“Obsessive Compulsive Disorder (OCD)” plus 2 more nursing article(s): NursingCrib.com Updates

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• Obsessive Compulsive Disorder (OCD)
• Operating Room Team: Sterile Members
• December 2010 Nursing Preboard Examination

Obsessive Compulsive Disorder (OCD) Posted: 07 Dec 2010 09:58 PM PST Obsessive Compulsive Disorder (OCD) is characterized by persistent thought and urges to perform repeated acts or rituals, usually as a means of releasing tension or anxiety. The frequency and intensity of the ritualistic behaviors, such as handwashing, ordering, or checking, are time consuming (taking more than one hour per day) and cause marked distress, significant impairment, or interfere with daily living. Obsession The person experiences recurrent and persistent thoughts, impulses, images that are intrusive, disturbing, inappropriate, and usually triggered by anxiety. The thoughts, images, and impulses are not simply excessive worries about real life problems. The person recognizes the thoughts, images, and impulses are from within own mind. Compulsion Repetitive behaviors or mental acts that a person feels driven to perform, which usually adhere to a rigid and specifically defined routine. The behaviors and ideations are typically aimed at reducing anxiety or preventing some dreaded situation from occurring. Specific Biological Factors There is some evidence that indicates OCD is linked to a deficiency in serotonin. Clients have also been shown to have abnormalities in frontal lobes and basal ganglia; it is unclear what the implications are for clinical care. Signs and Symptoms Obsessions – recurrent, persistent ideas, thoughts or impulses, involuntarily coming to awareness. Ruminations – forced preoccupation with thoughts about a particular topic, associated with brooding and inconclusive speculation. Cognitive rituals – elaborate series of mental acts the client feels compelled to complete. Compulsive motor rituals – elaborate rituals of everyday functioning such as grooming, dressing, eating, washing or checking doors or appliances. Other symptoms – chronic anxiety, low self-esteem, difficulty expressing positive feelings and depressed mood. Nursing Diagnoses Anxiety Powerlessness Ineffective verbal communication Self-esteem disturbance Impaired social interaction Risk for injury Sleep pattern disturbances Ineffective breathing pattern Nursing Interventions Limit, but do not interrupt, the compulsive acts. Teach the client to use alternate coping methods to decrease anxiety. Client's behavior maybe frustrating to staff and family. Power struggles often result. Consistency to the approach to care is critical. Assess the client's needs carefully. Provide an environment that has structure and predictability as a strategy to decrease anxiety. Risk associated with the use of alcohol and drug abuse. Related posts: Bipolar Disorder Signs and Symptoms Major Depressive Disorder Symptoms and Therapeutic Management Paraphilias

Operating Room Team: Sterile Members Posted: 07 Dec 2010 09:43 PM PST Operating Room Team When a patient is about to undergo a surgical procedure direct patient care will be pass on to the operating room personnel. The operating room (OR) team is responsible for the well-being of a patient throughout the operation. This team should not only consider the patient's privacy but will also promote safety measures for the patient. One way of promoting safety of patients inside the OR is by preventing infection from the surgical incision that will be done. As described, the OR team is similar to that of a symphony orchestra. There are many members in an orchestra but they work together in unison and harmony to create a superb outcome.  The operating room (OR) team does the same thing. They coordinate their work with each other to have a successful operation. Classification of OR team There are two types of OR team according to the functions of its members. Sterile team members Surgeon Assistants to the surgeon Scrub person (either a registered nurse or surgical technologist) Unsterile team members Anesthesiologist Circulator Biomedical technicians, radiology technicians or other staff that might be needed to set up and operate specialized equipment or devices essential in monitoring the patient during a surgical operation Operating Room Team: Sterile Personnel The members of the OR sterile team will do the following things: Perform surgical hand washing (arms are included). Don sterile gowns and gloves. Enter the sterile field. Handles sterile items only. Functions only within a limited area (sterile field). Wear mask. Operating Surgeon The surgeon is a licensed physician (MD), osteopath (DO), oral surgeon (DDS or DMD), or podiatrist (DPM). This professional is especially trained and is qualified by knowledge and experience for the performance of a surgical operation. Responsibilities of a surgeon: Preoperative diagnosis and care of the patient Performance of the surgical procedure Postoperative management of care Assistants to surgeon During a surgical procedure, the operating surgeon can have one or two assistants to perform specific tasks under his/her (operating surgeon) direction. The responsibilities of a surgeon's assistant: Help maintain the visibility of the surgical site Control bleeding Close wounds Apply dressings Handles tissues Uses instruments Types of Assistants to Surgeon: First Assistants could either be: A qualified surgeon or resident in an accredited surgical education program. The first assistant should be capable of assuming the operating surgeon's responsibility in cases of incapacitation or accidents. Registered Nurse and surgical technologists that have a written hospital policy permitting the action. Second Assistant could be a registered nurse or surgical technologist. These staff should be trained and they mar retract tissues and suction body fluids to help provide exposure of the surgical site. Scrub Person A scrub person could be the following: Registered Nurse Surgical technologist Licensed practical/vocational nurse The responsibility of a scrub person is to maintain the integrity, safety and efficiency of the sterile field throughout the surgical procedure. image from merckmanuals.com Related posts: DUTIES OF SCRUB NURSE ROLE OF SCRUB NURSE ROLE OF CIRCULATING NURSE

December 2010 Nursing Preboard Examination Posted: 07 Dec 2010 11:38 AM PST December 2010 Nursing Board Exam Preboard Examination. Mark the letter of your choice then click on the next button. Your score will be posted as soon as the you are done with the quiz. We will be posting more of this soon. Please be informed that the December 2010 Nursing Board Exam Results will be posted here in  NursingCrib.com as soon as the PRC has released the official list of successful examinees. It is highly recommended to subscribe on our mailing list to get a copy of the result via email. Enter your email address: 1.    Which of the following neurotransmitters is decreased in Parkinson's disease? a. Adrenaline b. Serotonin c. Epinephrine d. Dopamine 2.    The doctor prescribed Mr. Lorenzo with Bromocriptine (Parlodel). What classification does this drug belong? a. Anticholinergic drugs b. Dopamine Metabolism Inhibitor c. Dopamine Receptor Agonist d. Dopamine Precursor 3.    The primary clinical manifestations of Parkinson's disease include the following apart from: a. Pill-rolling tremors b. Loss of intellectual capacity c. Slowed retarded movements d. Muscular rigidity 4.    The nurse understood that the medication therapy for Parkinson's disease is: a. Curative – cures the disorder b. Producing unwanted side effects a week after administration. c. Palliative – manages the symptoms only d. Administered for 2-4 weeks only. 5.    The nurse is encouraging Emma to join the group session. Emma verbalized no desire for social involvement. She further told the nurse that her pleasure is on reading books and not on joining the group. Based on Emma's history, she has no close friends or confidants and she seemed indifferent to criticism and praise by others. What type of personality disorder does Emma has? a. Schizoid personality disorder b. Avoidant personality disorder c. Antisocial personality disorder d. Schizotypal personality disorder 6.    Emma's classified personality disorder is under which cluster? a. Cluster A b. Cluster B c. Cluster C d. Not classified 7.    Personality disorders (PD) are listed by the DSM-IV-TR as a separate and distinct category from other mental illnesses. The disorder falls on the Axis II of the multi-axial classification system. The following statements are true of personality disorders except: a. Most patients with personality disorders are treated in acute care settings due to the inflexible and maladaptive personality. b. Nurses most often encounter clients with antisocial and borderline personality disorders. c. There is difficulty diagnosing and treating clients with PD because of the similarities and subtle differences between categories and types. d. Many people with PD have also coexisting mental illnesses. 8.    PD's under cluster B includes which of the following? a. Paranoid b. Narcissistic c. Dependent d. Passive-aggressive 9.    Medications given to clients with PD focus on the client's symptoms rather than the particular subtype. Cognitive-perceptual disturbances respond to low-dose antipsychotic medications. Symptoms under cognitive-perceptual disturbance does not include: a. Depression b. Magical thinking c. Odd beliefs d. Ideas of references 10.    During the nurse's rounds, Emma gestured as if she is listening to someone. Then she told the nurse that she hears voices. Initially, the nurse should respond: a. "What are you thinking about?" b. "I understand how you feel, but I don't hear any voices." c. "You must be kidding me." d. "What are the voices telling you?" 11.    Maslow's heirachy of needs is very helpful in prioritizing nursing interventions. Nurse Anna, is caring for patients in the ward. In prioritizing her nursing care services she should first implement: a. Identifying the support system of a depressed patient b. Changing bed linens c. Initiating oxygen therapy d. Discussing about the love life of a teenager patient 12.    In the current conceptual model, the four main concepts that appears common to nursing are the following: 1.    Psychology 2.    Medicine 3.    Person 4.    Nursing 5.    Environment 6.    Health a. 1,2,3,4 b. 2,3,4,5 c. 3,4,5,6 d. 1,3,5,6 13.    Throughout Nurse Anna's shift her topmost priority in order to create a therapeutic milieu or environment for her patient should be on: a. Accepting her individuality as a person b. Promoting safety c. Orienting new nurses to the physical set-up of the hospital d. Explaining the disease process to the patient 14.    As a nurse, Nurse Anna assumes different roles in caring for her patients. Which of the following demonstrates the nurse's role as an educator: a. Informs the client about the progress of his condition b. Evaluate the client's learning needs and his/her readiness to learn c. Allow the client to actively participate in his/her care d. Communicate the needs of the client 15.    Florence Nightingale became the "Mother of Modern Nursing" for the reason of: a. Providing services to the wounded soldiers during the Crimean war b. Establishing the red cross movement c. Bringing light of what a professional nursing should really be and putting up a school of nursing d. Serving all patients for free 16.    A nurse is obtaining supplies necessary to start an IV line for a client who will be undergoing blood transfusion. Which needle size should the nurse select for the initiation of the IV? a. 23-gauge b. 18-gauge c. 20-gauge d. 25-gauge 17.    A client on clear liquid diet complained of nausea and has vomited. The doctor prescribed an anti-emetic drug. After the administration of the drug, the client appears to be relaxed. After 4 hours the client asked for something to eat because he is hungry. Which food is appropriate to be given to the client? a. Apple juice b. Hot tea c. Hot milk d. Dry toast 18.    The client who underwent a nasal surgery was brought back to the surgical unit. Which position would the nurse anticipate for the doctor to prescribe in this client, in order to reduce swelling? a. Fowler's position b. Lithotomy position c. Sim's position d. Prone position 19.    A nasogastric tube is in place. Nurse Anna keeps in mind that though NGT is beneficial in some clients its use still present possible complications. One of the common complications is aspiration pneumonia. What causes aspiration pneumonia in NGT feeding? a. Streptococcus pneumonia b. a virus reaches the lungs when airborne droplets are inhaled through the mouth and nose c. Histoplasma capsulatum and blastomyces infestation d. Regurgitation of formula contents from the stomach into the respiratory tract 20.    To prevent aspiration pneumonia, what should the nurse do? a. Place the client in a left-side lying position b. Elevating the head of bed at all times c. Increase fluid intake of the client d. Place the client in a right side-lying position 21.    Formulating a patient's discharge plan begins during: a. Prior to patient discharge b. During admission c. A day after the surgery d. When the client leaves the hospital 22.    The surgeon is liable for the negligent acts of the nurses and other members of the OR team during a surgery when he/she has the right to control and supervise. This is based on the on rule or doctrine called: a. Doctrine of respondent superior b. Borrowed servant rule c. Doctrine of corporate negligence d. Res Ipsa Liquitor 23.    Any nurse practicing nursing without license is guilty of: a. Tort b. Malpractice c. Misdemeanor d. Negligence 24.    What is the main difference between assault and battery? a. Assault is the carrying out of physical harm while battery is a threat to harm someone physically. b. Assault is a legal wrong committed by a person involving injury of another or loss of or damage to personal property while battery is failure to use such care as a reasonably prudent and careful person would use under similar circumstances. c. Assault is failure to use such care as a reasonably prudent and careful person would use under similar circumstances while battery is a legal wrong committed by a person involving injury of another or loss of or damage to personal property. d. Assault is done by telling someone that you will kill or harm him physically while battery is the performance of the actual physical harm. 25.    A foreign object is left in a patient's body which results to sustained injury by a patient. Which doctrine applies in this situation? a. Doctrine of respondent superior b. Borrowed servant rule c. Doctrine of corporate negligence d. Res Ipsa Liquitor 26.    The four D's of malpractice includes the following choices apart from: a. Duty to demonstrate and deliver a standard of care directly proportional to the degree of specialty training received. b. Deviation of that duty by omission or commission. c. Damage to the nurse or nurse's personal property. d. Direct cause of a personal injury or damage because of deviation of duty. 27.    Liability for assault and battery may be charged if the surgeon goes beyond the limits to which the patient consented. However, during the operation, the surgeon performed an additional surgery during the course of an authorized surgical procedure to correct an abnormality when an unexpected condition is encountered. Which doctrine implies that the doctor is not charged of assault and battery? a. Doctrine of respondent superior b. Extension doctrine c. Doctrine of informed consent d. Doctrine of Res Ipsa Liquitor 28.    The physician fails to inform the patient about the surgical operation and the nurse did not obtained an informed consent before the surgical procedure is done. The acts of the medical team is considered as: a. Malpractice b. Assault c. Breach of duty d. Battery 29.    Which of the following is true of continuing education? a. Continuing education is a measurement of proven competence in practice. b. Continued education helps the practitioner keep abreast of current trends and practices. c. Continuing education is the only method of self-development. d. Continuing education is not a personal responsibility but rather should be mandated by the institution. 30.    To safeguard the OR team from possible lawsuits, which of the following preventive strategy should be implemented: a. Maintenance of good communications with each team members. b. Establishing a positive rapport with patients. c. Documentations of assessments, interventions and evaluations of patient care. d. All of the above. 31.    Basing on the given data, the child most likely has the respiratory disorder of: a. Laryngotracheobronchitis b. Epiglottitis c. Croup d. Pneumonia 32.    As the child's condition is considered an emergent one, which equipment should the nurse prepare at the bedside? a. Endotracheal tube b. Nasogastric tube c. Tongue depressor d. Catheter 33.    During assessment the nurse expects that Charle's history of present illness would possibly reveal which of the following data? a. Aspiration b. Cough becoming worst at night c. Tonsillitis d. Eating disorder 34.    The doctor ordered diagnostic test to be performed to Charles. Basing on the patient's condition the nurse would expect which of the following test to be done to the client? a. Lateral neck radiograph b. Echocardiogram (ECG) c. Mantoux test d. Bronchoscopy 35.    Which of the following physician's order should the nurse question in the case of Charles? a. Cefuroxime 20 mg/kg IV every 12 hours b. Cefuroxime 125 mg PO every 12 hours c. Endotracheal intubation d. Prophylactic tracheostomy 36.    Charles is in what stage of cognitive development according to Jean Piaget's theory? a. Sensorimotor b. Preoperational stage c. Concrete operational d. Formal operations 37.    The nurse expects that Charles is most afraid of: a. Unfamiliar people b. Strangers c. Being fat or having acne d. Being cut or wounded 38.    Knowing Charles age, the nurse would expect these characteristics to be observed in the patient apart from: a. Button buttons b. Lace shoes c. Identifies with his mother and is attached to his father d. Curious, creative, imaginative and imitative 39.    Regarding dental hygiene the nurse expects Charles (basing on his age) to do which task? a. Brushing teeth alone b. Brushing teeth with assistance c. Begins brushing teeth d. All of the above 40.    Based on Erik Erickson's psychosocial theory, Charles is in what stage? a. Initiative vs. Guilt b. Phallic c. Autonomy vs. Shame and Doubt d. Latency 41.    Which of the following interventions, when done by the school nurse should be corrected? a. Cold compress application b. Instruct the student not to blow the nose for 2 days after the removal of the nasal packs. c. Avoid oral-temperature taking. d. Pressure over the soft tissue of the nose for 2-3 minutes. 42.    The doctor identified the student's case to be an anterior nose bleeding which accounts for the most common type. The following management is applicable in this case apart from: a. Proper positioning b. Application of topical vasoconstrictors c. Pressure over the soft tissues of the nose d. Nose packing with gauze impregnated with petroleum jelly or antibiotic ointment 43.    The student asked the nurse of what are the possible causes of nose bleeding or epistaxis. The nurse correctly identifies the cause of epistaxis by stating which of the following? a. "Irritation of the nasal cavity most commonly causes the rupture of tiny, distended vessels in the mucous membrane of any area of the nose." b. "All posterior nose bleeding episodes are caused by a deviated nasal septum." c. "Humidity has nothing to do with nose bleeding." d. "Drinking ASA most commonly cause nose bleeding." 44.     During a meeting the head nurse allows the nursing staff to make decisions concerning the completion of their work. She provided the members with all the materials they need to accomplish their goals and allowed them to set their goal independently. The head nurse is using which style of leadership? a. Authoritarian b. Democratic c. Laissez Faire d. Multi critic 45.    In another hospital the head nurse does not consult the employees for any problems and decides on her own. She does not allow any one during meeting to give any output and expect the members to obey the orders without explanation. A structured set of rewards and punishments are produced to motivate everyone to follow. This is an example of which leadership style? a. Authoritarian b. Democratic c. Laissez Faire d. Multi critic 46.    Which of the following situations does a democratic leadership style should not be used? a. The manager doesn't understand his or her responsibilities and is hoping the employees can cover for him or her. b. Managers are unable to thank employees for their good work. c. There is not enough time to get everyone's input. d. All of the above 47.    "The increase in the fertility rate in the United States from the years 1976 to 2006 was due to increased levels of income and economic stability." The independent variable in this statement is: a. Fertility rate b. Income and economic stability c. In the United States from the years 1976-2006 d. Increase in fertility rate 48.    Danny and Jane decided to study the effects of incomplete laboratory equipments to the level of competency of nursing students. The dependent variable in the statement is: a. Level of competency b. Laboratory equipments c. Nursing students d. Danny and Jane 49.    Abstract in writing up a research has the following purposes except: a. Re-establish the topic of the research b. Indicate the methodology used c. Present the main conclusion d. Introduce the research by presenting its context or background 50.    IMCI strategy is very important for nurses to know. Which statement incorrectly identifies the principle of integrated care? a. All sick children must be examined for "general danger signs". b. Diagnosis is the topmost priority in IMCI. c. Counseling of caretakers about home management d. Use limited number of essential drugs and encourage active participation of caretakers in the treatment of children Related posts: Community Health Nursing Practice Test Part 3 Psychiatric Mental Health Nursing Test Part 3 Psychiatric Mental Health Nursing Test Part 2

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