays for health care? ✔✔third party payer systems
-deductibles and copayment (out of pocket)
- annual limits
- underinsured adults and children
-preexisting conditions and healthcare reform
HMO (Health Maintenance Organization) ✔✔- limits coverage to care from doctors who work for or contract with the HMO
- won't cover out of network care except in an emergency
- HMO requires to live or work in it's service area to be eligible
PPO (Preferred Provider Organization) ✔✔A type of health plan that contracts with medical providers, such as hospitals and doctors, to create a network of participating providers. You pay less if you use providers that belong to the plan's network.
EPO (Exclusive Provider Organization) ✔✔-requires you to use doctors and hospitals within the EPO network
- cannot go outside network
-there are no out of network benefits
government reimbursement of health services ✔✔- no universal coverage
-medicare, medicaid (CMS)
-military
-VA
- FEHBP
- coverage for state employees
- children's health insurance plan (CHIP)
-indian health services
contributing factors in rising health care costs ✔✔- price for new technology
- construction of new facilities
-use acute measures to determine costs
Holistic Model of Health ✔✔-healing the whole person
- involves thinking about effects of illness on body, mind, emotions, spirituality, religion, personal relationships
team nursing model ✔✔a small group of licensed and unlicensed personnel, with a team leader, responsible for providing patient care to a group of patients
Total care nursing model ✔✔-RN charge assigns RNs and LPNs to a group of patients and they are to give full care for 8 hr shift
-RNs with light work load are to help LPNs with things they are not allowed to do
Primary Nursing Model ✔✔vA nurse is accountable for planning, evaluating, and directing the care of a pt 24/7 throughout stay.
functional nursing model ✔✔-a method of providing patient care by which each licensed and unlicensed staff member performs specific tasks for a large group of patients (may be seen during a mass casualty event)
- one person takes all vitals, one gives all baths
case management model ✔✔A model of delivering patient care based on patient outcomes and cost containment. Components of case management are a case manager, critical paths/critical pathways, and unit-based managed care.
primary prevention ✔✔-Efforts to prevent an injury or illness from ever occurring.
-vaccines
secondary prevention ✔✔-Efforts to limit the effects of an injury or illness that you cannot completely prevent.
-screenings like colonoscopy
tertiary prevention ✔✔-actions taken to contain damage once a disease or disability has progressed beyond its early stages
healthy people 2030 ✔✔- eliminate disease, liability, injury, premature death
-disabilities
NINR (National Institute of Nursing Research) ✔✔A federal agency responsible for the support of nursing research by establishing a national research agenda, funding grants and research awards, and providing training.
- increase emphasis on scholarly work
- growing # of nurses that are academically prepared to conduct research
Research Process ✔✔-plan or proposal
- research problem statement
- hypothesis
- research design
- research analysis
research ✔✔formalized process of systemic investigation designed to test a research question or hypothesis and draw conclusions from collected data.
nursing research ✔✔- Systematic inquiry to develop knowledge about issues of importance to the nursing profession
- needs to improve patient care
- funding from NIR, private orgs, nursing orgs
- purpose: to answer question or theory
- secondary: improve evidence based practice
evidence-based practice ✔✔approach to client care in which the nurse integrates the client's preferences, clinical expertise, and the best research evidence to deliver quality care(ask, acquire, analyze, apply and assess)
Quantitative Research ✔✔-statistics, numbers, measurable, objective
Qualitative Research ✔✔- emotion, subjective, reactions
5 rights of participants ✔✔-self-determination
-privacy and dignity
- anonymity and confidentiality
patient centered care ✔✔providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions
why is pcc helpful ✔✔-sharing power and responsibility between patients and caregivers
-communication with patients is shared in fully open manner
- patients individuality, emotional needs, values, and life issues are considered
Patient Self-Determination Act ✔✔A federal law passed in 1990 that requires hospitals and other health care providers to provide written information to patients regarding their rights under state law to make medical decisions and execute advance directives.
health care disparities ✔✔differences among populations in the availability, accessibility, and quality of health care services
cultural competence ✔✔the ability to interact effectively with people of different cultures
Patient advocacy is: ✔✔speaking up for your patient
Delegation ✔✔the process of assigning managerial authority and responsibility to managers and employees lower in the hierarchy
Informatics Nurse ✔✔Advance knowledge and proficiency in the use of IT as it applies to nursing practice.
types of informatics in nursing ✔✔- automated dispensing of medication and bar coding
- computerized monitoring of adverse events
- electronic medical health records
-personal health record
- professional order entry system
- tablets and smartphones
- nurse call
- voice mail
- virtual appointments
Telehealth ✔✔-Use of technology to deliver health-related services and information, including telemedicine
- two way interactive video
