Comprehensive Examination Questions Essay Example | Topics and Well Written Essays - 2000 words

Comprehensive Examination Questions - Essay Example These are the consecutive model and the concurrent model. In the case of consecutive model, a teacher would first obtain a certain qualification in one or more than one subjects (which can be a first university degree) and then she/he would study for an extended period of time to obtain an extra qualification in teaching. In certain systems, it is a postgraduate degree. In the case of concurrent model, the student would concurrently study one or more than one academic subject together with the techniques of teaching that subject, which would eventually lead to the eligibility to be a teacher in that subject. Through the above discussion, we understand the beginning of the process of teacher development. Stage theories develop from this very process of ‘making’ a teacher. In this process of teacher development, illustrations, examples, explanations, and demonstrations are crucial. In a word, the ways of representing and formulating the subject that makes it comprehensible to others †¦ (it) also includes an understanding of what makes the learning of specific topics easy or difficult: the conceptions and preconceptions that students of different ages and backgrounds bring them to the learning (Craft et al, 2001). Hence, teacher development would be a stage-wise process that would enable the teacher to handle the various needs of this demanding profession in today’s complex environment. In this context, one of the two current stage theories that would be discussed here is given by R. Fessler and J. Christiansen. According to them, an individual teacher would go across eight life-long stages of career. More or less time would be spent in a given stage according as the organizational and personal environment influencers. These eight stages in the Fessler and Christiansen Teacher Career Cycle can be defined as Preservice, Induction, Competency Building, Enthusiastic and Growing, Career Frustration, Stability, Career Wind-Down, and

Macro Economic Essay Example | Topics and Well Written Essays - 1750 words

Macro Economic - Essay Example However, later a twin debt blow has been considered as one of the most prominent reasons behind the debt crisis. The twin blow came out of the banking crisis together with the previously mentioned extremely high sovereign debt. The European Central Bank (ECB) launched the single currency (euro) in 1999 along with the Economic and Monetary Union (EMU), aiming to gain monetary efficiency. An Economic and Monetary Union offers a series of monetary efficiency gains in forms of accounting ease among the member states that in turn reduces opportunity cost of transforming one currency into another, development among member states would be at par owing to reduction of any possible economic shock (that are often regional in nature), member states under an Economic and Monetary Union following a common currency would also abstain from intra inflow and outflow of speculative capital, furthermore policy formation among member states would be coherent and coordinated in nature that will eventuall y usher better economic growth and development. While fiscal irresponsibility on the part of periphery countries has been considered by many analysts as the root of the ongoing crisis, this paper argues that the impact on capital flows within the euro-zone of financial deregulation and liberalization and of the adoption of the common currency was critical in exacerbating a growing competitiveness gap between core and periphery countries and explaining the evolution of the crisis. Debt crisis unfolds- credit failures The crisis in Europe began when financial markets lost confidence in the creditworthiness of PIIGS countries (Portugal, Ireland, Italy, Greece and Spain) and interest rates on government bonds soared to astonishing levels that forced the governments of these countries to seek bailouts from the international community, including the European Community, the IMF and the European Central Bank (ECB), collectively known as Troika. This was the period of the great financial cri sis of 2007-08 which also affected the US economy. All began with the credit markets and spread to the other sectors of the economy owing to large scale defaulters of loans (ch 31). As determinants of growth, one can say that demand is important for supply or production to expand. The ongoing debt crisis began with defaults of mortgage loans the demand for which led to a rapid boom in the housing sector which led to the final illusion when defaulters began to rise (ch 25). It is often been opined that the utopia of a welfare state amidst the current era of globalization that fuels on competitiveness (both are diametrically opposite in nature) and populist policies like raising the wage of the public sector employees in turn cumulatively burdened the governments with high level of debt. This phenomenon is most evident among periphery countries and can only be reckoned as fiscal recklessness. It is evident from the above argument that fiscal disciplines on behalf of the periphery coun tries would restore Euro its previous status without any additional measures and to be precise further fiscal incentive. What lies beneath? – Expectations and mal-adjustment A deeper analysis of the dynamics underlying the current Euro crisis exhibits that financial deregulation and liberalization was a major cause of the crisis in periphery countries in the euro-zone. Driving up expectations owing to a sudden boom can

6 Skills you need to success Essay Example for Free

6 Skills you need to success Essay While we all aspire to climb to the top of our respective professions, but from time to time we come up against a roadblock, a barrier that slows our climb to the top. Whether you are being consistently overlooked in favor of someone else who is a bit more productive or perhaps there is just some intangible quality that allows other people to get ahead of you, it can be immensely frustrating to be denied a job you know you could excel in. With this in mind, we decided to consider the six skills you need to succeed. It is worth noting that all of these skills are transferable and have as much relevance in your personal life as they do in your professional life. Just as importantly, these are all skills that can be learned, so no one should feel that they are at a disadvantage with any of these. Work on them and you will reap the rewards accordingly. After reading this, the career ladder will suddenly seem a much easier climb than it did before. 1- Speaking skills Whether you are hustling for a promotion when you bump into a CEO in an elevator or making an important speech at an international conference, the ability to speak with a wide variety of people is an absolute essential. Good eye contact, a varied vocabulary and the ability to tailor your language to suit your audience are all essential characteristics of an artful speaker. Being a good speaker will give you presence and make you memorable to those who are listening. Practice talking with anyone and everyone you meet, look for a debating society or a Toastmasters group. The  rewards are worth it. Being more adept in social situations and being better equipped to network successfully will help you forge working relationships that could be very advantageous to you in the future. It will also be useful to you for performing duties as a best man. 2- Confidence in decision making Nothing says mediocrity like indecision. A good leader is decisive and will always back himself up when making the correct decision. If you want to be considered leadership material, you have to possess these characteristics. If you are paralyzed by the fear of getting it wrong, you will end up doing nothing, which is worse than trying something and failing. A lot of high-fliers are prepared to take risks knowing that a mistake can be corrected. Learn to evaluate different decisions for their pros and cons, and make decisions that will take you closer to completing a given task. The key is to make sure that your decisions are thought out and reasoned. Be confident in your judgment and believe in yourself to get things right. Don’t just play it safe every time — you will blend into the wallpaper and no one will notice you. Putting yourself on the line will earn you respect, and if your decisions turn out to be right, you can expect to be rewarded for your efforts. 3- Accountability Another major part of being successful is accepting responsibility, both for successes and failures. If you want other people to respect you, acknowledge your errors rather than trying to blame someone else for your shortcomings. Everyone makes mistakes, but the real test is how you react to that. Putting yourself in the firing line is the mark of a man who wants to achieve great things and is prepared to be scrutinized. It is a sign of confidence and self-belief, and is a key ingredient among men who want to be successful. Being able to admit you have made a mistake is also a sign of humility and can garner respect from your employees. A useful way to hold yourself accountable is to scrutinize your to-do lists, see what you accomplished and what you did not. Look at ways you can improve your performance and take appropriate steps to correct mistakes yourself. Three more skills you need to succeed after the jump 4- A positive attitude Being positive about work and life is also essential to success. While your colleagues may laugh at your endless cynicism and misanthropic tendencies, your boss will see you as someone who hates his job and who will never support the aims of the company. We should distinguish between the occasional bad day (although you should always try to minimize this and remain upbeat no matter how trying the circumstances) and being consistently pessimistic. The eternal pessimist will always try to drag other people down and will probably be less productive. If you can cultivate a positive outlook, you will encourage others to be more positive. Youll also be more productive and possibly more credible as someone with executive potential. A positive attitude is entirely self-determined and can be helped by accentuating the positives in any situation. Don’t see problems; see solutions. 5- Self-presentation Learning how to present yourself to others is another major aspect of being successful. Good grooming and, in particular, smart attire will project an image of success to other people — before you have even said a word. Wearing a well-cut suit, quality shoes and an elegant timepiece speak of a man who takes pride in his appearance. High sartorial standards indicate someone who has high standards generally, and this will cause people to view you favorably. A huge amount of your impact on colleagues, bosses or clients will be based on how well put together you appear. And while substance is crucial, having a great style to support it is no bad thing. Read fashion magazines and think about visiting a hairstylist rather than a barber. If you can afford it, have suits and shoes made to measure; they will fit much better than off-the-rack goods. Don’t forget that the way you look also enhances the way you feel about yourself, making you more confident. 6- Time management skills It doesn’t matter how well you dress, how positive you are or how well-spoken you are if you cannot keep everything under control. Disorganization means that you will be forever playing catch-up with your work, rushing to meet  deadlines and producing work below par. Learn to keep a detailed diary, listing deadlines and setting a schedule for your work, to ensure it is all done with time to spare. Your work will be of better quality and you will be entrusted with increased responsibility. It will also afford you additional leisure time. It is a key element to success and well worth practicing. This means overcoming procrastination (which we can all be guilty of at times), setting goals that are challenging (but realistic) and trying to use your time efficiently. Don’t check your e-mails 17 times every hour; spend that time writing up that project that is due tomorrow. Ideally, you will reach a stage when you can get ahead of the curve and start taking on additional projects and responsibilities — a surefire way of setting yourself up for that promotion. Success is simple when you follow these professional skills success is simple There you have it: An essential list to help you move up in the world and stake your claim in business. There are more, of course, but no other general guide is more comprehensive. A final word of advice: Worry not about an intangible trait you may not have. If you have not been born and raised as the best communicator or dealmaker, you can make your mark with expertise in a specific field or venture. As long as you make your mark in something, the sky is the limit. Just keep in mind that the best of the best have a wide scope of knowledge and do not focus on one area alone.

Effects of Alzheimers and Risk Factors

Effects of Alzheimers and Risk Factors Alzheimers disease (AD) is a chronic degenerative disease process that is currently affecting upwards of 5.3 million people in the United States (Alzheimers Association, 2010). This disease can cause physical and mental hardships on not only the client but on caregivers alike. In the following paper we will discuss the disease process including causes and risk factors, the effects on the clients activities of daily living, the challenges with social, family, spiritual and cultural life, disease prevention and treatment along with long term management, and lastly, nursing care and interventions that can facilitate the life of a client with Alzheimers. Because the disease results in cognitive impairment, psychological effects will be referred to throughout the paper. In order to grasp the needs of a client with Alzheimers disease, we must first understand the disease process itself. According to Mosbys Medical Dictionary Alzheimers disease is defined as, a condition characterized by progressive mental deterioration (2009). As individuals age numerous variations in the brain occur. Some of these changes include a decrease in brain size, deterioration of the cerebral cortex, and a loss of neurons that is dramatically hastened in the patient with AD. A decline in production of acetylcholine, norepinephrine, dopamine and serotonin is common in patients with this disease (Ignatavicius Workman, 2010, p. 970). These things can subsequently cause brain cell death which leads to rapid memory loss (Mayo Clinic, 2011). There is inconclusive evidence on where the impairment occurs when processing information in the brain. A recent journal article, published in Brain Imaging and Behavior, comments on this ongoing mystery and writes, [It is unknown] whether t he memory impairment results from failure of encoding, consolidation or the retrieval mechanism (Blacker, OKeefe, OBrien, Pihlajamaki, Sperling, 2011. p. 37). The etiology of AD is unfortunately still unidentified. It is known, however, that people with this disease actually do have a smaller amount of living brain cells than a person without the disease. Connections in the brain are also diminished and cannot transmit as easily (Mayo Clinic, 2011). Professionals have speculated many risk factors that they think contribute to a diagnosis of Alzheimers disease. The two most important factors include an age over 65, and being of the female gender. However, genetic factors, chemical imbalances, being of an African American descent, lower educational level, environmental agents (such as viruses like herpes zoster, herpes simplex, exposure to zinc and copper), and immunological changes are all also potential causes (Ignatavicius Workman, 2010, p. 970). AD is easily identifiable by its signs and symptoms which manifest in different stages. There are three stages that occur. The first stage is the early onset of Alzheimers in which patients will have simple forgetfulness and often will deny that there is a problem, resulting in seclusion. Stage two is progressively worse; the patient will soon become disoriented to time, place and events. In this stage incontinence as well as speech and language become problematic for the patient. The patient begins to become progressively more embarrassed and agitated. In the final stage, or stage three, the patient is no longer able to care for him or herself and is often unable to verbalize needs or able get out of bed without assistance (Ignatavicius Workman, 2009, p. 971-972). This stage of Alzheimers significantly affects patients activities of daily living. Simple tasks such as brushing teeth, combing hair and changing clothes are impossible for the patient to do. Because of their self-care d eficit, the patients family may have to provide personal cares along with ADLs and psychological reassurance. This can cause both emotional and financial stress for the family. Forgetting peoples names or faces can have a debilitating effect on a patients social life. Patients will often have little to no social etiquette demonstrated by screaming obscenities, playing with their own fecal matter and other aggressive behaviors as an example. Sleep patterns are often disturbed and patients usually take frequent naps during the day and are active at night (sundowners syndrome). This disrupts the patient and his or her familys daily routine (Ignatavicius Workman, 2009, p. 973). This type of diagnosis could likely affect their cultural beliefs as well. For example, cultures, such as Hispanic, strongly believe in elder respect and taking care of the elderly. Extended family will often live under one roof. For these cultures a patient with AD may become more of a burden to the whole family rather than a culture that might accept assistance from a nursing home or assisted living center. Spiritual life can also be affected. The client may no longer be able to go to religious services due to their potential social inappropriateness or because the family may have to closely accompany them. The client may forget, or find it unnecessary, to partake in practices that they previously carried out. This may make the client and family feel very frustrated. Whereas there is no known way to prevent AD, there are many interventions to prevent the complications associated with the disease. Since memory impairment is the main symptom of Alzheimers the client is expected to be very confused and disoriented. The nurse should be prepared to answer all the patients questions truthfully and keep him or her oriented by possibly providing single date calendars and keeping them on a non-changing routine. These things will help them to become more comfortable in their environment and be familiar with what is going to happen (Ignatavicius Workman, 2010, p. 975). Validation therapy is one way that health care providers can achieve both of these goals. This therapy entails the staff member recognizing the patients feelings and concerns without lying to them or dismissing the fear. For example if the client has already eaten breakfast, and returns to the dining hall expecting a second breakfast, an appropriate response from the nurse would be something along the lines of, I notice you are still hungry, I will get you another piece of toast. It would be inappropriate for the nurse to tell the client that he or she has already eaten because this may cause the client to become very agitated. The response does not dispute the client, but it also does not support the idea that he or she has not eaten breakfast (Ignatavicius Workman, 2010, p. 975). Caregivers should also promote self care management. Sustaining independence in the clients ADLs is very important for the client with AD and can sometimes help to prolong self physical management. The nurse will also need to instigate bowel and bladder programs. It is important that these clients are toileted every two hours and as needed. Incontinence can be very embarrassing for the client and anything the staff can do to prevent this is encouraged. Staff should keep the client well hydrated and may need to remind the client to drink often. If on a 2 hour and PRN schedule the client is l ess likely to acquire an injury by trying to get up and go to the bathroom on their own. Next, it may be helpful to regularly take the client on walks and to provide them with something to do. Be sure to minimize stimulation and ensure safety. As for long term management of the disease it is likely that the client will eventually need to be placed in a long term care setting such as assisted living. Interestingly enough, in a journal article from The International Journal of Geriatric Psychiatry it states that recent evidence suggests that behavioral interventions and techniques are more effective than any other means of care including pharmacological approaches. They affirm that staff should be well trained to deal with these clients and that they play a huge role in the clients overall disposition and how he or she will cope with managing their disease (Ayalon, Arean, Bornfeld, Beard, 2009, p. 118-123). For some psychological management, caregivers should promote memory training and assist with facial recognition. It is important that they use redirection techniques and promote effective communication that has been tailored to that client specifically (Ignatavicius Workman, 2010, p. 974-978). Alzheimers disease is very complex and has many components to successful nursing interventions, but when followed can lead to great results. Two creative nursing interventions that we were able to come up with are (Pts. with AD should be involved in social interaction to decrease feelings of boredom, anxiety and decreased self-esteem. A possible intervention the nurse can use to help a pt. with AD is to encouraging the pt. to sing with others and help pick out music; this can possibly improve the pts. mood and behavior. It is believed that listening to enjoyable music during routine activities can decrease agitated behavior. Fun activities such as playing musical instruments ( triangle, maraca or even a toy hand drum) can be easy for the pt. to do and also entertaining. ) I am not sure what to do about the other one but with my grandpa we used to put a picture on his door to help him remember what room was his, but that kind of similar to what we talked about above. By 2050 it is expected that the prevalence of Alzheimers disease will increase to 14 million people (Ignatavicius Workman, 2010, p. 970). As healthcare providers it is important that we educate ourselves on this disease because it is nearly inevitable for anyone of us to avoid caring for a client diagnosed with it. In this paper we discussed the disease process including causes and risk factors, the effects on the clients activities of daily living, the challenges with social, family, spiritual and cultural life, disease prevention and treatment along with long term management, and lastly, nursing care and interventions that can facilitate the life of a client with Alzheimers disease.

Theme of The Country of the Blind Essay -- H. G. Wells

H. G. Wells uses ethnocentrism as a strong device in the short story ‘The Country of the Blind’ to generate the central conflict and to convey the theme: the perils of that deadly combination of stubbornness and blindness. The people of the country of the blind have been isolated from the outside world for fifteen generations, making it hard for them to easily accept the truth and facts about the real world. An accidental fall while climbing a mountain leaves Nunez stuck in a valley, which turns out to be the country of the blind. Nunez, the seeing protagonist, after discovering the citizens are ‘blind’, expects this to be an adventure and eventually came up with an idea to be the king, since he can ‘see’. The idea of ruling the country of the blind evokes the ethnocentrism within Nunez and the blind people. Both, Nunez and the blind people refuse to accept new beliefs and values at first. But as compilations built up, Nunez accepts the way of life and traditions but not the beliefs. Nunez encounters the first ethnocentric conflict unexpectedly when the first three blind men ‘disc...

Bloodchild: Oppression in Science Fiction Essay -- Butler Bloodchild E

Bloodchild: Oppression in Science Fiction Throughout American literary history, nearly every form of literature has covered the topic of slavery and black oppression in America. From William Lloyd Garrison’s abolitionist papers to Harriet Beecher Stowe’s controversial Uncle Tom’s Cabin to Alice Walker’s The Color Purple, the exploration of the black position in America has been a theme that engrossed generations. In the past century, as science fiction has established its place in the literary genre, authors such as Octavia Butler have become increasingly popular. In her short story "Bloodchild", Butler extends the discussion of oppression in America into the science fiction genre. In this manner her story, "†¦like almost all science fiction, though it seems to concern itself with human beings and worlds of the far distance and future, it also concerns itself with the here and now" (Asimov 110). Within the first few passages of "Bloodchild", Butler establishes that the Tlic clan has oppressed the Terran clan in the past. Though this history of superiority and oppression exists between the two species, T’Gatoi, a Tlic, is still a friend of this Terran family. "Only she [T’Gatoi] and her political faction stood between us and the hordes who did not understand why there was a Preserve†¦or†¦did not care" (Butler 1036). Gan and his family are forced to live on a preserve, keeping the Tlic from entering in and enslaving his family further. Already, one can see the similarity to the United States of America’s relations with the African-American people. Butler substitutes the race issue with a difference of species, creating an obvious physical incongruity between the oppressed and oppressors. This physical difference was often r... ...d its treatment of those who differ physically from the majority of the population. Through science fiction, Butler has reached another section of the literary audience, and challenged them to open their minds and to change their world. Bibliography Primary Source Butler, Olivia. "Bloodchild." The Prentice Hall Anthology of Science Fiction and Fantasy. Ed. Garyn G. Roberts. Upper Saddle River: Prentice-Hall Inc., 2001.1035-1049. Secondary Sources Asimov, Isaac. "Science Fiction and Society". Asimov on Science Fiction. American Medical Association. 103-111 Du Bois, W.E.B. The Souls of Black Fold. New York: Fawcett World Library, 1903. Litwak, Leon. Trouble in Mind: Black Southerners in the Age of Jim Crow. New York: Knopf, 1998. Rundblad, Georganne and Peter Kivisto. Multiculturalism in the United States. Thousand Oaks: Pine Forge Press, 2000.

Activity and Exercise

Chapter 38: Activity and Exercise! Test Bank! ! MULTIPLE CHOICE! ! 1.! The coordinated efforts of the musculoskeletal and nervous system maintain balance, posture, and body alignment. Body alignment refers to! ! a.! A low center of gravity balanced over a wide base of support.! b.! The result of weight, center of gravity, and balance.! c.! The relationship of one body part to another.! d.! The force that occurs in a direction to oppose movement.! ! !! ANS: C! Body alignment refers to the relationship of one body part to another body part along a horizontal or vertical line.Body balance occurs when a relatively low center of gravity is balanced over a wide, stable base of support. Coordinated body movement is a result of weight, center of gravity, and balance. Friction is a force that occurs in a direction to oppose movement.! !! DIF: Remember! REF:! 746-747! ! OBJ:! Describe the role of the musculoskeletal and nervous systems in the regulation of movement.! TOP:! Assessment! MSC:! Te aching/Learning! ! ! ! 2.! A structural curvature of the spine associated with vertebral rotation is known as! a.! Scoliosis.! b.! Osteogenesis.! c.! Osteomalacia.! .! Arthritis.! ! !! ANS: A! Scoliosis is a structural curvature of the spine associated with vertebral rotation. Osteogenesis imperfecta is an inherited disorder that makes bones porous, short, bowed, and deformed. Osteomalacia is an uncommon metabolic disease characterized by inadequate and delayed mineralization, resulting in compact and spongy bone. Arthritis is an inflammatory joint disease characterized by inflammation or destruction of the synovial membrane and articular cartilage, and by systemic signs of inflammation.! !! DIF: Remember! REF:! 749! ! OBJ:!Discuss physiological and pathological influences on body alignment and joint mobility.! TOP:! Assessment! MSC:! Teaching/Learning! ! ! ! a.! 3.! Unlike arthritis, joint degeneration! Occurs only from noninflammatory disease.! b.! Occurs only from inflammatory di sease.! c.! Involves overgrowth of bone at the articular ends.! d.! Affects mostly non–weight-bearing joints! ! !! ANS: C! Joint degeneration, which can occur with inflammatory and noninflammatory disease, is marked by changes in articular cartilage combined with overgrowth of bone at the articular ends. Degenerative changes commonly affect weight-bearing joints.! ! DIF: Understand! REF:! 749! ! OBJ:! Discuss physiological and pathological influences on body alignment and joint mobility.! TOP:! Assessment! MSC:! Teaching/Learning! ! ! The nurse is providing care to a patient who is bedridden. To prevent fatigue, the nurse raises the height of the bed. The nurse understands that balance is maintained by raising the bed to! ! 4.! a.! Prevent a shift in the nurse’s base of support.! b.! Narrow the base of support.! c.! Allow the nurse to bring his or her feet close together.! d.! Shift the center of gravity further away from the base of support.! ! !! ANS:A! Raising the h eight of the bed when performing a procedure prevents bending too far at the waist and causing a shift in the base of support. Balance is maintained by maintaining proper body alignment and posture through two simple techniques. First, widen the base of support by separating the feet to a comfortable distance. Second, increase balance by bringing the center of gravity closer to the base of support.! !! DIF: Understand! REF:! 747! ! OBJ:! Discuss physiological and pathological influences on body alignment and joint mobility.! TOP:! Assessment! MSC:! Teaching/Learning! ! ! ! 5.!Approximately what percentage of all back pain is associated with manual lifting tasks?! a.! 10%! b.! 25%! c.! 50%! d.! 75%! ! !! ANS: C! Half of all back pain is associated with manual lifting tasks.! !! DIF: Remember! REF:! 758! ! OBJ:! Describe how to maintain and use proper body mechanics.! TOP:! Assessment! MSC:! Teaching/Learning! ! ! ! ! The nurse is preparing to position an immobile patient. Before doin g so, the nurse must understand that! ! 6.! a.! Manual lifting is the easier method and should be tried first.! b.! Following body mechanics principles alone will prevent back injury.! c.!Body mechanics can be ignored when patient handling equipment is used.! d.! Body mechanics alone are not sufficient to prevent injuries.! ! !! ANS: D! Body mechanics alone are not sufficient to prevent musculoskeletal injuries when positioning or transferring patients. The use of patient-handling equipment in combination with proper body mechanics is more effective than either one in isolation. Body mechanics cannot be ignored even when patient handling equipment is being used. Manual lifting is the last resort, and it is only used when it does not involve lifting most or all of the patient’s weight.! !! DIF: Understand!REF:! 758! ! OBJ:! Describe how to maintain and use proper body mechanics.! TOP:! Assessment! MSC:! Teaching/Learning! ! ! ! ! ! 7.! The nurse is preparing to reposition a pa tient. Before doing so, the nurse must! a.! Assess the weight to be lifted and the assistance needed.! b.! Attempt to manually lift the patient alone before asking for assistance.! c.! Attempt a manual lift only when lifting most or all of the patient’s weight.! d.! Not use the agency lift team if a mechanical lift is available.! ! !! ANS: A! Before lifting, assess the weight to be lifted and determine the assistance needed and the resources available.Manual lifting is the last resort, and it is used when the task at hand does not involve lifting most or all of the patient’s weight. Use safe patient handling equipment in conjunction with agency lift teams to reduce the risk of injury to the patient and members of the health care team.! !! DIF: Apply! REF:! 758! ! OBJ:! Describe how to maintain and use proper body mechanics.! TOP:! Implementation!! MSC:! Teaching/Learning! ! ! ! ! Isotonic, isometric, and resistive isometric are three categories of exercise. They are cl assified according to the type of muscle contraction involved.Of the following exercises, which are considered isotonic?! ! 8.! a.! Bicycling, swimming, walking, jogging, dancing! b.! Tightening or tensing of muscles without moving body parts! c.! Push-ups, hip lifting, pushing feet against a footboard on the bed! d.! Quadriceps set exercises and contraction of the gluteal muscles! ! !! ANS: A! Examples of isotonic exercises are walking, swimming, dance aerobics, jogging, bicycling, and moving arms and legs with light resistance. Isometric exercises involve tightening or tensing of muscles without moving body parts. Examples include quadriceps set exercises and contraction of the gluteal muscles.Examples of resistive isometric exercises are push-ups and hip lifting, as well as placing a footboard on the foot of the bed for patients to push against with their feet.! !! DIF: Remember! REF:! 747! ! OBJ:! Describe how exercise and activity benefit physiological and psychological functio ning.! TOP:! Assessment! MSC:! Teaching/Learning! ! ! 9.! In planning a physical activity program for a patient, the nurse must understand that! ! a.! Isotonic exercises cause contraction without changing muscle length.! b.! The best program includes a combination of exercises.! c.!Isometric contraction involves the movement of body parts.! d.! Resistive isometric exercises can lead to bone wasting.! ! !! ANS: B! The best program of physical activity includes a combination of exercises that produce different physiological and psychological benefits. Isotonic exercises cause muscle contractions and changes in muscle length. Isometric exercises involve tightening or tensing of muscles without moving body parts. Resistive isometric exercises help promote muscle strength and provide sufficient stress against bone to promote osteoblastic activity.! !! DIF: Understand!REF:! 747! ! OBJ:! Describe how exercise and activity benefit physiological and psychological functioning.! TOP:! Assessme nt! MSC:! Teaching/Learning! ! ! An active lifestyle is important for maintaining and promoting health. In developing an exercise program, the nurse understands that! ! 10.! a.! Physical exercise is contraindicated for patients with chronic illnesses.! b.! Regular physical activity is beneficial only for the body part that is exercised.! c.! Physical exercise has no effect on psychological well-being.! d.! Physical activity enhances functioning of all body systems.! !! ANS: D! Regular physical activity and exercise enhance the functioning of all body systems, including cardiopulmonary functioning, musculoskeletal fitness, weight control and maintenance, and psychological well-being. It is also essential in treatment for chronic illness.! !! DIF: Understand! REF:! 747! ! OBJ:! Describe the benefits of implementing an exercise program for the purpose of health promotion.! TOP:! Assessment! MSC:! Teaching/Learning! ! ! 11.! The nurse is developing an exercise program for elderly patien ts living in a nursing home.To develop a beneficial health promotion program, the nurse needs to understand that when dealing with the elderly! ! a.! Exercise is of very little benefit because the patients are old.! b.! It is important to disregard their current interests in favor of exercise.! c.! No physical benefit can be gained without a formal exercise program.! d.! Adjustments to exercise programs may have to be made to prevent problems.! ! !! ANS: D! Exercise is extremely beneficial for older adults, but adjustments to an exercise program may have to be made for those of advanced age to prevent problems.When developing an exercise program for any older adult, consider not only the person’s current activity level, range of motion, muscle strength and tone, and response to physical activity, but also the person’s interests, capacities, and limitations. Older adults who are unable to participate in a formal exercise program are able to achieve the benefits of impro ved joint mobility and enhanced circulation by simply stretching and exaggerating movements during performance of routine activities of daily living.! !! DIF: Understand! REF:! 759! ! OBJ:! Describe the benefits of implementing an exercise program for the purpose of health promotion.!TOP:! Assessment! MSC:! Teaching/Learning! ! ! The nurse is attempting to start an exercise program in a local community as a health promotion project. In explaining the purpose of the project, the nurse explains to community leaders that! ! 12.! a.! A sedentary lifestyle contributes to the development of health-related problems.! b.! The recommended frequency of workouts should be twice a day.! c.! An exercise prescription should incorporate aerobic exercise only.! d.! The purpose of weight training is to bulk up muscles.! ! !! ANS: A! A sedentary lifestyle contributes to the development of health-related problems.A holistic approach is taken to develop overall fitness and includes warm-ups, aerobic ex ercise, resistance training, weight training, and so forth. The recommended frequency of aerobic exercise is 3 to 5 times per week or every other day for approximately 30 minutes. Crosstraining is recommended for the patient who prefers to exercise every day. Some patients use weight training to bulk up their muscles. However, the purposes of weight training from a health perspective are to develop tone and strength and to simulate and maintain healthy bone.! !! DIF: Understand! REF:! 796-797! ! OBJ:!Describe the benefits of implementing exercise and activity.! TOP:! Assessment! MSC:! Teaching/Learning! ! ! ! The patient is eager to begin his exercise program with a 2-mile jog. The nurse instructs the patient to warm up with stretching exercises. The patient states that he is ready and does not want to waste time with a â€Å"warm-up. † The nurse explains that the warm-up! ! 13.! a.! Allows the body to readjust gradually to baseline functioning.! b.! Prepares the body and dec reases the potential for injury.! c.! Should not involve stretching exercises because they can lead to injury.! d.!Should be performed with high intensity to prepare for the coming challenge.! ! !! ANS: B! The warm-up activity prepares the body for activity and decreases the potential for injury. It usually lasts about 5 to 10 minutes and may include stretching, calisthenics, and/or aerobic activity performed at a lower intensity. The cool-down period allows the body to readjust gradually to baseline functioning and provides an opportunity to combine movement such as stretching with relaxation-enhancing mind-body awareness.! !! DIF: Understand! REF:! 757! ! OBJ:! Describe the benefits of implementing exercise and activity.!TOP:! Assessment! MSC:! Teaching/Learning! ! ! ! Many patients find it difficult to incorporate an exercise program into their daily lives because of time constraints. For these patients, it is beneficial to reinforce that many ADLs are used to accumulate the reco mmended 30 minutes or more per day of moderate-intensity physical activity. When instructing these patients, the nurse explains that! ! 14.! a.! Housework is not considered an aerobic exercise.! b.! To strengthen back muscles, the patient should bend using back muscles.! c.! Daily chores should begin with gentle stretches.! d.!The patient should stick to one chore until it is done before beginning a new one.! ! !! ANS: C! Daily chores should begin with gentle stretches. Housework is considered aerobic exercise. To make it more aerobic, work faster and scrub harder. Bend your legs rather than your back to prevent back injury. Alternate cleaning activities to prevent overworking the same muscle groups.! !! DIF: Understand! REF:! 757! ! OBJ:! Describe important factors to consider when planning an exercise program for patients across the life span and for those with specific chronic illnesses.! TOP:! Assessment! MSC:! Teaching/Learning! ! ! 15.!The nurse is developing an exercise plan for someone diagnosed with congestive heart failure and exercise intolerance. In doing so, the nurse should! ! a.! Plan for 20 minutes of continuous aerobic activity and increase as tolerated.! b.! Perform 6-minute walks at the patient’s pace at least 2 times a day.! c.! Instruct the patient that he should not take his beta blocker medication on exercise days.! d.! Encourage a high-calorie diet to plan for extra calorie expenditure.! ! !! ANS: B! For the diagnosis of exercise intolerance, the patient should begin by performing 6minute walks at his own pace at least twice a day.The patient would not be able to tolerate 20 minutes of continuous aerobic activity. Patients should be instructed to take medications as ordered. Low-calorie, low-sodium, and high-protein diets are best for this type of patient.! !! DIF: Apply! REF:! 755! ! OBJ:! Describe important factors to consider when planning an exercise program for patients across the life span and for those with specific chroni c illnesses.! TOP:! Implementation! MSC:! Teaching/Learning! ! ! Which of the following exercise activities would most likely provide the opportunity for mind-body awareness?! 16.! a.! Warm-up activity! b.! Resistance training! c.! Aerobic exercise! d.! Cool-down activity! ! !! ANS: D! The cool-down period allows the body to readjust gradually to baseline functioning and provides an opportunity to combine movement such as stretching with relaxationenhancing mind-body awareness. The warm-up activity prepares the body and decreases the potential for injury. Aerobic exercise includes running, bicycling, jumping rope, and so forth, and is the main portion of exercise activity; it precedes the cool-down period.Resistance training increases muscle strength and endurance and is associated with improved performance of daily activities but not with enhancing mind-body awareness.! !! DIF: Analyze! REF:! 757! ! OBJ:! Describe important factors to consider when planning an exercise program for patients across the life span and for those with specific chronic illnesses.! TOP:! Evaluation! MSC:! Teaching/Learning! ! ! The patient is brought to the emergency department with possible injury to his shoulder. To help determine the degree of injury, the nurse should evaluate! ! 17.! a.!The patient’s gait.! b.! The patient’s range of motion.! c.! Fine motor coordination.! d.! Activity tolerance.! ! !! ANS: B! Assessing range of motion is one assessment technique used to determine the degree of damage or injury to a joint. Gait is the manner or style of walking. It may have little bearing on the shoulder damage. Assessing fine motor coordination would be beneficial in helping to assess the patient’s ability to perform tasks but would not help in evaluating the shoulder. Activity tolerance refers to the type and amount of exercise or activity a person is able to perform.Damage to the shoulder would affect this, but this would not have a direct bearing on the am ount of damage done to the shoulder.! !! DIF: Apply! REF:! 752-753! ! OBJ:! Assess patients for impaired mobility and activity intolerance.! TOP:! Implementation!! MSC:! Teaching/Learning! ! ! ! The nurse is examining a patient who is admitted to the emergency department with severe elbow pain. Of the following situations, which would cause the nurse to suspect a ligament tear or joint fracture?! ! 18.! a.! Range of motion of the elbow is limited.! b.! Joint motion is greater than normal.! c.!The patient has arthritis.! d.! The elbow cannot be moved (frozen).! ! !! ANS: B! Increased mobility (beyond normal) of a joint may indicate connective tissue disorders, ligament tears, or possible joint fractures. Limited range of motion often indicates inflammation such as arthritis, fluid in the joint, altered nerve supply, or contractures (frozen joints).! !! DIF: Analyze! REF:! 752-753! ! OBJ:! Assess patients for impaired mobility and activity intolerance.! TOP:! Evaluation! MSC:! Teachin g/Learning! ! ! ! The patient has been bedridden for several months owing to severe congestive heart disease.In determining a plan of care for this patient that will address his activity level, the nurse formulates which of the following nursing diagnoses?! ! 19.! a.! Fatigue related to poor physical condition! b.! Impaired gas exchange related to decreased cardiac output! c.! Decreased cardiac output related to decreased myocardial contractility! d.! Activity intolerance related to physical deconditioning! ! !! ANS: D! When activity and exercise are problems for a patient, nursing diagnoses often focus on the individual’s ability to move. The diagnostic label directs nursing interventions.In this case, physical deconditioning must be addressed relative to activity level, perhaps leading to 6-minute walks twice a day. Physical deconditioning is the cause of fatigue as well, so it would take priority over that diagnosis. Decreased cardiac output and myocardial contractility ar e serious concerns that must be addressed before activity intolerance to keep the patient safe and to help determine the level of exercise that the patient can tolerate, but reconditioning of the patient’s body will help improve contractility and cardiac output.! !! DIF: Apply! REF:! 753| 755! ! OBJ:!Formulate nursing diagnoses for patients experiencing problems with impaired mobility and activity intolerance.! TOP:! Implementation!! MSC:! Teaching/Learning! ! The patient weighs 450 lbs (204. 5 kg) and complains of shortness of breath with any exertion. His health care provider has recommended that he begin an exercise program. He states that he can hardly get out of bed and just cannot do anything around the house. To focus on the cause of the patient’s complaints, the nurse devises which of the following nursing diagnoses?! ! 20.! a.! Activity intolerance related to excessive weight! .! Activity intolerance related to bed rest! c.! Impaired gas exchange related to sh ortness of breath! d.! Imbalanced nutrition: less than body requirements! ! !! ANS: A! The diagnostic label directs nursing interventions. This requires the correct selection of related factors. For example, Activity intolerance related to excess weight gain requires very different interventions than if the related factor is prolonged bed rest. In this case, the intolerance is related to the patient’s excessive weight. He is not on bed rest, although he claims that it is difficult for him to get out of bed.Shortness of breath is a symptom, not a cause, of Impaired gas exchange, making this nursing diagnosis ineffective. The patient certainly has an imbalance of nutrition, but it is more than body requirements.! !! DIF: Apply! REF:! 753! ! OBJ:! Formulate nursing diagnoses for patients experiencing problems with impaired mobility and activity intolerance.! TOP:! Implementation!! MSC:! Teaching/Learning! ! The patient is being admitted for elective knee surgery. While the nurse is admitting the patient, she will! ! 21.! a.! Begin to develop a discharge plan.! b.!Plan to wait until after the surgery to plan for discharge.! c.! Place a generalized discharge plan in the record for later use.! d.! Address immediate needs of the patient only and address other needs later.! ! !! ANS: A! The nurse needs to begin discharge planning when the patient enters the health care system. The nurse cannot wait until after surgery to begin to plan for discharge. In addition, the discharge plan is always individualized to the patient and directed at meeting the actual and/or potential needs of the patient.! !! DIF: Apply! REF:! 754! ! OBJ:!Write a nursing care plan for a patient with impaired mobility and activity intolerance.! TOP:! Implementation!! MSC:! Teaching/Learning! ! ! The patient is admitted with a stroke. The outcome of this disorder is uncertain, but the patient is unable to move his right arm and leg. The nurse understands that! ! 22.! a.! Active range of motio n is the only thing that will prevent contractures from forming.! b.! Passive range of motion must be instituted to help prevent contracture formation.! c.! Range-of-motion exercises should be started 2 days after the patient is stable.! d.!Range-of-motion exercises should be done on major joints only.! ! !! ANS: B! When patients cannot participate in active range of motion, the nurse must institute passive range of motion to maintain joint mobility and prevent contractures. Passive range of motion can be substituted for active when needed. For the patient who does not have voluntary motor control, passive range-of-motion exercises are the exercises of choice. Unless contraindicated, the nursing care plan includes exercising each joint (not just major joints) through as nearly a full range of motion as possible.Initiate passive range-of-motion exercises as soon as the patient loses the ability to move the extremity or joint.! !! DIF: Understand! REF:! 759! ! OBJ:! Describe intervent ions for maintaining activity tolerance and mobility.! TOP:! Assessment! MSC:! Teaching/Learning! ! ! The patient has been in bed for several days and needs to be ambulated. Before ambulation, the nurse! ! 23.! a.! Removes the gait belt to allow for unrestricted movement.! b.! Has the patient get up from bed before he has a chance to get dizzy.! c.! Has the patient look down to watch his feet to prevent tripping.! d.!Dangles the patient on the side of the bed.! ! !! ANS: D! Some patients experience orthostatic hypotension—a drop in blood pressure that occurs when the patient changes from a horizontal to a vertical position. Assist the patient to a position of sitting at the side of the bed, and dangle for 1 to 2 minutes before standing. The nurse needs to provide support at the waist so that the patient’s center of gravity remains midline. This is achieved with the use of a gait belt. A gait belt encircles the patient’s waist and may have handles attached for th e nurse to hold while the patient ambulates.The patient should maintain as normal a walking posture as possible with the head erect.! !! DIF: Apply! REF:! 759! ! OBJ:! Describe interventions for maintaining activity tolerance and mobility.! TOP:! Implementation!! MSC:! Teaching/Learning! ! ! 24.! The nurse is ambulating a patient in the hall when she notices that he is beginning to fall. The nurse should! ! a.! Grab the patient and hold him tight to prevent the fall.! b.! Gently lower the patient to the floor.! c.! Jump back and let the patient fall naturally.! d.! Push the patient against the wall and guide him to the floor.! !! ANS: B! If the patient has a fainting episode or begins to fall, assume a wide base of support with one foot in front of the other, thus supporting the patient’s body weight. Then extend one leg and let the patient slide against the leg, and gently lower the patient to the floor, protecting the patient’s head. Grabbing the patient will shift t he nurse’s center of gravity and may lead to a back injury. Allowing the patient to fall could lead to head injury for the patient. Pushing the patient against the wall could also cause the patient to hit his head and cause injury.! !! DIF:Apply! REF:! 759! ! OBJ:! Describe interventions for maintaining activity tolerance and mobility.! TOP:! Implementation!! MSC:! Teaching/Learning! ! ! ! a.! 25.! In assisting the patient to exercise, the nurse should! Expect that pain will occur with exercise of unused muscle groups.! b.! Set the pace for the exercise class.! c.! Force muscles or joints to go just beyond resistance.! d.! Stop the exercise if pain is experienced.! ! !! ANS: D! Assess for pain, shortness of breath, or a change in vital signs. If present, stop exercise. Let each patient exercise at his or her own pace.Assess for joint limitations, and do not force a muscle or a joint during exercise.! !! DIF: Apply! REF:! 759! ! OBJ:! Describe interventions for maintaining act ivity tolerance and mobility.! TOP:! Implementation!! MSC:! Teaching/Learning! ! ! The nurse is developing a plan of care for a patient diagnosed with activity intolerance. Of the following strategies, which has the best chance of maintaining patient compliance?! ! 26.! a.! Performing 20 minutes of aerobic exercise daily with 10 minute warm-up and cool-down periods! b.! Instructing the patient to use an exercise log to record day, time, duration, and responses to exercise activity! .! Instructing the patient on the evils of not exercising, and getting her to take responsibility for her current health status! d.! Arranging for the patient to join a gym that she will have to pay, for so that she does not need to depend on insurance! ! !! ANS: B! Keeping a log may increase adherence to an exercise prescription. Cross-training (combination of exercise activities) provides variety to combat boredom and increases the potential for total body conditioning as opposed to daily aerobic exerci se. â€Å"Blaming† a patient for his or her health status is usually counterproductive.Instead, the nurse should instruct the patient about the physiological benefits of a regular exercise program. Developing a plan of exercise that the patient may perform at home may improve compliance.! !! DIF: Evaluate! REF:! 756! ! OBJ:! Evaluate the nursing care plan for maintaining activity and exercise for patients across the life span and with specific chronic illnesses.! TOP:! Evaluation! MSC:! Teaching/ Learning! ! 27.! The nurse is working with the patient in developing an exercise plan. The patient tells the nurse that she just will not participate in a formal exercise program.The nurse then suggests that exercise activities can be incorporated into activities of daily living. The patient seems to be agreeable to that concept. Of the following activities, which would be considered a moderate-intensity activity?! ! a.! Doing laundry! b.! Making the bed! c.! Ironing! d.! Folding clo thes! ! !! ANS: D! Low-intensity ADLs include doing the laundry, making the bed, ironing, and washing dishes. Moderate-intensity ADLs include sweeping the kitchen or sidewalk, washing windows, folding clothes, and vacuuming.! !! DIF: Evaluate! REF:! 757! ! OBJ:!Evaluate the nursing care plan for maintaining activity and exercise for patients across the life span and with specific chronic illnesses.! TOP:! Evaluation! MSC:! Teaching/ Learning! ! MULTIPLE RESPONSE! ! Bones perform five functions in the body: support, protection, movement, mineral storage, and hematopoiesis. In the discussion of body mechanics, which are the most important? (Select all that apply. )! ! 1.! a.! Support! b.! Protection! c.! Movement! d.! Mineral storage! e.! Hematopoiesis! ! !! ANS: A, C! Bones perform five functions in the body: support, protection, movement, mineral storage, and hematopoiesis.In the discussion of body mechanics, two of these functions —support and movement—are most import ant. In support, bones serve as the framework and contribute to the shape, alignment, and positioning of body parts. In movement, bones together with their joints constitute levers for muscle attachment. As muscles contract and shorten, they pull on bones, producing joint movement. Protection involves encasing the soft tissue organs in a protective cage. Mineral storage helps to strengthen bones but also helps regulate blood levels of certain nutrients. Hematopoiesis is the formation of blood cells.! !! DIF: Remember!REF:! 747! ! OBJ:! Describe the role of the musculoskeletal and nervous systems in the regulation of movement.! TOP:! Assessment! MSC:! Teaching/Learning! ! ! When assessing the activity tolerance of a patient, the nurse would evaluate which of the following? (Select all that apply. )! ! 2.! a.! Skeletal abnormalities! b.! Emotional factors! c.! Age! d.! Pregnancy status! e.! Race! ! !! ANS: A, B, C, D! Factors influencing activity tolerance include physiological factor s such as skeletal abnormalities, emotional factors such as anxiety/depression, developmental factors such as age and gender, and pregnancy status.Race is not a factor because people of all races are faced with similar factors that affect their activity tolerance.! !! DIF: Apply! REF:! 754! ! OBJ:! Assess patients for impaired mobility and activity intolerance.! TOP:! Implementation!! MSC:! Teaching/Learning! ! ! ! In developing a nursing care plan for increasing activity tolerance in a patient, the nurse should (Select all that apply. )! ! 3.! a.! Use generalized therapies because they work for everyone.! b.! Consult with members of the health care team.! c.!Avoid goals published by the American College of Sports Medicine.! d.! Involve the patient and the patient’s family in designing an exercise plan.! e.! Consider the patient’s ability to increase activity level.! ! !! ANS: B, D, E! When planning care, the nurse should consult/collaborate with members of the health care team to increase activity, involve the patient and family in designing an activity and exercise plan (especially if family members are also providers of care), and consider the patient’s ability to increase activity level.Therapies should be individualized to the patient’s activity tolerance. Information from the American College of Sports Medicine serves as a standard that the nurse should use when applying activity and exercise goals.! !! DIF: Apply! REF:! 754! ! OBJ:! Write a nursing care plan for a patient with impaired mobility and activity intolerance.! TOP:! Implementation!! MSC:! Teaching/Learning!