Caring Interventions
b (Rationale In Maslow's hierarchy of needs, physiologic needs are at the most basic level; these needs include air, food, water, and shelter. The second level is safety needs, which comprise physical safety, financial stability, harmonious family relationships, and freedom from psychological threats. The third level of need encompasses love and belonging and includes relationships and affection. The fourth level, self-actualization, is reflective of the individual's need to reach his highest level of function and fulfillment, both personally and professionally. The fifth and highest level is esteem needs, which include confidence, independence, competence, respect, and achievement.)
During a classroom discussion about Maslow's hierarchy of needs, a nursing student asks, "What is the most basic level of need? " What is the best response by the nursing instructor? a "Love and belonging needs are the most basic; these include relationships and affection. " b "Physiologic needs are the most basic; these include shelter and water. " c "Esteem needs are the most basic; these include respect and competence. " d "Safety needs are the most basic; these include physical and psychological safety.
c (Rationale: Aesthetic knowing is the art of nursing and is expressed by the individual nurse through his or her creativity and style in meeting the needs of clients. Understanding how other nurses meet the needs of their clients, and seeing a variety of methods to provide the same care, will help improve this type of knowledge for the students. The other options are ways to improve empirical knowing. )
During a midterm evaluation, the nurse educator tells the students they need to work on improving their aesthetic knowledge. Which is a good way for the students to accomplish this? a Take better notes. b Read about the same topic from a variety of sources. c Spend time in the clinical area with seasoned nurses. d Study harder.
b,e (Rationale When presencing, the nurse does not direct the client; rather, by being present, the nurse serves as the client's guide. During presencing, the nurse remains receptive, open, and available without judging or labeling the client's perceptions, feelings, or behaviors.Forms of presencing include face-to-face discussions and lingering presence.)
Mr. Terisson, a 53-year-old male client, is diagnosed with pancreatic cancer. His nurse, Layne, is with him when he receives the news from the physician. After the physician leaves the room, Mr. Terrison slams his fist against the wall and then silently stares out the window. Which nursing behaviors best reflect Layne's use of presencing in Mr. Terrison's care? (Select all that apply.) a Gently telling the client that his behaviors are rooted in fear b Speaking with the client face-to-face c Directing the client to assess his emotional response d Privately recognizing the client's behaviors as being reflective of powerlessness e Quietly sitting in the client's room
a (In Maslow's hierarchy of needs, esteem needs comprise confidence, independence, respect, competence, and achievement. In particular, the new nurse's statements reflect a desire for independence, confidence, and competence. Safety needs include physical safety, financial stability, harmonious family relationships, and freedom from psychological threats. Self-actualization is reflective of the individual's need to reach his highest level of function and fulfillment, both personally and professionally. Love and belonging needs are reflective of the individual's need to be cared about by and to fit in with others.)
A new nurse is meeting with his mentor. During their conversation, the new nurse states, "I want to be able to take care of my clients without always needing help. I want to feel like I know what I need to do, and I want to be able to provide my clients with the best care." Considering Maslow's hierarchy of needs, how should the mentor interpret the new nurse's statement? a His needs are related to self-esteem. b His needs are related to love and belonging. c His needs are related to self-actualization. d His needs are related to safety.
d (Feedback Rationale: It is imperative that nurses attend to their own needs because caring for self is central to caring for others. As nurses take on multiple commitments to family, work, school, and community they risk exhaustion, burnout, and stress. None of the other options depicts the nurse caring for self, but rather caring for other people or trying to stay on top of the many tasks involved in a daily routine. )
A nurse educator teaches students about caring nursing practice. Which situation demonstrates that the nurse is able to implement the whole idea of caring? a The nurse takes care of aging parents in addition to providing care to immediate family. b The nurse is a volunteer at church and school events. c The nurse makes lists every morning, so the day stays organized and planned. d The nurse is able to carve out time for a favorite hobby at least once a week.
d (Rationale: Conscience deals with morals, ethics, and an informed sense of right and wrong as well as an awareness of personal responsibility. This nurse understands the situation of taking on a critically ill client while already caring for two previously assigned clients and makes an appropriate request for a change in assignment. Compassion is about being aware of one's relationship to others, sharing joys, sorrows, pain, and accomplishments, and participating in the experience of another. Confidence is the quality that fosters trust. It means the nurse has comfort with himself, his clients, and his family. Commitment is a convergence between one's desires and obligations and the deliberate choice to act in accordance with them. )
A nurse is working in a busy intensive care unit. A client is admitted with extensive medical problems and requires a ventilator. Because the nurse has already been assigned to care for two other clients, the nurse requests that the nurse manager change assignments so that appropriate attention can be given to this new admission. Which one of Roach's six C's of caring is the nurse emulating? a Confidence b Compassion c Commitment d Conscience
a,b,d (Rationale Examples of nursedash-client interactions that both reflect and facilitate the development of compassion include validating the client's experience through attentive listening and eye contact. Encouraging the atheist client to speak with the hospital chaplain is not congruent with compassionate care. Compassion is reflected when the nurse comforts the client in ways that are meaningful to the client.)
A terminally ill client says to the hospice nurse, "I'm afraid to die. Just thinking about it scares me so much. Will you please hold my hand? " When the nurse offers to pray with the client, the client states, "I'm an atheist. I think prayer is a waste of words. " Which response best demonstrates compassion in nursing care? (Select all that apply.) a Holding the client's hand b Using attentive listening as a communication technique c Facilitating a meeting between the client and the hospice organization's chaplain d Maintaining eye contact with the client e Singing a song that the nurse finds comforting
a,b,c,d (Rationale: Courtesy is not listed by Roach as one of the six C's of caring. The six C's are; compassion, competence, confidence, conscience, commitment, and comportment. )
According to Roach, which are included in the six C's of caring in nursing? (Select all that apply.) a Commitment b Compassion c Competence d Comportment e Courtesy
a (Rationale Competence is the nurse's ability to effectively demonstrate a set of attributes, such as professional attitude and knowledge, skills, and values, and to fulfill her professional responsibility through nursing practice. Empowerment assists the client to autonomously identify her own health needs in lieu of being instructed how to do so. Compassion develops as a result of being directly involved with the client's experience. Presencing involves the nurse's immersion in a nurse -client interaction that helps the client define her health choices while understanding the client's authority to make her own decisions.)
As the nurse is discharging a client, the client states, "You've been a great nurse. You're knowledgeable and skilled, and you have a great attitude. You're a real professional. " Which nursing caring behavior or process is the client best describing? a Competence b Presencing c Empowerment d Compassion
b,c,d (Rationale Characteristics of the self-aware nurse include the ability to identify personal strengths and weaknesses. The self-aware nurse is aware of assumptions, beliefs, values, and prejudices that can impair judgment. Self-awareness promotes the nurse's understanding, respect, and empathy for others.)
At a nurses' retreat, participants are discussing the characteristics of a self-aware nurse. Which descriptions are most accurate? (Select all that apply.) a "The self-aware nurse is free from assumptions, beliefs, values, and prejudices that can impair judgment. " b "Empathy toward others is a characteristic of the self-aware nurse. " c "A self-aware nurse is more likely to be respectful toward others. " d "The self-aware nurse is able to recognize personal strengths. e "The self-aware nurse does not have personal weaknesses.
c (Rationale Empowerment assists the client to autonomously identify her own health needs in lieu of being instructed how to do so. Competence is the nurse's ability to effectively demonstrate a set of attributes, such as a professional attitude and knowledge, skills, and values, and to fulfill her professional responsibility through nursing practice. Compassion develops as a result of being directly involved with the client's experience. Presencing involves the nurse's immersion in a nursedash-client interaction that helps the client define her health choices while understanding the client's authority to make her own decisions.)
The client tells her nurse, "You helped me learn how to recognize my own health needs without telling me how I should think. " Which nursing caring behavior or process is the client best describing? a Compassion b Presencing c Empowerment d Competence
b (To provide safe, effective client care, competence and compassion must coexist. Without compassion, nursing competence can be interpreted as impersonal and insensitive. In turn, compassion without competence presents real threats to clients' health and safety.)
The clinical nursing instructor is evaluating a nursing student who has been struggling with inserting intravenous catheters. The nursing student states, "The other students are so much better at nursing than I am. I love comforting my clients, but I would rather be able to start an IV." Which response best reflects the relationship between competence, compassion, and nursing practice? a "Successfully inserting an IV is a direct reflection of compassionate client care." b "Safe, effective nursing care requires both compassion and competence." c "Technical expertise is very important, but compassion is the key to nursing." d "In nursing, technical expertise is more valuable than compassion."
a (Personal knowing requires the nurse to build an authentic personal relationship with the client, as opposed to simply viewing the client as an object. In this scenario, although the client is sedated and unable to verbally communicate, the nurse demonstrates viewing the client as person, rather than as an object to be assessed. Empirical knowing is based in nursing-related facts and observations and is objective in nature. Aesthetic knowing relates to the nurse's specific personal style during the delivery of care and develops through increasing awareness of and respect for other people's unique experiences and perspectives. Ethical knowing encompasses the "moral component" of nursing knowledge and requires the nurse to be aware of current nursing codes of ethics, as well as knowing the employing institution's rules, regulations, and values.)
The critical care nurse is conducting a physical assessment on a sedated client who is tracheally intubated and requires mechanical ventilation. Before the nurse places the diaphragm of his stethoscope on the client's abdomen, he states, "Mr. Ryhlman, I'm going to listen to your stomach now. My stethoscope might be a little bit cold." Which way of knowing is best reflected by the nurse's actions? a Personal knowing b Ethical knowing c Aesthetic knowing d Empirical knowing
c (Leaving the client reflects neither competence nor caring in nursing. Were the client in respiratory distress, administration of a breathing treatment would take priority over psychosocial concerns. However, because the client appears to be calm and in no physical distress, the most appropriate response is to demonstrate genuine compassion and concern for the client by briefly exploring his statement about depression. Ignoring his comment and administering a nebulized breathing treatment might be interpreted by the client as suggesting disinterest or insensitivity on the nurse's part. However, the client's teaching is a priority, especially in light of the fact that he has COPD and is audibly wheezing. In the context of nursing, competent, caring nursing interventions combine genuine interest and concern for the client's well-being with safe, proficient client care.)
The home care nurse visits a client with chronic obstructive pulmonary disease (COPD) to complete a scheduled teaching session about how to use a nebulizer. When the nurse greets the client, the client states, "I'm okay. I'm just feeling really depressed today." Although the client appears to be calm and in no physical distress, the nurse hears a faint wheeze when the client exhales. Which nursing response best reflects a competent, caring nursing intervention? a Encouraging the client to discuss his feelings and rescheduling the teaching session for the following day b Asking the client to choose another time for the teaching session and respecting his need for privacy by leaving c Expressing concern for the client's depression and asking him if he wants to discuss his feelings, but planning to complete the scheduled teaching session d Assembling the nebulizer for the client and immediately administering a breathing treatment to him
d (Rationale In Maslow's hierarchy of needs, physiologic needs are at the most basic level; these needs include air, food, water, and shelter. The second level is safety needs, which comprise physical safety, financial stability, harmonious family relationships, and freedom from psychological threats. The third level is love and belonging needs, which include relationships and affection. The fourth level, self-actualization, is reflective of the individual's need to reach his highest level of function and fulfillment, both personally and professionally. The fifth and highest level is esteem needs, which include confidence, independence, competence, respect, and achievement.)
The new nurse tells his preceptor, open double quote"I want the other nurses to consider me competent and proficient.close double quote" Which category of Maslow's hierarchy of needs is reflected by the nurse's statement? a Safety b Self-actualization c Love and belonging d Esteem
d (Rationale Ethical knowing incorporates every intentional action and behavior by the nurse that may be subject to being judged right or wrong. Personal knowing refers to the nurse's ongoing self-exploration and journey toward self-actualization. Empirical knowing is based in nursing-related facts and observations, and nursing theories and analyses that seek to explain these facts and observations.Aesthetic knowing relates to the nurse's specific personal style during care delivery.)
The nurse educator is instructing a group of students about ways of knowing. Which statement by the student best reflects ethical knowing? a "Ethical knowing relates to the nurse's specific personal style during care delivery. b "Ethical knowing refers to the nurse's ongoing self-exploration and journey toward self-actualization. c "Ethical knowing is rooted in nursing-related facts and observations. d "Ethical knowing applies to every intentional nursing action that may be subject to being judged right or wrong.
a,c,d,e (Rationale Effective self-care leads to more than just physiologic health and physical fitness. Along with enhancing the individual's sense of well-being, effective self-care also builds self-esteem, which in turn promotes effective use of problem solving and critical thinking skills. Effective self-care reduces the risk for burnout, the manifestations of which include depersonalization of clients. General examples of self-care activities are eating a balanced diet, exercising on a regular basis, getting adequate rest and sleep, and engaging in recreational activities.)
The nurse is creating a brochure about effective self-care for nurses. Which statements should the nurse include in the brochure? (Select all that apply.) a Effective self-care promotes enhanced critical thinking ability. b Effective self-care promotes depersonalization of clients. c Self-care activities include getting adequate rest. d Prayer and meditation are examples of self-care activities. e Effective self-care builds self-esteem.
a,b,d,e (Rationale Empirical knowing, also referred to as "the science of nursing, " is based in nursing-related facts and observations, and in nursing theories and analyses that seek to explain these facts and observations. Methods of developing empirical knowing include ongoing academic nursing education. Empirical knowing is objective in nature.)
The nursing instructor asks the class to describe empirical knowing. Which student responses are most accurate? (Select all that apply.) a "It includes observations related to nursing." b "It's also called the science of nursing." c "It's subjective in nature." d "It can be developed through ongoing academic education." e "It incorporates nursing-related facts."
c (Rationale Inadequate self-care can lead to decreased physical and psychosocial wellness. In turn, decreased wellness may contribute to impaired work performance as well as a weakened affiliation with the profession of nursing. As a result, the nurse's demonstrated professionalism toward clients, peers, and other members of the healthcare team may suffer.)
The nursing instructor is teaching a class about the relationship between the concept of self-care and the concept of professional behaviors. Which statement should he include in the teaching? a Prioritizing self-care weakens the nurse's professional affiliation with nursing. b Focusing on self-care diminishes the nurse's professionalism toward clients. c Inadequate self-care can impair professional work performance by leading to decreased physical wellness. d Psychosocial wellness does not influence professional behaviors.
b,c,e (Rationale Client care comprises the implementation of collaborative and independent nursing interventions that are intended to restore health, prevent illness or injury, or promote wellness. Yet nursing interventions can be implemented even in the absence of genuine interest or concern for the client's well-being. Likewise, genuine interest or concern for the client's well-being does not necessarily equate to safe, proficient implementation of nursing interventions. In nursing, the meaning of caring extends well beyond simply implementing interventions or feeling interest or concern.)
The staff nurse is writing a journal article that explores the principle of caring as it applies to nursing. Which statements should she include in the article? (Select all that apply.) a Client care is synonymous with caring in nursing. b Caring in nursing extends beyond feelings of interest or concern. c In nursing, demonstration of caring includes the safe, proficient implementation of nursing interventions. d In nursing, concern for the client's well-being will produce safe, effective care. e Nursing interventions can be implemented in the absence of genuine caring.
a,e (Rationale The caring process is shaped by many factors, including an individual's perceptions, experiences, and values. The nurse's level of development also shapes the caring process as do circumstances such as the time and setting of the care being provided.Unseen processes, such as thoughts and emotions, may affect the client's concerns at any given time and impact the nature of care.)
The student nurse asks her nurse mentor to explain the factors that shape the caring process in nursing. Which statements should the nurse mentor include in her reply? (Select all that apply.) a "The process of caring can be influenced by the client care setting. " b "The nurse's level of development does not affect the caring process. " c "Perceptions do not affect the caring process. " d "Circumstances such as space do not affect the caring process. " e"Factors that influence the caring process may include the timing of the interaction.
d (Personal knowing refers to the nurse's ongoing self-exploration and journey toward self-actualization. Aesthetic knowing encompasses the "art of nursing." Empirical knowing encompasses the "science of nursing." Ethical knowing is reflective of the "moral component" of nursing knowledge.)
Which way of knowing refers to the nurse's ongoing self-exploration and journey toward self-actualization? a Aesthetic knowing b Empirical knowing c Ethical knowing d Personal knowing
d (Rationale: Caring practice involves connection, mutual recognition, and involvement. It is more than just performing skills adequately or even efficiently. It's a sense that the nurse has made a difference to someone else. Caring means that people, relationships, and things matter. Explaining a procedure, then seeking permission to begin lets the client know that the nurse respects the client as an individual. All the other options are examples of appropriate and professional nursing care but do not address a caring aspect. )
The student nurse is following a preceptor on the assigned clinical shift. Which behavior of the nurse would the student interpret as caring? a Making sure that all medications and treatments are done on time b Advising the physician that the client wants to speak to him or her prior to a procedure c Using aseptic technique when performing a dressing change d Explaining an invasive procedure to the client, then asking if it is all right to begin the procedure
c (Empowerment reflects the client's development of the ability to autonomously identify her own health needs in lieu of being instructed how to do so. Compassion develops as a result of being intimately involved with the client's experience. Presencing involves the nurse's immersion in a nurse-client interaction that helps the client define her health choices while respecting the client's authority to make his own decisions. Competence is the nurse's ability to effectively demonstrate a set of attributes, such as professional attitude, personal characteristics, knowledge, skills, and values, and to fulfill the nurse's professional responsibility through nursing practice.)
Which caring behavior or process reflects the client's development of the ability to autonomously identify her own health needs in lieu of being instructed how to do so? a Compassion b Competence c Empowerment d Presencing
a,c,e (For individuals who are bullied, effects may include emotional distress, anxiety, a sense of isolation, depression, and increased work absenteeism.)
Which conditions or behaviors are most likely to be exhibited by an individual who is bullied? (Select all that apply.) a Depression b Workaholism c Emotional distress d Socialization e Anxiety
a,b,c,d (Rationale Key elements to the pattern of aesthetic knowing include empathy, holistic thinking, compassion, and sensitivity. Application of nursing-related facts is reflective of empirical knowledge.)
Which nursing action best reflects the principle of aesthetic knowing? (Select all that apply.) a Viewing the client holistically b Being sensitive to the client's needs c Demonstrating empathy toward the client d Providing compassionate client care e Applying nursing-related facts to client care
c (Rationale Caring in nursing combines genuine interest or concern for the client's well-being with safe, proficient implementation of nursing interventions that are intended to restore health, prevent illness or injury, or promote wellness. Caring in nursing is best reflected by the nurse's verbalizing concern regarding a client's complaint of anxiety and providing a back massage per the client's request. Repositioning an uncomfortable client primarily to prevent the client from complaining suggests an absence of genuine interest or concern. Silently empathizing with a client who is in pain is an incomplete representation of caring in nursing, as no nursing intervention is implemented. Taken alone, proficiency with clinical skills (such as insertion of intravenous access devices) does not fully reflect caring in nursing.)
Which nursing behavior best reflects caring in nursing? a Demonstrating success when inserting intravenous access devices on the first attempt for all clients b Repositioning an uncomfortable client with the primary goal of stopping the client's complaining c Verbalizing concern regarding a client's complaint of anxiety and providing a back massage per the client's request d Silently empathizing with a client who complains of pain and hoping the client feels better
d (In the context of nursing, caring extends beyond simply implementing interventions or feeling interest or concern. In nursing, the term "care" often equates to behaviors, which may or may not reflect caring. In particular, client care comprises the implementation of collaborative and independent nursing interventions. Nursing interventions can be implemented even in the absence of genuine interest or concern for the client's well-being. Likewise, genuine interest or concern for the client's well-being does not necessary equate to safe, proficient client.)
Which statement best describes caring in the context of nursing? a Concern for the client's well-being equates to safe, proficient client care. b Client care is synonymous with caring. c Implementation of nursing interventions always reflects concern for the client's well-being. d Caring extends beyond implementing interventions or feeling interest or concern.
d (Rationale Personal knowing refers to the nurse's ongoing self-exploration and journey toward self-actualization. Aesthetic knowing encompasses the "art of nursing. " Empirical knowing encompasses the "science of nursing. " Moral and ethical care reflects ethical knowing.)
Which statement by the nurse best describes personal knowing? a "My client care is moral and ethical. b "During client care, I incorporate what I know about the art of nursing. " c "Nursing is a science. " d "Knowledge is a journey toward self-actualization.
a,b (In Western culture, autonomous coping is highly valued. As such, seeking social support may be viewed as a sign of weakness. To avoid appearing to be weak, individuals influenced by Western culture tend to avoid asking for help when needed; ineffective self-care may result.)
Which statements best reflect Western cultural views of asking for help as part of self-care? (Select all that apply.) a Western cultural beliefs may influence an individual to practice ineffective self-care. b Autonomous coping is highly valued in Western culture. c In Western culture, seeking social support tends to be viewed as a sign of strength. d Asking for help when needed is commonplace in Western culture. e In Western culture, coping styles usually are not subject to judgment.
a (Aesthetic knowing encompasses the "art of nursing." Empirical knowing encompasses the "science of nursing." Ethical knowing is reflective of the "moral component" of nursing knowledge. Personal knowing refers to the nurse's ongoing self-exploration and journey toward self-actualization.)
Which way of knowing encompasses the "art of nursing"? a Aesthetic knowing b Personal knowing c Empirical knowing d Ethical knowing
