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Exam 1 Study Guide
Exam 1 Study Guide
Exam 1 Study Guide
of Professional Nursing
Exam 1 Study Guide—Fall 2016
Intro to Nursing, Evidence-Based Practice, and Health (Chapters 1-4)
Nursing Process: Assessment, diagnosis, planning, interventions, and evaluation (Chapters 10-15)
• Review each step and be ready to apply this information to a specific situation. For example, if the nurse had
collected all the data on a patient and was clustering the data to identify a problem, what phase does this represent?
The answer would be diagnosis, which is identifying the problem or potential problem. Be familiar with each phase
of the nursing process in order to identify the phase in an example.
• Review principles of body mechanics to prevent injury when lifting and moving objects and clients.
Develop a habit of erect posture (correct alignment).
Use the longest and the strongest muscles of the arms and the legs to help provide the power needed in strenuous
activities.
Use the internal girdle and a long midriff to stabilize the pelvis and to protect the abdominal viscera when stooping,
reaching, lifting, or pulling.
Work as closely as possible to an object that is to be lifted or moved. Face the direction of your movement.
Avoid twisting your body. Use the weight of the body as a force for pulling or pushing. Slide, roll, push, or pull an
object, rather than lift it.
Use the weight of the body to push an object by falling or rocking forward and to pull an object by falling or rocking
backward.
Push rather than pull equipment when possible.
Begin activities by broadening your base of support. Spread the feet to shoulder width.
Flex the knees, put on the internal girdle, and come down close to an object that is to be lifted.
Break up heavy loads into smaller loads
Fundamentals of Professional Nursing
Exam 1 Study Guide—Fall 2016
• Review the effects of immobility on the body by systems.
Cardiovascular system: increased cardiac workload, orthostatic hypotension, and venous stasis, with resulting
venous thrombosis.
Respiratory System: decreased ventilatory effort and increased respiratory secretions. Decrease in the depth and rate
of respiration, reduced need for oxygen by body cells. When areas of lung tissue are not used over time, atelectasis
(incomplete expansion or col- lapse of lung tissue) may occur. Hypostatic pneumonia is a type of pneumonia that
results from inactivity and immobility.
Musculoskeletal system: decreased muscle size (atrophy), tone, and strength; decreased joint mobility and flexibility
(ankyloses); bone demineralization (osteoporosis); and limited endurance, resulting in problems with ADLs.
Metabolic processes: Decrease metabolic rate, fever, trauma, chronic illness, or poor nutrition increases and increase
catabolism. Anorexia, or decreased appetite, often accompanies and compounds this problem.
Gastrointestinal system: constipation, poor defecation reflexes, and an inability to expel feces and gas adequately.
Urinary system: Poor perineal hygiene, incontinence, decreased fluid intake, or an indwelling urinary catheter can
increase the risk for urinary tract infection in an immobile patient.
Skin: impaired circulation that accompanies immobility result in skin breakdown and pressure ulcers.
Psychosocial outlook: influence body image, diminished self-esteem and a person’s opportunities to interact socially
and deprive.
• Review safe patient handling and movement.
Assess the patient first. Encourage patients to assist tin their own transfers. Assess the patient’s ability to understand
instructions and cooperate with the staff to achieve the movement. Ensure that enough staff is available and present
to safely move the patient. Plan carefully what you will do before moving or lifting a patient. Explain to the patient
what you plan to do. Lock the wheels of the bed, wheelchair, or stretcher so that they do not slide while you are
moving the patient.
The gait belt is used to help the patient stand and provides stabilization during pivoting. Gait belts also allow the
nurse to assist in ambulating patients who have leg strength, can cooperate, and require minimal assistance. Do not
use gait belts on patients with abdominal or thoracic incisions.
Friction-reducing sheets can be used under patients to prevent skin shearing when moving patients in bed and when
assisting with lateral transfers. Their use reduces friction and the force required to move patients.
• Review patient positioning: Table 32-6
Fowler’s position: semi-sitting, fowler’s elevated 45 to 60 degrees. Used to promote cardiac and respiratory
functioning that providing maximal space in the thoracic cavity. High fowler’s 90 degree for maximal lung
expansion. The heels, sacrum, and scapulae are at risk for skin breakdown and require frequent assessment.
• Define the terms:
atrophy: decreased muscle size, contractures: permanent contraction of a muscle, dangling, flaccidity: decreased
muscle tone, footdrop: Planter flexion that can cause an alteration in the length of muscles, spasticity: increased
muscle tone, and osteoporosis.
• Review the handout from lab with the various therapeutic communication techniques as well as the blocks to communication.
Fundamentals of Professional Nursing
Exam 1 Study Guide—Fall 2016
• Review non-verbal communication
• Review the use of therapeutic communication in the nursing process (p.457-458).
• Review the phases of the helping relationship.
• Review “Communicating with Patients Who Have Special Needs” (Box 20-6).
• Review the physiologic processes involved in homeostatic regulation of temperature, pulse, respirations, and blood
pressure.
• Review the factors that increase or decrease the body temperature, pulse, respirations, and blood pressure.
o Mechanisms of heat transfer: Radiation, convection, evaporation, conduction.
o Ranges of normal for blood pressure, pulse, respirations, temperature, and O2 saturation (Table 24-3)
o How each vital sign is measured and which equipment/site is most appropriate for the client
o Know terms: afebrile, febrile, bradycardia, tachycardia, bradypnea, tachypnea, apnea, eupnea.
o Pulse rhythm and amplitude (Table 24-5),
o Factors affecting VS
o When to take an apical pulse:
If a peripheral pulse is difficult to assess accurately because it is irregular, weak, or very rapid, the apical rate should
be assessed using a stethoscope. An apical pulse is also assessed when giving medications that alter heart rate and
rhythm. Apical pulse measurement is also the preferred method of pulse assessment for infants and children less
than 2 years of age.
• Terms: pruritus (Itching), maceration (overhydration that softening and breakdown of skin, results from prolonged
exposure to moisture), excoriation (scratch or abrasion of the epidermis), abrasion (friction; rubbing or scraping epidermal
layers of skin), pressure ulcers (compromised circulation secondary to pressure or pressure combined with friction).
• What duties can the RN delegate to the assistive personnel and what must be done by the professional RN?
Basic personal care measure has often been assigned to an unlicensed staff member rather than the professional nurse.
Unlicensed assistive personnel are increasingly performing hygiene measures, the nurse is responsible for ensuring that
hygiene measures are performed satisfactorily. Bed bath, oral hygiene
• Review procedure for bed bath: head to toe, clean to soiled areas.
• Care of the skin
• Bathing patients with dementia
• Definitions and order of assessment for of abdomen: inspection, auscultation, palpation and percussion.
Fundamentals of Professional Nursing
Exam 1 Study Guide—Fall 2016
• General survey (what is included?): It includes observing the
patient’s overall appearance and behavior, taking vital signs,
measuring height, weight, and waist circumference, and calculating
the body mass index (BMI).