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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Study, learn, and succeed with the help of Excelsior College Learning Resources.

Three Easy Ways to Register for Exams:Register online—Goto www.excelsior.eduandclickonExcelsiorCollegeExaminations.FollowthesimpleonlineregistrationinstructionstoregisterusingyourVisa,MasterCard,orDiscoverCard.

Register by phone—Calltollfree888-72EXAMS (888-723-9267).

Register by mail—Usetheregistrationformincludedinourcurrentexaminationregistrationpacket.

Free Content Guides for Excelsior College ExaminationsCheckoutanexamyouareconsideringandbeginyourstudieswithafreecontentguide.Eachguidecontainsanoutlineofthetopicscoveredintheexamaswellasalistofreferences,samplequestionsandanswerrationales,andaspecialsectiontitled,“HowtoStudywithExcelsiorCollegeExaminationsContentGuides.”YoucandownloadcontentguidesbyvisitingourWebsiteatwww.excelsior.eduandthenclickingontheExcelsiorCollegeExaminationslink.(Ifyouhaven’talready,youwillbepromptedtosetupaMyECpage.)

Toreceiveasinglecontentguidebymail,calltollfreeat888-72EXAMS(888-723-9267).Westronglyadviseyoutoprepareforyourexamination(s)bystudyingfromtheresourcesrecommendedbytheExcelsiorCollegefacultywhodevelopourexaminations.Therecommendedresourcesarelistednearthebackofeachcontentguide.

Comprehensive Guided Learning Packages ForseveralselectedExcelsiorCollegeExaminations,youcangetallthestudyresourcesyouneedforsuccessfulpreparationinacomprehensiveGuidedLearningPackageproducedexclusivelybyExcelsiorCollege,availablefromtheExcelsiorCollegeBookstore.EachGuidedLearningPackagehasbeencarefullydevelopedtoprovidethorough,integratedlearningresourcesforyou.Includedareacourseguide,sampleexamquestions,tips,textbooks,andassociatedmaterials.VisitourWebsiteforacurrentlistofGuidedLearningPackages.

Excelsior College BookstoreTheExcelsiorCollegeBookstoreoffersrecommendedtextbooks,educationallypricedsoftware,andotherresourcestohelpyouprepareforExcelsiorCollegeExaminationsandcourses,GRESubjectTests,andotherexamsandcourseworkyoumayundertakeasyouworktowardyourExcelsiorCollegedegree.

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Youcannowuseyourusernameandpasswordforallonlineservices(includingtheEPN)atExcelsiorCollegebyvisitingtheWebsitehomepageandclickingontheOnlineServicesbutton.Onceyoucompletetheshortregistrationform,youwillobtainausernameandpasswordfortheEPNimmediately.

Copyright © 2006 Excelsior College. All rights reserved. “Excelsior College” is a registered servicemark of Excelsior College. All rights reserved.

(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)


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)


1) Evaluate,record,andreportthepatient’sresponsetonursingactions(forexample:patient’stemperatureremainswithinnormallimits)


C. Medication administration


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)


1) Evaluate,record,andreportthepatient’sresponsetonursingactions(forexample:patientadherestothemedicationregimen)


D. Safety


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)


1) Evaluate,record,andreportthepatient’sresponsetonursingactions(forexample:patientambulateswiththenurse’sassistance)


IV. Comfort, Rest, and Activity (15%) 54 hours

KozierCh. 31,Hygiene

Ch. 42,ActivityandExercise

Ch. 43,RestandSleep

Ch. 44,PainManagement

A. Hygiene


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)


1) Evaluate,record,andreportthepatient’sresponsetonursingactions(forexample:thepatient’slipsremaindryandcracked)


B. Rest and sleep


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)


1) Evaluate,record,andreportthepatient’sresponsetonursingactions(forexample:patientstatesthathefeelswellrested)


C. Mobility and immobility


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


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


1) Evaluate,record,andreportthepatient’sresponsetonursingactions(forexample:patient’sjointsarefreelymovablewithinnormalrangeofmotion)


D. The pain experience


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


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)


1) Evaluate,record,andreportthepatient’sresponsetonursinginterventions(forexample:patientstatesthatpainhasbeenrelieved)


V. Nutrition (10%) 36 hours

KozierCh. 45, Nutrition


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


a. Evaluate,record,andreportthepatient’sresponsetonursinginterventions(forexample:thepatienthasgainedtwopoundsthisweek)


VI. Elimination (11%) 40 hours

KozierCh. 46,FecalElimination

Ch. 47,UrinaryElimination


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)


a. Evaluate,record,andreportthepatient’sresponsetonursingactions(forexample:patientreportspassingahard,drystool)


20 FN/OR

VII. Oxygenation (10%) 36 hours

KozierCh. 48, Oxygenation


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


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)


a. Evaluate,record,andreportthepatient’sresponsetonursingactions(forexample:patient’s24-hourfluidintakeis2,500cc)


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.

Register online atwww.excelsior.edu

Call toll free 888-72EXAMS (888-723-9267) OutsidetheU.S.andCanada,call518-464-8500oremail:[email protected]

Register by mailCallExcelsiorCollegeandrequestaregistrationpacket.

Now, registering to take any of these exams is easier than ever!

Ask your advisor how these Excelsior College Examinations can move you closer to your degree goal.

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

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