“Building Continuity and
Improving Transitions Between
Levels 1 and 2 of the
NMNEC Curriculum”
Let’s discuss how to integrate clinical
into L2 and L3. We’ll discuss clinical
activities progression, simulated
charting vs. HER charting, articulating
care, and concept-based activities.
Overview of L1-L2
Objectives
Essense
Advantages – Disadvantages - Challenges
Sue Koronkiewicz, MSN, RN, CNE
BSN Undergraduate Program Director
UNM College of Nursing
Michael Shannon, MSN, RN
Central New Mexico Community College
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Recognizing the
Stems/Prefixes/Suffixes
Michael Shannon, MSN, RN
Central New Mexico Community College
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Learning and understanding the roots of most words
in the field of Health and Medicine can help you to
understand what is being discussed ORIGIN OF
MEDICAL TERMS
Hippocrates was a Hippocrates was a Greek physician
and is known as the is known as the “father of
medicine.”
75% of medical terms are based on terms are based
on either Greek or Latin words.
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Rule 1:
A stem word (the main
meaning) is used before a
suffix that begins with a
vowel
 Scler/ + Osis = Sclerosis =
(hardening) (abnormal
condition)
Rule 2: A combining vowel –
usually an o (Sometimes ‘a,’ ‘e,’
‘i,’ ‘u,’ or ‘y.’is used to link a
stem word to a suffix that
begins with a consonant and to
link a stem word to another
stem word to form a compound
word.
 Colon + o + scope =
colonoscope
(colon) (instrument to
view)
Sclerosis
Colon + o + scopy = the
procedure
Colonoscopy
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cardi
gastr or ventr
hepat
nphr or ren
oste or ossi
thorac or steth
arthr
cyt
colp
derm
=
=
=
=
=
=
=
=
=
=
heart
stomach
liver
kidney
bone
chest
joint
root for cell
vagina
skin
A combining vowel is used to link a stem word
to another stem word to another one for a
compound word such as:
 Gastr + o + enter = itis = gastroenteritis
(stomach) (intestine) (inflammation)
 Oste + o + arthr + itis = osteoarthritis
(bone) (joint) (inflammation)
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A suffix is a word ending. Changing the suffix
gives medical words a new meaning.
Usually indicates a procedure, condition,
disorder or disease.
Most suffixes are derived from Greek
or Latin words.
(A suffix that is well known is – ology – the study of)
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What is a SUFFIX part 2
A suffix is the word ending that follows the
word stem and changes its changes its
meaning.
A suffix often indicates the:
 procedure
 condition
 disorder
 disease
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Notice the connecting vowel
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Enterotomy
Appendectomy
Gastrorrhaphy
Cystoplasty
Steatorrhea
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Tomy – cut or incision
Rhaphy- sewing
Plasty –
molding/repair
Rhea - discharge
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Nephrotomy is…
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Gastroplasty is…
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Colporrhaphy is…
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Appendectomy is…
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Incision of the kidney
Surgical operation for morbid
obesity that changes the shape
of the stomach
Surgical repair of a defect in
the vaginal wall
Removal/cutting of appendix
Source: http://www.medterms.com/script/main/hp.asp
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Arthr/o + centesis = arthrocentesis
(joint) (puncture)
Thorac/o + -tomy = thoracotomy
(chest) (incision)
Gastro/o + -megaly = gastromegaly
(stomach) (enlargement)
Colon/o + -scopy = colonoscopy
(colon) (see/search)
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Hepatitis: hepa - liver; itis- inflammation of
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Splenomegaly: Spleno – spleen; megaly-large
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Acrophobia: acro – edge; phobia- fear of
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Artheriosclerosis: atherio-artery; sclerosis-
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Cardiogram: cardio-heart; gram - record or
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hardening of
write
Laparoscopy: laparo-abdomen; scopy- to look
in or search
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A prefix is a word element located at the
beginning of a word.
 Prefixes can alter the meaning of the
word.
 Usually indicates a number, time,position,
direction, color, or sense of negation.
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peri - prefix means
around
hemi - prefix means
half
micro - prefix
means small
Neo - prefix means
new
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a part of the word
part of the word that
precedes word root
and changes its
changes
Often indicates
location, time, or
number.
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Peri + cardio + logy = pericardiology
(around) (heart-pericardium) (study of)
Hyper + therm + -ia = hyperthermia
(excessive) ( heat) (condition)
Intra + muscul + -ar = intramuscular
(in, within) (muscle) (relating to)
Macro + gloss + -ia = macroglossia
(large - enlargement) (tongue) (condition)
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Do you remember what cardi means?
– it is a root that means …
 -ogist – suffix that means one who
 -ology – is a suffix that means the
heart
study of
------------------------------Cardiology is…
Cardiologist is…
So
the study of
the heart
one who
studies the
heart
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1.
All medical terms can be broken down
into word parts. The three word parts
are the prefix, the stem (root), and the
suffix. Usually, only two of these parts
are present in a medical term. The
word parts, then, of a medical term
may include the _________, the stem,
and the suffix.
prefix
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2.
The part of the word which gives
the basic meaning to the word is
called the ___________.
stem
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3. Dermatology is _____________________________.
The study of skin
The branch of medicine concerned with the
study of the skin, diseases of the skin, and
the relationship of cutaneous lesions to
systemic disease
http://www.medilexicon.com/medicaldictionary.php?t
=23957
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4. Osteo is a stem which means bone. A person
who has osteo-arthritis, for example, has
inflammation of the ______ and joint.
bone
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5. Rhino and naso are stems which mean nose.
A person who has rhinitis has inflammation
of the __________.
nose
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6.
So…rhinoplasty is
____________________________.
Surgery to reshape the nose
http://www.nlm.nih.gov/medline
plus/ency/article/002983.htm
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7.
Nephritis is
Nephritis is inflammation of the kidney.
http://www.nlm.nih.gov/medlineplus/ency/ar
ticle/000464.htm
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8. Laryngo is a stem meaning
larynx or voice box. A
laryngoscopy is an examination
of the interior of the __________.
Larynx
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9. Phlebo and veno are stems which mean vein.
A phlebectomy is the ______________________.
Surgical removal of veins such as
varicose veins on the surface of the
legs.
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10. Arterio is a stem which means artery. A
person who has arteriosclerosis has
________________________.
Hardening of the arteries
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http://medlineplus.gov/
http://www.medic8.com/MedicalDictionary.htm
http://www.nlm.nih.gov/
http://www.medterms.com/script/main/hp.asp
http://www.medicinenet.com/diseases_and_conditions/article.htm
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Semper Fi means ?
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Semper Gumby ?
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Artery… building for paintings
Barium…what you do when the pt dies
Coma…punctuation mark
Dilate…live longer than expected
Node…knew about something
Urine…opposite of your out
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Cauterize…made eye contact with her
Fibula…a small lie
Impotent…distinguished, well known
Rectum… nearly killed him
Terminal illness…sick at the airport
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Adenoma… what you say to Bella when you
don’t know the answer
Anally…occurs yearly
Atonic…goes with gin
Protein…favors young people
Placenta…Red Christmas flower
Introducing Pharmacology concepts into Level
One - NMNEC Nursing Program
Dianne Ranck, RN-C, BSN, MSN-Ed
Assistant Professor
Santa Fe Community College
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Two+ semesters ago
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Students’ interest in case study meds, etc.
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15-20 minutes q 2 wk / handouts
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Pharmacology instr reports IMPROVEMENT….
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For my little 20 - 25 min sessions biweekly
(fortnightly):
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Actively participate in discussions
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Participate in class-made quizzes
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Increase awareness of medication safety!
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Create ‘muscle memory’ of medication safety.
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6 - 8 - 10! right of medication
administration
Create that muscle memory -- habit
Educate the nurse to enlighten/empower the
patient
Multiple factors involved --
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IOM 1999, 44,000 to 98,000 deaths per year
Canadian hospitals = 10,000
Federal initiatives. 50% TJC standards related
to patient safety.
AHRQ establishes safety indicators.
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In a simple way – seek to improve nurses’
function in med administration.
Encourage education of nurses to educate
patients, family.
Patients resuming control of some of their
care
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Increases understanding, application
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Solidifies concept use
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Initiated Spring 17 semester (see sample)
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Very Low key / low acuity approach
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20-25 minutes every few weeks
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In Lab, preferably
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Provide one sheet info to class, discuss; a/v
enrichment, as available
Small group review/practice
 Jeopardy-style questions
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How to choose the meds, pharma concepts
Format of handouts morphs, often based on
response, NMNEC understanding.
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I believe this simple program should continue.
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Improved safety for patients.
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Improved nurses level of knowledge, confidence
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Improved patient understanding.
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Improved patient satisfaction.
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Improved test and NCLEX scores
Shawna Kemper MSN, RN, CNE
Assistant Director / Assistant Professor
San Juan College
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Discuss strategies for preparing Level One
Students for Higher level test questions
Discuss appropriate test questions for level
one students
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NCLEX-RN® detailed test plan (candidate version)
shared with students on first day of class
◦ https://www.ncsbn.org/2016_RN_Test_Plan_Candidate
.pdf
NCLEX-RN® detailed test plan (educator version)
utilized by all faculty when writing exam questions
◦ https://www.ncsbn.org/2016_RN_DetTestPlan_Educato
r.pdf
Client Needs
Safe and Effective Care
Environment
• Management of Care
• Safety and Infection Control
Percentage of Items from
each Category/Subcategory
17 – 23%
9 – 15%
Health Promotion and
Maintenance
6 - 12%
Psychosocial Integrity
6 – 12%
Physiological Integrity
• Basic Care and Comfort
• Pharmacological and
Parenteral Therapies
• Reduction of Risk Potential
• Physiological Adaptation
Retrieved from:
https://www.ncsbn.org/2016_
RN_DetTestPlan_Educator.pdf
6 – 12%
12 – 18%
9 – 15%
11 – 17%
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Safe and Effective Care Environment
◦ Management of Care
 Confidentiality and Information Security
 NMNEC Concept: Health Care Law. Exemplar: HIPAA
 Legal Rights and Responsibilities
 NMNEC Concept: Health Care Law
◦ Safety and Infection Control
 Standard Precautions/Transmission-Based Precautions
 NMNEC Skill: handwashing/ PPE
 Use of Restraints/Safety Devices
 NMNEC Skill: Fall and self-harm prevention
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Reference: NCSBN (2016). NCLEX-RN detailed test plan. Retrieved from:
https://www.ncsbn.org/2016_RN_DetTestPlan_Educator.pdf
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Intro to Nursing Concepts Course
◦ Concept of Professional Identity is taught first
Exemplar: Clinical Judgment/reasoning
Application or higher type questions
incorporated in to every lecture
Mini quizzes implemented in the Intro to
Concepts Course
Testing Resources
Attempt to have questions at the application
level or higher on all exams (although some
knowledge questions are OK, particularly with
skills, ex: ordering of steps)
 To test at the application and higher level you need to
teach at that application or higher level
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“Select all that apply” questions included on
EVERY exam
No backtracking on exam
Exams are timed and time decreases each
semester
Student required to meet with instructor if 77%
is not achieved on the exam
Exam Reviews
◦ Each question must have rationale – why an option is
correct as well as why distractors are incorrect
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Within your assigned group create an
Application Question related to the concept
of Safety
Make sure to include Rationale
A patient of a different ethnic background than the nurse states:
"There's no sense talking; you wouldn't understand because you live in
another world." What would be the nurse's best response?
a. "I do understand; we all go through similar experiences."
*b. "Please give an example of something you think I wouldn't
understand."
c. “Please be assured that I interact with individuals from all cultures."
d. "Perhaps we should discuss something else."
Rationale: By asking for an example, the nurse opens up the opportunity for the
patient to explore feelings. It would not be appropriate to state understanding, give
reassurance of cultural understanding, or change the subject. None of these options
identify with the patient's perspective.
A patient has an ankle restraint applied. Upon assessment the
nurse finds the patient’s toes a light blue color. Which action
should the nurse take next?
*a. Remove the restraint.
b. Place a blanket over the feet.
c. Immediately do a complete head-to-toe neurologic
assessment.
d. Take the patient’s blood pressure, pulse, temperature, and
respiratory rate.
Rationale:
If the patient has altered neurovascular status of an extremity such as cyanosis,
pallor, and coldness of skin or complains of tingling, pain, or numbness,
remove the restraint immediately.. Light blue is cyanosis, indicating the
restraints are too tight, not that the patient is cold and needs a blanket. A
complete head-to-toe neurological assessment is not needed at this time. The
nurse can take vital signs after the restraint is removed
The housekeeper approaches the nurse and states "What kind of surgery
did the patient in room 4 have? I think that patient is my neighbor." What
should be the nurse's appropriate reply?
a. "It was just a minor surgery. I am not allowed to give you any details."
*b. "I cannot answer that question. It is very important to protect our
patients' privacy."
c. "I cannot give you any information about the patient, but I can let
them know you were here."
d. "The patient had their gallbladder removed and a liver biopsy.”
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Rationale: Giving any information to the housekeeper about the patient violates patient privacy. The
nurse is still disclosing information about the patient's medical condition. The correct answer, “I
cannot answer that question” demonstrates respect and protects the patient's confidentiality.
Regardless whether the patient is the housekeeper’s neighbor or not does not mean information
about the patient is given. By passing this information about what kind of surgery may facilitate a
possible confirmation of her identity to the housekeeper which is clearly a violation of HIPAA.
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Morrison, S., Nibert, A., Flick, J. (2006). Critical thinking and test
item writing. Houston, TX: Health Education Systems,
NCSBN (2016). NCLEX-RN detailed test plan – Candidate Version.
Retrieved from:
https://www.ncsbn.org/2016_RN_Test_Plan_Candidate.pdf
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NCSBN (2016). NCLEX-RN detailed test plan – Educator Version.
Retrieved from:
https://www.ncsbn.org/2016_RN_DetTestPlan_Educator.pdf
Nugent, P. M., Vitale, P.M. (2016). Test success; test taking
techniques for beginning nursing students. Philadelphia, PA: F.A.
Davis.
Nugent, P. M., Vitale, P.M. (2015). Fundamentals Success: A Q & A
review. Applying critical thinking to test taking. Philadelphia, PA:
FA Davis
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Shawna Kemper MSN, RN, CNE
Assistant Director/ Assistant Professor
San Juan College
4601 College Blvd.
Farmington, New Mexico 87402
(505) 566-3785
[email protected]
Evangelina Ramirez, MSN, RN
College Assistant Professor
Simulation Laboratory Coordinator
New Mexico State University
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How is each school in NMNEC using NANDA
when teaching the Nursing Process?
Is NANDA necessary to provide for a
continuity in the development of the Nursing
Process?
Is NANDA relevant?
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One of the commonalities in most nursing
programs is the recognized need to develop a
plan of care when in the health care
environment.
The question is….are we all playing the same
tune?
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Developed in 1982
Standardized Nursing Terminology
Organizes diagnoses into different categories
◦ Almost tailor-made for the Concept-Based
Curriculum
◦ Taxonomies are based on Gordon’s functional
health patterns
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Quick email survey - >50% response
100% of respondents state that they integrate
NANDA into their curriculum
NMSU integrates NANDA into the curriculum
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Relevant when speaking to other nurses
Not so much so when speaking to families
and physicians
So, does it provide for a seamless transition?
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Adapted from: Gordon, M. (1994) Nursing
Diagnosis: Process and Application, 3d Ed.
St. Louis: Mosby
Herdman, T.H. & Kamitsuru, S. (Eds.).
(2014). NANDA International Nursing
Diagnoses: Definitions & Classification,
2015–2017. Oxford: Wiley Blackwell.