Nursing exam 3 - Practice ATI Questions and Answers PDF

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Practice ATI Questions and Answers...

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Anxiety: o Mild: Crying, laughing, sleeping, cursing o Physical activity, exercise o Smoking, drinking o Lack of eye contact, withdrawal o Moderate: Narrows a person’s perceptual fields so that the focus is on immediate concerns, with inattention to other communications and details. o Manifested by a quavering voice, tremors, increased muscle tension, a complaint of “butterflies in the stomach,” and slight increases in respirations and pulse o Severe: Creates a very narrow focus on specific details, causing all behavior to be geared toward getting relief. The person has impaired learning ability and is easily distracted. Characterized by extreme fear of a danger that is not real, by emotional distress that interferes with everyday life, and by avoiding situations that cause anxiety o Manifested by difficulty communicating verbally, increased motor activity, a fearful facial expression, headache, nausea, dizziness, tachycardia, and hyperventilation. o Anxiety is no longer functioning as a signal for danger or motivation for a needed change, but instead results in maladaptive behaviors and emotional disability that signal the presence of an anxiety disorder. o Panic: Causes the person to lose control and experience dread and terror. The resulting disorganized state is characterized by increased physical activity, distorted perception of events, and loss of rational thought. Manifested by difficulty communicating verbally, agitation, trembling, poor motor control, sensory changes, sweating, tachycardia, hyperventilation, dyspnea, palpitations, a choking sensation, and sensations of chest pain or pressure. The person is unable to learn, concentrates only on the present situation, and often experiences feelings of impending doom. This level of anxiety can lead to exhaustion and death. Acupuncture: o Acupuncture addresses a person’s qi. Qi is believed to flow vertically in the body through an intricate structure of 12 primary meridians, energy circuits that nourish and support all cells and organs of the body o Consists of placing very thin, short, sterile needles at particular. Acupoints, believed to be the centers of nerve and vascular tissue, along a meridian o Acupuncture either increases or decreases the flow of qi along the meridian, restoring the balance of yin and yang o Change in flow of energy contributes to healing o Acupuncture has been used in China dating back 5,000 years, and has only been in the US since the 1970’s. Allopathic medicine: o Dominant for 100 years in the United States and has spearheaded remarkable advances in biotechnology, surgical interventions, pharmaceutical approaches, and diagnostic tools o Effective with aggressive treatment in an emergency or acute situation o Not effective in dealing with persistent symptoms related to chronic illness and patient quality of life Aging Sensory Changes:

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Vision changes: Presbyopia, o Diseases that alter vision § cataracts, macular degeneration, glaucoma, diabetic retinopathy, hypertensive retinopathy, temporal arteritis, detached retina Hearing changes: Presbycusis, conductive hearing loss, sensorineural hearing loss o Diseases that alter hearing § Central auditory processing disorder, tinnitus, Meniere’s disease Taste and smell changes: Decline in sensitivity to airborne chemical stimuli o Decreased ability to detect foods that are sweet o Disease that alter taste/smell § Burning mouth syndrome Peripheral sensation changes: Peripheral nerve that controls touch, declines o Two-point discrimination and vibratory sense decrease. The ability to perceive painful stimuli is preserved, but there may be slowed reaction The ability to perceive painful stimuli is preserved, but there may be slowed reaction Disease that alter peripheral sensations § Peripheral neuropathy, diabetic neuropathy, phantom limb pain, acute sensory loss.

Adaptation: is when the body quickly adapts to constant stimuli; a stimulus must be variable or irregular to evoke a response Anticipatory guidance: Focuses on psychologically preparing a person for an unfamiliar or painful event; can reduce anxiety, coping mechanisms are more effective

Alarm reaction: o Initiated when a person perceives a specific stressor and various defense mechanisms are activated; the perception of threat may be conscious or unconscious o Hormone levels rise; sympathetic nervous system initiates the fight or flight response, preparing the body to either fight off the stressor or to run away from it o Shock phase is characterized by an increase in energy levels, oxygen intake, cardiac output, blood pressure, and mental alertness o Countershock phase is a reversal of body changes Biofeedback: Method of gaining mental control of the autonomic nervous system and thus regulating body responses, such as BP, HR, and headaches o A monitoring device is used, and the patient tries to control the readings through relaxation and conscious thought. Chinese Medicine: o Yin-yang theory: The concept of two opposing, yet complementary, forces that shape the world and all life o A vital energy or life force called qi circulates in the body through a system of pathways called meridians. Health is an ongoing process of maintaining balance and harmony in the circulation of qi • o Uses eight principles to analyze symptoms and categorize conditions o Cold/heat o Inferior/exterior o Excess/deficiency o Yin/yang

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Uses five elements to explain how the body works; these elements correspond to particular organs and tissues in the body o Fire o Earth o Metal o Water o Wood

Circadian Rhythm: Predictable fluctuations in processes that occur in repeated cycles of time, completing a full cycle every 24 hours. Fluctuations in a person’s heart rate, blood pressure, body temperature, hormone secretions, metabolism, and performance and mood display circadian rhythms. Chiropractic Medicine: o Chiropractic health care is a profession that focuses on the relationship between the body’s structure – mainly the spine – and its functioning o Practitioners primarily perform adjustments to the spine or other parts of the body with the goal of correcting alignment problems, alleviating pain, improving function, and supporting the body’s natural ability to heal itself. o Chiropractors may combine the use of spinal adjustments and other manual therapies with several other treatments. Heat and ice o Electrical stimulation o Relaxation techniques o Rehabilitative and general exercise o Counseling about diet, weight loss, and other lifestyle factors o Dietary supplements. Crisis: o A crisis is a disturbance caused by a precipitating event, such as a perceived loss, a threat of loss, or a challenge, that is perceived as a threat to self. o In a crisis, the person’s usual. methods of coping are ineffective. This failure produces high levels of anxiety, disorganized behavior, and an inability to function adequately. o May be maturational, situational, or adventitious. Crisis Intervention: Identify the problem – List alternatives – Choose from among alternatives – implement the plan – Evaluate the outcome. Compensation: o Cause: a person attempts to overcome a perceived weakness by emphasizing a more desirable trait or overachieving in a more comfortable area. o Example: a student who has difficulty with academics may excel in sports Coping mechanisms: Behaviors used to decrease stress and anxiety. Many are learned, based on a person’s family, past experiences, and sociocultural influences and expectations o Can be positive or negative o Typical coping behaviors: Crying, laughing, sleeping, cursing § Physical activity, exercise § Smoking, drinking § Lack of eye contact, withdrawal § Limiting relationships to those with similar values and interests Confusion: Reduced awareness, easily distracted, easily startled by sensory stimuli, alternates between drowsiness and excitability; resembles minor form of delirium state Chakra: Concentrated areas of energy aligned vertically in the body that relate to each other as well as specific areas of the body, mind, and spirit

Denial: o Cause: a person refuses to acknowledge the presence of a condition that is disturbing. o Example: despite finding a lump in her breast, a woman does not seek medical treatment. Displacement: o Cause: a person transfers (displaces) an emotional reaction from one object or person to another object or person. o Example: an employee who is angry with a coworker kicks a chair. Dissociation: o Cause: a person subconsciously protects him or herself from the memories of a horrific or painful event by allowing the mind to forget the incident. o Example: an adult cannot recall childhood memories surrounding a traumatic death of a sibling Delirium: Disorientations, restlessness, confusion, hallucinations, agitation, alternating with othr conscious states Dementia: Difficulties with spatial orientation, memory, language; changes in personality

Dyssomnias: Sleep disorders where people have a hard time falling asleep or remaining asleep. Defense mechanisms: Protect a person’s self-esteem and are useful in mild to moderate anxiety o When extreme, they distort reality and create problems with relationships; mechanisms become maladaptive instead of adaptive Essential Oils: Ginger: nausea • Peppermint: nausea • Lavender: sleep • Chamomile: sleep, antiinflammatory • Aloe: wound healing • Echinacea: enhances immunity • Garlic: inhibits platelet aggregation • Ginkgo biloba: improves memory • Ginseng: increases physical endurance • Valerian: promotes sleep, reduces anxiety Guided imagery: A person creates a mental image, concentrates on the image, and becomes less responsive to other stimuli Hypothalamus: The hypothalamus is the control center for sleeping and waking. If the hypothalamus is injured, the person’s sleep pattern would be altered. Holism: o A theory and philosophy that focuses on connections and interactions between parts of the whole o By using a holistic perspective, all living organisms, including humans, are continuously connecting and interacting with their environment o Nursing practice is built on a holistice philosophy o Healing the whole person is the goal

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Holistic nurses frequently include CHA to their practices; use CHA for self-care, an essential component of holistic practice The American Holisitc Nursing Association promotes the education of nurses, other health care profesionals, and the public in all aspects of holistic caring and healing

Hypersomnia: o Excessive sleep, particularly during the day. o Treatment: Stimulant drugs, antidepressants, attention to diet and behavioral changes. Healing Touch: o The goal of healing touch is to restore wholeness through harmony and balance, enhancing the person’s ability to self-heal o Healing touch would be used when assessing and treating the human energy system; effects physical, emotional, mental, and spiritual health and healing

Insomnia: o Characterized by difficulty falling asleep, intermittent sleep or difficulty maintaining sleep, despite adequate opportunity and circumstances to sleep; people may complain of feeling tired, lethargic or irritability during the day. Difficulty concentrating is also common. Older adults who experience insomnia while in an acute care setting may manifest delirium as a symptom of sleep deprivation. o Can be short-term or chronic. Chronic insomnia can cause obesity, type II diabetes, depression, cardiovascular disorders (heart failure, stroke, hypertension, heart attack) are all conditions linked to chronic insomnia. o 30-35% of adults in the United States complain of insomnia § People older than 60 years old, women after menopause, and people with a history of depression are more likely to experience insomnia § Many reports are due to disrupted circadian rhythms. o Causes: Periods of stress, some change in the normal environment such as shift work; as a result of pain, discomfort, or limited mobility, and side effects of medications. o Treatments: Stop the misuse of alcohol and caffeine § Cognitive behavior therapy. Can include relaxation, stimulus cognitive therapy, cognitive therapy, work through maladaptive sleep beliefs; biofeedback, additional relaxation techniques, and sleep hygiene. Introjection: o Cause: a person incorporates qualities or values of another person into his or her own ego structure. This mechanism is important in the formation of conscience during childhood. o Example: an older sibling tells his preschool sister not to talk to strangers, expressing his parents’ values to his younger sister. Locked-in syndrome: Full consciousness; sleep-wake cycles present; quadriplegic, auditory and visual function preserved; emotion preserved

Local Adaptation Syndrome: A localized response of the body to stress; only involves a specific body part (tissue or organ) o The stress leading up to LAS can be traumatic or pathologic o Primarily homeostatic, short-term adaptive response o Two responses o Inflammatory response § Local response to injury or infection; serves to localize and prevent the spread of infection and promote wound healing Nightmares: o Frightening dreams that are vivid and disturbing o Occur more frequently in children and represent a normal developmental process. Naturopaths: o Naturopaths believe that health is a dynamic state of being that provides abundant energy for people to deal with life in our complex society. o Naturopathic practitioners use many different treatment approaches, including dietary and lifestyle changes, stress. Reduction, herbs and other dietary supplements, manipulative therapies, and practitioner-guided detoxification o In the United States, naturopathic medicine is practiced by naturopathic physicians, traditional naturopaths, and other health care providers who also offer naturopathic services. Narcolepsy: o Rare condition characterized by excessive daytime sleepiness and frequent overwhelming urges to sleep or inadvertent daytime lapses into sleep. Usually occur in adolescents or early adulthood and are usually lifelong; diagnosis is lengthy and difficult. 70% of people with narcolepsy also experience cataplexy, the sudden, involuntary loss of skeletal muscle tone lasting from seconds to 1-2 minutes; other symptoms include, hallucinations or sleep paralysis. o Treatment: No cure, medications that restore alertness allow near-normal functioning for most patients § CNS stimulants, modafinil (wakefulness promoting compound), sodium oxybate (sedative used for treating narcoleptic symptoms). Projection: o Cause: a person attributes thoughts or impulses to someone else. o Example: a person who denies any sexual feelings for a coworker accuses him of sexual harassment. Proprioception: Describes the sense, usually at a subconscious level, of the movements and position of the body and especially its limbs, independent of vision Parasomnias: Patterns of waking behavior that appear during REM or NREM stages of sleep o More commonly seen in children; usually outgrown by adulthood; safety and prevention are concerns o Can be rare or regularly occurring. Parasomnias: Can be treated by improving sleep habits, including maintaining a regular sleep schedule; good sleep hygiene, and obtaining an adequate amount of sleep. Medication may be

used to control symptoms of the behaviors associated with the parasomnia cause risk for injury to or disrupt the sleep of the patient or another person. Regression: o Cause: a person returns to an earlier method of behaving. o Example: children often regress to soiling diapers or demanding a bottle when they are ill. Repression: o Cause: a person voluntarily excludes an anxiety-producing event from conscious awareness. o Example: a father may not remember shaking his crying baby.

Rationalization: o Cause: a person tries to give a logical or socially acceptable explanation for questionable behavior (“behavior justification”). o Example: A patient who forgot to keep a health care appointment says, “If patients didn’t have to wait 3 months to get an appointment, they wouldn’t forget them.”

REM Sleep disorders: Characterized by “acting out” dreams while sleeping; during an episode the sleeper can moan and thrash around in the bed, possibly causing harm to oneself or a partner. Reflex pain response: o Response of the CNS to pain; rapid and automatic, serving as a protective mechanism to prevent injury o Reflex depends on an intact, functioning neurologic reflex arc and involves both sensory and motor neurons Restless Leg Syndrome: o People with RLS cannot lie still and report unpleasant creeping, crawling, or tingling sensations in the legs. Usually, these sensations are in the calf, but they may occur anywhere from the ankle to the thigh. Occasionally, RLS can occur in the arms, face, torso. Patients describe an irresistible urge to move the kegs when these sensations occur, usually during the evening and night. In some cases, symptoms may affect both sides of the body. RLS is seen in patients with ESRD, diabetes, iron deficiency, peripheral neuropathy, and pregnancy. OTC medications such as antihistamines can exacerbate the symptoms of RLS. This disorder has no specific diagnostic test and no known cure. o Nonpharmacologic measures to prevent or alleviate this discomfort include massaging the legs, walking, doing knee bends, and moving or gently stretching the legs. o Research continues into additional treatment options, but the following may prove effective: § Eliminating caffeine, tobacco and alcohol § Taking a mild analgesic at bedtime § Applying heat or cold to the extremity § Using relaxation techniques.

Biofeedback and transcutaneous electrical nerve stimulation (TENS) may also relieve symptoms Sensory Experience: o Sensory reception: Process of receiving data about the external or internal environment through the senses o Visual (sight), auditory (hearing), olfactory (smell), gustatory (taste), tactile (touch) o Sensory perception: The conscious process of selecting, organizing, and interpreting data from the senses into meaningful information o Influenced by the intensity, size, change, or representation of stimuli, as well as by past experiences, knowledge, and attitudes o Sensory deprivation: Insufficient quantity or quality of stimuli; may result from decreased sensory input or monotonous unpatterned, and unmeaningful input o Sensory overload: Excessive stimuli over which a person feels little control; the brain is unable to meaningfully respond to or ignore stimuli. Sublimation: o Cause: a person substitutes a socially acceptable goal for one whose normal channel of expression is blocked. o Example: a person who is aggressive toward others may become a star football player.

Stereognosis: The sense that perceives the solidity of objects and their size, shape, and texture

Stage of resistance: Vital signs, hormone levels and energy production return to normal o If the stress can be confined or managed to a small area, the body regains homeostasis. If the stressor is prolonged or strong enough to overwhelm the body’s ability to defend itself, the adaptive mechanisms become exhausted Stage of exhaustion: o Results when the adaptive mechanisms can no longer provide defense; depletion of resources results in damage to the body in the form of wear and tear or systemic damage o Without defense against the stressor, the body may either rest and mobilize its defenses to return to normal or reach total exhaustion and die. Sleep enuresis: o Urinating during sleep or bedwetting o Occurs most commonly in males who are over 3 years of age Sleep-related eating disorders: o Occurs when the person eats while sleeping but has no recollection of eating in the morning o Can occur during sleepwalking and those affected can gain weight and experience injury either from cooking in their sleep or eating potentially dangerous raw food; may show signs of sleep disruption during waking hours.

Sleep terrors: o More common in children and occur during the deepest stage if sleep o Waking up screaming and sitting up in bed; may appear to be awake and reasonable but are unable to communicate when ...