| A | B |
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| Who is the primary focus of all agencies providing healthcare services? | The patient. |
| Identify three to five members of the healthcare team. Is the patient a member of the team? | NA, LPN, RN, social worker, physician, patient |
| Medicare | Government funded, paying a portion of healthcare costs for persons 65 or older or younger persons with permanent disabilities |
| Medicaid | A state and federally funded government program that pays healthcare costs for persons of any age who do not have the financial resources for healthcare |
| What is meant by holistic care? | Treatment of the whole person physically, emotionally, socially, and spiritually |
| What is OBRA as it pertains to you as a CNA? | Regulations that are a result of federal legislation, which mandate improvements in the long-term care. It requires each facility to assist residents to attain and maintain the highest level of mental, physical, physiological well being possible in their individual circumstances. |
| Can a CNA work as a ?CNA? without being under the authority of a licensed professional, such as a RN or LPN? | No, The NA works under the guidance of a licensed professional (RN or LPN). Each healthcare facility has a line of authority. Commonly with nursing this line will consist of a nursing supervisor, a charge nurse, or a team leader. A NA must always understand and be capable of handling their task |
| When a nurse delegates a task to you, what must be clearly communicated? | The task, unique needs, symptoms or problems of the patient, special needs, terminology, complete directions, feedback |
| The 5 rights of delegation are: | The right to ask, the right circumstances, the right person, the right directions and communication, and the right supervision. |
| What do you do if you have concerns for the patient?s or your own safety in completing the task? | Report to the nurse or your supervisor, or another higher authority if you don?t receive satisfaction |
| What if the nurse refuses to explain or assist you with task completion? Who would you go to for help in resolving the issue? | Go to your supervisor for help. |
| What formal document is given to the patient/resident in each of the following settings: Admission to the hospital, admission to home care, admission to long-term care? | Patient?s Bill of Rights, Client?s Rights, Resident?s Rights |
| What is meant by informed consent? | The person has the right to decide what will be done to his or her body and who can touch his or her body. The doctor is responsible for informing the person about all aspects of treatment. |
| Does the patient have the right to refuse treatment even if care providers believe this will cause the person harm? | Yes as long as the patient is able to make informed decisions about their treatment |
| Is the patient a part of the planning procedure for all procedures? | Yes if they want to be |
| Who owns the medical information in the patient?s chart? | The hospital |
| Are you allowed to share this with other individuals | No |
| If you?re not caring for that patient are you allowed to examine the information in the chart | No |
| Define HIPAA. What do you do when visitors/outsiders inquire about a patient? What may occur if this violated? | (Health Insurance Portability and Accountability Act of 1996) Protects the privacy and security of a person?s health information. 2 Don?t say anything to the visitors and report it to your supervisor. If this is violated your certification can be taken away. |
| Define ethics | The knowledge of right and wrong conduct |
| What is the ultimate goal in ethical decision making? | Protection of the patient, we are ethically to not judge the patient?s decisions based on our own values and beliefs when they may be different from our own. |
| What do you do if you witness someone engaging in unethical behavior? | Report it to your supervisor. |
| When is unethical behavior reported and to whom | It is reported immediately to the supervisor. |
| Define confidential | Keeping what is said or written to oneself; private, not shared |
| Assault | Intentionally attempting or threatening to touch person?s body without a person?s consent or the person fears bodily harm i.e. threatening to tie down a patient. |
| Carelessness | The person does not take time to do their job correctly. Does not think out the procedure. |
| Verbal abuse | May be directed to the patient or expressed about the patient. Examples are using profanity with the patient, raising your voice at the patient, calling the patient names, etc. |
| Physical abuse | Actual physical harm to the patient. Examples are handling the patient roughly, hitting, slapping, and performing the wrong procedure. |
| Slander | Making false statements orally such as suggesting a co-worker uses drugs |
| Malpractice | Negligence by a professional person. |
| False imprisonment | The unlawful restraint or restriction of person?s freedom of movement such as restraining a patient unnecessarily. |
| Neglect | The unintentional tort where the negligent person did not act in a reasonable and careful manner. As a result a person or the person?s property was harmed. Failure to provide the services or care necessary to avoid physical harm, mental anguish, or mental illness. Example is not turning a patient frequently enough while knowing you are not performing accurate care |
| What 3 things must be present for a fire to occur? | Fuel, oxygen, heat |
| Identify four criteria you should know in case of a fire? | Hospital evacuation plan, your fire station, where alarm boxes are located, and where extinguishers are located |
| What type of extinguisher can be used for all types of fires? | ABC, multipurpose |
| What does PASS stand for , and what is it referring to? | P-ull the ping, A-im low, S-queeze the handle, S-weep from side to side. It refers to how to use a fire extinguisher |
| Define and describe R.A.C.E.? | R-escue patients who are in immediate danger, if possible. A-larm sound the fire alarm, This is why it is important to know the location of fire alarms before the need to use it occurs. C-onfine the fire. This means removing all patients and staff beyond fire doors. E-vacuacte/Extinguish. Facility personal should continue with the evacuation until it becomes unsafe to continue. |
| Identify a minimum of 3 safety precautions the healthcare provider should implement when using electrical equipment. | Inspect the cords. Make sure it?s grounded. Be alert for trouble signs. Water plus electricity equals trouble |
| How often do you inspect electrical equipment? | Daily |
| Identify the stages of Maslow?s hierarchy and Erickson theory of aging. | Maslow 1. Physical needs 2. Safety 3.Love and Belonging 4. Self-esteem 5. Self-actualization |
| What happens when the stages are not met throughout life? | The person cannot move on to the next stage. |
| What nursing actions convey a sense of caring to the patient/resident? | Hold hand, smile, and give yourself |
| Define communication | It is the way information, whether facts or feelings, is shared |
| Verbal communication | Communication that uses words, spoken or written. |
| Nonverbal communication | Message that is sent through the use of one?s body rather than speech or writing |
| Aphasia | The patient cannot understand spoken or written language, or cannot express spoken or written language, or both |
| Body language | Nonverbal communication |
| How would you communicate with a patient with aphasia? | Face the patient and make eye contact before speaking. Say the [patient?s name and give a social greeting before give instructions. Speak slowly and clearly. Use short complete sentences. Pause between sentences to allow the patient time to comprehend and interpret what was said. Check the patient?s comprehension before you proceed. Ask a question based on information based on what you just gave the patient. |
| What assistive devices can you use for the patient that cannot use words? | Pictures, written word, touching, gestures, pocket talker |
| Indentify a minimum of 5 ways to communicate. | Spoken word, tone of voice, written word, facial expression, body posture |
| What 4 things are needed for successful communication? | Message, sender, receiver, feedback |
| 80% of communication is | Nonverbal |
| What key elements insure effective communication? | Speak clearly, take time and observe, maintain eye contact, be a good listener, and get the patient?s attention. |
| When you first meet a patient how do you introduce yourself and how do you address the patient? | Say your name and position, use the patient?s last name when addressing the patient until given permission to use another name |
| What actions should you take when communicating with a hearing/visually impaired patient? | Hearing impaired |
| If the patient/resident does not understand what you said, despite that you spoke clearly, is the appropriate to rephrase or repeat the question? | Rephrase the question |
| Define comfort | A state of wellbeing where the person is without physical or emotional pain |
| Empathy | Looking at something from another?s point of view, when considering what they consider to be a comfortable state |
| Pain | A discomfort that means to ache, hurt, or be sore. |
| Rest | To be calm, at ease, and relaxed without anxiety or stress |
| Sleep | Basic need that allows the mind and body to rest |
| List the benefits of sleep | Allows tissue healing and repair to take place. Lowers stress, tension, anxiety. Freshens and renews the person. Regains energy and alertness. |
| What are the objective and subjective signs of pain? | Subjective |
| What communication tool is used to assist patients to accurately describe pain? | Pain rating scale |
| When do you report the patient?s pain? | Report as soon as possible |
| What do you report if the patient is unable to verbalize their pain? | Report facial gestures |
| How is the patient outward expression of pain affected by culture? | Language to express pain may be affected. Reaction to pain may restrained or exaggerated |
| Indentify a minimum of 4 criteria for assessing and reporting pain. | Location, when it started, intensity, describe the pain (aching, burning, dull sharp) |
| Indentify 10 things that affect pain, comfort, rest, and sleep. | Clothing, personal hygiene, bathing, caffeine, food, bedding, body position, temperature, odors, noise |
| Indentify a minimum of 5 things that decrease pain and promote comfort. | Back rubs, repositioning the patient in a more comfortable position, eliminate the thing causing anxiety, try not to startle the patient |
| Indentify the difference between delirium and dementia. | Delirium is temporary, dementia is chronic |
| Describe the 3 stages of dementia. Indentify 3 characteristics for each stage | Mild |
| Define Sundowning and how does it affect routine patient care? | Confusion and restlessness that increases when darkness occurs. Perform treatments earlier in the day and provide a quiet, calm setting in the evening |
| What is catastrophic reaction and what is your reaction when this occurs? | An extreme reaction where the person reacts as if there is going to be a disaster or tragedy. React in a-calm, reassuring manner, while maintaining a calm, quiet environment. |
| What if the person with dementia/Alzheimer?s demonstrates inappropriate sexual behavior or touches you inappropriately or misinterprets your attempts at dressing or bathing? | Inform the resident that the behavior is not appropriate and follow facility polices. |
| Name 5 items you can use to promote reality or orientation for a confused patient. | Clock, radio, tv, mirror, newspaper |
| What is validation therapy? | It allows the person to express their feelings. The program is based on the belief that developmental tasks from earlier years must be resolved on their own. It tries to maintain the person?s dignity by acknowledging the person feelings and memories. |
| Your patient states that her daughter is visiting today. You know that her daughter died 10 years ago. Using validation therapy what would be your response? | Ask about her daughter and say that you will inform her when her daughter arrives. |
| The number one concern with caring for the patient with delirium/Alzheimer?s is | Independence for as long as possible. |
| What resident characteristics contribute to falls? | Confusion, disorientation, poor vision, hearing loss, smell and touch, mobility, drugs. |
| When do most falls occur and why? | During shift changes, because there is confusion about who is responsible for giving care and when the residents try go to the bathroom. |
| Identify a minimum of 5 fall preventing measures. | 1.ÿÿÿÿÿÿ Make sure the patient?s basic needs are met, 2.never leave the patient alone in the bath or shower, 3. Leave floors clear or free of clutter spills and other obstacles, 4. Keep the bed in its lowest position except when working with patient. 5. Make sure of rooms, hall ways and stairs have good lighting. |
| Is it acceptable to use side rails to prevent an unsteady patient from getting out of bed? | It?s acceptable but only if the patient requests it and if it is noted in the patients chart and care plan. |
| If the person begins to fall do you attempt to catch him? What actions do you take? | Do not attempt to catch him. The actions taken would be, stand behind person with feet apart. Keep your back straight. Bring the person close to your body as fast as possible. Move your leg so the persons butt rest on it and they are able to slide to the floor. Stay with the person and call the nurse to them. Assistant the nurse in transferring the patient to the bed. |
| Do restraints prevent falls? Can you apply a restraint to a patient that is wandering? What should you try before using a restraint? | No, They cause falls and injuries. No because they will resist. Before using a restraint you should try diversions, answering the call light promptly, spending time with patient, give the patient a task to do, use cushions. |
| Which of the following represents a restraint: Geri chair, tucking sheets in tight to prevent movement, using side rails and patient is unable to lower them. What form of abuse does this represent? | All a restraints. The abuse this represent physical abuse. |
| Name 4 criteria for applying a restraint | 1.ÿÿÿÿÿÿ The patient must either have impaired mobility, receiving medications that affect mental status balance or coordination; they must be disoriented because of change in environment or medical disorder. They must have impaired hearing or vision. |
| How often is an applied restraint checked, when is it removed and for how long? | Its checked every 15 min. it is removed every two hours for at least 10 min. |
| Your patient Mr. Jones needs assistance with his AM care. At 9AM when washing his feet you notice a reddened area on his heal and he complains of pain when you touch it. He states the foot is painful all the time, like a dull ache. The foot is also swollen. You take is temperature. | Set up for the questions that comes after. |
| What is the subjective pain for this situation? | What the patient tells you, the duration and the dull ache. |
| What is the objective data for this situation? | The swollenness and patients temperature and color. Location of swell. |
| What instrument could be used to assess his pain level? | The Pain scale |
| When should this be reported to the nurse? | Right away if possible. Or as soon as possible. |
| His objective and subjective data is what part of the nursing process? | Assessment pg. 91 |
| Alteration in comfort related pain is what part of the nursing process? | Implementation pg. 91 |
| Your actions include elevating the leg., and notifying the nurse of his pain level. These actions are also called? | Approaches pg. 94 |
| Record 9 AM in military time? | Military time is 0900. |
| Where would you record his temperature? | Flow sheet |
| A friend of your family was admitted to your unit. You cared for him on Monday, but another nurse cared for him on Tuesday. Your family members know he was admitted to your hospital and are requesting you find out his condition. | Set up for questions that comes after. |
| Who does the information in the chart belonging to? What do you need prior to disclosing any of this patient?s prior health information? | The patient. There needs to be ?a need to know? |
| Can you share that information with your family since you are certain the patient will do so anyway? | No, it is confidential |
| Sharing private health information is a violation of___________ what could happen as a result? The patient had a blood test order on Monday while you were caring for him. The results were available on Tuesday. Can you view his chart in order to obtain the results of the test? | HIPPA. If this is violated I could get in trouble with the hospital and possibly the law. Loose my certification. I cannot view his results because that is the doctor?s job and the nurses job not my business. |
