Fundamentals of Nursing content guide - Gulf Coast … of Nursing Use this guide if you are planning...
Transcript of Fundamentals of Nursing content guide - Gulf Coast … of Nursing Use this guide if you are planning...
Fundamentals of Nursing
Use this guide if you are planning to test between September 1, 2006 and September 30, 2007.
If you are planning to test on or after October 1, 2007, you should also obtain the revised version of this guide which will be available in late summer 2007. You may access the revised version online from our Web site or request a printed copy by contacting the College.
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(continued on page 33)
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Important information to help you prepare for this Excelsior College® Examination
General Description of the ExaminationTheExcelsiorCollegeExaminationinFundamentalsofNursingmeasuresknowledgeandunderstandingofthematerialusuallytaughtinacourseinfundamentalsofnursinginanassociatedegreenursingprogram.Theexaminationassumesabasicknowledgeofanatomyandphysiology,chemistry,andmathematics.Questionsontheexaminationfocusonthehealthproblemsofadultpatientsthatarecommonlyencounteredbyassociatedegreenursesinhealthcaresettings.
Theexaminationrequiresyoutodemonstrateknowledgeandunderstandingofthetheoreticalframeworkforeachcontentareaaswellastheabilitytoapplythisknowledgethroughuseofthenursingprocess.
The major content areas on the examination and the percent of the examination devoted to each content area are listed below.
Content AreaPercent of the Examination
I. TheProfessionofNursing 8%
II. CommunicationandInterpersonalRelations 10%
III. ProtectionandPromotionofSafety 25%
IV. Comfort,Rest,andActivity 15%
V. Nutrition 10%
VI. Elimination 11%
VII.Oxygenation 10%
VIII.FluidandElectrolyteBalance 11%
Total 100%
Uses for the ExaminationExcelsiorCollege,thetestdeveloper,recommendsgrantingeight(8)semesterhoursoflower-levelundergraduatecredittostudentswhoreceivealettergradeofCorhigheronthisexamination.ThisrecommendationisendorsedbytheAmericanCouncilonEducation.However,theexamisnotapplicabletowardanursingdegreeatExcelsiorCollege.Othercollegesanduniversitiesalsorecognizethisexamasabasisforgrantingcreditoradvancedstanding.Individualinstitutionssettheirownpoliciesfortheamountofcreditawardedandtheminimumacceptablescore.Beforetakingtheexam,youshouldcheckwiththeinstitution
fromwhichyouwishtoreceivecredittodeterminewhethercreditwillbegrantedand/ortofindouttheminimumgraderequiredforcredit.
Examination Length and ScoringTheexaminationconsistsofapproximately160four-optionmultiple-choicequestions,someofwhichareunscored,pretestquestions.Thepretestquestionsareembeddedthroughouttheexam,andtheyareindistinguishablefromthescoredquestions.Itistoyouradvantagetodoyourbestonallofthequestions.Youwillhavethree(3)hourstocompletetheexamination.Scoresarebasedonabilitylevelasdefinedintheitemresponsetheory(IRT)methodof
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examdevelopmentandscoring,ratherthansimplyonyourtotalnumberofcorrectanswers.Yourscorewillbereportedasalettergrade.
Examination AdministrationTheexaminationisadministeredbycomputeratPearsonProfessionalCentersthroughouttheUnitedStatesandinCanada,AmericanSamoa,Guam,PuertoRico,Saipan(NorthernMarianaIslands),andtheVirginIslands.AllquestionsregardinginternationaladministrationoftheexaminationsshouldbedirectedtotheTestAdministrationofficeatExcelsiorCollege.Thisofficeisalsoresponsibleforconsideringrequestsforexceptionssuchasreasonableaccommodationsforthosewithdisabilities.
Computer-Delivered TestingIfyouaretestingatPearsonProfessionalCenters,yourexamwillbedeliveredbycomputer.Youwillenteryouranswersonthecomputerusingeitherthekeyboardorthemouse.
Thesystemusedforourcomputer-deliveredtestingisdesignedtobeasuser-friendlyaspossible,evenforthosewithlittleornocomputerexperience.Instructionsprovidedonscreenaresimilartothoseyouwouldreceiveinapaperexaminationbooklet.
TolearnmoreaboutthePearsoncomputer-deliveredtestingsystem,youcanuseaninteractivetutorialorviewscreenshotsthatshowyouhoweachfeatureofthesystemworks.ThetutorialisavailablefromtheExaminationspageontheExcelsiorCollegeWebsiteorfromthePearsonregistrationpagededicatedtoExcelsiorCollegeExaminations.Gotowww.excelsior.edu,clickontheExcelsiorCollegeExaminationslink,thenclickontheComputer-DeliveredExamTutoriallinkintheExaminationResourcesandServicesbox.
For your benefit:
A Word of Caution About Test Preparation and Tutorial ServicesTherearetutorialandtestpreparationservicesandfor-profitpublishingcompaniesthatclaimtheycanassistyouwithpassingExcelsiorCollegeExaminationsorinearninganExcelsiorCollegedegree.TheymayimplyanaffiliationwiththeCollegeandmayallegethattheirmaterialsorserviceswillprovideyouwithaspecialadvantageinpassingExcelsiorCollegeExaminationsorincompletingExcelsior’sdegreerequirements.Despitesuchrepresentations,thematerialsandservicesofferedbytheseorganizationsusuallydonotprovideanyspecialadvantageandoftendonotaccuratelyreflectthecurrentcontentofExcelsiorCollegeExaminations.Manyoftheseorganizationswillchargeyouhundreds,eventhousands,ofdollarsforthesameservicesyoucanreceivedirectlyfromExcelsiorCollege—servicesthatareincludedinthefeesyoupayasanenrolledstudent.
ExcelsiorCollegeisheadquarteredinAlbany,NewYork,whereouradmissionscounselorsandacademicadvisorsofferassistanceandsupporttoourstudents.Additionally,ourSchoolofNursinghasanetworkofRegionalPerformanceAssessmentCenterswhereExcelsiorCollegerepresentativeshelpnursingstudentsandadministertheCollege’sclinicalperformanceexaminations.Wedonothavebranchoffices.
Makesureyourdollarsandtimearespentwisely:comedirectlytothesourceforyourExcelsiorCollegedegree.Ifyouareapproachedbyorareconsideringusingacompanyororganizationtohelpyouearnyourdegreeortakeanexamination,checkwithusfirsttofindoutiftheservicesormaterialsofferedareendorsedorrecognizedbyExcelsiorCollege.Iftheyarenotendorsedorrecognizedbyus,youcannotbeassuredthattheirservicesandmaterialsreflectthequalityandaccuracyofthoseavailabledirectlyfromExcelsior.ContactourAdmissionsOfficetollfreeat888-647-2388orviaemailatadmissions@excelsior.edu.
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How to Study with Excelsior College Examinations Content Guides
AcommitteeofteachingfacultyandpracticingprofessionalsdeterminesthecontenttobetestedoneachExcelsiorCollegeExamination.ExcelsiorCollegeAssessmentUnitstaffoverseethetechnicalaspectsoftestconstructioninaccordancewithcurrentprofessionalstandards.Topromotefairnessintesting,wetakespecialcaretoensurethatthelanguageusedintheexamsandrelatedmaterialsisconsistent,professional,anduserfriendly.Editorialstaffperformsystematicquantitativeandqualitativereviewsthataddressaccuracy,clarity,andcompliancewithconventionsofbias-freelanguageusage.
How Long Will It Take Me to Study?AnExcelsiorCollegeExaminationisawaytodocu-mentthatyouhavelearnedmaterialcomparabletothecontentofoneormorecollege-levelcourses.Toprepare,youshouldstudyandreviewasyouwouldifyouweretakingacollegecourse.Remember,asanindependentstudent,youareactingasyourownteacher.
TofullyprepareforanExcelsiorCollegeExaminationrequiresself-directionanddiscipline.Studyinvolvescarefulreadingandreflectionandsystematicreview.Collegeprofessorsadvisethatineachweekofasemester,youshouldplanonspendingthreehoursstudyingforeverysemesterhourofcredityouwillbeearning.Forexample,forathree-creditcourse,youcanexpecttostudyforninehoursineachweekofa15-weeksemester:
9×15=135hoursofstudyfora3-creditexam
UsethissystemtodeterminehowmuchtimeyoushouldplantospendstudyingandreviewingforyourExcelsiorCollegeExamination:
My exam is
_____credits×3hoursperweek×15weeks=
_____totalhoursofstudy.
The Content OutlineAtthecoreofeachcontentguideisadetailedcontentoutlinethatbeginswithacontent/percentchartshowingtherelativeimportanceofeachmajorcontentareatoyourlearning.Theseweightingsmaybeusefultoyouasyouallocateyourstudytime.Forexample,ifyouarepreparingforthe3-creditexaminFoundationsofGerontology,andwishtotaketheexam15weeksfromtoday,youmightcreatethefollowingschedule,knowingthatyoushouldplanatotalof135hoursofstudy:
Content AreaPercent of Exam
Hours Week
ImportantConceptsofGerontology
10% 13.5 1
DemographyofAging 12% 16.2 2–3
BiologyandPhysicalHealth 17% 23 3–5
PsychologyandMentalHealth 14% 19 6–7
Sociology 14% 19 8–9
Economics,Work,andRetirement
14% 19 10–11
PoliticalBehaviorandPublicPolicy
14% 19 12–13
DeathandDying 5% 6.75 14
(GeneralReview,CatchingUp) xx ?? 15
Wehaveannotatedyourcontentoutlineintwowaystohelpyouplanyourstudy.First,wehaveindicatedtheminimumhoursofstudyyoushouldexpecttodevotetoeachcontentarea.Second,forthoseexamsthatdonothaveguidedlearningmaterials,wehaveindicatedsectionsoftherecommendedresourcesthataremostimportanttoyourunderstandingofthatareaoftheoutline.Theseannotationsarenotintendedtobecomprehensive.Tocoverallofthematerialinthecontentoutline,youmayneedtorefertootherchaptersintherecommendedtextbooks.Chapter numbers and titles may differ in subsequent editions.
Mostofthecontentoutlinescontainmanyexamplestoillustratethetypesofinformationyoushouldbestudying.Althoughtheseexamplesarenumerous,youshouldnotassumethateverythingontheexamwillcomefromtheseexamplesonly.Conversely,
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youshouldnotexpectthateverydetailyouhavestudiedwillbedirectlytestedontheexam.Anyexamisonlyabroadsampleofallthequestionsthatcouldbeaskedaboutagivensubjectmatter.
Using the Recommended ResourcesItisimportanttostructureyourstudyusingthecontentoutlinealongwiththeRecommendedResources:regularcollegetextbooks,primaryandsecondarysourcematerials,publicationspreparedespeciallybyExcelsiorCollegestafftosupportyourexampreparation,andinsomecasesaudiovisualmaterialsorjournalarticles.AdditionalorOtherResourcesmayprovideclarificationforsomeofthetopicsonthecontentoutlineorprovideenrichmentinareasofinterest,butarenotessentialtoyourpreparation.
Paycloseattentiontowhetherwearerecommendingthatyouusealloftheresourcesorofferingyouachoice.Manyofourcontentguidesprovideabriefdescriptionofthematerialsthatmayhelpyoutochooseamongalternatives.Youcanalsolookupthebooksonthepublisher’sWebsite,whereyoumaybeabletoviewsamplepages,reviewthetableofcontents,andexploresupplementarymaterials.Ifyouencountertopicsinthecontentoutlinethatarenotcoveredintheresourceyouareusing,tryusingoneofthealternatives,orcheckthelistofadditionalresources.
Sometextbookpublisherssellworkbooksorstudyguidestoaccompanytheirtexts.Ifthecommitteedevelopingyourexaminationhasevaluatedsuchworkbooks,youwillfindthemlistedinthecontentguide.
IfyourexamhasaGuidedLearningPackage,itwillbetoyouradvantagetousetheentirepackage.Youwillhaveacoherentcourseofstudytofollowinpreparationforyourexam,andyouwillsavemoneyoverpurchasingthematerialsindividually.Anintegralpartofeachguidedlearningpackageisthecourseguide,preparedbyExcelsiorCollegedistancelearningspecialistsincollaborationwiththetestdevelopers.ExcelsiorCollegecourseguidesmaybepurchasedonlyfromtheExcelsiorCollegeBookstore.Donotconfusethesewithstudyguidessoldbyotherpublishers.
Using the Sample Questions and Rationales
Foreachexamination,samplequestionsareprovidedtoillustratethosetypicallyfoundontheparticularexamination.Thesamplequestionsarenotintendedtobeapracticetest,buttheymayserveasmodelsifyouwishtocreateyourowntestquestionsforreviewpurposes.
Inthelastpagesofthisguide,youwillfindrationalesforthemultiple-choicesamplequestions.Thekey(correctanswer)isindicatedinbold.Therationalesexplainwhythekeyisthecorrectanswerandwhatiswrongwiththeotheranswerchoices.Inaddition,eachquestionisreferencedtothecontentoutline.Especiallyifyouchoseoneofthewronganswers,youshouldreturntoitssectionofthecontentoutlineforadditionalstudy.
Study TipsYoushouldbeanactiveuseroftheresourcematerial.Aimforunderstandingratherthanmemorization.Themoreactiveandinvolvedyouarewhenyoustudy,themorelikelyyouwillbetoretaintheinformationandbeabletounderstandandappropriatelyapplyit.Asapreparatoryactivity,youmayfinditfuntosearchon“learningstyle”ontheInternetforavarietyofinformationand“tests”designedtoidentifyhowyoulearnbest.
Studentsandeducatorsgenerallyagreethatthefollowingtechniquesarevaluable:
•preview or surveyeachchapter
•highlight or underline textyoubelieveisimportant
•write questions or commentsinthemargins
•practice re-stating contentinyourownwords
•try to determine how what you are reading relates tothechaptertitle,sectionheadings,andotherorganizingelementsofthetextbook
•find ways to engageyoureyes,yourears,andyourmuscles,aswellasyourbrain,inyourstudies
•study with a partner or a small group(areyouanenrolledstudent?trytheElectronicPeerNetwork[EPN])
•prepare your review notesasflashcardsorcreateaudiotapesthatyoucanusewhilecommutingorexercising
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Whenyoufeelconfidentthatyouunderstandacontentarea,reviewwhatyouhavelearned.Reviewinvolvestakingasecondlookatthematerialtoevaluatehowwellyouhavelearnedit.Ifyouhaveastudypartner,youcanreviewbyexplainingthecontenttoyourpartnerorwritingtestquestionsforeachothertoanswer.Reviewquestionsfromtextbookchaptersmaybehelpfulforpartnerorindividualstudy,aswell.
On the Day of Your ExamDoyourselfsomefavors:
•arriveatthetestsiterestedandpreparedtoconcentrateforanextendedperiod
•besuretoallowsufficienttimetotravel,park,andlocatethetestcenter
•practicehealthyeatingandstresscontrol
•dresscomfortably:thecomputerwillnotmindthatyou’rewearingyourfavoriterelaxationoutfit
•bepreparedforpossiblevariationsintemperatureatthetestcenterduetochangesintheweatherorenergyconservationmeasures
•bringyourIDsandATTletterandsomepencilsandpens,butotherwise,don’tweighyourselfdownwithbelongingsthatwillhavetobekeptinalockerduringthetest.
Academic HonestyRemember,professionalethicalprinciplesandtheExcelsiorCollegeacademichonestypolicybothassumethatyourworkisyourown,thatyouwillnotcheat,plagiarize,copy,steal,orotherwiseacquireordistributetheCollege’sintellectualproperty.Whilethetemptationmaybestrongtojotdownwhatyourememberofquestionsonyourexamandshareyourmemorieswithyourfriends,ortosearchoutWebsitesorstudyguideswhereothertesttakersorpublishershavepostedwhattheyallegetobequestions(withorwithoutproposedanswers)fromExcelsiorCollegeExaminations,youoweittoyourselftoresist.Regardlessofwhetheryouarecaught,yourgradeandyourprofessionalcredentialswillalwaysbetaintedifyouknowthattheywereawardedbasedonfalseinformationaboutWhatYouKnow.
Academic Honesty Nondisclosure StatementBeginningApril2003,alltesttakersmustagreetoabidebythetermsoftheExcelsiorCollegeAcademicHonestyPolicybeforetakinganexam.Theagreementwillbepresentedonscreenatthetestingcenterpriortothestartofyourexam.Byacceptingthetermsoftheagreement,youwillbeabletoproceedwithyourexam.Ifyouchoosenottoacceptthetermsofthisagreement,yourexamwillbeterminated,andyouwillberequiredtoleavethetestingcenter.Youwillnotbeeligibleforarefund.
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I. The Profession of Nursing (8%) 29 hours
Kozier (2004)Ch. 3, NursingTheoriesand
ConceptualFrameworks
Ch. 4,LegalAspectsofNursing
Ch. 5, Values,Ethics,andAdvocacy
Ch. 6, HealthCareDeliverySystems
Ch. 8, HealthPromotion
Ch. 11, Health,Wellness,andIllness
Ch. 15,CriticalThinkingandtheNursingProcess
Ch. 20,DocumentingandReporting
Ch. 40,StressandCoping
A. Legal issues in nursing
1. Generallegalconcepts:statutory,common,civil,andcriminallaws
2. Nursepracticeacts
a. Definitionandpurposesofnursepracticeacts
b. Impactonthepracticeofnursing
c. ANAStandardsofCare
d. Licensure:legalrequirements,groundsforrevocation,groundsorsuspension
3. Legalliabilityinnursing
a. Typesofcrimes:felonies,misdemeanors
b. Areasofliability:torts,negligence,invasionofprivacy,defamationofcharacter,assaultandbattery,falseimprisonment,abandonment
c. GoodSamaritanLaws
d. Informedconsent
e. APatient’sBillofRights
B. Roles and functions of the nurse
1. Caregiver
2. Decisionmaker
3. Communicator
4. Managerofcare
5. Advocate
6. Teacher
C. Ethics and values in nursing
1. ANACodeofEthics
2. Resolutionofethicalproblems
3. Natureandfunctionofvalues
D. Basic nursing concepts
1. Thehealthcontinuum
a. Wellness-illnesscontinuum
b. Factorsinfluencinghealth
1) Individualfactors(forexample:genetics,age)
2) Environmentalfactors(forexample:occupationalhazards,stress)
3) Socioeconomicandculturalfactors(forexample:lifestyle,single-parenthouseholds,fastfoods,healthpractices)
c. Effectsofhospitalizationsand/orillness(forexample:lossofincome,changeinself-image,disruptionoffamily)
2. Thehealthcaredeliverysystem
Content Outline
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3. Maslow’shierarchyofneeds
a. Structureofhierarchy
b. Implicationfornursingcare
4. Homeostasisandadaptationtostress
a. Generalconceptsofhomeostasisandregulatorymechanisms
b. GeneralconceptandnatureofstressbasedonSelye’stheory
c. Factorsinfluencingadaptation(forexample:age,lifestyle,occupation,copingstrategies)
d. Psychophysiologicalsignsofincreasedstress(forexample:changesinvitalsigns,memoryorperceptualchanges)
5. Psychophysiologicaladaptationstostress(forexample:fightorflightresponse,restandactivitychanges,defensemechanisms)
E. Nursing process methodology
1. Purposes
2. Steps
a. Assessment:establishingadatabaseconcerningpatientneeds,includinggatheringsubjectiveandobjectivedataandassessingindividualfactorsrelatedtohealth
b. Diagnosis:identificationofthepatient’sactualorpotentialnursingdiagnosesafteranalyzingandinterpretingdata
c. Planning:settingpriorities,identifyingpatient-centeredoutcomesandselectingnursinginterventionstoachievethoseoutcomesusingclinicalpathways
d. Implementation:usingnursinginterventionstohelpthepatientachievegoals
e. Evaluation:determiningtheextenttowhichoutcomeshavebeenachieved
3. ElementsofanursingdiagnosisstatementaccordingtoNorthAmericanNursingDiagnosisAssociationTaxonomy,1997
4. Characteristicsofagoal:measurable,patient-oriented,attainablewithaspecifiedtimeperiod
F. Recording and reporting
1. Conceptsandprinciples
a. Purposesofrecording:charting,documentation(forexample:providingarecordofcaregiven,chartingpatient’sresponsetocare,evaluationandrevisionofthenursingcareplan)
b. Purposesofreporting:intermittent,change-of-shift(forexample:promotingcontinuityofpatientcare,evaluationofeffectivenessofnursinginterventions)
c. Principlesofwrittencommunication(forexample:accuracy,legibility,legality,abbreviations)
d. Principlesoforalcommunication(forexample:objectivity,clarity,timeliness)
2. Inclusionofappropriateinformationwhenrecordingandreporting(forexample:whenusingnarrativemethod,whenusingSOAPmethod;onamedicationadministrationrecord,onanursingcareplan,inateamconference,atchange-of-shift)
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II. Communication and Interpersonal Relations (10%) 36 hours
KozierCh. 16, Assessing
Ch. 17, Diagnosing
Ch. 18, Planning
Ch. 19,ImplementingandEvaluating
Ch. 24, Caring,Comforting,andCommunicating
Ch. 25, Teaching
Ch. 28,HealthAssessment
A. Theoretical framework
1. Therapeuticcommunication
a. Definitionandgoals
b. Typesofcommunication:verbal,nonverbal
c. Principlesoftherapeuticcommunication
1) Techniquesthatfacilitatecommunication
2) Techniquesthatblockcommunication
2. Thenurse-patientrelationship
a. Definitionandoutcomesofthenurse-patientrelationship
b. Componentsofthenurse-patientrelationship
c. Phasesofthenurse-patientrelationship
3. Factorsinfluencingthecommunicationprocess(forexample:cultural,sensorylosses,languagebarriers,perceptionoftherelationship,personalexperiencesandneeds,attitudes)
4. Patientinstruction:principlesofteaching/learning
B. Nursing care
1. Assessment:establishadatabaseconcerningcommunication
a. Gatherobjectiveandsubjectivedata(forexample:primarylanguage,useofsignlanguage,unabletoread,hearingability)
b. Assessfactorsinfluencingcommunicationandthenurse-patientrelationship(seeIIA3)
2. Diagnosis:identifythepatient’sactualorpotentialnursingdiagnosesrelatedtocommunication
a. Analyzeandinterpretdata(forexample:patternsofcommunication,readinessforlearning)
b. Identifynursingdiagnoses(forexample:impairedverbalcommunicationrelatedtooralsurgery;knowledgedeficit:low-caloriedietrelatedtorecentlyorderedtherapy)
3. Planning:setpriorities,identifypatient-centeredoutcomesandselectinterventionsrelatedtocommunication
a. Setprioritiesandestablishoutcomes(forexample:patientwillcommunicateneedsusinganalternatemeansofcommunication[chalkboard];patientwillmakeappropriatemealselections)
b. Incorporatefactorsinfluencingcommunicationinplanningpatientcare(seeIIA3)
c. Selectnursinginterventionstofacilitatecommunication(forexample:providethepatientwitha“magicslate”;selectmaterialsappropriatetothepatient’seducationallevel)
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4. Implementation:usenursinginterventionstoachieveoutcomesrelatedtocommunicationandthenurse-patientrelationship
a. Usefacilitativecommunicationtechniques(seeIIA1c)
b. Establishatherapeuticnurse-patientrelationship(seeIIA2)
5. Evaluation:determinetheextenttowhichoutcomeshavebeenachieved
a. Evaluate,record,andreportthepatient’sresponsetonursingactions(forexample:duetosedation,patientisnotabletousethemagicslate;patientselectsfoodsappropriatetoalow-caloriediet)
b. Modifytheplanofcareifnecessary
III. Protection and Promotion of Safety (25%) 90 hours
KozierCh. 29,Asepsis
Ch. 30, Safety
Ch. 33, Medications
Ch. 34, SkinIntegrityandWoundCare
Ch. 36,SensoryPerception
A. Asepsis
1. Theoreticalframework
a. Chainofinfection
b. Principlesofmedicalandsurgicalasepsis
c. Methodsoftransmission(forexample:directcontact,vehicles,airborne)
d. Standard(universal)precautions
e. Factorsinfluencinganindividual’ssusceptibilitytoinfection(forexample:stress,nutritionalstatus,physicalstatus,medications,heredity,lifestyle,socioeconomicstatus,occupation)
2. Nursingcare
a. Assessment:establishadatabaseconcerningasepsis
1) Gatherobjectiveandsubjectivedata(forexample:WBCcount[normalvalues],historyofexposuretopathogens,fever,thirst)
2) Assessfactorsinfluencingsusceptibilitytoinfection(seeIIIA1e)
b. Diagnosis:identifythepatient’sactualorpotentialnursingdiagnosesrelatedtoasepsis
1) Analyzeandinterpretdata(forexample:identifypathogenandpossiblemethodoftransmission)
2) Identifynursingdiagnoses(forexample:highriskforinfectionrelatedtopoornutritionalstatusandexposuretopathogens)
c. Planning:setpriorities,identifypatient-centeredoutcomesandselectappropriateinterventionsrelatedtoasepsis
1) Setprioritiesandestablishoutcomes(forexample:patientwillwashhandsafterusingthetoilet)
2) Incorporatefactorsinfluencingtheindividual’ssusceptibilitytoinfection(seeIIIA1e)
3) Selectnursinginterventionstohelpthepatientachievetheoutcomes(forexample:utilizeappropriateasepticmeasures,determineappropriatebarriers)
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d. Implementation:usenursinginterventionstoachievetheoutcomesrelatedtoasepsis
1) Usenursingmeasurestocontainorganisms(forexample:usemedicalasepsis)
2) Usenursingmeasurestoexcludeorganisms(forexample:usesurgicalasepsiswhenprovidingwoundcare)
3) Instructthepatientregardingpreventionofinfection(forexample:handwashing)
e. Evaluation:determinetheextenttowhichoutcomeshavebeenachieved
1) Evaluate,record,andreportthepatient’sresponsetonursingactions(forexample:woundisapproximatedandfreeofdrainage)
2) Continuallyreassessthephysicalenvironment(forexample:dressingsaredisposedofinaclosedcontainer)
3) Modifytheplanofcareifnecessary
B. The body’s defenses (includes the body systems, the immune system, and the inflammatory response)
1. Theoreticalframework
a. Physiologicalresponses(forexample:antigen-antibodyresponse,leukocytosis,signsofinflammation,secretionofmucus,movementofcilia,removalofwasteproducts,woundhealing,fever)
b. Factorsinfluencingthebody’sdefenses
1) Individualfactors(forexample:age,nutritionalstatus,skinintegrity,hygienicpractices,physicalactivity,healthstatus,cigarettesmoking)
2) Environmentalfactors(forexample:climate,occupationalhazards,exposuretocommunicablediseases,cigarettesmoke,radiation)
c. Techniquescommonlyusedtopromotethebody’sdefenses(forexample:applicationofheatandcold,tetanusbooster,fluvaccine)
2. Nursingcare
a. Assessment:establishadatabaseconcerningdefenses
1) Gatherobjectiveandsubjectivedata(forexample:conditionofthepatient’sskinandmucousmembrane,vitalsigns,redness,pain,swelling,WBCcount,historyofimmunizations)
2) Assessfactorsinfluencingthebody’sdefenses(seeIIIB1b)
b. Diagnosis:identifythepatient’sactualorpotentialnursingdiagnosesrelatedtodefenses
1) Analyzeandinterpretdata(forexample:culturereports,identifyimpairmentoftheskin,WBCcount[normalvalues],characteristicsofdrainage)
2) Identifynursingdiagnoses(forexample:highriskforinfectionrelatedtoalteredskinintegrity)
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c. Planning:setpriorities,identifypatient-centeredoutcomesandselectinterventionsrelatedtodefenses
1) Setprioritiesandestablishoutcomes(forexample:patientwillremainafebrile)
2) Incorporatefactorsinfluencingthebody’sdefenses(seeIIIB1b)
3) Selectnursinginterventionstohelpthepatientachievetheoutcomes(forexample:monitorvitalsignsq4h)
d. Implementation:usenursinginterventionstoachieveoutcomesrelatedtothebody’sdefenses
1) Usenursingmeasurestopromotethebody’sdefenses(forexample:provideadequatenutrition,applyheatandcoldtreatments,providewoundcare,collectspecimensforculture)
2) Instructthepatienttosupportand/orrestorethebody’sdefenses(forexample:emphasizetheneedtoavoidexposuretoinfectiousagents)
e. Evaluation:determinetheextenttowhichoutcomeshavebeenachieved
1) Evaluate,record,andreportthepatient’sresponsetonursingactions(forexample:patient’stemperatureremainswithinnormallimits)
2) Modifytheplanofcareifnecessary
C. Medication administration
1. Theoreticalframework
a. Pharmacokinetics:absorption,distribution,metabolism,excretion
b. Principlesofadministration:calculations(includingequivalents),routesandsites,safetymeasures,controlledsubstances,useofnasogastricandgastrostomytubes,transcribingmedicationorders
c. Factorsinfluencingmedicationactionandeffectiveness(forexample:age,sex,weight,psychologicalfactors,timeofadministration,environment)
2. Nursingcare
a. Assessment:establishadatabaseconcerningthepatient’smedicationregimen
1) Gatherobjectiveandsubjectivedata(forexample:historyofallergies,vitalsigns,durationofpain)
2) Assessfactorsinfluencingmedicationactionandeffectiveness(seeIIIC1c)
b. Diagnosis:identifythepatient’sactualorpotentialnursingdiagnosesrelatedtomedications
1) Analyzeandinterpretdata(forexample:changesinvitalsigns,recognizesideeffects)
2) Identifynursingdiagnoses(forexample:noncompliancerelatedtofearofsideeffects)
c. Planning:setpriorities,identifypatient-centeredoutcomesandselectinterventionsrelatedtothepatient’smedicationregimen
1) Setprioritiesandestablishoutcomes(forexample:patientwilladheretoregimenasagreed)
12 FN/OR
2) Incorporatefactorsinfluencingmedicationactionandeffectiveness(seeIIIC1c)
3) Selectnursinginterventionstohelpthepatientachieveoutcomes(forexample:instructthepatienttotakethemedicationwithfood)
d. Implementation:usenursinginterventionstoachieveoutcomesrelatedtothemedicationregimen
1) Usenursingmeasurestosafelyadministermedications(forexample:calculationandmeasurement,patientidentification,transcription,accuraterecording,selectionofcorrectsite,administrationofcontrolledsubstances)
2) Provideinformationandinstructionregardingthemedicationregimen(forexample:self-administration,storage,reportingsideeffects)
e. Evaluation:determinetheextenttowhichoutcomeshavebeenachieved
1) Evaluate,record,andreportthepatient’sresponsetonursingactions(forexample:patientadherestothemedicationregimen)
2) Modifytheplanofcareifnecessary
D. Safety
1. Theoreticalframework
a. Factorsinfluencinganindividual’ssafety
1) Individualfactors(forexample:age,medications,levelofawareness,sensoryperception,emotionalstate)
2) Environmentalfactors(forexample:occupation,presenceofleadpaint)
3) Socioeconomicandculturalfactors(forexample:abilitytocommunicate,unemployment)
4) Psychologicalfactors(forexample:stress,anxiety)
b. Identificationofenvironmentalhazards(forexample:physicalandmechanical,thermal,chemical,radiation,ecological)
c. Devicescommonlyusedtopromotesafety(forexample:restraints,walkers,siderails)
2. Nursingcare
a. Assessment:establishadatabaseconcerningthepatient’ssafetyneeds
1) Gatherobjectiveandsubjectivedata(forexample:confusion,visualacuity)
2) Determinepresenceofenvironmentalhazards(seeIIID1b)
3) Assessfactorsinfluencingthepatient’ssafety(forexample:age,hearingimpairment)(seeIIID1a)
b. Diagnosis:identifythepatient’sactualorpotentialnursingdiagnosesrelatedtosafety
1) Analyzeandinterpretdata(forexample:recognizelossofequilibrium)
2) Identifynursingdiagnoses(forexample:highriskforinjuryrelatedtosensorydeficit)
c. Planning:setpriorities,identifypatient-centeredoutcomesandselectinterventionsrelatedtosafety
1) Setprioritiesandestablishoutcomes(forexample:patientwillrequestassistancewithambulation)
13FN/OR
2) Incorporatefactorsinfluencingsafetyinplanningforindividualizedpatientcare(forexample:considerage,lifestyle,levelofconsciousness,mobility)
3) Selectnursinginterventionsforalleviatingorminimizingsafetyhazards(forexample:modifytheenvironment)
4) Selecttheappropriatesafetydevicebasedontheindividual’sneeds(forexample:walkers,restraints)
d. Implementation:usenursinginterventionstoachieveoutcomesrelatedtosafety
1) Usenursingmeasurestoprovideasafeenvironment(forexample:elevatesiderails,userestrainingjacket)
2) Useequipmentanddevicessafely(forexample:walkers,icepacks,heatapplications)
3) Instructthepatientregardingsafety(forexample:orienttoenvironment,explainuseofwheelchair)
e. Evaluation:determinetheextenttowhichoutcomeshavebeenachieved
1) Evaluate,record,andreportthepatient’sresponsetonursingactions(forexample:patientambulateswiththenurse’sassistance)
2) Modifytheplanofcareifnecessary
IV. Comfort, Rest, and Activity (15%) 54 hours
KozierCh. 31,Hygiene
Ch. 42,ActivityandExercise
Ch. 43,RestandSleep
Ch. 44,PainManagement
A. Hygiene
1. Theoreticalframework
a. Componentsofhygiene
b. Factorsinfluencinghygiene(forexample:culturalfactors,age,physicalstatus,bodyimage,self-esteem)
c. Agentscommonlyusedontheskinandmucousmembrane(forexample:soaps,lotions,emollients,mouthwashes)
2. Nursingcare
a. Assessment:establishadatabaseconcerninghygiene
1) Gatherobjectiveandsubjectivedata(forexample:cleanlinessoftheskin,conditionofthenails,complaintsofdryness)
2) Assessfactorsinfluencingthepatient’shygiene(seeIVA1b)
b. Diagnosis:identifythepatient’sactualorpotentialnursingdiagnosesrelatedtohygiene
1) Analyzeandinterpretdata
2) Identifynursingdiagnoses(forexample:alteredoralmucousmembranerelatedtomouthbreathing)
14 FN/OR
c. Planning:setpriorities,identifypatient-centeredoutcomesandselectinterventionsrelatedtohygiene
1) Setprioritiesandestablishoutcomes(forexample:patient’soralmucousmembranewillbepinkandmoist)
2) Incorporatefactorsinfluencinghygieneinplanningpatientcare(seeIVA1b)
3) Selectnursinginterventionstoachieveoutcomes(forexample:providemouthcareq2h)
d. Implementation:usenursinginterventionstoachieveoutcomesrelatedtohygiene
1) Usenursingmeasurestoprovidecomprehensivehygieniccare(forexample:bathing,haircare,nailcare,skincare,perinealcare)
2) Usenursingmeasurestopromotepsychologicalcomfort(forexample:provideprivacyduringbathing)
3) Provideinformationandinstruction(forexample:instructthepatientontheuseofdentalfloss,discussindicationsforuseofskinlotionsratherthanalcohol-baseskinproducts)
e. Evaluation:determinetheextenttowhichoutcomeshavebeenachieved
1) Evaluate,record,andreportthepatient’sresponsetonursingactions(forexample:thepatient’slipsremaindryandcracked)
2) Modifytheplanofcareifnecessary
B. Rest and sleep
1. Theoreticalframework
a. Principlesrelatedtorestandsleep(forexample:sleepstages,circadianrhythm)
b. Factorsinfluencingrestandsleep(forexample:age,noiselevel,fatigue,useofcaffeine,useofalcohol,hospitalization,sensorydeprivation)
c. Agentscommonlyusedtopromoterestandsleep(sedatives,hypnotic)
2. Nursingcare
a. Assessment:establishadatabaseconcerningrestandsleep
1) Gatherobjectiveandsubjectivedata(forexample:usualsleephabits,useofover-the-countermedications,bedtimeroutines)
2) Assessfactorsinfluencingthepatient’srestandsleep(seeIVB1b)
b. Diagnosis:identifythepatient’sactualorpotentialnursingdiagnosesrelatedtorestandsleep
1) Analyzeandinterpretdata(seeIVB2a)
2) Identifynursingdiagnoses(forexample:sleeppatterndisturbancerelatedtounfamiliarsurroundings)
c. Planning:setpriorities,identifypatient-centeredoutcomesandselectinterventions
1) Setprioritiesandestablishoutcomes(forexample:patientwillgetsixhoursofuninterruptedsleeppernight
2) Incorporatefactorsinfluencingrestandsleep(seeIVB1b)
15FN/OR
3) Selectnursinginterventionstohelpthepatientachieveoutcomes(forexample:reorientthepatienttothesurroundings)
d. Implementation:usenursinginterventionstoachieveoutcomesrelatedtorestandsleep
1) Usenursingmeasurestoinducerestandsleep(forexample:administerabackrub,provideabedtimesnack,provideaquietenvironment)
2) Usenursingmeasuresspecifictodrugclassificationsforprescribedmedications(forexample:raisethesiderailsafteradministeringasleepmedication)
3) Usenursingmeasurestomodifytheenvironment(forexample:providesensorystimulation,preventsensoryoverload)
4) Provideinformationandinstruction(forexample:discussrelaxationtechniqueswiththepatient)
e. Evaluation:determinetheextenttowhichoutcomeshavebeenachieved
1) Evaluate,record,andreportthepatient’sresponsetonursingactions(forexample:patientstatesthathefeelswellrested)
2) Modifytheplanofcareifnecessary
C. Mobility and immobility
1. Theoreticalframework
a. Principlesofbodymechanics,transfer,ambulation,range-of-motion,exercise
b. Responsesofbodysystemstomobility(forexample:improvedcirculation,peristalsis)
c. Complicationsresultingfromimmobility(forexample:muscleweakness,contractures,retainedsecretions,decubitusulcers,hypostaticpneumonia,constipation)
2. Nursingcare
a. Assessment:establishadatabaseconcerningmobilityandimmobility
1) Gatherobjectiveandsubjectivedata(forexample:range-of-motion,skinintegrity,eliminationpatterns,activitylevel,jointmobility)
2) Assessthepatient’sresponsestomobilityandimmobility(seeIVC1b–c)
b. Diagnosis:identifythepatient’sactualorpotentialnursingdiagnosesrelatedtomobilityorimmobility
1) Analyzeandinterpretdata
2) Identifynursingdiagnoses(forexample:highriskforimpairedphysicalmobilityrelatedtobedrest)
c. Planning:setpriorities,identifypatient-centeredoutcomes,andselectappropriateinterventionsrelatedtomobilityorimmobility
1) Setprioritiesandestablishoutcomes(forexample:patientwillmaintainusualrangeofmotioninalljoints)
2) Considertheresponsesofthebodytomobilityandimmobility(seeIVC1b–c)
16 FN/OR
3) Selectnursinginterventionstohelpthepatientachieveoutcomes(forexample:supervisethepatientinactiverange-of-motionexercisest.i.d.)
d. Implementation:usenursinginterventionstoachieveoutcomesrelatedtomobilityorimmobility
1) Useappropriatedevicestomaintainnormalbodyalignment(forexample:footboard,pillows,trochanterroll)
2) Usenursingmeasurestopromotemobilityandmaintainmuscletone(forexample:rangeofmotion,ambulation,positioning)
3) Usenursingmeasurestopreventtissuebreakdown(forexample:massage,pressure-relievingdevices,turning)
4) Usenursingmeasurestopreventcomplicationsrelatedtoimmobility(forexample:legexercises,antiembolismstockings,deepbreathingandcoughing)
5) Instructthepatientregardingactivityneeds
e. Evaluation:determinetheextenttowhichoutcomeshavebeenachieved
1) Evaluate,record,andreportthepatient’sresponsetonursingactions(forexample:patient’sjointsarefreelymovablewithinnormalrangeofmotion)
2) Modifytheplanofcareifnecessary
D. The pain experience
1. Theoreticalframework
a. Conceptsrelatedtopain(forexample:gatecontroltheory,acutevs.chronicpain,painthreshold,endorphins)
b. Factorsinfluencingpain(forexample:etiologyofpain,durationofpain,sensoryoverload,culturalfactors)
c. Agentsandtechniquescommonlyusedtocontrolpain(forexample:guidedimagery,relaxation,administrationofnonnarcoticanalgesics,narcoticanalgesics,patient-controlledanalgesia,placebos,cutaneousstimulation)
2. Nursingcare
a. Assessment:establishadatabaseconcerningpain
1) Gatherobjectiveandsubjectivedata(forexample:changesinvitalsigns,facialexpression,bodylanguage,verbalizationbythepatient)
2) Assessfactorsinfluencingthepatient’spain(seeIVD1b)
b. Diagnosis:identifythepatient’sactualorpotentialnursingdiagnosesrelatedtopain
1) Analyzeandinterpretdata
2) Identifynursingdiagnoses(forexample:painrelatedtorecentabdominalsurgery)
c. Planning:setpriorities,identifypatient-centeredoutcomesandselectinterventionsrelatedtopain
1) Setprioritiesandestablishoutcomes(forexample:patientwillreportdecreaseinpain)
2) Incorporatefactorsinfluencingpain(seeIVD1b)
17FN/OR
3) Selectnursinginterventionstohelpthepatientachieveoutcomes(forexample:positionthepatienttominimizestressontheincision;administerpainmedicationonaregularschedule)
d. Implementation:usenursinginterventionstoachieveoutcomesrelatedtopain
1) Usenursingmeasurestoreducethepatient’spain(forexample:positioning,cutaneousstimulation,assesstheoperativesite,promoterelaxation)
2) Usenursingmeasuresspecifictodrugclassificationsforprescribedmedications(forexample:monitorvitalsignsforapatientreceivinganarcoticanalgesic,scheduleadministrationofmedicationstomaximizeeffectiveness)
3) Instructthepatientregardingpain(forexample:useofrelaxationtechniques,useofguidedimagery)
e. Evaluation:determinetheextenttowhichoutcomeshavebeenachieved
1) Evaluate,record,andreportthepatient’sresponsetonursinginterventions(forexample:patientstatesthatpainhasbeenrelieved)
2) Modifytheplanofcareifnecessary
V. Nutrition (10%) 36 hours
KozierCh. 45, Nutrition
A. Theoretical framework
1. Processesofingestion,digestion,andabsorptionofnutrients
2. Normalnutritionalrequirements
a. FoodGuidePyramid
b. Basicfunctionsandcommonfoodsourcesofcarbohydrates,proteins,fats,vitamins,minerals
c. Caloricvalues
3. Commonnutritionaldisturbances(forexample:vomiting,heartburn,obesity,anorexia,malnutrition)
4. Factorsinfluencingnutrition
a. Individualfactors(forexample:age,sedentarylifestyle,vegetariandiet,dentalstatus,physicalcondition,needforassistancewithfeeding)
b. Socioeconomicandculturalfactors(forexample:income,religion)
c. Psychologicalfactors(forexample:faddiets,anorexia)
5. Adaptationsofnormaldiet:definitions,foodsallowed,andindicationsforuse
a. Clearliquid
b. Fullliquid
c. Soft
6. Alternativefeedingmethods(forexample:gavage,gastrostomy)
7. Agentscommonlyusedtopromotenutrition(forexample:vitaminsandminerals)
18 FN/OR
B. Nursing care
1. Assessment:establishadatabaseconcerningnutritionalstatus
a. Gatherobjectiveandsubjectivedata(forexample:weight,height,anorexia)
b. Assessfactorsinfluencingnutrition(seeVA4)
2. Diagnosis:identifythepatient’sactualorpotentialnursingdiagnosesrelatedtonutrition
a. Analyzeandinterpretdata(forexample:serumalbumin,bodyweight)
b. Identifynursingdiagnoses(forexample:alterednutrition:lessthanbodyrequirementsrelatedtoanorexia)
3. Planning:setpriorities,identifypatient-centeredoutcomesandselectinterventionsrelatedtonutrition
a. Setprioritiesandestablishoutcomes(forexample:patientwillgainonepoundperweekuntilidealbodyweightisachieved)
b. Incorporatefactorsinfluencingnutritioninplanningforpatient’sdietaryneeds(forexample:plannutritionallyadequatedietbasedonpatient’sculturalpreferences)(seeVA4)
c. Selectnursinginterventionstohelpthepatientachieveoutcomesrelatedtonutrition
4. Implementation:usenursinginterventionstoachieveoutcomesrelatedtonutrition
a. Usenursingmeasurestoincreasenutritionalintake(forexample:assistinfoodselection,assistinfeeding,modifytheenvironment,placethepatientinthemostappropriateposition)
b. Usenursingmeasuresappropriatetoparticularfeedingmethods(forexample:nasogastrictubefeedings,gastrostomytubefeedings)
c. Usenursingmeasuresspecifictodrugclassificationsforprescribedmedications(forexample:administerliquidironthroughastraw)
d. Instructthepatientregardingnutrition
5. Evaluation:determinetheextenttowhichoutcomeshavebeenachieved
a. Evaluate,record,andreportthepatient’sresponsetonursinginterventions(forexample:thepatienthasgainedtwopoundsthisweek)
b. Modifytheplanofcareifnecessary
VI. Elimination (11%) 40 hours
KozierCh. 46,FecalElimination
Ch. 47,UrinaryElimination
A. Theoretical framework
1. Urinaryelimination
a. Anatomyandphysiologyofurinarytract
b. Commondisturbances(forexample:incontinence,frequency,retention)
2. Intestinalelimination
a. Anatomyandphysiologyofintestinaltract
b. Commondisturbances(forexample:constipation,diarrhea,impaction,flatulence,incontinence)
19FN/OR
3. Factorsinfluencingelimination
a. Individualfactors(forexample:age,activitylevel,dietaryhabits)
b. Environmentalfactors(forexample:privacy)
c. Psychologicalfactors(forexample:stress)
4. Agentscommonlyusedtopromoteelimination(forexample:laxatives,stoolsofteners,antidiarrhealagents)
B. Nursing care
1. Assessment:establishadatabaseconcerningelimination
a. Gatherobjectiveandsubjectivedata(forexample:changesinnormaleliminationpatterns;color,odor,andconsistencyofurineandfeces)
b. Assessfactorsinfluencingelimination(seeVIA3)
2. Diagnosis:identifythepatient’sactualorpotentialnursingdiagnosesrelatedtoelimination
a. Analyzeandinterpretdata(forexample:urinalysis,[normalvalues],frequencyofelimination,intakeandoutput,presenceofoccultblood)
b. Identifynursingdiagnoses(forexample:constipationrelatedtoinsufficientintakeofdietaryfiber)
3. Planning:setpriorities,identifypatient-centeredoutcomesandselectinterventionsrelatedtoelimination
a. Setprioritiesandestablishoutcomes(forexample:patientwillhaveonesoftbrownstooldaily)
b. Incorporatefactorsinfluencingeliminationinplanningpatientcare(forexample:thepatientisonbedrest)(seeVIA3)
c. Selectnursinginterventionstohelpthepatientachieveoutcomes(forexample:consultwiththedieticianaboutincreasingfiberinthepatient’sdiet)
4. Implementation:usenursinginterventionstoachieveoutcomesrelatedtoelimination
a. Usenursingmeasurestofacilitateelimination(forexample:performcatheterization,administerenema,administerlaxativesandstoolsofteners,provideappropriateintake,collectspecimens,ensureappropriateactivity,decreasestress,provideproperpositioning,ensureprivacy)
b. Usenursingmeasuresspecifictodrugclassificationsforprescribedmedications(forexample:administeralaxativeatthetimethatevacuationisdesired,encouragethepatienttoretainthesuppositoryfor15minutes)
c. Instructthepatientregardingelimination(forexample:assistpatienttoplananexerciseprogramandtoincreaseintakeoffluids)
5. Evaluation:determinetheextenttowhichoutcomeshavebeenachieved
a. Evaluate,record,andreportthepatient’sresponsetonursingactions(forexample:patientreportspassingahard,drystool)
b. Modifytheplanofcareifnecessary
20 FN/OR
VII. Oxygenation (10%) 36 hours
KozierCh. 48, Oxygenation
A. Theoretical framework
1. Normalrespiratoryfunctions
a. Anatomyandphysiology
b. Ventilation,diffusion,andtransport
2. Commonrespiratorydisturbances(forexample:dyspnea,tachypnea,orthopnea,hypoxia)
3. Factorsinfluencingoxygenation
a. Individualfactors(forexample:fever,activitylevel,excesssecretions)
b. Environmentalfactors(forexample:smoking,roomventilation)
c. Psychologicalfactors(forexample:stress,anxiety)
4. Techniquescommonlyusedtopromoteoxygenation(forexample:administrationofoxygenvianasalcannulaandfacemask,incentivespirometry,chestphysiotherapy)
B. Nursing care
1. Assessment:establishadatabaseconcerningoxygenationstatus
a. Gatherobjectiveandsubjectivedata(forexample:skincolor,toleranceforactivity,vitalsigns,respiratorystatus,shortnessofbreath,confusion,restlessness)
b. Assessfactorsinfluencingoxygenation(seeVIIA3)
2. Diagnosis:identifythepatient’sactualorpotentialnursingdiagnosesrelatedtooxygenation
a. Analyzeandinterpretdata(forexample:vitalsigns,hemoglobin,hematocrit[normalvalues])
b. Identifynursingdiagnoses(forexample:ineffectivebreathingpatternrelatedtoabdominalpain)
3. Planning:setpriorities,identifypatient-centeredoutcomesandselectinterventionsrelatedtooxygenation
a. Setprioritiesandestablishoutcomes(forexample:patientwilldemonstrateincreaseddepthofrespiration)
b. Incorporatefactorsinfluencingoxygenationinplanningpatientcare(forexample:painassessment,anxiety,positioning)
c. Selectnursinginterventionstohelpthepatientachieveoutcomes(forexample:providecomfortmeasures,repositionthepatient,administertheprescribedanalgesic)
4. Implementation:usenursinginterventionstoachieveoutcomesrelatedtooxygenation
a. Usenursingmeasurestopromoteoxygenation(forexample:turning,deepbreathing,andcoughing;administeringoxygen;nasopharyngealsuctioning;monitoringvitalsigns;reducinganxiety)
b. Usenursingmeasuresappropriatetothemethodofoxygenadministration(humidifiers,oxygenmasks,cannula)
c. Instructthepatientregardingoxygenation(forexample:demonstratecoughinganddeep-breathingexercises)
21FN/OR
5. Evaluation:determinetheextenttowhichoutcomeshavebeenachieved
a. Evaluate,record,andreportthepatient’sresponsetonursingactions(forexample:patient’srespirationsare12–14/minute,deepandrhythmic)
b. Modifytheplanofcareif
necessary
VIII. Fluid and Electrolyte Balance (11%) 40 hours
KozierCh. 50,Fluid,Electrolyte,and
Acid-BaseBalance
A. Concepts and principles
1. Principlesrelatedtofluidandelectrolytebalance(forexample:composition,regulation,andmovementoffluidandelectrolytes)
2. Commondisturbancesoffluidandelectrolytebalance
a. Hypercalcemia,hypocalcemia
b. Hyperkalemia,hypokalemia
c. Hypernatremia,hyponatremia
d. Hypermagnesemia,hypomagnesemia
e. Hypervolemia,hypovolemia
3. Commonintravenousfluids
a. LactatedRinger’s
b. 5%dextroseandwater
c. Normalsaline
d. Halfsaline
4. Factorsinfluencingfluidandelectrolytebalance
a. Physicalstatus(forexample:vomiting,fever,diarrhea,useofdiuretics,exercise)
b. Environmentalfactors(forexample:temperature,humidity)
5. Agentscommonlyusedtopromotefluidandelectrolytebalance(forexample:administrationofIVfluids,electrolytesupplements)
B. Nursing care
1. Assessment:establishadatabaseconcerningfluidandelectrolytestatus.
a. Gatherobjectiveandsubjectivedata(forexample:skinturgor,pulsequality,conditionoforalmucousmembranes,output,weight,edema,muscleweakness,thirst)
b. Assessfactorsinfluencingfluidandelectrolytestatus(seeVIIIA4)
2. Diagnosis:identifythepatient’sactualorpotentialnursingdiagnosesrelatedtofluidsandelectrolytes
a. Analyzeandinterpretdata(forexample:serumelectrolytelevel,hematocrit[normalvalues]specificgravityofurine[normalvalues])
b. Identifynursingdiagnoses(forexample:fluidvolumedeficitrelatedtoinsufficientintake)
3. Planning:setpriorities,identifypatient-centeredoutcomesandselectinterventionsrelatedtofluidsandelectrolytes
a. Setprioritiesandestablishoutcomes(forexample:patient’stotalfluidintakewillbe2,500cc/day)
b. Incorporatefactorsinfluencingfluidandelectrolytestatus(forexample:establishapatternoffluidintakebasedonindividualpatientpreferences)(seeVIIIA4)
c. Selectnursinginterventionstohelpthepatientachieveoutcomes(forexample:monitorIVtherapy,provideoralfluids)
22 FN/OR
4. Implementation:usenursinginterventionstoachieveoutcomesrelatedtofluidandelectrolytebalance
a. Promotefluidandelectrolytebalance(forexample:assistwithfoodandfluidselection,measureandrecordintakeandoutput)
b. Usenursingmeasuresappropriatetooralandparenteralreplacement(forexample:establishdailyfluidregimenwithpatient,assistwithparenteraladministrationoffluids[gravityflowandIVinfusionpumps],identifysignsandsymptomsofuntowardreactions)
c. Instructthepatientregardingfluidandelectrolyterequirements(forexample:discussdietarysourcesofpotassium)
5. Evaluation:determinetheextenttowhichoutcomeshavebeenachieved
a. Evaluate,record,andreportthepatient’sresponsetonursingactions(forexample:patient’s24-hourfluidintakeis2,500cc)
b. Modifytheplanofcareifnecessary
23FN/OR
1. Amentallycompetentpatientrefusesaninjection.Thenurseadministerstheinjectiondespitethepatient’srefusal.Inthissituation,thenursecanbeheldliableforwhichoffense?
1) assault
2) battery
3) invasionofprivacy
4) amisdemeanor
2. Whichtermdescribestherulesorprinciplesthatgovernprofessionalconduct?
1) beliefs
2) ethics
3) morals
4) values
3. Apatientisbeingadmittedtothehospital.Thenursenotesthatthepatient’spulseandbloodpressurearehigherthantheywereonpreviousroutineofficevisits.Howshouldthenurseinterpretthesefindingsinitially?
Thefindingsareindicativeof
1) theresistancestageofstress.
2) anautonomicnervoussystemresponse.
3) aninflammatoryresponse.
4) thelocaladaptationsyndrome.
4. Whichobservationismostindicativeofalocalizedinfection?
1) diaphoresis
2) fatigue
3) fever
4) swelling
5. Whichinformationinapatient’shealthhistoryindicatesthatthepatientisatriskforinfection?
1) Thepatienthadmumpsthreeyearsago.
2) Thepatienthadrubellaoneyearago.
3) Thepatienthadatetanusbooster12yearsago.
4) Thepatientwasayearlatereceivingthepoliovaccine.
6. Apatientisbeingdischargedwithanindwellingurinarycatheter.Whichinstructionshouldthenursegivetothepatienttohelppreventaurinarytractinfection?
1) Allowthecollectionbagtofillcompletelybeforeemptyingit.
2) Separatethecatheterfromthetubingwhenemptyingthecollectionbag.
3) Clampthetubingbeforeexercisingorambulating.
4) Positionthetubingsotheurineflowsintothecollectionbag.
7. Whichassessmentfindingindicatesthatahospitalizedpatientisatriskforphysicalinjury?
1) diminishedlungsounds
2) hyperactivebowelsounds
3) weakrighthandgrasp
4) bilateral+1ankleedema
8. WhenadministeringamedicationviatheZ-trackmethod,thenurseshouldincludewhichaction?
1) Massagethesitefollowingtheinjection.
2) Givetheinjectionintosubcutaneoustissue.
3) Changetheneedlepriortotheinjection.
4) Administerthemedicationrapidly.
Sample Questions
The questions that follow illustrate those typically found
on this examination. These sample questions are includ-
ed to familiarize you with the type of questions you will
find on the examination. The answer rationales can be
found on pages 27–30 of this guide.
24 FN/OR
9. Whenadministeringamedicationtoapatientwithdecreasedliverfunction,thenurseshouldbemostconcernedwithwhichmechanismofthedrug’saction?
1) absorption
2) distribution
3) excretion
4) metabolism
10. Whichinstructionshouldthenursegive
toapatientwhousesabathoil?
1) Becertaintoremovealloilresiduefromtheskin.
2) Takeprecautionstopreventfallsinthebathtub.
3) Alternatetheuseofbathoilwithaskinlotion.
4) Useawashclothtoapplythebathoil.
11. Towhichstageofsleepwillapatientreturnafterbeingawakenedforatreatment?
1) thestagefromwhichshewasawakened
2) thefirststageofsleep
3) therapideyemovementstage
4) thesecondstageofsleep
12. Apatientisonbedrest.Toavoidacomplicationofimmobility,thenurseshouldgiveprioritytowhichassessment?
1) activitytolerance
2) bowelsounds
3) lungsounds
4) urinaryoutput
13. Whichanalgesicismostcommonlyassociatedwithanincreasedincidenceofgastricbleedinginolderadults?
1) acetaminophen(Tylenol)
2) codeine
3) indomethacin(Indocin)
4) meperidinehydrochloride(Demerol)
14. Whichmeasureshouldthenurseinclude
intheplanofcareforapatientwhoisexperiencingpain?
1) Implementpainreliefmeasuresbeforethepainbecomessevere.
2) Usethesamepainreliefmeasureforeachpainexperience.
3) Administerpainmedicationsonapredeterminedschedule.
4) Encouragethepatienttoincreasetheintervalsbetweenpainmedicationrequests.
15. Whichfoodishighestinsaturatedfat?
1) butter
2) margarine
3) oliveoil
4) peanutoil
16. Whichobservationindicatesthatapatientisrespondingpositivelytooxygentherapy?
1) dyspnea
2) eupnea
3) hyperpnea
4) orthopnea
17. Whichassessmentdatashouldalertthenursetothelikelihoodthatapatientmaybeexperiencingfluidvolumedeficit?
1) increasedhematocrit
2) leukocytosis
3) distendedneckveins
4) peripheraledema
18. Whenapatient’sserumsodiumlevelis129mEq/L,thenurseshouldanticipatean
orderforwhichIVfluid?
1) 5%dextroseinwater
2) 5%dextrosein0.45%NaCl
3) 5%dextrosein0.9%NaCl
4) lactatedRinger’ssolution
25FN/OR
19. ThephysicianordersanIVinfusionof1,000cc0.9%NaCltorunover10hours.TheIVadministrationsetdelivers10dropspercc.Thenurseshouldregulatetheflowrateathowmanydropsperminute?
1) 6to7
2) 16to17
3) 25to26
4) 31to32
20. Whichinstructionaltechniqueshouldmaximizeindependenceforapatientwhoneedstolimitsodiuminthediet?
1) Calculatetheactualvolumeofsaltinthepatient’susualdiet.
2) Providethepatientwithalistoffoodsthatmustbeavoided.
3) Givethepatientasetofwritten,preplanned,low-sodiummenus.
4) Explaintothepatienthowtoreadandinterpretfoodlabels.
26 FN/OR
ThestudymaterialslistedbelowarerecommendedbyExcelsiorCollegeasthemostappropriateresourcestohelpyoustudyfortheexamination.ForinformationonorderingfromtheExcelsiorCollegeBookstore,seetheinsidefrontcoverofthisguide.Youmayalsofindresourcematerialsinthelibrariesofcolleges,schoolsofnursing,medicalschools,andhospitals.Publiclibrariesmayhavesomeofthetextbooksormaybeabletoobtainthemthroughaninterlibraryloanprogram.
Youshouldallowsufficienttimetoobtainresourcesandtostudybeforetakingtheexam.
Learning Resources for this Exam
Order the resources you need today!
The Excelsior College Bookstore is available by phone, fax, email, Web site, and mail.
See page ii for ordering information.
Recommended ResourcesKozier,B.,Erb,G.,Berman,A.,&Snyder,S.(2004).Fundamentals of nursing: Concepts, process, and practice
(7thed.).UpperSaddleRiver,NJ:PrenticeHall.
Study Guide:Barnes,S.,&Snyder,S.(2004).Study guide for Fundamentals of nursing: Concepts, process, and practice(7thed.).
UpperSaddleRiver,NJ:PrenticeHall.
Additional ResourcesTheexaminationdevelopmentcommitteehasalsosuggestedthefollowingtextbookswhichmayprovidefurtherclarificationofthecontent.
Aschenbrenner,D.S.,&Venable,S.J.(2005).Drug therapy in nursing(2nded.).Philadelphia:Lippincott,WilliamsandWilkins.
Kozier,B.etal.(2004).Techniques in clinical nursing: Basic to intermediate skills(5thed.).MenloPark,CA:PrenticeHall.
Wilkinson,J.(2005).Nursing diagnosis handbook: With NIC interventions and NOC outcomes(8thed.).RedwoodCity,CA:PrenticeHall.
27FN/OR
Rationales for Sample Questions
1.(IA3b)
1) Assaultisathreatoranattempttomakebodilycontactwithanotherpersonwithoutthatperson’sconsent.Thisnurseactuallytouchedthepatient.
*2) Battery is assault carried out and includes the willful, angry, and violent touching of another person’s body or clothes. Administering an injection after a patient has refused it is a classic example of battery.
3) Thenurse’sactionisnotaninvasionofprivacy.Anexampleofinvasionofprivacyisbreachofconfidentiality.
4) Amisdemeanorisaclassificationofacrime;itisnotinitselfatypeofoffense.
2.(IC)
1) Beliefsareindividuallyheldattitudesandarenottherulesofaprofession.
*2) Ethics are the rules or principles that govern professional conduct; ethics are the expected, publicly stated standards of a particular group.
3) Moralsarepersonalstandardsofrightandwrong,notthestandardsofagroup.
4) Valuesarethebeliefsofanindividual,nottherulesofaprofession.
3.(IIB)
1) Thestageofresistanceoccurslaterinanillness,asthebodyadapts.
*2) Stress activates the sympathetic nervous system, causing the findings.
3) Theinflammatoryresponseisalocalizedresponsetotissueinjuryorinfection.
4) Thelocaladaptationsyndromeoccurswhenonepartofthebodyrespondstoaninjury.
4.(IIIB2a)
1) Diaphoresisisasystemicresponsetofeverandinfection.
2) Fatigueisasystemicresponsetoinfection.
3) Feverisasystemicresponsetoinfection.
*4) Swelling occurs when blood vessels dilate to increase blood flow to localized infectious agents.
5.(IIIB1b)
1) Thiswouldhavenoeffectonapatient’sriskforinfection.
2) See1).
*3) A tetanus booster should be repeated every 10 years in adults, so this patient is susceptible to tetanus, that is, at risk for infection.
4) Thepatientdidreceivethepoliovaccine,eventhoughitwaslate,sothepatientisimmunetopolioandnotatriskforinfection.
6.(IIIB2c)
1) Afullbagofstandingurineisamediumforbacterialgrowth.
2) Thedrainagesystemshouldremainintact.Breakingtheconnectionallowsaportalforbacteriatoenterthesystem.
3) Clampingthetubingpromotesstasisofurineinthebladder.
*4) Positioning the tubing correctly promotes drainage and limits urinary stasis, thereby limiting bacterial growth.
*correct answer
28 FN/OR
7.(IIIB2a)
1) Diminishedbreathsoundsplaceapatientatriskforimpairedgasexchange,notphysicalinjury.
2) Hyperactivebowelsoundsdonotplaceapatientatriskforphysicalinjury.
*3) A weak right hand grasp indicates the patient has altered mobility, placing the patient at risk for physical injury.
4) Bilateralankleedemaisanindicatoroffluidvolumeexcesswhichdoesnotplaceapatientatriskforphysicalinjury.
8.(IIIC1b)
1) Massagingthesitefollowingtheinjectionisnotrecommendedbecauseitmayforcethemedicationbackintotheneedletrackandcauseirritation.
2) TheZ-trackmethodisusedforintramuscularinjections,notsubcutaneousinjections.
*3) Changing the needle prior to the injection ensures that no medication clings to the needle as it is inserted through the subcutaneous tissue into the muscle where it is injected.
4) Themedicationshouldnotbeadministeredrapidly.Itisinjectedslowlyandtheneedleisallowedtoremaininplacefor10secondsafterinjectingthemedication.
9.(IIIC2a)
1) Absorptionistheprocessbywhichadrugistransferredfromitssiteofentrytothebloodstream.
2) Distributionisthemovementofadrugthroughoutthebody.Therateofdistributiondependsonperfusionandcapillarypermeabilityofthedrug.Distributionusuallydoesnotinvolvetheliver.
3) Excretionistheremovalofadrugfromthebody.Thekidneysexcretemostdrugs.
*4) Metabolism is the breakdown of a drug into inactive form. Liver disease may interfere with this process.
10.(IIID2d)
1) Asmallamountofoilontheskinwillhelptomoisturize.
*2) Oil is a slippery substance and can cause falls in the bathtub.
3) Alternatingtheuseofbathoilwithaskinlotionispersonalpreferenceandnotapriorityinstructionforthepatient.
4) Theoilcanbeappliedanywaythepatientlikes.Thisisnotapriorityinstruction.
11.(IVB1a)
1) Thepatientwillnotreturntothestagefromwhichshewasawakened.
*2) After being awakened, a patient begins the sleep cycle at stage one and progresses through all of the stages.
3) See2).
4) See2).
12.(IVC1c)
1) Theinabilitytoendureorcompletedailyactivitiesisnotlifethreatening.
2) Poorgastrointestinaleliminationisnotlifethreatening.
*3) Loss of respiratory functioning may become a serious threat to health.
4) Urinaryproblemshavealowerprioritythandopulmonaryproblems.
13.(IVD1c)
1) Tylenolisnotassociatedwithgastricbleeding.
2) Codeineisanarcoticanalgesicandisnotassociatedwithgastricbleeding.
*3) Indocin is a nonsteroidal anti-inflammatory agent (NSAID). NSAIDs have been associated with gastric irritation and bleeding. Indocin is especially difficult to tolerate and should be used cautiously, if at all, in older adults.
4) Demerolisanarcoticanalgesicandisnotassociatedwithgastricbleeding.
*correct answer
29FN/OR
14.(IVD2c)
*1) Providing an analgesic before the onset of pain is preferable. If the nurse waits for the patient to report pain, a larger dose may be required.
2) Painmayvaryinintensityfrommomenttomomentanddifferentpainreliefmeasuresmayberequiredtocontrolpain.
3) Thechoiceofpainrelieversisbasedonthepatient’sreportofpain.Reportofmildpainmayrequireadifferentanalgesicthanmoreseverepain.
4) Paintherapyshouldnotincreasediscomfortorharmthepatient.Inatrustingrelationship,thenurseshouldmanagethepatient’spainregardlessofthetimeintervals.
15.(VA2b)
*1) Butter, being of animal origin, contains saturated fat.
2) Margarinecontainsmonounsaturatedfat.
3) Oliveoilcontainsmonounsaturatedfat.
4) Peanutoilcontainsmonounsaturatedfat.
16.(VIIB1b)
1) Dyspnea,feelingshortofbreath,isnotapositiveresponsetooxygentherapy.
*2) Eupnea, normal effortless breathing, is a positive response to oxygen therapy.
3) Hyperpnea,anincreaseddepthofrespiration,isnotapositiveresponsetooxygentherapy.
4) Orthopnea,theinabilitytobreatheexceptinanuprightposition,isnotapositiveresponsetooxygentherapy.
17.(VIIIA1)
*1) Loss of fluid makes the blood more concentrated and results in an increased hematocrit.
2) LeukocytosisisanelevatedWBCandisevidenceofinfection,notfluidvolumedeficit.
3) Distendedneckveinsareanindicatoroffluidvolumeexcess.
4) Peripheraledemaisanindicatoroffluidvolumeexcess.
18.(VIIIB1b)
1) A5%dextroseinwatersolutionissodium-freeandwouldnotbeusedforapatientwithhyponatremia.
2) A5%dextrosein0.45%NaClsolutiononlycontainshalfasmuchsodiumasdoesnormalbloodandwouldnotbeusedforapatientwithhyponatremia.
*3) A 5% dextrose in 0.9% NaCl solution is normal saline and would provide additional intake of sodium for a patient with hyponatremia.
4) LactatedRinger’ssolutionisanisotonicsolutionusedprimarilyformaintainingorreplacingvolume.
19.(VIIIB3b)
1) See2).
*2) The standard formula for calculating IV flow rate is:
volume (mL) x drop factor (gtt/mL)
time in minutes
1,000 x 10
600 = 16.66
3) See2).
4) See2).
*correct answer
30 FN/OR
20.(VIIIB3c)
1) Calculatingthevolumeofsaltinthepatient’sdietdoesnotteachthepatienthowtolimitsodiuminthediet.
2) Givingthepatientalistoffoodstoavoidmayprovideinformationregardingfoodshighinsodium,butitdoesnotteachthepatienthowtoreadandinterpretfoodlabels.
3) Givingthepatientasetofpreplannedmenusdoesnotallowforflexibilityinthedietandpatientsoftenhavedifficultycomplyingwithstrictplans.
*4) Sodium is found in many foods and the patient must know how to read and interpret food labels in order to calculate a daily intake. The patient can then include personal preferences in the dietary plan, which should improve compliance with limiting sodium.
*correct answer
31FN/OR
ToniStoneDoherty,MS,RN(WesternConnecticutStateUniversity,AdultHealth,1990)AssistantProfessor,DutchessCommunityCollege
LorettaKloda,MS,RN(UniversityofRochester,Nursing,1964)Professor,MonroeCommunityCollege
MarySchinner,MS,RN(SUNYatBuffalo,AdultHealth,1972)DeanofHealthSciences,TrocaireCollege
MicheleMorganWoodbeck,MS,RN(RussellSageCollege,Medical-SurgicalNursing,1979)AssistantProfessor,HudsonValleyCommunityCollege
Excelsior College Examination Development Committee in Fundamentals of Nursing
32 FN/OR
Notes
Online Practice ExamsWhen you register for your test, why not purchase the corresponding practice exam as well?AnExcelsiorCollegePracticeExamallowsyoutosamplethetypesofquestionsyoumayencounteronthecredit-bearingtestyouwilltakeatPearsonProfessionalCenters.YoutakeyourpracticeexamsusinganypersonalcomputerwithasupportedWebbrowser(checkbrowsercom-patibilityathttp://www.webct.com/tuneup).Eachpracticeexamhastwoforms(100questionseach,witha2-hourtimelimit)thatyoumaytakewithina120-daywindow.Aftereachpracticeexam,youwillbeabletocheckonlinehowyouperformedonindividualquestionsandwhyyouranswerwasrightorwrong.FeedbackisnotintendedtopredictyourperformanceontheactualExcelsiorCollegeExamination,butrathertohelpyouimproveyourknowledgeoftherelevantsubjectandidentifyareasofweaknessthatyoushouldaddressbeforesittingfortheexam.
PracticeexamsarenowofferedforallsevenoftheNursingConceptsexams,andasoffall2006,forsevenadditionalexams:Anatomy&Physiology,Ethics:Theory&Practice,LifeSpanDevelopmentalPsychology,Microbiology,AbnormalPsychology,FoundationsofGerontology,andOrganizationalBehavior.Visitwww.excelsior.eduforupdatesandthemostcurrentpracticeexamofferings.
Improve Your Writing Skills with MY Access!Studieshaveshownthatthemoreguidedwritingyoudo,thebetteryourwritingbecomes.MYAccess!™cantrulyenableyoutobeyourownwritingteacher.Inadditiontoprovidingwritingassignmenttopicpromptsandwritingfeedbackinfivecategories(focusandmeaning,contentanddevelopment,organization,languageuseandstyle,andmechanicsandconven-tions),MYAccess!givesstudentsacompletesuiteofwriter’stoolsincludingrevisionchecklists,athesaurus,andawriter’sjournal.
FormoreintroductoryinformationabouttheMYAccess!service,pleasevisitwww.excelsior.eduandclickontheAboutlink,thentheMyECResourcesandServiceslink,andthenscrolldowntotheMYAccess!CollegeWritingToollink.
Visit the Excelsior College Virtual Library
TheExcelsiorCollegeVirtualLibrary(ECVL)isanonlinelibrarydesignedfordistancelearners.CreatedthroughourpartnershipwiththeSheridanLibrariesofTheJohnsHopkinsUniversityandlocatedatwww.library.excelsior.edu,theECVLprovidesaccesstoabroadarrayofresourcessuchasjournalarticles,books,Websites,databases,andreferenceservices.TheseresourcescanhelpyouprepareforExcelsiorCollegecoursesandexaminations,andyoucanusethemtoenhanceyourresearchactivitiesaswell.
Learn Online with Subject Matter ExpertsExcelsiorCollegeonlinetutoringservicesprovideenrolledandprospectivestudentsaccesstosubjectmatterexperts.Theseservicesareavailableonafee-for-servicebasisandcurrentlyassiststudentswithwritingandstatistics.Forfurtherinformationabouttheseservices,emaillearn@excelsior.eduorcalltheOfficeofOnlineEducationandLearningServicestollfreeat888-647-2388(press1-4-4atthegreeting).
Study, Learn, and Succeed with the Help of Excelsior College Learning Resources.
(continued from page ii)
MYAccess!™wasdevelopedbyandisownedexclusivelybyVantageLearning.MYAccess!™isatrademarkofVantageLearning.
You Can Prepare Online for Your Nursing Concepts Exams with special eight-week Online Conferences available directly from Excelsior College.
Designedespeciallyfornursingstudents,theseeight-weekstudysessionstitledNursingConcepts:OnlineConferencesprovidemanybenefitstostudentsplanningtotaketheNursingConceptsexams.
Note:BothenrolledandprospectivestudentsareeligibletoparticipateintheNursingConcepts1andNursingConcepts2conferences.OnlyenrolledstudentsmayregisterfortheremainderoftheNursingConcepts:OnlineConferencesseries.
FindoutmoreaboutthisuniqueprogramandotherguidedlearningopportunitiesavailabledirectlyfromExcelsiorCollege.CalltheLEARNOfficetollfreeat888-647-2388(press1-3-1-6attheautomatedgreeting).OrvisitthenursingpageontheExcelsiorCollegeWebsiteatwww.excelsior.edu foralistofdatesandfees.
33
TheinformationinthiscontentguideiscurrentasofJuly1,2006.
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Examination Credit Hrs.
Arts and SciencesAbnormalPsychology†...................................3*AmericanDream†..........................................6*Anatomy&Physiology†..................................6Bioethics......................................................3*CollegeWriting†............................................3CulturalDiversity...........................................3*EnglishComposition†....................................6Ethics:Theory&Practice†.............................3*FoundationsofGerontology............................3*JuvenileDelinquency......................................3*LifeSpanDevelopmentalPsychology†.............3Microbiology†................................................3OrganizationalBehavior..................................3*Pathophysiology.............................................3*PsychologyofAdulthood&Aging.....................3*ReligionsoftheWorld....................................3*ResearchMethodsinPsychology....................3*SocialPsychology..........................................3*Statistics......................................................3WorldConflictsSince1900............................3*WorldPopulation...........................................3*
Business Ethics:Theory&Practice†.............................3*HumanResourceManagement.......................3*LaborRelations.............................................3*OrganizationalBehavior..................................3*
Education LiteracyInstructionintheElementarySchool.......................................6*
Examination Credit Hrs.
Nursing: Associate LevelNursingConcepts1.......................................4NursingConcepts2.......................................4NursingConcepts3➀.....................................4NursingConcepts4➀.....................................4NursingConcepts5➀.....................................4NursingConcepts6➀.....................................4NursingConcepts:FoundationsofProfessionalPractice➀..........4FundamentalsofNursing**...........................8Maternal&ChildNursing(associate)**..........6MaternityNursing**......................................3
Nursing: Baccalaureate LevelCommunityHealthNursing.............................4*ManagementinNursing.................................4*ResearchinNursing......................................3*AdultNursing**............................................8*Maternal&ChildNursing(baccalaureate)**....8*Psychiatric/MentalHealthNursing**..............8*
* Indicatesupper-levelcollegecredit.
** TheseexaminationsdonotapplytowardtheExcelsiorCollegenursingdegrees.
† GuidedLearningPackagesareavailablefortheseexams.
➀ YoumustbeenrolledinExcelsiorCollegepriortoregisteringto take these Associate Degree Nursing examinations. Ifyouneedtheseexamsforanothernursingprogram,pleasecontact that institution for the testing code you need toregisterfortheseexams.
And when you’re ready to test,youcanscheduleto take your exam at Pearson Professional CentersthroughourWebsite:www.excelsior.edu.
403assess.06-017;7/05
rev.05/06EX#:0116