NCLEX-RN Notes: Core Review and Exam Prep (2007)
Prepare for success with NCLEX-RN Notes: Core Review and Exam Prep (2007), a comprehensive guide to your certification test.
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Bonus CD-ROM Includes—
• 1000 plus NCLEX-style questions
• Rationales for correct and incorrect responses
• Alternate format questions
• Strategic tips for successfully answering questions
All questions coded for—
• Client Need
• Content Area
• Cognitive Domain
• Difficulty Level
All combined to promote success on NCLEX examinations
• 1000 plus NCLEX-style questions
• Rationales for correct and incorrect responses
• Alternate format questions
• Strategic tips for successfully answering questions
All questions coded for—
• Client Need
• Content Area
• Cognitive Domain
• Difficulty Level
All combined to promote success on NCLEX examinations
Minimum System Requirements
PC
CPU:Pentium III or higher
64 MB Ram; 128 MB Ram preferred
800 x 600 monitor with thousands of colors
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8x CD-ROM drive
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or issued by FAD from time to time. At its sole option, FAD may make
such updates available to the Licensee or authorized transferees who
have returned the registration card, paid the update fee, and returned the
original CD-ROM to FAD.
PC
CPU:Pentium III or higher
64 MB Ram; 128 MB Ram preferred
800 x 600 monitor with thousands of colors
OS: Windows/2000/XP
8x CD-ROM drive
135 MB hard disk space
LICENSE AGREEMENT
1. F. A. Davis (“FAD”) grants the recipient of the NCLEX-RN® Notes: Core
Review & Exam Prep, limited license for the program on the enclosed CD-
ROM (“Software”). FAD retains complete copyright to the Software and
associated content.
2. Licensee has nonexclusive right to use this copy of the Software on one
computer on one screen at one location. Any other use is forbidden.
3. Licensee may physically transfer the Software from one computer to
another, provided that it is used on only one computer at any one time.
Except for the initial loading of the Software on a hard disk or for archival
or backup purposes, Licensee may not copy, electronically transfer, or
otherwise distribute copies.
4. This License Agreement automatically terminates if Licensee fails to
comply with any term of this Agreement.
5. SOFTWARE UPDATES. Updated versions of the Software may be created
or issued by FAD from time to time. At its sole option, FAD may make
such updates available to the Licensee or authorized transferees who
have returned the registration card, paid the update fee, and returned the
original CD-ROM to FAD.
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or FAD’s authorized representative or distributor. Your receipt shall be
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quality and performance of a nonwarranted program is with you.
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defects are correctable. No oral or written information or advice given by
FAD, its dealers, distributors, agents, or employees shall create warranty or
in any way increase the scope of this limited warranty.
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Software. In no event shall FAD and its licensors be liable to you or any
other person for any direct, indirect, incidental, consequential, special,
exemplary, or punitive damages for tort, contract, strict liability, or other
theory arising out of the use of, or inability to use, the Software.
ENTIRE AGREEMENT. This Agreement contains the entire understanding of
the parties hereto relating to the subject matter hereof and supersedes all
prior representations or agreements.
GOVERNING LAW. This Agreement and Limited Warranty are governed by
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be addressed to F.A. Davis, Publishers, 1915 Arch Street, Philadelphia, PA
19103.
INSTALLATION INSTRUCTIONS
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Step 1. Insert CD into your CD-ROM drive.
Step 2. After a few moments, the CD-ROM menu will automatically open.
Step 3. Select the item to install
If the CD-ROM Menu does not automatically open, from the START Menu,
select RUN and enter X:\SETUP.EXE (where “X” is the letter of your CD-ROM
drive) and select OK
For Technical Support, e-mail: support@fadavis.com
FAD warrants that the CD-ROM on which the Software is furnished will be
free from defects of sixty (60) days from the date of delivery to you by FAD
or FAD’s authorized representative or distributor. Your receipt shall be
evidence of the date of delivery. The Software and accompanying materials
are provided “as is” without warranty of any kind. The complete risk as to
quality and performance of a nonwarranted program is with you.
FAD makes no warranty that the Software will meet your requirements or
that Software operation will be uninterrupted or error free or that Software
defects are correctable. No oral or written information or advice given by
FAD, its dealers, distributors, agents, or employees shall create warranty or
in any way increase the scope of this limited warranty.
REMEDIES. FAD’s entire liability and your exclusive remedy shall be limited
to replacing the defective media if returned to FAD (at your expense)
accompanied by dated proof of purchase satisfactory to FAD not later than
one week after the end of the warranty period, provided you have first
received a Return Authorization by calling or writing FAD in advance. The
maximum liability of FAD and its licensors shall be the purchase price of the
Software. In no event shall FAD and its licensors be liable to you or any
other person for any direct, indirect, incidental, consequential, special,
exemplary, or punitive damages for tort, contract, strict liability, or other
theory arising out of the use of, or inability to use, the Software.
ENTIRE AGREEMENT. This Agreement contains the entire understanding of
the parties hereto relating to the subject matter hereof and supersedes all
prior representations or agreements.
GOVERNING LAW. This Agreement and Limited Warranty are governed by
the laws of the Commonwealth of Pennsylvania. All warranty matters should
be addressed to F.A. Davis, Publishers, 1915 Arch Street, Philadelphia, PA
19103.
INSTALLATION INSTRUCTIONS
Windows
Step 1. Insert CD into your CD-ROM drive.
Step 2. After a few moments, the CD-ROM menu will automatically open.
Step 3. Select the item to install
If the CD-ROM Menu does not automatically open, from the START Menu,
select RUN and enter X:\SETUP.EXE (where “X” is the letter of your CD-ROM
drive) and select OK
For Technical Support, e-mail: support@fadavis.com
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NCLEX-RN®
Notes
Purchase additional copies of this book at
your health science bookstore or directly
from F. A. Davis by shopping online at
www.fadavis.com or by calling 800-323-
3555 (US) or 800-665-1148 (CAN)
A Davis’s Notes Book
Barbara A. Vitale, RN, MA
NCLEX-RN®
Notes
Core Review & Exam PrepCore Review & Exam Prep
Notes
Purchase additional copies of this book at
your health science bookstore or directly
from F. A. Davis by shopping online at
www.fadavis.com or by calling 800-323-
3555 (US) or 800-665-1148 (CAN)
A Davis’s Notes Book
Barbara A. Vitale, RN, MA
NCLEX-RN®
Notes
Core Review & Exam PrepCore Review & Exam Prep
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F. A. Davis Company
1915 Arch Street
Philadelphia, PA 19103
www.fadavis.com
Copyright © 2007 by F. A. Davis Company
All rights reserved. This book is protected by copyright. No part of it may be
reproduced, stored in a retrieval system, or transmitted in any form or by any
means, electronic, mechanical, photocopying, recording, or otherwise, without
written permission from the publisher.
Printed in China by Imago
Last digit indicates print number: 10 9 8 7 6 5 4 3 2 1
Publisher, Nursing: Robert G. Martone
Project Editor: Padraic Maroney
Manager of Art and Design: Carolyn O’Brien
Content Development Manager: Darlene Pedersen
Contributing Author: Mary Ann Hellmer-Saul, RN, AAS, BS, MS, PhD, ANP
Consultants: Paula A. Olesen, RN, MSN; Daryl Boucher, MSN, RN, CCEMTP; Golden
Tradewell, PhD, RN; Kathy Whitley, RN, MSN, FNP; Leesa A. McBroom, MSN, APRN,
FNP-C; Lindsey L. Carlson, MSN, RN; Eileen Kaslatas, MSN, RN; Joanne Vitale, RPA-
C, BA; William Hendricks, RPh; Jean Prochilo, RN, BS; Nina Goldsztejn, RN, BC,
BSN, MSN, NP
As new scientific information becomes available through basic and clinical
research, recommended treatments and drug therapies undergo changes. The
author(s) and publisher have done everything possible to make this book accurate,
up to date, and in accord with accepted standards at the time of publication. The
authors, editors, and publisher are not responsible for errors or omissions or for
consequences from application of the book, and make no warranty, expressed or
implied, in regard to the contents of the book. Any practice described in this book
should be applied by the reader in accordance with professional standards of care
used in regard to the unique circumstances that may apply in each situation. The
reader is advised always to check product information (package inserts) for changes
and new information regarding dose and contraindications before administering
any drug. Caution is especially urged when using new or infrequently ordered
drugs.
Authorization to photocopy items for internal or personal use, or the internal or
personal use of specific clients, is granted by F.A. Davis Company for users
registered with the Copyright Clearance Center (CCC) Transactional Reporting
Service, provided that the fee of $.10 per copy is paid directly to CCC, 222
Rosewood Drive, Danvers, MA 01923. For those organizations that have been
granted a photocopy license by CCC, a separate system of payment has been
arranged. The fee code for users of the Transactional Reporting Service is:
8036–1570/07 0 $.10.
1915 Arch Street
Philadelphia, PA 19103
www.fadavis.com
Copyright © 2007 by F. A. Davis Company
All rights reserved. This book is protected by copyright. No part of it may be
reproduced, stored in a retrieval system, or transmitted in any form or by any
means, electronic, mechanical, photocopying, recording, or otherwise, without
written permission from the publisher.
Printed in China by Imago
Last digit indicates print number: 10 9 8 7 6 5 4 3 2 1
Publisher, Nursing: Robert G. Martone
Project Editor: Padraic Maroney
Manager of Art and Design: Carolyn O’Brien
Content Development Manager: Darlene Pedersen
Contributing Author: Mary Ann Hellmer-Saul, RN, AAS, BS, MS, PhD, ANP
Consultants: Paula A. Olesen, RN, MSN; Daryl Boucher, MSN, RN, CCEMTP; Golden
Tradewell, PhD, RN; Kathy Whitley, RN, MSN, FNP; Leesa A. McBroom, MSN, APRN,
FNP-C; Lindsey L. Carlson, MSN, RN; Eileen Kaslatas, MSN, RN; Joanne Vitale, RPA-
C, BA; William Hendricks, RPh; Jean Prochilo, RN, BS; Nina Goldsztejn, RN, BC,
BSN, MSN, NP
As new scientific information becomes available through basic and clinical
research, recommended treatments and drug therapies undergo changes. The
author(s) and publisher have done everything possible to make this book accurate,
up to date, and in accord with accepted standards at the time of publication. The
authors, editors, and publisher are not responsible for errors or omissions or for
consequences from application of the book, and make no warranty, expressed or
implied, in regard to the contents of the book. Any practice described in this book
should be applied by the reader in accordance with professional standards of care
used in regard to the unique circumstances that may apply in each situation. The
reader is advised always to check product information (package inserts) for changes
and new information regarding dose and contraindications before administering
any drug. Caution is especially urged when using new or infrequently ordered
drugs.
Authorization to photocopy items for internal or personal use, or the internal or
personal use of specific clients, is granted by F.A. Davis Company for users
registered with the Copyright Clearance Center (CCC) Transactional Reporting
Service, provided that the fee of $.10 per copy is paid directly to CCC, 222
Rosewood Drive, Danvers, MA 01923. For those organizations that have been
granted a photocopy license by CCC, a separate system of payment has been
arranged. The fee code for users of the Transactional Reporting Service is:
8036–1570/07 0 $.10.
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ISBN: 0-8036-1335-0
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ISBN: 0-8036-1109-9
MedSurg Notes: Nurse’s Clinical Pocket Guide
ISBN: 0-8036-1115-3
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ISBN: 0-8036-1335-0
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ISBN: 0-8036-1109-9
MedSurg Notes: Nurse’s Clinical Pocket Guide
ISBN: 0-8036-1115-3
NutriNotes: Nutrition & Diet Therapy Pocket Guide
ISBN: 0-8036-1114-5
IV Therapy Notes: Nurse’s Clinical Pocket Guide
ISBN: 0-8036-1288-5
PsychNotes: Clinical Pocket Guide
ISBN: 0-8036-1286-9
LabNotes: Pocket Guide to Lab & Diagnostic Tests
ISBN: 0-8036-1265-6
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1
NCLEX-RN®
■ The National Council Licensure Examination for registered nurses
(NCLEX-RN®) measures the knowledge and abilities necessary for entry-
level nurses.
■ It is administered by Computer Adaptive Testing (CAT), which
individualizes tests to match the unique competencies of each test taker.
■ Each exam adheres to the NCLEX-RN® Test Plan, which describes the
content and scope of RN competencies.
■ Practices basic to nursing (e.g., nursing process, caring, teaching,
learning, communication, documentation) are integrated throughout,
and most questions require application and analysis of information.
NCLEX-RN® Test Plan—Distribution of Content
Patient Needs and % of Items
Safe and Effective Care Environment
■ Management of Care
■ Safety/Infection Control
Health Promotion and Maintenance
Psychosocial Integrity
Physiological Integrity
■ Basic Care/Comfort
■ Pharmacological/Parenteral gfd Therapies
■ Reduction of Risk Potential
■ Physiological Adaptation
Taking the NCLEX-RN® Test on a Computer
■ First: You will receive general information about the exam and the testing
center. Your time spent on this will not count.
■ Second: You will take a tutorial on how to use the computer to answer the
questions on NCLEX-RN®. Your answers will not count toward your score,
but the time you take will be subtracted from the total 6 hours you have
for the exam.
■ Third: You will then be presented with real NCLEX-RN® items; there will
be between 75 and 265 items. The test ends when it is 95% certain your
ability is ↑ or ↓ the passing standard.
TIPS
13%–19%
8%–14%
6%–12%
6%–12%
6%–12%
13%–19%
13%–19%
11%–17%
NCLEX-RN®
■ The National Council Licensure Examination for registered nurses
(NCLEX-RN®) measures the knowledge and abilities necessary for entry-
level nurses.
■ It is administered by Computer Adaptive Testing (CAT), which
individualizes tests to match the unique competencies of each test taker.
■ Each exam adheres to the NCLEX-RN® Test Plan, which describes the
content and scope of RN competencies.
■ Practices basic to nursing (e.g., nursing process, caring, teaching,
learning, communication, documentation) are integrated throughout,
and most questions require application and analysis of information.
NCLEX-RN® Test Plan—Distribution of Content
Patient Needs and % of Items
Safe and Effective Care Environment
■ Management of Care
■ Safety/Infection Control
Health Promotion and Maintenance
Psychosocial Integrity
Physiological Integrity
■ Basic Care/Comfort
■ Pharmacological/Parenteral gfd Therapies
■ Reduction of Risk Potential
■ Physiological Adaptation
Taking the NCLEX-RN® Test on a Computer
■ First: You will receive general information about the exam and the testing
center. Your time spent on this will not count.
■ Second: You will take a tutorial on how to use the computer to answer the
questions on NCLEX-RN®. Your answers will not count toward your score,
but the time you take will be subtracted from the total 6 hours you have
for the exam.
■ Third: You will then be presented with real NCLEX-RN® items; there will
be between 75 and 265 items. The test ends when it is 95% certain your
ability is ↑ or ↓ the passing standard.
TIPS
13%–19%
8%–14%
6%–12%
6%–12%
6%–12%
13%–19%
13%–19%
11%–17%
Loading page 10...
2
■ Answers may be selected or deleted several times if desired before
confirming a final answer. You must answer every question. You cannot
return to a previous question.
■ A time-remaining clock is in the screen’s upper right-hand corner.
■ A calculator on the computer is available for calculations.
Go to www.NCSBN.org to access an NCLEX tutorial to practice multiple
choice and alternate format items on the computer.
Critical Thinking
Definition, Influences, and Uses of Critical Thinking
■ Definition of critical thinking: Cognitive technique by which you reflect on
and analyze your thoughts, actions, decisions
■ Intellectual standards that influence critical thinking: Focused, methodical,
clear, deliberate, logical, relevant, accurate, precise
■ Processes that require critical thinking: Test taking, nursing process,
problem solving, decision making, diagnostic reasoning
Maximize Your Critical Thinking Abilities
Action Benefit
Be positive: Be optimistic
■ Maintain positive mental
attitude: Replace negative
thoughts with positive ones
Be calm: Control anxious feelings
■ Use relaxation techniques:
Practice breathing exercises and
guided imagery
Be inquisitive: Question and investigate
■ Ask the questions how, why,
what: e.g., How does Colace
promote a bowel movement? Why
does BP drop with hemorrhage?
Be persistent: Follow a course of action
■ Develop self-discipline: Be
logical and organized
TIPS
■ ↑Positive thinking and ↓negative
thinking that can interfere with
learning
■ ↓Anxiety
■ ↑Control in relation to intellectual
tasks
■ ↑Ability to determine significance
of information
■ ↑Understanding/retention of
information
■ ↑Ability to apply information
■ ↑Control over variables
associated with thinking
■ Answers may be selected or deleted several times if desired before
confirming a final answer. You must answer every question. You cannot
return to a previous question.
■ A time-remaining clock is in the screen’s upper right-hand corner.
■ A calculator on the computer is available for calculations.
Go to www.NCSBN.org to access an NCLEX tutorial to practice multiple
choice and alternate format items on the computer.
Critical Thinking
Definition, Influences, and Uses of Critical Thinking
■ Definition of critical thinking: Cognitive technique by which you reflect on
and analyze your thoughts, actions, decisions
■ Intellectual standards that influence critical thinking: Focused, methodical,
clear, deliberate, logical, relevant, accurate, precise
■ Processes that require critical thinking: Test taking, nursing process,
problem solving, decision making, diagnostic reasoning
Maximize Your Critical Thinking Abilities
Action Benefit
Be positive: Be optimistic
■ Maintain positive mental
attitude: Replace negative
thoughts with positive ones
Be calm: Control anxious feelings
■ Use relaxation techniques:
Practice breathing exercises and
guided imagery
Be inquisitive: Question and investigate
■ Ask the questions how, why,
what: e.g., How does Colace
promote a bowel movement? Why
does BP drop with hemorrhage?
Be persistent: Follow a course of action
■ Develop self-discipline: Be
logical and organized
TIPS
■ ↑Positive thinking and ↓negative
thinking that can interfere with
learning
■ ↓Anxiety
■ ↑Control in relation to intellectual
tasks
■ ↑Ability to determine significance
of information
■ ↑Understanding/retention of
information
■ ↑Ability to apply information
■ ↑Control over variables
associated with thinking
Loading page 11...
3
Maximize Your Critical Thinking Abilities (Continued)
Action Benefit
■ Develop perseverance: Adhere
to a preset study schedule; remain
determined
■ Maintain motivation: Set short
and long-term goals; divide tasks
into steps; reward self
Be creative: Be innovative and resourceful
■ Develop open-mindedness:
Compartmentalize identified
beliefs, opinions, biases,
stereotypes, prejudices
■ Develop comfort with ambiguity:
Recognize that there is more than
1 way to perform a task/achieve a
goal
■ Develop independent thought:
Consider all possibilities and
arrive at an autonomous
conclusion
■ Take risks: Implement unique
interventions within the definition
of nursing practice and safety
guidelines
Be reflective: Thoughtfully explore and assess
■ Develop courage: Confront difficult
tasks (e.g., reviewing mistakes)
with a non-judgmental attitude
■ Develop humility: Admit your
limitations—defensive thinking
promotes negativity, which closes
the mind
■ Use retrospective reviews: Recall
information/event to rediscover/
explore its meaning; conduct
internally or with others
TIPS
■ ↓Procrastination; ↑enthusiasm
■ ↑Efficiency of time management
■ ↓Stress of making purposeful
daily study decisions: inspires
action
■ ↑Goal-directed behavior
■ ↑Openness to different
perspectives; ↓egocentric
thinking; ↑nonjudgmental
thinking/practice
■ ↑Comprehension, synthesis,
interpretation, analysis of
information: promotes practice
based on principles; innovation
■ ↑Ability to synthesize, summarize,
conceptualize: promotes practice
based on principles; ↑innovation
■ Removes negative emotions from
the task; ↑positive thinking
■ Allows an open mind to explore
and acquire information; permits
nonjudgmental review of
mistakes
■ Identifies strengths, weaknesses,
and gaps in knowledge;
↑understanding of relationships
between information and its
application; ↓future mistakes
Maximize Your Critical Thinking Abilities (Continued)
Action Benefit
■ Develop perseverance: Adhere
to a preset study schedule; remain
determined
■ Maintain motivation: Set short
and long-term goals; divide tasks
into steps; reward self
Be creative: Be innovative and resourceful
■ Develop open-mindedness:
Compartmentalize identified
beliefs, opinions, biases,
stereotypes, prejudices
■ Develop comfort with ambiguity:
Recognize that there is more than
1 way to perform a task/achieve a
goal
■ Develop independent thought:
Consider all possibilities and
arrive at an autonomous
conclusion
■ Take risks: Implement unique
interventions within the definition
of nursing practice and safety
guidelines
Be reflective: Thoughtfully explore and assess
■ Develop courage: Confront difficult
tasks (e.g., reviewing mistakes)
with a non-judgmental attitude
■ Develop humility: Admit your
limitations—defensive thinking
promotes negativity, which closes
the mind
■ Use retrospective reviews: Recall
information/event to rediscover/
explore its meaning; conduct
internally or with others
TIPS
■ ↓Procrastination; ↑enthusiasm
■ ↑Efficiency of time management
■ ↓Stress of making purposeful
daily study decisions: inspires
action
■ ↑Goal-directed behavior
■ ↑Openness to different
perspectives; ↓egocentric
thinking; ↑nonjudgmental
thinking/practice
■ ↑Comprehension, synthesis,
interpretation, analysis of
information: promotes practice
based on principles; innovation
■ ↑Ability to synthesize, summarize,
conceptualize: promotes practice
based on principles; ↑innovation
■ Removes negative emotions from
the task; ↑positive thinking
■ Allows an open mind to explore
and acquire information; permits
nonjudgmental review of
mistakes
■ Identifies strengths, weaknesses,
and gaps in knowledge;
↑understanding of relationships
between information and its
application; ↓future mistakes
Loading page 12...
4
General Study Skills
■ Set goals
■ Take class notes
■ Manage your time
■ Control internal and external distractions
■ Establish a routine
■ Simulate a school environment
■ Prepare for class
■ Balance sacrifices and rewards
Use Techniques Appropriate for Learning Domains
Action Benefit
Cognitive domain (thinking): Knowing, comprehending, applying, analyzing,
synthesizing, evaluating
■ Use all your senses
■ Use memorization techniques
■ Put information into own words
■ Apply information in new
situations
Affective domain (feeling): Receiving, valuing, organizing, characterizing
■ Observe role models
■ Explore feelings, beliefs, values
■ Integrate values into philosophy
of life
Psychomotor domain (doing): Imitating, manipulating, developing precision,
articulating, naturalizing
■ Observe others performing a skill
■ Manipulate equipment while
doing procedures
■ Include speed/timing when
practicing skills
■ Practice skills repeatedly
TIPS
■ ↑Reception of information
■ ↑Retention of basic information
■ ↑Understanding
■ Encourages correct use of
information
■ ↑Sensitivity
■ ↑Self-disclosure/growth
■ ↑Consistency in actions; allows
for self-actualization
■ Identifies steps of a skill
■ Transfers information from head
to hands
■ Promotes proficiency through
repetition
■ Perfects the skill; naturalization
occurs when skill becomes
automatic
General Study Skills
■ Set goals
■ Take class notes
■ Manage your time
■ Control internal and external distractions
■ Establish a routine
■ Simulate a school environment
■ Prepare for class
■ Balance sacrifices and rewards
Use Techniques Appropriate for Learning Domains
Action Benefit
Cognitive domain (thinking): Knowing, comprehending, applying, analyzing,
synthesizing, evaluating
■ Use all your senses
■ Use memorization techniques
■ Put information into own words
■ Apply information in new
situations
Affective domain (feeling): Receiving, valuing, organizing, characterizing
■ Observe role models
■ Explore feelings, beliefs, values
■ Integrate values into philosophy
of life
Psychomotor domain (doing): Imitating, manipulating, developing precision,
articulating, naturalizing
■ Observe others performing a skill
■ Manipulate equipment while
doing procedures
■ Include speed/timing when
practicing skills
■ Practice skills repeatedly
TIPS
■ ↑Reception of information
■ ↑Retention of basic information
■ ↑Understanding
■ Encourages correct use of
information
■ ↑Sensitivity
■ ↑Self-disclosure/growth
■ ↑Consistency in actions; allows
for self-actualization
■ Identifies steps of a skill
■ Transfers information from head
to hands
■ Promotes proficiency through
repetition
■ Perfects the skill; naturalization
occurs when skill becomes
automatic
Loading page 13...
5
Specific Study Skills
How to Remember/Recall Information: Commit Facts to Memory
Action Benefit Example
Memorization: Repeatedly
reciting out loud,
reviewing in your mind,
writing it down
Alphabet cues:
Combination of
significant letters
Acronyms: Word formed
from the first letters of a
series of facts
Mnemonics: A phrase,
motto, verse
TIPS
■ Repetition ↑retention of
information
■ Each letter prompts recall of
specific information
■ Each letter jolts retrieval of
specific information
■ Prompts recall of specific
information
■ Lists on index cards: Steps of a
procedure; signs of a specific
electrolyte imbalance
■ Flash cards: Drug classification on
one side and action on reverse side;
medical terminology on one side and
definition on reverse side
■ The 3 Ps: Cardinal signs of diabetes
mellitus:
■ Polyuria: Increased secretion/
excretion of urine
■ Polydipsia: Excessive thirst
■ Polyphagia: Eating excessive
amounts of food
■ RACE: Procedure for a fire in a health
care facility
■ Rescue people in immediate danger
■ Activate the fire alarm
■ Confine the fire
■ Evacuate people to a safe area
■ “There are 15 grains of sugar in 1
graham (gram) cracker.” This sentence
should help you remember that 15
grains are equivalent to 1 gram.
Specific Study Skills
How to Remember/Recall Information: Commit Facts to Memory
Action Benefit Example
Memorization: Repeatedly
reciting out loud,
reviewing in your mind,
writing it down
Alphabet cues:
Combination of
significant letters
Acronyms: Word formed
from the first letters of a
series of facts
Mnemonics: A phrase,
motto, verse
TIPS
■ Repetition ↑retention of
information
■ Each letter prompts recall of
specific information
■ Each letter jolts retrieval of
specific information
■ Prompts recall of specific
information
■ Lists on index cards: Steps of a
procedure; signs of a specific
electrolyte imbalance
■ Flash cards: Drug classification on
one side and action on reverse side;
medical terminology on one side and
definition on reverse side
■ The 3 Ps: Cardinal signs of diabetes
mellitus:
■ Polyuria: Increased secretion/
excretion of urine
■ Polydipsia: Excessive thirst
■ Polyphagia: Eating excessive
amounts of food
■ RACE: Procedure for a fire in a health
care facility
■ Rescue people in immediate danger
■ Activate the fire alarm
■ Confine the fire
■ Evacuate people to a safe area
■ “There are 15 grains of sugar in 1
graham (gram) cracker.” This sentence
should help you remember that 15
grains are equivalent to 1 gram.
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6
How to Understand Information: Translate, Interpret, and Determine Implications of Information
Action Benefit Example
Explore how or why
information is relevant
and valuable
Study in small groups
How to Manipulate Information: Apply, Solve, Modify, and Use Information
Action Benefit Example
Relate new information to
prior learning
Recognize commonalities
TIPS
■ Significant information is
more likely remembered
■ Sharing/listening
↑understanding and
corrects misinformation
■ Placing information within
a personal frame of
reference makes informa-
tion more meaningful
■ Application of information
to similar situations
↑learning
■ Elevation of an extremity reduces
peripheral edema
■ How: Hand held above elbow/shoulder
↑venous return via gravity, which ↓edema
■ Discussing differences between hyper- and
hypoglycemia
■ Debating the pros and cons of
breastfeeding
■ Identify more correct things the nurse
should do in addition to the correct
answer presented in a test question
■ Pathophysiology of diabetes should build
on normal physiology of the pancreas
■ Placing a pt in a left side–lying position
after a liver biopsy should build on the
fact that pressure compresses blood
vessels, which supports hemostasis
preventing hemorrhage
■ Actions that use the principle of gravity:
Enema instillation, elevation of extremity
to limit edema, high Fowler’s position to
promote respirations
How to Understand Information: Translate, Interpret, and Determine Implications of Information
Action Benefit Example
Explore how or why
information is relevant
and valuable
Study in small groups
How to Manipulate Information: Apply, Solve, Modify, and Use Information
Action Benefit Example
Relate new information to
prior learning
Recognize commonalities
TIPS
■ Significant information is
more likely remembered
■ Sharing/listening
↑understanding and
corrects misinformation
■ Placing information within
a personal frame of
reference makes informa-
tion more meaningful
■ Application of information
to similar situations
↑learning
■ Elevation of an extremity reduces
peripheral edema
■ How: Hand held above elbow/shoulder
↑venous return via gravity, which ↓edema
■ Discussing differences between hyper- and
hypoglycemia
■ Debating the pros and cons of
breastfeeding
■ Identify more correct things the nurse
should do in addition to the correct
answer presented in a test question
■ Pathophysiology of diabetes should build
on normal physiology of the pancreas
■ Placing a pt in a left side–lying position
after a liver biopsy should build on the
fact that pressure compresses blood
vessels, which supports hemostasis
preventing hemorrhage
■ Actions that use the principle of gravity:
Enema instillation, elevation of extremity
to limit edema, high Fowler’s position to
promote respirations
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7
How to Analyze Information: Examine the Organization, Structure, and Interrelationships of Information
Action Benefit Example
Recognize differences
Practice test taking
Review rationales for
all options
Modify test questions
Analyze your
performance
TIPS
■ ↑Ability to analyze and
discriminate significance of
information
■ Reinforces learning, builds
endurance,↑test-taking and
time-management skills,
↑testing comfort
■ Reinforces concepts and
principles, ↑new learning,
strengthens critical thinking,
corrects misinformation
■ Identify commonalities and
differences, ↑opportunities for
exploring content
■ Analysis identifies areas of
strength, gaps in knowledge,
information-processing errors,
effectiveness of educated
guesses, plans for future study
■ Variety of causes that can ↑BP:
Hypervolemia, rigid arterial walls,
emotional stress
■ Answer questions at the end of a
chapter
■ Take a simulated test in a NCLEX prep
book
■ Take a simulated NCLEX test on a
computer
■ Review why the correct answer is
correct
■ Review why the incorrect options are
incorrect; look up additional
information in textbooks
■ Change a key word in a stem to
change the focus: “Identify the pt
adaptation associated with acute pain.”
Change the word acute to chronic and
then identify if any options apply
■ Identify number of questions
answered correctly/incorrectly
■ Group questions answered incorrectly
by Knowledge Deficits and Information
Processing Errors (see Tab 8)
■ Identify Personal Performance Trends
(see Tab 8)
■ Design a plan for future test success
How to Analyze Information: Examine the Organization, Structure, and Interrelationships of Information
Action Benefit Example
Recognize differences
Practice test taking
Review rationales for
all options
Modify test questions
Analyze your
performance
TIPS
■ ↑Ability to analyze and
discriminate significance of
information
■ Reinforces learning, builds
endurance,↑test-taking and
time-management skills,
↑testing comfort
■ Reinforces concepts and
principles, ↑new learning,
strengthens critical thinking,
corrects misinformation
■ Identify commonalities and
differences, ↑opportunities for
exploring content
■ Analysis identifies areas of
strength, gaps in knowledge,
information-processing errors,
effectiveness of educated
guesses, plans for future study
■ Variety of causes that can ↑BP:
Hypervolemia, rigid arterial walls,
emotional stress
■ Answer questions at the end of a
chapter
■ Take a simulated test in a NCLEX prep
book
■ Take a simulated NCLEX test on a
computer
■ Review why the correct answer is
correct
■ Review why the incorrect options are
incorrect; look up additional
information in textbooks
■ Change a key word in a stem to
change the focus: “Identify the pt
adaptation associated with acute pain.”
Change the word acute to chronic and
then identify if any options apply
■ Identify number of questions
answered correctly/incorrectly
■ Group questions answered incorrectly
by Knowledge Deficits and Information
Processing Errors (see Tab 8)
■ Identify Personal Performance Trends
(see Tab 8)
■ Design a plan for future test success
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8
Test-Taking and Study Tips
See enclosed disk for 160 examples of questions demonstrating the 15 test-
taking tips and alternate format questions.
Identify positive polarity in a stem
■ Correct answer is in accord with a truth, fact, principle, or action that
should be done; it attempts to determine if you can understand, apply, or
differentiate correct information.
✔ Study Tip: Review content being tested; identify additional things the
nurse should do.
Identify negative polarity in a stem
■ Correct answer reflects something that is false; the words except,
not, contraindicated, unacceptable, least, avoid, violate, untrue, side
effect, and exception indicate negative polarity. If 3 answers appear
correct, you may have missed the negative word in the stem.
✔ Study Tip: Change negative word to a positive word and then answer
the question.
Identify words that set a priority
■ Correct answer is what should be done first; the words initial, main,
primary, initially, greatest, best, first, most, and priority require ranking of
options from most to least desirable. If unable to identify correct answer,
eliminate least desirable option and repeat again until left with a final
option.
✔ Study Tip: After selecting correct answer, select what action should be
done next.
Identify opposites in options
■ When 2 options reflect extremes on a continuum, frequently 1 of them is
the correct answer; opposites may be obvious or obscure.
✔ Study Tip: Examples of opposites: hypo- vs. hyper-; increase vs.
decrease; brady- vs. tachy-; identify what is associated with the incorrect
opposite (e.g., tachycardia is associated with hyperthyroidism vs.
bradycardia being associated with hypothyroidism).
Identify key words in a stem
■ Identify important word or phrase that modifies another word (e.g., early
vs. late sign of shock).
✔ Study Tip: Change key words in stem; this changes focus of question
and ↑opportunities for learning.
TIPS
Test-Taking and Study Tips
See enclosed disk for 160 examples of questions demonstrating the 15 test-
taking tips and alternate format questions.
Identify positive polarity in a stem
■ Correct answer is in accord with a truth, fact, principle, or action that
should be done; it attempts to determine if you can understand, apply, or
differentiate correct information.
✔ Study Tip: Review content being tested; identify additional things the
nurse should do.
Identify negative polarity in a stem
■ Correct answer reflects something that is false; the words except,
not, contraindicated, unacceptable, least, avoid, violate, untrue, side
effect, and exception indicate negative polarity. If 3 answers appear
correct, you may have missed the negative word in the stem.
✔ Study Tip: Change negative word to a positive word and then answer
the question.
Identify words that set a priority
■ Correct answer is what should be done first; the words initial, main,
primary, initially, greatest, best, first, most, and priority require ranking of
options from most to least desirable. If unable to identify correct answer,
eliminate least desirable option and repeat again until left with a final
option.
✔ Study Tip: After selecting correct answer, select what action should be
done next.
Identify opposites in options
■ When 2 options reflect extremes on a continuum, frequently 1 of them is
the correct answer; opposites may be obvious or obscure.
✔ Study Tip: Examples of opposites: hypo- vs. hyper-; increase vs.
decrease; brady- vs. tachy-; identify what is associated with the incorrect
opposite (e.g., tachycardia is associated with hyperthyroidism vs.
bradycardia being associated with hypothyroidism).
Identify key words in a stem
■ Identify important word or phrase that modifies another word (e.g., early
vs. late sign of shock).
✔ Study Tip: Change key words in stem; this changes focus of question
and ↑opportunities for learning.
TIPS
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9
Identify patient-centered options
■ Correct answers testing principles in the affective domain focus on
feelings, choices, empowerment, and preferences.
✔ Study Tip: Examples of pt-centered options: Acknowledging: “Losing
your independence must be difficult?” Offering a choice: “Would you
like your bath at 7 or 10 today?” Empowering: Encourage pt to write
down questions for the physician. Determining preferences: “What
foods do you like to eat?”
Identify equally plausible options
■ When 2 options are similar and 1 is not better than the other, generally
both are incorrect.
✔ Study Tip: Identify other equally plausible facts related to either the 3
incorrect options or the correct answer.
Identify options with “absolute” terms
■ The words all, just, none, only, never, every, and always have no
exceptions; 1 of these before a statement that is true generally makes
it an incorrect option. Options with absolute terms are more often
incorrect.
✔ Study Tip: Examples of options to be eliminated: Always position an
infant prone and just prescription drugs can cause interactions;
exceptions include: Always maintaining an airway and focusing on
the pt.
Identify the global option
■ A global option is a broad general statement, whereas the 3 other options
are specific and inherently are included under the mantel of the global
option.
✔ Study Tip: What else can be included under the global option?
Identify options that deny a patient’s feelings, needs, concerns
■ Options that deny feelings, give false reassurance, focus on nurse,
encourage cheerfulness, or change the subject cut off communication and
should be eliminated.
✔ Study Tip: Examples of options to be eliminated: Denies feelings: “Don’t
cry. It is not so bad.” False reassurance: “You’ll feel better tomorrow.”
Focuses on the nurse: “The thought of dying would frighten me.”
Cheerfulness: “Cheer up. You are getting better.”
Identify the unique option
■ When 3 options are similar in some way and 1 is different, the unique
option often is the correct answer (e.g., 3 options promote a bowel
movement and correct answer causes diarrhea).
TIPS
Identify patient-centered options
■ Correct answers testing principles in the affective domain focus on
feelings, choices, empowerment, and preferences.
✔ Study Tip: Examples of pt-centered options: Acknowledging: “Losing
your independence must be difficult?” Offering a choice: “Would you
like your bath at 7 or 10 today?” Empowering: Encourage pt to write
down questions for the physician. Determining preferences: “What
foods do you like to eat?”
Identify equally plausible options
■ When 2 options are similar and 1 is not better than the other, generally
both are incorrect.
✔ Study Tip: Identify other equally plausible facts related to either the 3
incorrect options or the correct answer.
Identify options with “absolute” terms
■ The words all, just, none, only, never, every, and always have no
exceptions; 1 of these before a statement that is true generally makes
it an incorrect option. Options with absolute terms are more often
incorrect.
✔ Study Tip: Examples of options to be eliminated: Always position an
infant prone and just prescription drugs can cause interactions;
exceptions include: Always maintaining an airway and focusing on
the pt.
Identify the global option
■ A global option is a broad general statement, whereas the 3 other options
are specific and inherently are included under the mantel of the global
option.
✔ Study Tip: What else can be included under the global option?
Identify options that deny a patient’s feelings, needs, concerns
■ Options that deny feelings, give false reassurance, focus on nurse,
encourage cheerfulness, or change the subject cut off communication and
should be eliminated.
✔ Study Tip: Examples of options to be eliminated: Denies feelings: “Don’t
cry. It is not so bad.” False reassurance: “You’ll feel better tomorrow.”
Focuses on the nurse: “The thought of dying would frighten me.”
Cheerfulness: “Cheer up. You are getting better.”
Identify the unique option
■ When 3 options are similar in some way and 1 is different, the unique
option often is the correct answer (e.g., 3 options promote a bowel
movement and correct answer causes diarrhea).
TIPS
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10
✔ Study Tip: Identify additional similar or different examples of correct
and incorrect options.
Identify clues in a stem
■ A word(s) in the stem that is identical, similar, paraphrased, or closely
related to a word(s) in an option is called a clang; a clang can be
obvious or obscure. Generally, an option with a clang is the correct
answer.
✔ Study Tip: Identify a similar word(s) that relates to an important word in
the stem (e.g., to the word movement in a stem consider similar words
such as activity and mobility that may be found in an option).
Identify duplicate facts in options
■ If 2 or more facts are in each option and identical or similar facts are in at
least 2 of the 4 options, and you can identify at least 1 fact that is correct
or incorrect, you can eliminate at least 2 options.
✔ Study Tip: Identify additional facts that may be correct.
Use Maslow to identify correct option
■ Answer the question in light of Maslow’s hierarchy of needs; basic
physiologic needs are 1st-level needs that are a priority and are followed
by needs associated with safety and security (2nd), love and belonging
(3rd), self-esteem (4th), and self-actualization (5th).
✔ Study Tip: Identify an intervention associated with each level of
Maslow’s hierarchy of needs in relation to the question.
Use multiple test-taking tips
■ First analyze the stem for 1 or more test-taking tips. Then analyze the
options for 1 or more test-taking tips. When you focus on what the stem is
asking and eliminate options from consideration, you maximize the ability
to select the correct answer.
✔ Study Tip: Practice answering questions at the end of a chapter or in
test-taking books using the presented test-taking tips.
Alternate Format Questions and Test-Taking Tips
Alternate format questions evaluate certain knowledge more effectively than
the typical multiple-choice question. They supplement multiple-choice
questions, which remain the majority of questions. Any format, including the
standard multiple-choice question, may include a chart, table, or graphic
image. Alternate format questions are scored as either right or wrong, and
partial credit is not given.
TIPS
✔ Study Tip: Identify additional similar or different examples of correct
and incorrect options.
Identify clues in a stem
■ A word(s) in the stem that is identical, similar, paraphrased, or closely
related to a word(s) in an option is called a clang; a clang can be
obvious or obscure. Generally, an option with a clang is the correct
answer.
✔ Study Tip: Identify a similar word(s) that relates to an important word in
the stem (e.g., to the word movement in a stem consider similar words
such as activity and mobility that may be found in an option).
Identify duplicate facts in options
■ If 2 or more facts are in each option and identical or similar facts are in at
least 2 of the 4 options, and you can identify at least 1 fact that is correct
or incorrect, you can eliminate at least 2 options.
✔ Study Tip: Identify additional facts that may be correct.
Use Maslow to identify correct option
■ Answer the question in light of Maslow’s hierarchy of needs; basic
physiologic needs are 1st-level needs that are a priority and are followed
by needs associated with safety and security (2nd), love and belonging
(3rd), self-esteem (4th), and self-actualization (5th).
✔ Study Tip: Identify an intervention associated with each level of
Maslow’s hierarchy of needs in relation to the question.
Use multiple test-taking tips
■ First analyze the stem for 1 or more test-taking tips. Then analyze the
options for 1 or more test-taking tips. When you focus on what the stem is
asking and eliminate options from consideration, you maximize the ability
to select the correct answer.
✔ Study Tip: Practice answering questions at the end of a chapter or in
test-taking books using the presented test-taking tips.
Alternate Format Questions and Test-Taking Tips
Alternate format questions evaluate certain knowledge more effectively than
the typical multiple-choice question. They supplement multiple-choice
questions, which remain the majority of questions. Any format, including the
standard multiple-choice question, may include a chart, table, or graphic
image. Alternate format questions are scored as either right or wrong, and
partial credit is not given.
TIPS
Loading page 19...
11
Ordered response (drag and drop) question
■ Presents a scenario or makes a statement and then lists a variety of
actions or factors that must be placed in sequence or in order of priority.
The sequence chosen must be identical to the correct sequence to receive
credit.
✔ Test-Taking Tip: Identify the action/factor you believe should be first.
Identify the action/factor you believe should be last. Evaluate the
remaining 2 actions/factors and make a final determination as to which
one goes second. The remaining action/factor is placed third.
Fill-in-the-blank (calculation) question
■ Requires manipulation, interpretations, or solving a problem based on
presented information. It requires an intellectual skill such as computing
a drug dosage, calculating an I&O, or determining the amount of IV
solution to be given. The recorded answer must be identical to the
correct answer to receive credit. You do not have to type in the unit of
measurement.
✔ Test-Taking Tip: Before attempting to answer the question, recall
information related to the question (e.g., memorized equivalents,
formulas); this taps your knowledge first and limits confusion.
Multiple-response question
■ Asks a question and then lists several responses. You must identify the 1
or more responses that are correct. All correct responses must be selected
to receive credit.
✔ Test-Taking Tip: Before looking at presented options, quickly review
information you know about the topic. This taps your knowledge first
and limits confusion after looking at presented options. Compare your
list to presented options. Some of your recalled information should
match. Then review the remaining presented options and determine if
they are applicable. If you look at the presented options first, eliminate
at least 1 or 2 you believe are wrong. Then identify at least 1 or 2 you
believe are correct. Finally, evaluate the remaining options and make a
determination if they are correct or not.
Hot-spot question
■ Asks a question in relation to a graphic image, picture, chart, or table. You
must identify a location or analyze information on the illustration to
answer the question. Your answer must mirror the correct answer exactly
to receive credit.
✔ Test-Taking Tip: Read the question carefully to identify exactly what the
question is asking. This limits misinterpretation and confusion. When
questions reflect anatomy and physiology, close your eyes, visualize the
area, briefly recall the significant structures and functions, and then look
TIPS
Ordered response (drag and drop) question
■ Presents a scenario or makes a statement and then lists a variety of
actions or factors that must be placed in sequence or in order of priority.
The sequence chosen must be identical to the correct sequence to receive
credit.
✔ Test-Taking Tip: Identify the action/factor you believe should be first.
Identify the action/factor you believe should be last. Evaluate the
remaining 2 actions/factors and make a final determination as to which
one goes second. The remaining action/factor is placed third.
Fill-in-the-blank (calculation) question
■ Requires manipulation, interpretations, or solving a problem based on
presented information. It requires an intellectual skill such as computing
a drug dosage, calculating an I&O, or determining the amount of IV
solution to be given. The recorded answer must be identical to the
correct answer to receive credit. You do not have to type in the unit of
measurement.
✔ Test-Taking Tip: Before attempting to answer the question, recall
information related to the question (e.g., memorized equivalents,
formulas); this taps your knowledge first and limits confusion.
Multiple-response question
■ Asks a question and then lists several responses. You must identify the 1
or more responses that are correct. All correct responses must be selected
to receive credit.
✔ Test-Taking Tip: Before looking at presented options, quickly review
information you know about the topic. This taps your knowledge first
and limits confusion after looking at presented options. Compare your
list to presented options. Some of your recalled information should
match. Then review the remaining presented options and determine if
they are applicable. If you look at the presented options first, eliminate
at least 1 or 2 you believe are wrong. Then identify at least 1 or 2 you
believe are correct. Finally, evaluate the remaining options and make a
determination if they are correct or not.
Hot-spot question
■ Asks a question in relation to a graphic image, picture, chart, or table. You
must identify a location or analyze information on the illustration to
answer the question. Your answer must mirror the correct answer exactly
to receive credit.
✔ Test-Taking Tip: Read the question carefully to identify exactly what the
question is asking. This limits misinterpretation and confusion. When
questions reflect anatomy and physiology, close your eyes, visualize the
area, briefly recall the significant structures and functions, and then look
TIPS
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12
at the picture. When questions involve graphs or tables, first break them
into segments for analysis and then review them as a whole.
Chart/exhibit question
■ Presents a problem and then provides a chart/exhibit that has several
tabs. Each tab has to be clicked to retrieve information contained within
the tab. The data must be analyzed and the significant information
gleaned from the material presented to answer the question or eliminate
incorrect options. These questions require the highest level of critical
thinking (analysis and synthesis).
✔ Test-Taking Tip: First identify what the question is asking, then click each
tab to collect data. Dissect, analyze, and compare and contrast the
information collected in light of what the question is asking. Extensive
information must be recalled from your body of knowledge and
compared to the information in context of the situation presented
in the question.
TIPS
at the picture. When questions involve graphs or tables, first break them
into segments for analysis and then review them as a whole.
Chart/exhibit question
■ Presents a problem and then provides a chart/exhibit that has several
tabs. Each tab has to be clicked to retrieve information contained within
the tab. The data must be analyzed and the significant information
gleaned from the material presented to answer the question or eliminate
incorrect options. These questions require the highest level of critical
thinking (analysis and synthesis).
✔ Test-Taking Tip: First identify what the question is asking, then click each
tab to collect data. Dissect, analyze, and compare and contrast the
information collected in light of what the question is asking. Extensive
information must be recalled from your body of knowledge and
compared to the information in context of the situation presented
in the question.
TIPS
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13
BASICS
Child: 1year–adolescent
Tap and ask, “Are you OK?”
Carotid or femoral
Center of chest, between nipples
1 hand: Heel of 1 hand
2 hands: Heel of 1 hand and heel of
second hand on top
Witnessed collapse with no response; unwitnessed event after 5 cycles of CPR
Place on hard surface; head tilt-chin lift (lift-jaw thrust with spinal trauma);
look, listen, feel for air; if not breathing, give 2 breaths; cover nose and
mouth of infant when rescue breathing
Infant: 1yr
No response to verbal or tactile stimuli
Brachial or femoral
Center of chest below nipples
1 rescuer: 2 fingers
2 rescuers: 2 thumb-encircling hands
Rate: Approximately 100/min
Depth: Approximately 1 /3 to 1 /2 depth of chest
1 rescuer—30:2; 2 rescuers—15:2
Sudden collapse: ASAP
All others: After 5 cycles of CPR
No recommendation for infants 1yr
Pulse with no breaths: 60/min: 12 to 20 breaths/min; 60/min: continue CPR
Cardiopulmonary Resuscitation (CPR)—Child and Infant
Maneuver
Assess for response
Activate 911
1 rescuer
Airway breaths
Pulse check
Compression landmarks
Compression method:
“Hard and fast” with
chest recoil
Compression rate and
depth
Comp/vent ratio
Defibrillation
Rescue breathing
BASICS
Child: 1year–adolescent
Tap and ask, “Are you OK?”
Carotid or femoral
Center of chest, between nipples
1 hand: Heel of 1 hand
2 hands: Heel of 1 hand and heel of
second hand on top
Witnessed collapse with no response; unwitnessed event after 5 cycles of CPR
Place on hard surface; head tilt-chin lift (lift-jaw thrust with spinal trauma);
look, listen, feel for air; if not breathing, give 2 breaths; cover nose and
mouth of infant when rescue breathing
Infant: 1yr
No response to verbal or tactile stimuli
Brachial or femoral
Center of chest below nipples
1 rescuer: 2 fingers
2 rescuers: 2 thumb-encircling hands
Rate: Approximately 100/min
Depth: Approximately 1 /3 to 1 /2 depth of chest
1 rescuer—30:2; 2 rescuers—15:2
Sudden collapse: ASAP
All others: After 5 cycles of CPR
No recommendation for infants 1yr
Pulse with no breaths: 60/min: 12 to 20 breaths/min; 60/min: continue CPR
Cardiopulmonary Resuscitation (CPR)—Child and Infant
Maneuver
Assess for response
Activate 911
1 rescuer
Airway breaths
Pulse check
Compression landmarks
Compression method:
“Hard and fast” with
chest recoil
Compression rate and
depth
Comp/vent ratio
Defibrillation
Rescue breathing
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14
Ethical and Legal Foundations
Basis of Ethical Decision Making
■ Autonomy: Support personal freedom and decision making
■ Beneficence: Promote good
■ Fidelity: Keep promises and commitments
■ Justice: Treat people fairly and equally
■ Nonmaleficence: Do no harm
■ Paternalism: Make or allow a person to make a decision for
another
■ Respect: Acknowledge rights of others
■ Veracity: Tell the truth
Legal Terms
■ Advance directive: Written document that addresses treatment desires in
the future if unable to make decisions
■ Living will: Specifically identifies treatment desires
■ Health care proxy (durable power of attorney): Assigns decision making
to another
■ Do not resuscitate: Order stating that a patient should not
be revived; at request of patient when able; health care proxy,
family member, or legal guardian when patient is unable to give
consent
■ Assault: Threat of unlawful touching of another
■ Battery: Unlawful touching of another without consent (e.g., procedures
performed without consent)
■ False imprisonment: Restriction/retention of patient without consent; use
restraints in compliance with policy and procedure; have patient sign
release if desiring to leave facility against medical advice
■ Good Samaritan Law: Legal protection for those who render care in an
emergency without expectation of remuneration
■ Libel: Written statement causing harm to patient
BASICS
Ethical and Legal Foundations
Basis of Ethical Decision Making
■ Autonomy: Support personal freedom and decision making
■ Beneficence: Promote good
■ Fidelity: Keep promises and commitments
■ Justice: Treat people fairly and equally
■ Nonmaleficence: Do no harm
■ Paternalism: Make or allow a person to make a decision for
another
■ Respect: Acknowledge rights of others
■ Veracity: Tell the truth
Legal Terms
■ Advance directive: Written document that addresses treatment desires in
the future if unable to make decisions
■ Living will: Specifically identifies treatment desires
■ Health care proxy (durable power of attorney): Assigns decision making
to another
■ Do not resuscitate: Order stating that a patient should not
be revived; at request of patient when able; health care proxy,
family member, or legal guardian when patient is unable to give
consent
■ Assault: Threat of unlawful touching of another
■ Battery: Unlawful touching of another without consent (e.g., procedures
performed without consent)
■ False imprisonment: Restriction/retention of patient without consent; use
restraints in compliance with policy and procedure; have patient sign
release if desiring to leave facility against medical advice
■ Good Samaritan Law: Legal protection for those who render care in an
emergency without expectation of remuneration
■ Libel: Written statement causing harm to patient
BASICS
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15
■ Malpractice: Professional negligence; occurs when the nurse owed a duty
to the patient, the nurse did not carry out that duty, and it resulted
in injury to the patient
■ Negligence: Failing to perform an act that a reasonable prudent nurse
would do under similar circumstances; may be an act of omission or
commission. Examples: Failure to ensure patient safety (falls); improper
performance of a treatment (burns from warm soak); med errors;
inappropriate use of equipment (excessive IVF via pump); and failure
to monitor, report, or document patient’s status
■ Organ donation: Donor card, living will, or family consent if patient
is unable to participate in decision is necessary to donate organs
■ Respondeat superior: Latin term meaning “let the master answer”;
employer is responsible for acts of employee causing harm during
employment activities
■ Slander: Oral statement resulting in damage to patient; nurse incorrectly
tells others that patient has AIDS and it affects patient’s business
■ Uniform Determination of Death Act:
■ Cardiopulmonary criteria: Irreversible cessation of circulatory and
respiratory function
■ Whole-brain criteria: Irreversible cessation of all functions of the entire
brain and brain stem (organs may be healthy for donation even though
meeting whole-brain criteria)
Disease and Treatment Mnemonics
CAUTION: EARLY SIGNS OF CANCER INFECT: S&S OF INFECTION
Change in bowel or bladder habits
A sore throat that doesn’t heal
Unusual bleeding or discharge
Thickening or lump
Indigestion; dysphagia
Obvious change in a wart or mole
Nagging cough ot hoarseness
RICE: TREATMENT FOR
ACUTE INJURY
Rest; ↓stress/strain on injury
Ice; vasoconstriction ↓edema and pain
Compression; external pressure
Elevate: gravity ↓edema
BASICS
Increased pulse, respirations, WBCs
Nodes are enlarged
Function is impaired
Erythema, Edema, Exudate
Complains of discomfort/pain
Temperature – local or systemic
■ Malpractice: Professional negligence; occurs when the nurse owed a duty
to the patient, the nurse did not carry out that duty, and it resulted
in injury to the patient
■ Negligence: Failing to perform an act that a reasonable prudent nurse
would do under similar circumstances; may be an act of omission or
commission. Examples: Failure to ensure patient safety (falls); improper
performance of a treatment (burns from warm soak); med errors;
inappropriate use of equipment (excessive IVF via pump); and failure
to monitor, report, or document patient’s status
■ Organ donation: Donor card, living will, or family consent if patient
is unable to participate in decision is necessary to donate organs
■ Respondeat superior: Latin term meaning “let the master answer”;
employer is responsible for acts of employee causing harm during
employment activities
■ Slander: Oral statement resulting in damage to patient; nurse incorrectly
tells others that patient has AIDS and it affects patient’s business
■ Uniform Determination of Death Act:
■ Cardiopulmonary criteria: Irreversible cessation of circulatory and
respiratory function
■ Whole-brain criteria: Irreversible cessation of all functions of the entire
brain and brain stem (organs may be healthy for donation even though
meeting whole-brain criteria)
Disease and Treatment Mnemonics
CAUTION: EARLY SIGNS OF CANCER INFECT: S&S OF INFECTION
Change in bowel or bladder habits
A sore throat that doesn’t heal
Unusual bleeding or discharge
Thickening or lump
Indigestion; dysphagia
Obvious change in a wart or mole
Nagging cough ot hoarseness
RICE: TREATMENT FOR
ACUTE INJURY
Rest; ↓stress/strain on injury
Ice; vasoconstriction ↓edema and pain
Compression; external pressure
Elevate: gravity ↓edema
BASICS
Increased pulse, respirations, WBCs
Nodes are enlarged
Function is impaired
Erythema, Edema, Exudate
Complains of discomfort/pain
Temperature – local or systemic
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Therapeutic Nurse-Patient Relationship
Phases of Interaction
Phase Nurse Patient
Preinteraction:
Begins before
contact with patient
Orientation
(introductory):
Begins at first
meeting of
nurse/patient
Working: Begins
when patient
identifies problems
to be worked on
Resolution
(termination):
Begins when
problems are
resolved; ends
when relationship
is terminated
BASICS
Explore personal feelings, values, attitudes
Collect data about patient
Plan for 1st interaction
Listen; be empathetic
Identify boundaries of relationship
(termination begins here)
Clarify expectations
Establish rapport
Assist with exploration of issues
Support healthy problem solving
Assist with strategy development
Identify own reactions to client based on
own needs, conflicts, relationships
(counter transference)
Review objectives/goals achieved
Reinforce adaptive behaviors
Share feelings about termination
Avoid discussing previous issues
Encourage independence; focus on future
Promote positive family interactions
Refer to community resources
Patient has no role in this phase
Recognize need for help
Commit to a therapeutic
relationship
Begin to test relationship
Develop trust in nurse
Examine personal issues
Develop strategies to resolve issues
May superimpose feelings from
another relationship onto the
nurse/patient relationship
(transference)
Share feelings about termination
(anger, rejection, regression;
negative feelings may be
expressed to deal with loss)
May attempt to discuss previous
issues
Assume responsibility for use of
community resources
Therapeutic Nurse-Patient Relationship
Phases of Interaction
Phase Nurse Patient
Preinteraction:
Begins before
contact with patient
Orientation
(introductory):
Begins at first
meeting of
nurse/patient
Working: Begins
when patient
identifies problems
to be worked on
Resolution
(termination):
Begins when
problems are
resolved; ends
when relationship
is terminated
BASICS
Explore personal feelings, values, attitudes
Collect data about patient
Plan for 1st interaction
Listen; be empathetic
Identify boundaries of relationship
(termination begins here)
Clarify expectations
Establish rapport
Assist with exploration of issues
Support healthy problem solving
Assist with strategy development
Identify own reactions to client based on
own needs, conflicts, relationships
(counter transference)
Review objectives/goals achieved
Reinforce adaptive behaviors
Share feelings about termination
Avoid discussing previous issues
Encourage independence; focus on future
Promote positive family interactions
Refer to community resources
Patient has no role in this phase
Recognize need for help
Commit to a therapeutic
relationship
Begin to test relationship
Develop trust in nurse
Examine personal issues
Develop strategies to resolve issues
May superimpose feelings from
another relationship onto the
nurse/patient relationship
(transference)
Share feelings about termination
(anger, rejection, regression;
negative feelings may be
expressed to deal with loss)
May attempt to discuss previous
issues
Assume responsibility for use of
community resources
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BASICS
Interviewing
Interviewing Skills
■ Active listening: Absorbs content/feelings; uses all senses; includes
verbal/nonverbal attending, appropriate gestures (head nodding), eye
contact, sitting, open posture, vocal cues (“mmm”).
■ Clarification: Asks for more information. Checks accuracy. ↓Ambiguity: “I
am not sure I know what you mean by that.”
■ Confrontation: Presents reality, identifies inconsistencies. ↑Self-
awareness. Use gently after trust is developed. Pt: “I never have
any visitors.” Nurse: “I was here yesterday when you had 3
visitors.”
■ Direct: Collects specific information quickly: “Where is your pain?”
■ Focusing: Let patient finish thoughts. Centers on key elements to
↓rambling. “When talking about your house, you mentioned scatter rugs.
Let’s talk more about being safe in your home.”
■ Nonverbal: Promotes verbalization. Techniques include leaning forward,
nodding head, smiling, gestures.
■ Open-ended: Invites elaboration, nonthreatening. Avoids yes/no answer:
“Tell me about what a typical day is like for you.”
■ Paraphrasing: Restates message in same/similar words. Focuses on
content; encourages discussion. Pt: “I may not make it through the
surgery.” Nurse: “You think you are going to die?”
■ Reflection: Describes/interprets feelings/mood: “You sound upset.”
■ Silence: Allows for reflection, processing a response. Prompts talking.
Useful when patient is sad/grieving or remaining quiet.
■ Summarizing: Reviews key elements; brings closure. Clarifies
expectations: “Today we talked about . . .”
■ Touch: Conveys caring, is reassuring. May invade personal space; avoid
with suspicious or angry patients. Hold patient’s hand, patting gently on
patient’s shoulder.
■ Validation: Confirms what the nurse heard or observed: “I understand that
you just said . . .”
Barriers to Communication
■ Pain
■ Failing to listen
■ Overly optimistic statements (false reassurance)
■ Advising
■ Changing topic
■ Judgmental or minimizing comments
BASICS
Interviewing
Interviewing Skills
■ Active listening: Absorbs content/feelings; uses all senses; includes
verbal/nonverbal attending, appropriate gestures (head nodding), eye
contact, sitting, open posture, vocal cues (“mmm”).
■ Clarification: Asks for more information. Checks accuracy. ↓Ambiguity: “I
am not sure I know what you mean by that.”
■ Confrontation: Presents reality, identifies inconsistencies. ↑Self-
awareness. Use gently after trust is developed. Pt: “I never have
any visitors.” Nurse: “I was here yesterday when you had 3
visitors.”
■ Direct: Collects specific information quickly: “Where is your pain?”
■ Focusing: Let patient finish thoughts. Centers on key elements to
↓rambling. “When talking about your house, you mentioned scatter rugs.
Let’s talk more about being safe in your home.”
■ Nonverbal: Promotes verbalization. Techniques include leaning forward,
nodding head, smiling, gestures.
■ Open-ended: Invites elaboration, nonthreatening. Avoids yes/no answer:
“Tell me about what a typical day is like for you.”
■ Paraphrasing: Restates message in same/similar words. Focuses on
content; encourages discussion. Pt: “I may not make it through the
surgery.” Nurse: “You think you are going to die?”
■ Reflection: Describes/interprets feelings/mood: “You sound upset.”
■ Silence: Allows for reflection, processing a response. Prompts talking.
Useful when patient is sad/grieving or remaining quiet.
■ Summarizing: Reviews key elements; brings closure. Clarifies
expectations: “Today we talked about . . .”
■ Touch: Conveys caring, is reassuring. May invade personal space; avoid
with suspicious or angry patients. Hold patient’s hand, patting gently on
patient’s shoulder.
■ Validation: Confirms what the nurse heard or observed: “I understand that
you just said . . .”
Barriers to Communication
■ Pain
■ Failing to listen
■ Overly optimistic statements (false reassurance)
■ Advising
■ Changing topic
■ Judgmental or minimizing comments
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18
■ Challenging, defensive, or disapproving responses
■ Direct probing and “how” and “why” questions
■ Interruptions, environmental noise, or extremes in temperature
■ Trite, common expressions (clichés)
Leadership
Leadership and Management Terms
■ Accountability: Answerable for actions/judgments regarding care
■ Autonomy: Nurse can make independent decision to decide/act
■ Case management: Coordination of interdisciplinary care for pt
■ Decentralized management: Staff participate in decision making
■ Performance appraisal: Evaluation of a nurse’s compliance (quality
& quantity) with standards and roles within job description
■ Professional standards: Actions consistent with minimum safe
professional conduct. Description of responsibilities. ANA, JCAHO, agency
policy and procedure
■ Quality improvement: Activities to ↑achievement of ideal care
■ Responsibility: Duties and activities that nurse is hired to perform
Leadership Styles
■ Autocratic: Complete control over decisions, goals, plan, and evaluation of
outcomes; firm, insistent; often used in emergencies or when staff is
inexperienced or new
■ Democratic: Participative; shares responsibilities; uses role to motivate
staff to achieve communal goals (shared governance), encourages
intercommunication and contributions; used to help staff grow in abilities;
↑motivation, ↑staff satisfaction
■ Laissez-faire: Nondirective; relinquishes control & direction to staff; best
used with experienced, expert, mature staff who know roles
Tasks That May Not Be Delegated to Unlicensed Nursing Personnel
■ Assessing, analyzing, and interpreting data
■ Identifying nursing diagnoses
■ Formulating a plan of care
■ Evaluating pt responses to nursing care and extent of outcome
achievement
■ Screening and classifying pts to determine priority to receive intervention
(triage)
BASICS
■ Challenging, defensive, or disapproving responses
■ Direct probing and “how” and “why” questions
■ Interruptions, environmental noise, or extremes in temperature
■ Trite, common expressions (clichés)
Leadership
Leadership and Management Terms
■ Accountability: Answerable for actions/judgments regarding care
■ Autonomy: Nurse can make independent decision to decide/act
■ Case management: Coordination of interdisciplinary care for pt
■ Decentralized management: Staff participate in decision making
■ Performance appraisal: Evaluation of a nurse’s compliance (quality
& quantity) with standards and roles within job description
■ Professional standards: Actions consistent with minimum safe
professional conduct. Description of responsibilities. ANA, JCAHO, agency
policy and procedure
■ Quality improvement: Activities to ↑achievement of ideal care
■ Responsibility: Duties and activities that nurse is hired to perform
Leadership Styles
■ Autocratic: Complete control over decisions, goals, plan, and evaluation of
outcomes; firm, insistent; often used in emergencies or when staff is
inexperienced or new
■ Democratic: Participative; shares responsibilities; uses role to motivate
staff to achieve communal goals (shared governance), encourages
intercommunication and contributions; used to help staff grow in abilities;
↑motivation, ↑staff satisfaction
■ Laissez-faire: Nondirective; relinquishes control & direction to staff; best
used with experienced, expert, mature staff who know roles
Tasks That May Not Be Delegated to Unlicensed Nursing Personnel
■ Assessing, analyzing, and interpreting data
■ Identifying nursing diagnoses
■ Formulating a plan of care
■ Evaluating pt responses to nursing care and extent of outcome
achievement
■ Screening and classifying pts to determine priority to receive intervention
(triage)
BASICS
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19
■ Giving/monitoring parenteral medications
■ Performing patient teaching
■ Performing professional procedures (e.g., sterile irrigations, insertion
of urinary catheter, colostomy irrigation, tracheal suctioning)
Leader and/or Manager Qualities
Effective leaders and managers need to:
■ Understand human behavior
Have insight into its relationship to beliefs, values, feelings; be sensitive
to others’ feelings and problems
■ Use effective communication skills
Be clear, concise, avoid ambiguity; use appropriate format (verbal,
written, formal, informal); be aware of own nonverbal behavior; support
staff in growth of skills
■ Use power appropriately
Power attained through place in table of organization (positional); power
attained through knowledge and experience or perceived by staff
(professional); do not abuse
■ Respond to staff needs
Listen attentively, attend to needs, provide positive feedback, avoid
favoritism, set realistic expectations, avoid mixed messages, and treat
staff with respect: Counsel privately; keep promises; avoid threats,
superior attitude, criticism, or aggressive confrontation
■ Delegate appropriately
Right person (competent subordinate), right task (is within scope of
practice), right situation (nursing assistant should not perform a routine
task on an acutely ill patient), right communication (clear instructions,
validate understanding of instructions), right supervision (monitor actions,
evaluate outcomes, review with subordinate); leader retains accountability
■ Provide opportunities for personal growth
Aid less experienced nurse to ↑knowledge, experience, responsibility
(e.g., mentor/preceptor, continuing education, staff education)
■ Use critical thinking and problem solving
Process requires effective communication, assessment, planning, and
participation of staff and evaluation of outcomes
■ Recognize conditions that are conducive to change
Need is recognized by all staff and all have a stake in outcome; include
all creatively in the process; focus on benefits; provide positive feedback;
offer incentives
■ Process follows problem-solving process
BASICS
■ Giving/monitoring parenteral medications
■ Performing patient teaching
■ Performing professional procedures (e.g., sterile irrigations, insertion
of urinary catheter, colostomy irrigation, tracheal suctioning)
Leader and/or Manager Qualities
Effective leaders and managers need to:
■ Understand human behavior
Have insight into its relationship to beliefs, values, feelings; be sensitive
to others’ feelings and problems
■ Use effective communication skills
Be clear, concise, avoid ambiguity; use appropriate format (verbal,
written, formal, informal); be aware of own nonverbal behavior; support
staff in growth of skills
■ Use power appropriately
Power attained through place in table of organization (positional); power
attained through knowledge and experience or perceived by staff
(professional); do not abuse
■ Respond to staff needs
Listen attentively, attend to needs, provide positive feedback, avoid
favoritism, set realistic expectations, avoid mixed messages, and treat
staff with respect: Counsel privately; keep promises; avoid threats,
superior attitude, criticism, or aggressive confrontation
■ Delegate appropriately
Right person (competent subordinate), right task (is within scope of
practice), right situation (nursing assistant should not perform a routine
task on an acutely ill patient), right communication (clear instructions,
validate understanding of instructions), right supervision (monitor actions,
evaluate outcomes, review with subordinate); leader retains accountability
■ Provide opportunities for personal growth
Aid less experienced nurse to ↑knowledge, experience, responsibility
(e.g., mentor/preceptor, continuing education, staff education)
■ Use critical thinking and problem solving
Process requires effective communication, assessment, planning, and
participation of staff and evaluation of outcomes
■ Recognize conditions that are conducive to change
Need is recognized by all staff and all have a stake in outcome; include
all creatively in the process; focus on benefits; provide positive feedback;
offer incentives
■ Process follows problem-solving process
BASICS
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20
■ Change is planned and introduced gradually
■ Change is initiated in a calm rather than chaotic atmosphere; best after
a prior successful change
■ Resistance is recognized and addressed; causes of resistance: change is
threatening; lack of understanding; disagreeing with purpose/approach,
beliefs, and values; ↑in responsibility; habit; fear of failure
Levels of Management
■ First-level: Supervises nonmanagerial staff; oversees day-to-day activities
of a group (e.g., Team Leader, Charge Nurse)
■ Middle-level: Supervises a group of first-level managers (e.g., Supervisor,
Coordinator, Head Nurse)
■ Upper-level: Organizational executives; sets goals and strategic planning
(e.g., VP for Nursing, Associate Director of Nursing)
Staff Nurse Role
■ Function as role model regarding professional conduct
■ Receive report from nurse previously responsible for patient
■ Make rounds on all pts immediately after receiving report
■ Set priorities regarding pt needs: Immediate threat to survival (problems
with breathing, VS, ↓LOC), requests for help (pain, toileting), urgent but
not immediate needs (teaching)
■ Coordinate and/or perform care for assigned pts; use time-management
skills; complete all care assigned
■ Delegate care to subordinates that is within their job description
■ Monitor care delegated; establish clear expectations; encourage
communication; evaluate patient outcomes related to delegated tasks
(nurse retains accountability for delegated tasks)
■ Give report to next nurse responsible for patient
■ Engage in quality improvement (QI) activities
■ Participate in intradepartmental and interdepartmental meetings
Nurse Manager Role
■ Function as a role model regarding professional conduct
■ Set standards of performance; establish goals for the unit with the staff;
mobilize staff and agency resources to attain goals
■ Support mutual trust; treat staff with respect; counsel privately
■ Empower staff: Support innovation, seek staff members’ opinions,
promote professional environment and growth, reward growth
■ Perform pt rounds with multidisciplinary team
BASICS
■ Change is planned and introduced gradually
■ Change is initiated in a calm rather than chaotic atmosphere; best after
a prior successful change
■ Resistance is recognized and addressed; causes of resistance: change is
threatening; lack of understanding; disagreeing with purpose/approach,
beliefs, and values; ↑in responsibility; habit; fear of failure
Levels of Management
■ First-level: Supervises nonmanagerial staff; oversees day-to-day activities
of a group (e.g., Team Leader, Charge Nurse)
■ Middle-level: Supervises a group of first-level managers (e.g., Supervisor,
Coordinator, Head Nurse)
■ Upper-level: Organizational executives; sets goals and strategic planning
(e.g., VP for Nursing, Associate Director of Nursing)
Staff Nurse Role
■ Function as role model regarding professional conduct
■ Receive report from nurse previously responsible for patient
■ Make rounds on all pts immediately after receiving report
■ Set priorities regarding pt needs: Immediate threat to survival (problems
with breathing, VS, ↓LOC), requests for help (pain, toileting), urgent but
not immediate needs (teaching)
■ Coordinate and/or perform care for assigned pts; use time-management
skills; complete all care assigned
■ Delegate care to subordinates that is within their job description
■ Monitor care delegated; establish clear expectations; encourage
communication; evaluate patient outcomes related to delegated tasks
(nurse retains accountability for delegated tasks)
■ Give report to next nurse responsible for patient
■ Engage in quality improvement (QI) activities
■ Participate in intradepartmental and interdepartmental meetings
Nurse Manager Role
■ Function as a role model regarding professional conduct
■ Set standards of performance; establish goals for the unit with the staff;
mobilize staff and agency resources to attain goals
■ Support mutual trust; treat staff with respect; counsel privately
■ Empower staff: Support innovation, seek staff members’ opinions,
promote professional environment and growth, reward growth
■ Perform pt rounds with multidisciplinary team
BASICS
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21
■ Monitor nursing practice and achievement of standards
■ Design and implement a quality improvement (QI) program for the unit;
engage staff in QI activities
■ Assist in staff development plan and orientation of new employees
■ Schedule staffing for the unit
■ Conduct regular staff meetings with all shifts
■ Evaluate performance of subordinates (performance appraisal)
■ Participate in intradepartmental and interdepartmental meetings
Community Nursing
■ Community health nursing (public health nursing): Nursing care for a
specific population living in the same geographic area, or groups having
similar values, interests, and needs. Aims to develop a healthy
environment in which to live
■ Public health functions: Community assessment, policy development,
and facilitating access to resources. Cohesiveness is promoted by
engaging community members in the problem-solving process and
promoting empowerment through education, opportunities, and
resources. Successful public health programs are congruent with that
of the interests and goals of the community
■ Assessment of a community:
■ Structure (milieu): Geographical area, environment, housing, economy,
water, and sanitation
■ Population: Age and sex distribution, density, growth trends,
educational level, cultures and subcultures, religious groups
■ Social systems: Education, communication, transportation, wel-
fare, and health care delivery systems; government and volunteer
agencies
■ Community-based nursing: Nursing care delivered in the community
while focused on a specific individual’s or family’s health care needs. The
individual is viewed within the larger systems of family, community,
culture, and society
■ Vulnerable populations: People at risk for illness (e.g., homeless, living in
poverty, migrant workers, living in rural communities, pregnant
adolescents, suicidal individuals, frail older adults)
■ Stigmatized groups: People viewed with disdain/disgrace (e.g., pts with dx
of HIV positive, substance abuse, mental illness)
■ Settings in which nurses work: Homes, community health centers, clinics,
industry, rehabilitation centers, schools, crisis intervention centers (phone
lines), shelters, halfway houses, sheltered workshops, day care centers,
forensic settings
BASICS
■ Monitor nursing practice and achievement of standards
■ Design and implement a quality improvement (QI) program for the unit;
engage staff in QI activities
■ Assist in staff development plan and orientation of new employees
■ Schedule staffing for the unit
■ Conduct regular staff meetings with all shifts
■ Evaluate performance of subordinates (performance appraisal)
■ Participate in intradepartmental and interdepartmental meetings
Community Nursing
■ Community health nursing (public health nursing): Nursing care for a
specific population living in the same geographic area, or groups having
similar values, interests, and needs. Aims to develop a healthy
environment in which to live
■ Public health functions: Community assessment, policy development,
and facilitating access to resources. Cohesiveness is promoted by
engaging community members in the problem-solving process and
promoting empowerment through education, opportunities, and
resources. Successful public health programs are congruent with that
of the interests and goals of the community
■ Assessment of a community:
■ Structure (milieu): Geographical area, environment, housing, economy,
water, and sanitation
■ Population: Age and sex distribution, density, growth trends,
educational level, cultures and subcultures, religious groups
■ Social systems: Education, communication, transportation, wel-
fare, and health care delivery systems; government and volunteer
agencies
■ Community-based nursing: Nursing care delivered in the community
while focused on a specific individual’s or family’s health care needs. The
individual is viewed within the larger systems of family, community,
culture, and society
■ Vulnerable populations: People at risk for illness (e.g., homeless, living in
poverty, migrant workers, living in rural communities, pregnant
adolescents, suicidal individuals, frail older adults)
■ Stigmatized groups: People viewed with disdain/disgrace (e.g., pts with dx
of HIV positive, substance abuse, mental illness)
■ Settings in which nurses work: Homes, community health centers, clinics,
industry, rehabilitation centers, schools, crisis intervention centers (phone
lines), shelters, halfway houses, sheltered workshops, day care centers,
forensic settings
BASICS
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■ Roles of nurses: Discharge planner, case manager, counselor, and
epidemiologist, health promoter, case finder, caregiver, educator,
researcher, consultant, advocate, role model, change agent
■ Hospice care: Palliative (relieve or ↓discomfort) and supportive care for
dying persons and their caregivers. Experts in pain and symptom
management. Focuses on preserving dignity and quality over quantity of
life. Supports bereavement; usually during last 6mo of life
■ Respite care: Temporary care for homebound so that caregivers have relief
from day-to-day responsibilities
Patient Education
Learning Domains
Cognitive domain: Thinking, acquiring, comprehending, synthesizing,
evaluating, storing, and recalling information.
■ Build on what pt knows. Present essential information first. Add
information as pt asks questions.
■ Teaching strategies: Lecture, discussion, audiovisuals, printed material,
computer-assisted and Web-based instruction.
■ Evaluation: Assess knowledge by verbal/written means.
Affective domain: Addresses attitudes, feelings, beliefs, values. Takes time to
internalize need-to-change behavior.
■ Understand own value system. Respect uniqueness of each pt. Help pt
explore feelings.
■ Teaching strategies: Discussion, play, role modeling, panel discussion,
groups, role-playing.
■ Evaluation: Evidence of behavior incorporated into lifestyle.
Psychomotor domain: Addresses physical/motor skills. Requires dexterity
and coordination to manipulate equipment. Ultimately performs a task with
skill.
■ Achieve mastery of each step before moving on to next step.
■ Teaching strategies: Audiovisuals, pictures, demonstrations, models.
■ Evaluation: observation of performance of skill (return demonstration).
Teaching and Learning—General Concepts
■ Education can prevent illness, promote or restore health, ↓complications,
↑independence and coping, ↑individual and family growth. Incorporate
throughout health care delivery.
■ Environment should be conducive to learning: Private, quiet, well lit,
comfortable, and lack distractions (close door/curtain, shut off TV).
■ Teaching process should follow format of Nursing Process.
BASICS
■ Roles of nurses: Discharge planner, case manager, counselor, and
epidemiologist, health promoter, case finder, caregiver, educator,
researcher, consultant, advocate, role model, change agent
■ Hospice care: Palliative (relieve or ↓discomfort) and supportive care for
dying persons and their caregivers. Experts in pain and symptom
management. Focuses on preserving dignity and quality over quantity of
life. Supports bereavement; usually during last 6mo of life
■ Respite care: Temporary care for homebound so that caregivers have relief
from day-to-day responsibilities
Patient Education
Learning Domains
Cognitive domain: Thinking, acquiring, comprehending, synthesizing,
evaluating, storing, and recalling information.
■ Build on what pt knows. Present essential information first. Add
information as pt asks questions.
■ Teaching strategies: Lecture, discussion, audiovisuals, printed material,
computer-assisted and Web-based instruction.
■ Evaluation: Assess knowledge by verbal/written means.
Affective domain: Addresses attitudes, feelings, beliefs, values. Takes time to
internalize need-to-change behavior.
■ Understand own value system. Respect uniqueness of each pt. Help pt
explore feelings.
■ Teaching strategies: Discussion, play, role modeling, panel discussion,
groups, role-playing.
■ Evaluation: Evidence of behavior incorporated into lifestyle.
Psychomotor domain: Addresses physical/motor skills. Requires dexterity
and coordination to manipulate equipment. Ultimately performs a task with
skill.
■ Achieve mastery of each step before moving on to next step.
■ Teaching strategies: Audiovisuals, pictures, demonstrations, models.
■ Evaluation: observation of performance of skill (return demonstration).
Teaching and Learning—General Concepts
■ Education can prevent illness, promote or restore health, ↓complications,
↑independence and coping, ↑individual and family growth. Incorporate
throughout health care delivery.
■ Environment should be conducive to learning: Private, quiet, well lit,
comfortable, and lack distractions (close door/curtain, shut off TV).
■ Teaching process should follow format of Nursing Process.
BASICS
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Subject
National Council Licensure Examination