Friday, November 28, 2008

NLE Nov 2008 - Nursing Practice 1

Nursing Licensure Examination
November 29, 2008

NURSING PRACTICE I
TEST SCOPE:
I. Personal and Professional Growth and Development
A. Historical Perspective in Nursing
o Florence Nightingale – Nursing’s First Scientist-Theorist
o Nursing – Virginia Henderson
o Nursing is DYNAMIC
o Philippine Formal Nursing Education started in – Iloilo City
o Act # 2493 – First Law that has something to do with the practice of nursing
B. Nursing as a Profession
o BSN Program – Nurse Generalist
o ALTRUISM – Hallmark of Nursing Profession
o Code of Ethics for Filipino Nurses – BON Resolution # 220 Series of 2004
C. Theoretical Foundation of Nursing Applies in Health Care Situations
o Theory – supposition or system of ideas
o Stages of Nursing Expertise – Patricia Benner
o Self-care Deficit Theory – Dorothea Orem
o 4 Concepts in Nursing – Person, Health, Environment, Nursing
D. Continuing Professional Education
o CPE – 60 units for 3 years
o PRC Resolution # 2004-179 Series of 2004
o CPR (Employer)/Fire Safety Program – In-service education program
E. Professional Organizations in Nursing
o FNA – PNA
o ICN
o Sigma Theta Tau Fraternity
F. The Nurse in Health Care
o Roles and Functions of a Nurse – Manager, Patient’s Advocate, Change Agent
o Expanded Career Roles – Nurse Anesthetist, Nurse-Midwife, Nurse Practitioner, Clinical Nurse Specialist
II. Safe and Quality Care
A. The Nursing Process
o Assessment
o Nursing Diagnosis
o Planning
o Intervention
o Evaluation
B. Basic Nursing Skills
• Admission and Discharge
o Informed Consent – emancipated minor
• Vital Signs
o Assessment of Blood Pressure
o Errors of Blood Pressure
o Stethoscope
o Temperature – R-O-A-T
o Infection in Adult – Change in Mental Status
o Pulse Site – Apical Pulse
o Hyperthermia – earliest sign of thyroid storm
o Hypovolemic Shock or Increased ICP
• Physical Examinations and Health Assessment
o Percussion of Chest – Normal – Resonance
o Dorsal Surface of Hand – to detect warmth
o I A Pe Pa – Abdominal Assessment
• Administration of Medications
o Intramuscular – Z-track Technique, G20-23, 1”-2”
o Subcutaneous – slower absorption of medication, G25-27, 3/8”, 5/8”, ½”
o Insulin Administration – Abdomen, 0.5 – 1” away
o Iron Therapy – Empty Stomach, Before Meals
o Potassium Chloride Administration – Incorporated to PNSS
o Blood Transfusion – G18-19
• Asepsis and Infection Control
o Measles – Droplet Precaution
o AIDS – Universal Precaution
o Green Bin – biodegradable (food stuff)
• First Aid Measure
o Reduce Swelling – elevate the affected extremity; Cold and Warm Compress
• Wound Care
o Dressing Change
• Post-mortem Care
o Rigor-Algor-Livor Mortis
o Stages of Grieving – Kubler Ross
C. Measures to Meet Physiological Needs
• Oxygenation
o Sputum Specimen
o Thoracentesis
o Pulse Oximeter
o Incentive Spirometer
o Three-way Bottle System
• Nutrition
o NGT Insertion – High Fowler’s
o TPN – Infection, Check for Redness; Effectiveness – Daily Weight
o Low-sodium diet
o Low-fat diet
• Activity, Rest and Sleep
o Anemia - Rest
• Fluid and Electrolyte Balance
o Potassium Excess – Hyperkalemia – Tall T wave
o HypUkalemia – presence of U wave
o Thirst – first sign of dehydration
o Hypertonic Solutions – D5NS,D10W
• Urinary Elimination
o Urine Specimen – 24 hour urine specimen
o Indwelling Urinary Catheter
• Bowel Elimination
o Fecal Incontinence / Fecal Impaction
o Types of Laxatives – Colace – Stool Softeners
o Ileostomy – watery stool
o Colostomy - LICHE
• Safety, Comfort, Hygiene
o Oral Care – PNSS; Dryness – Petroleum Jelly
o Artificial Eye – Warm PNSS
• Mobility and Immobility
o Abduction – lessen the degree of fulcrum
o Sandbags, Trochanter Roll, Bed Cradle, Trapeze Bar
III. Health Education
A. Teaching and Learning Principles in the Care of Client
o Bloom’s Domain of Learning – Cognitive, Affective, Psychomotor
o Compliance
B. Discharge Planning
o Before beginning – have a Physician’s Authorization
o Rehabilitation – upon admission
IV. Ethico-Moral Responsibility
A. Bioethical Principles
o Justice – TRIAGE Nursing
o Paternalism
o Prudence, Fortitude, Temperance, Justice, Character, Values
V. Legal Responsibility
A. Legal Aspects in the Practice of Nursing
o Informed Consent – Emancipated Minors
o Elements of Negligence
o Assault, Battery, False Imprisonment, Invasion of Privacy
o Defamation – Libel, Slander
o Controlled Substances – Locked Cabinet
o Impaired Nurses
o Rape – Priority: Preservation of Evidence
o Violence , Neglect Abuse – Mandated Reporter
o Newborn screening act – RA 9288
o PRC Resolution # 2004-179 Series of 2004 – 60 CPE units
o Dangerous Drugs Act of 2002 – RA 9165
o Cheaper Medicines Act – RA 9502
o Telephone Orders
o Restraints
B. The Philippine Nursing Act of 2002 (R.A. 9173)
o 75%; 60%
o Removal examination – within 2 years
o Powers and Functions of the Board – Quasi-judicial – issue subpoena
o License – most important tool for legal control and enforcement of nursing practice – renewed every 3 years – 60 CPE units
o Prohibitions in the practice of nursing – Fine: 50000-100000
VI. Management of Environment and Resources
A. Theories and Principles of Management
o Span of Management
o Unity of Command
B. Leadership Style
o Autocratic, Democratic, Laissez Faire
o Situational Leadership Model
C. Primary Nursing
o 24-hour care
D. Delegation and Accountability
o Responsibility – obligation to complete a task
o Accountability – answerable to one’s action
o Assessment of Patient’s wound – not delegated
VII. Records Management
A. Anecdotal Report
B. Incident Report
C. Documentation – SOMR vs. POMR
D. Computerization – Nursing Informatics
E. Referral – Hospice Care Facilities – Terminally Ill Patients
ADDENDUM:
o Research – Qualitative vs. Quantitative
o Experimental, Quasi-experimental, Non-experimental
o Central Tendency – Mean, Median, Mode


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