Skip Navigation LinksHome > November 2013 - Volume 113 - Issue 11 > CE Test 2.4 Routine Dyspnea Assessment on Unit Admission
AJN, American Journal of Nursing:
doi: 10.1097/01.NAJ.0000437111.65929.39
Feature Articles

CE Test 2.4 Routine Dyspnea Assessment on Unit Admission

Contrada, Emily

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Continued Education
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TEST INSTRUCTIONS

* To take the test online, go to our secure Web site at http://www.nursingcenter.com/ce/ajn .

* To use the form provided in this issue, record your answers in the test answer section of the CE enrollment form below. Each question has only one correct answer. You may make copies of the form.

* Complete the registration information and course evaluation. Mail the completed enrollment form and registration fee to: Lippincott Williams and Wilkins, CE Group, 74 Brick Blvd., Bldg. 4, Suite 206, Brick, NJ 08723. You will receive your certificate in four to six weeks. For faster service, include a fax number and we will fax your certificate within two business days of receiving your enrollment form. You will receive your CE certificate of earned contact hours and an answer key to review your results. There is no minimum passing grade.

* Registration deadline is November 30, 2015.

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* Send in together two or more tests from any nursing journal published by Lippincott, Williams and Wilkins (LWW), and deduct $0.95 from the price of each test.

* We also offer CE accounts for hospitals and other health care facilities online at www.nursingcenter.com. Call 1-800-787-8985 for details.

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PROVIDER ACCREDITATION

LWW, publisher of AJN, will award the number of contact hours indicated for each continuing nursing education activity. LWW is accredited as a provider of continuing nursing education by the Commission on Accreditation of the American Nurses Credentialing Center (ANCC).

These activities are also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for the number of contact hours indicated. LWW is also an approved provider of continuing nursing education by the District of Columbia and Florida #50-1223. Your certificate is valid in all states.

The ANCC's accreditation status of the LWW Department of Continuing Education refers to its continuing nursing educational activities only and does not imply Commission on Accreditation approval or endorsement of any commercial product.

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CE TEST QUESTIONS

GENERAL PURPOSE:

To present the details of a pilot study designed to test the feasibility of measuring dyspnea as part of the initial patient assessment nurses perform on clinical inpatient units.

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LEARNING OBJECTIVES:

After reading this article and taking this test, you will be able to

* identify the background information helpful in understanding the need for the authors’ pilot study on measuring dyspnea during the initial patient assessment.

* recognize the implications for nursing practice based on the findings of this study.

1. The American Thoracic Society definition of dyspnea refers to

a. qualitatively distinct sensations.

b. severely intense discomfort.

c. a decline in oxygenation.

d. an objective measurement.

2. A study of patients undergoing cardiac stress testing reported specifically that those who had dyspnea had a higher risk of death from

a. pulmonary complications.

b. heart disease.

c. suicide.

d. any cause.

3. A health-related quality of life study of patients with esophagogastric cancer demonstrated that a 10-point poorer dyspnea rating prior to surgery was associated with a how much higher risk of death within the 5-year follow-up period?

a. 5%

b. 12%

c. 18%

d. 23%

4. The assessment of dyspnea to optimize care and improve symptom management requires applying a validated, quantitative tool

a. on a routine basis.

b. by all patient care staff.

c. to validate subjective reports.

d. when symptoms warrant it.

5. The authors modified the Medical Research Council breathlessness scale for use in an acute care setting by adding two grades, one of which was dyspnea while

a. hurrying.

b. eating.

c. undressing.

d. ambulating.

6. The numeric rating scale the authors used asked patients to rate their breathing discomfort at the time of the interview on a scale whose maximum was 10, defined as

a. uncomfortable.

b. insufferable.

c. agonizing.

d. unbearable.

7. The authors sought to compare dyspnea at the time of the interview with that from the previous week specifically because worsening dyspnea could

a. suggest a deterioration in status.

b. warrant immediate intervention.

c. alter the established prognosis.

d. indicate a misperception in severity.

8. Nurses noted that patients were unable to respond to 1 or more questions on what percentage of the dyspnea assessment forms?

a. 1%

b. 6%

c. 11%

d. 16%

9. On which clinical unit did usage of the dyspnea assessment tool remain strongest throughout the pilot study?

a. medicine

b. surgery

c. oncology

d. cardiology

10. On the unit with the highest usage of the dyspnea assessment tool (76% to 87% on weekdays), utilization on Saturdays and Sundays, respectively, was

a. 36% and 33%.

b. 47% and 44%.

c. 55% and 52%.

d. 68% and 61%.

11. What percentage of the nurse respondents noted that the assessment tool was “easy” or “very easy” to use?

a. 69%

b. 78%

c. 87%

d. 96%

12. Of the nurse participants, 92% reported that they believe dyspnea assessment to be

a. important.

b. indispensible.

c. unreliable.

d. time consuming.

13. The nurses also suggested reordering the tool's questions to enable patients to first rate the most important item, which is

a. recent improvement in breathing.

b. breathing discomfort right now.

c. recent worsening of breathing.

d. a 0 to 10 rating of breathing discomfort.

14. To capture patients whose dyspnea was alleviated through interventions in the ED, the authors added a question asking patients to rate any breathing discomfort they had

a. over the past 2 hours.

b. within the past 6 hours.

c. over the past 12 hours.

d. within the 24 hours before hospitalization.

15. The authors’ revised dyspnea assessment tool will allow nurses to omit the assessment of change in dyspnea over the past week if the patient

a. doesn't currently have dyspnea.

b. hasn't had dyspnea for the past 8 hours.

c. hasn't had dyspnea for the past 48 hours.

d. cannot rate the severity of dyspnea.

16. What percentage of patients in the authors’ pilot study reported having no dyspnea at the time of the assessment?

a. 56%

b. 66%

c. 77%

d. 83%

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