Kaplan Learning: Nursing Remediation

Remediation is the process by which a struggling learner may review and reinforce key material in order to progress in a chosen field of study.  Remediation is a useful tool because it allows the student additional time and resources to fully grasp concepts which may be difficult but not impossible to attain if allowed sufficient opportunity for topic mastery.  As such, the author of this paper will proceed to analyze material taken from Kaplan Education’s (2019) Nursing course.

Question 3 deals with myocardial infarction, commonly known as a “heart attack.”  This condition leads to the death of a portion of the heart muscle, caused by an interruption of the blood supply due to blockage of the coronary artery.  Several enzymes are used for diagnosis.  Nurses need to set priorities, implement the nursing process, and think critically.  Primary demographics affected are adults, who need physiological integrity and physiological adaptation.  Nurses should ensure bed rest, monitor vital signs, intake, and output, and instruct patients on lifestyle changes such as quitting smoking, reducing stress, and regular physical exercise.

Question 4 concerns learning disabilities. Learning disabilities include the entire autistic spectrum as well as dyslexia (a reading-related disability), attention deficit disorder (ADD), and attention deficit hyperactivity disorder (ADHD), among many others.  Treating learning disabilities requires making nursing judgments, planning out the nursing process, and meeting clients’ psychosocial needs.  These disorders primarily affect children, who need psychosocial integrity.  Nurses treating children with learning disabilities should consider using alternative methods of teaching like diagrams, pictures, lists, or verbal demonstrations.

Question 5 discusses glaucoma, defined as an “abnormal increase in intraocular pressure leading to visual disability and blindness” (Kaplan).  Indications of glaucoma include cloudy or blurry vision, loss of vision, the appearance of rainbows or halos around artificial light sources, decreased peripheral vision, eye pain, headache, nausea, vomiting, and excessive brow arching.  Nurses treating patients with glaucoma must be instructed in the correct use of prescribed medication, particularly miotics.  Understanding concepts, the planning stage of the nursing process, and therapeutic procedures are needed.  Primary demographics affected by glaucoma are adults, who need physiological integrity and reduced risk potential.

Question 6 discusses multiple sclerosis (MS), a potentially debilitating degenerative muscular disorder defined as a progressive disorder of nerve impulse transmission.  MS attacks the physical well-being of patients but leaves their intellect intact.  Understanding concepts, the assessment stage of the nursing process, and meeting clients’ physical needs are essential aspects of delivering effective services.  MS primarily affects adults, who need physiological integrity, basic care, and comfort.  Nurses should teach these patients exercises that improve relaxation, coordination, progressive resistance, range of motion, bladder control, and bowel training.

Question 16 concerns newborn infants afflicted with physical abnormalities at birth. Commonly observed abnormalities are cleft lip, cleft palate, clubfoot, developmental dysplasia of the hip (DDH), hypospadias, macrosomia, and patent ductus arteriosus (PDA).  Treatment of these patients requires an understanding of key concepts, implementation of the nursing process, and a thorough understanding of the therapeutic procedures which may be applied to alleviate the pain and discomfort that are often associated with such abnormalities.  These young and vulnerable clients need physiological integrity, basic care, and comfort.

Question 21 deals with various types of heart diseases.  Angina pectoris is chest pain that is caused by myocardial ischemia.  Coronary artery disease (CAD) is the most common form of cardiovascular disease in adults.  Cardiomyopathy is a potentially fatal disease of the heart muscle.  Making nursing judgments, the assessment stage of the nursing process and meeting clients’ physical needs are essential components of treating these diseases.  Heart diseases typically affect adults.  Clients suffering from heart disease need physiological integrity and physiological adaptation through certain behavioral changes.

Question 43 discusses patients having issues with their immunity.  The immune response is basically a reaction between foreign proteins called antigens and antibodies, which act as the body’s defense mechanism.  Immunity can either be active, meaning it is permanent, or it can be passive, meaning it is temporary.  Understanding immunity requires recalling and recognizing information, proper diagnosis of immune-related disorders, health promotion, and health maintenance.  Immune disorders typically affect adults, who need a safe and effective care environment, in addition to keeping any potential infections under control.

Question 51 tests knowledge of cystic fibrosis (CS).  CS is a genetically inherited disorder of the exocrine glands which can be life-threatening if left untreated.  CS is caused by a buildup of thick mucus that leads to obstructions.  To effectively treat CS patients, a nurse must demonstrate an understanding of key concepts, must master the implementation step of the nursing process, and possess a thorough understanding of therapeutic procedures.  CS primarily affects children.  These clients need physiological integrity and physiological adaptation.

Question 54 concerns herniated discs, which are ruptures of the fibrocartilage surrounding an intervertebral disc, releasing the nucleus pulposus at the center.  It is generally indicated by sciatica, groin pain, muscle spasms, numbness, and tingling in the extremities.  A nurse treating these patients must understand key concepts related to the topic, be proficient in the assessment stage of the nursing process, and knowledgeable of the diagnostic procedures necessary to pinpoint this affliction.  The primarily affected demographics are adults, who need physiological integrity, basic care, and comfort.

Question 61 pertains to physical assessment of the head and neck areas.  The ears should be inspected for palpation as well as placement, size, shape, symmetry, and skin condition.  The eyes should be inspected for ptosis (sinking eyelids), the normal coloration of the sclera (abnormal could indicate conjunctiva, commonly known as pink eye), pupil size, shape, equality, and reactivity to light.  Understanding concepts, the assessment stage of the nursing process, and diagnostic procedures are at the heart of this topic.  The demographic primarily affected is the adult population, who need physiological integrity as well as a reduction of the potential for risk.

Question 82 deals with gout.  Gout is a fairly common and severe form of arthritis indicated by severe pain, red coloration, and tender joints.  Making nursing judgments, implementation of the nursing process and meeting clients’ physical needs are at the heart of this topic.  The primary demographics affected by this disease are adults.  The clients’ needs consist of physiological integrity, basic care, and comfort.

Question 83 pertains to wound healing.  The primary intention is when skin edges are well approximated or closed, which allows the wound to heal quickly with minimal risk of infection or scarring.  The secondary intention is if the wound is left open, which causes it to fill up from the bottom with scar tissue and take longer to heal.  The tertiary intention is a wound that has been left open for several days before being closed.  Wound healing encompasses setting priorities, the planning stage of the nursing process, and meeting clients’ physical needs.  Primary demographics affected are adults, who need physiological integrity, basic care, and comfort.

Question 86 discusses growth and development in older adults.  Physiologic systems tend to decline in efficiency and overall function as patients age.  Patients could also be experiencing psychosocial distress in addition to physical pain as they cope with the loss of their friends and family members and as their family roles change.  Understanding important concepts, the evaluation stage of the nursing process, health promotion, and health maintenance categorize this topic.  These clients need health promotion and maintenance services.

Question 91 pertains to aphasia, which is a brain-damage-induced speech disorder.  Patients suffering from aphasia cannot comprehend or create audible speech due to their condition.  Most likely aphasia results from a left-sided stroke because most people are right-handed and the speech center is located in the left cranial hemisphere.  This topic encompasses the understanding of critical concepts, the diagnosis of patient pathology, and interpersonal communication skills.  Primarily affecting adults, these patients require physiological integrity and physiological adaptation.

Question 94 tackles the topic of wound infection, which falls under the categories of setting priorities, the assessment stage of the nursing process, and effective use of diagnostic procedures.  The demographics most afflicted by this disease are adults.  Physiological integrity and the reduction of the potential risk for additional, spreading, or worsening infection are at the center of caring for these clients.

Question 98 concerns cast care.  Casts are used to hold bones in place while they heal from fractures or breaks.  The cast must be kept clean as much as possible to avoid infection of the covered area.  The categories covered by this topic are understanding concepts, the planning stage of the nursing process, and thorough knowledge of therapeutic procedures.  The primary demographics are adults.  These clients need physiological integrity, basic care, and comfort.

Question 99 refers to Varicella zoster, or VZV, which is a virus commonly known as chickenpox. This highly contagious condition is indicated by itchy red blotches over the entire body.  VZV symptoms usually start out as a pruritic rash beginning as a macule, transitioning into a papule, and then finally developing into a vesicle.  Recalling and recognizing information, accurate diagnosis, and meeting clients’ physical needs compose the essential elements of this topic.  This disease is predominantly observed in children, although adults are also affected.  These clients need a safe and effective care environment in order to ensure infection control.

Question 101 discusses thyroidectomies, which are surgical procedures that remove infected, inflamed, cancerous, or malfunctioning thyroid glands.  Complications that may arise during this procedure are hemorrhage, respiratory disease, tetany caused by parathyroid injury, and damage to the laryngeal nerves.  Making nursing judgments, the evaluation stage of the nursing process and critical thinking are all essential components of this topic.  Most patients are adults, who need physiological integrity and their potential for risk reduced.

Question 103 discusses the procedure known as a cholangiography, which identifies potential blockages of a patient’s bile ducts.  Bile is particularly effective at digesting fatty acids and other lipids.  X-ray images allow the attending medical professional to assess the next best steps in the patient’s course of treatment.  This topic consists primarily of setting priorities, the planning stage of the nursing process, and effective use of diagnostic procedures.  The demographics predominantly served are adults, who need physiological integrity and reduction of risk potential.

Question 106 pertains to nasogastric tube insertion.  The nasogastric tube runs from the nose to the stomach.  It is used to instill medication, food, or fluids, to remove the contents of the stomach, or to obtain a specimen for lab analysis.  The categories covered by this topic are making sound nursing judgments, the evaluation stage of the nursing process, and appropriate identification and use of therapeutic procedures such as the continual e-monitoring of those patients.  The demographics predominantly served by this procedure are adults, who need their physiological integrity protected and their risk potential reduced.

Question 117 deals with paracentesis.  Paracentesis is a procedure that removes fluid or gas from a cyst or some other type of growth, typically performed with a hollow needle.  For example, stomach cancer in some patients may cause fluid to build up in their abdominal cavity.  Paracentesis is a minimally invasive treatment which could greatly reduce pain and increase comfort.  Understanding critical concepts, the implementation phase of the nursing process, and mastering diagnostic procedures are important elements of this topic.  This procedure is usually used on adults, who need physiological integrity and their potential exposure to risk reduced.

Question 118 concerns fetal complications during pregnancy.  Such complications may arise naturally as unforeseen, genetically predetermined birth defects or as a result of parental negligence, as is the case with fetal alcohol syndrome.  Other complications may arise due to human error during delivery or due to the baby exiting the vagina at a dangerous angle.  Understanding concepts, the implementation step of the nursing process, and correct use of therapeutic procedures categorize this topic.  These patients need physiological integrity, basic care, and comfort.

Question 121 tests the author’s knowledge of Myasthenia gravis, which is a disease affecting the neurological, muscular, and immune systems.  Indications are muscle weakness and fatigue.  This question falls under the categories of setting priorities, the planning phase of the nursing process, and meeting clients’ physical needs.  The predominant demographics afflicted are adults, who need physiological integrity, basic care, pain management, and comfort.

Question 124 discusses hearing impairment.  Hearing loss may be conductive, sensorineural, or a combination of the two.  Nurses treating hearing-impaired patients should be demonstrative in their gesticulations and speak loudly enough for the patient to hear if they possess at least partial hearing.  Hearing aid batteries should be changed at least weekly.  Do not use hairspray or perfume when wearing a hearing aid, and do not submerge them in water.  This topic encompasses the essential categories of understanding concepts, the assessment step of the nursing process, and meeting clients’ psychosocial needs.  The demographics most affected by hearing impairment are adults, who need their health promoted and maintained.

Question 127 deals with intramuscular injection (IM).  An IM is commonly used when administering vaccines because it delivers medicine directly into the muscles, where it can be more rapidly absorbed by the bloodstream.  Recalling and recognizing information, the implementation phase of the nursing process, and mastery of therapeutic procedures are essential facets of this topic.  IMs are predominantly utilized by adults, who will need physiological integrity, pharmacological, and parenteral therapies when undergoing this procedure.

Question 129 concerns patients who have been prescribed a low-fat diet.  A low fat diet may be prescribed for general health or weight purposes, and it is also used to help treat gallstones.  Certain medications may interact differently with patients on a low fat diet because fat is often highly absorbent of chemicals within the body.  Nurses treating patients on a low fat diet must be aware of key concepts, accurate diagnosis, and therapeutic procedures.  Most clients who are prescribed a low fat diet are adults, who need physiological integrity, basic care, and comfort.

Question 138 concerns therapeutic communication, which is used to comfort and console grieving patients, or to polish one’s bedside manner to deliver a truly superior standard of care.  This important topic covers making sound nursing judgments, the implementation phase of the nursing process, and effective and compassionate client communication.  Primarily adults are served with this technique.  These clients need psychosocial integrity above all else.

Question 140 deals with cardiac tests, which may include capillary refill time (a noninvasive evaluation of adequate arterial blood flow), catheterization, carotid arteriogram (to visualize the carotid arteries), pulmonary artery wedge pressure (PAWP), and pulse oximetry (measures oxygen concentration in arterial blood), among other techniques.  Cardiac tests fall under the categories of setting priorities, the assessment stage of the nursing process, and correct use of therapeutic procedures.  Cardiac tests are predominantly used to treat adults, who need physiological integrity and physiological adaptation.

Question 159 pertains to impetigo.  Impetigo is primarily cosmetic in nature, presenting as yellow-red crusted skin on the epidermal layer, typically around the mouth and nares.  Caused by a highly contagious bacterial infection (either streptococcal or staphylococcal), antibiotics are the most common course of treatment.  This question consists of understanding concepts, accurate diagnosis, and meeting clients’ physical needs.  Predominantly affecting adults, but often seen in children, these patients require a safe and effective care environment, as well as infection control.

Question 165 concerns the growth and development of preschool-aged children.  These patients are physically as well as psychologically vulnerable, so special care must be taken when treating them.  Pediatric nurses should possess a masterful understanding of key concepts, a firm grasp of proper diagnostic techniques, and a strong orientation towards health promotion and maintenance.  These patients are young children who need their health promoted and maintained.

Question 166 discusses fluid and electrolytes.  Dehydration can potentially be fatal if left untreated.  Electrolytic deficiencies can lead to muscle spasms or other dysfunctions.  Nurses who treat patients with fluid or electrolyte deficiencies must be proficient in making nursing judgments, in successfully planning the nursing process, and in meeting clients’ physical needs.  These patients tend to be children, and they need physiological integrity and adaptation.

Question 168 concerns mental health as it pertains to personality disorders.  According to the DSM-5, the major personality disorders are antisocial, avoidant, borderline, dependent, histrionic, narcissistic, obsessive-compulsive, paranoid, schizoid, and schizotypal. Nurses treating patients with personality disorders need to making sound nursing judgments, master the implementation step of the nursing process, and communicate clearly and effectively with clients.  These disorders affect primarily adults, who need their psychosocial integrity protected.

Question 169 concerns detached retinas.  The retina is located at the back of the eyeball and is critical for eyesight.  Cryosurgery, laser surgery, replantation, scleral buckles, and vitrectomies can all potentially save the patient’s vision.  This topic covers recalling and recognizing information, the assessment step of the nursing process, and correct use of diagnostic procedures.  The demographics most often presenting with this condition are children, who need physiological integrity and reduction of risk potential.

Question 174 pertains to blood administration.  Blood transfusions could be required for patients with certain blood disorders, or to replace blood lost to bleeding due to an injury.  This topic entails recalling and recognizing information, the assessment stage of the nursing process, and therapeutic procedures.  The demographics predominantly treated with this procedure are adults, who require physiological integrity, pharmacological, and parenteral therapies.

Question 177 discusses the growth and development of infants.  Infants are especially rapid growers because their cells are reproducing constantly.  Special care must be taken when treating infants, as medicinal dosages must be adjusted appropriately given the infants’ lower body weight.  Understanding concepts, proper diagnosis, and promotion and maintenance of the patients’ health are priorities.

Question 180 deals with chronic respiratory obstructive disorders, also known as COPD.  COPDs are lung disorders such as bronchitis and emphysema which can be treated but not cured.  Nurses who are treating patients with COPD should make sound nursing judgments, should master the implementation stage of the nursing process, and be adept in therapeutic procedures.  Predominantly affecting adults, these patients need physiological integrity and physiological adaptation.

Careful analysis of the preceding data suggests that the author’s greatest weaknesses are in pediatric nursing.  Making accurate diagnoses and sound nursing judgments are additional areas where the author can improve.  Some difficulties with recalling and recognizing information, understanding concepts, and therapeutic procedures were also observed upon further review of the material.  The author can take definite proactive steps to shore up these recognized educational deficiencies by taking additional practice tests and continuing to observe medical experts during the course of their professional duties.  Excellence in preparation is the key to preventing mishaps before they arise.

Reference

Kaplan Education. (2019). Nursing Assessment Test A. (Course Handout)