Foundations Chapter 7 Caring in Nursing Practice

1, 2, 5 Watson's 10 carative factors help to improve nursing care. Instilling faith and hope is one of the 10 factors. This provides direction to the patient who is trying to find meaning in the disease. Watson's theory includes expressing all positive and negative feelings. The theory also emphasizes developing a trusting relationship between the nurse and patient. Suppressing negative feelings and denying that anything is wrong are detrimental to the patient's recovery. Negative feelings, if suppressed, have adverse effects on physical and mental health. Denial may interfere with the patient's right to information.

A 60-year-old patient is undergoing treatment for a brain tumor. The patient is depressed due to the diagnosis. The nurse decides to practice Watson's carative theory for the patient. Which carative processes should the nurse include when working with this patient? Select all that apply. 1 Instilling faith and hope 2 Expressing feelings 3 Suppressing negative feelings 4 Denying that anything is wrong 5 Developing a trusting relationship

2 The nurse should strive to understand an event as it has meaning in the life of the other. Knowing the patient is essential when providing patient-centered care. Discussing regular health examinations and risk factors for cervical cancer are examples of enabling the patient. Providing a gender-congruent caregiver is an example of doing for the patient.

A Muslim woman enters the clinic to have a woman's health examination for the first time. Which nursing behavior applies Swanson's caring process of knowing the patient? 1 Sharing feelings about the importance of having regular woman's health examinations 2 Gaining an understanding of what a woman's health examination means to the patient 3 Recognizing that the patient is modest; obtaining gender-congruent caregiver 4 Explaining the risk factors for cervical cancer

2 Swanson's theory describes knowing as striving to understand an event as it has meaning in the life of the other. This theory supports the claim that caring is a central nursing phenomenon but not necessarily unique to nursing practice.

Which best describes knowing, according to Swanson's theory? 1 Sustaining faith in one's capacity to get through a situation 2 Striving to understand an event's meaning for another person 3 Being emotionally there for another person 4 Providing for others as they would do for themselves

1 The nurse sees the patient and the whole family as active participants in the care of the patient. Therefore, the nurse should include the family members willing to perform activities of daily living (ADL). The patient must give permission to share health care information, even with family members. Patients make their own health care decisions.

How does the nurse demonstrate caring to family members? 1 Helping the family to become active participants in care 2 Preventing the family from providing activities of daily living (ADLs) 3 Sharing all health care information without the patient's permission 4 Allowing the family to make health care decisions for the patient

2 Watson's transpersonal caring theory emphasizes care over cure. The nurse is not compliant with this aspect because the nurse is more inclined towards curing rather than caring. Watson's theory does not emphasize cures or conventional means of disease management. The theory does not specify the duration of time in conversation with the patient.

If the nurse only practices the curative regimen prescribed by the health care provider while dealing with patients, which aspect of Watson's transpersonal caring theory does the nurse fail to apply? 1 Intention to cure 2 Intention to care 3 Management by conventional means 4 Brief conversation with the patient

1, 2, 5 Nurses must listen to patients with openness. The nurse must keep an open mind and avoid making any assumptions about any patient. It is important to concentrate fully on what the patient has to say. Interacting with a patient is important in order to understand the thought process of the patient. Continuing the patient's medication is necessary, but interaction and communication with the patient are equally important.

A female patient is admitted to the psychiatric unit for major depressive disorder, and her husband has expressed concern that she has suicidal thoughts. The patient reports she feels overwhelmed at home with three children to care for and no help. Her husband travels for work and is rarely around. The patient expresses that she is unable to take it any longer and wants to end her suffering. What should be the nurse's approach when dealing with this patient? Select all that apply. 1 Actively listen to the patient with an open mind. 2 Avoid making any assumptions about the patient. 3 Avoid any kind of interaction with this patient, because she is in the psychiatric unit. 4 Just continue with administering the medication and tell the patient to be calm. 5 Listen attentively to the patient's complaint and concentrate on what the patient is saying.

1, 2, 4 When dealing with any patient, the nurse should be a caring listener. The nurse should pay attention to the patient's concerns. The nurse should make good eye contact, which signifies that the nurse is interested in the patient's problems. The nurse should listen to the patient with openness, keep silent, and let the patient speak. It is easy for the nurse to get distracted by tasks and workload, but the nurse should listen to the patient first and then complete the tasks.

A patient admitted to a hospital is very depressed. The patient wants to share personal concerns with the nurse. Which should the nurse do to be a good listener? Select all that apply. 1 Give complete attention to the patient. 2 Maintain good eye contact with the patient. 3 Listen to the patient while performing tasks simultaneously. 4 Be silent and listen to the patient. 5 Promise to come back after finishing the task at hand.

1, 4, 5 Touch is a comforting approach used by nurses to reach out to patients to communicate concern and support. Protective touch is a type of touch that protects the nurse emotionally and the patient physically from the consequences of caregiving. An example of protective touch is holding the patient to prevent a fall. The patient may view protective touch positively or negatively, depending on the patient's interpretation of the nurse's behavior and the context of the care. The protective touch does not protect the patient emotionally; however, it may provide physical protection. Protective touch does not render protection to the nurse in terms of occupation.

A patient has severe cancer-related pain throughout the body and tries to avoid being touched during examination by the nurse. What should the nurse learn about protective touch? Select all that apply. 1 It protects the nurse emotionally. 2 It protects the patient emotionally. 3 It protects the nurse occupationally. 4 It protects both the nurse and the patient. 5 It can be positive or negative.

2 Knowing the patient means understanding the patient and the patient's background. Hence, obtaining the health history and assessment relates to knowing the patient. Enabling refers to helping the patient through life transitions. Doing for is performing tasks for the patient. Being with is giving emotional support to the patient.

A patient is admitted to a hospital following severe pain in the abdomen. The nurse obtains the patient's complete history and assesses the patient thoroughly. Which process of Swanson's theory is the nurse using? 1 Enabling 2 Knowing 3 Doing for 4 Being with

1 A caring touch is a nonverbal communication that helps to comfort the patient and establish a personal connection between the nurse and the patient. A protective touch is used to protect the patient or the nurse. A noncontact touch is mainly eye contact, which does not involve physical touch. A task-oriented touch takes place when the nurse is performing some nursing task or procedure.

A patient is admitted to the hospital for the treatment of lymphoma. The nurse enters the patient's room to find the patient worried and depressed. The nurse warmly greets the patient and lightly touches the patient's shoulder. Which type of touch is this? 1 Caring 2 Protective 3 Noncontact 4 Task-oriented

1, 2, 5 Watson's 10 carative factors focus on the relationship between the nurse and the patient. The factors include expressing all positive and negative feelings. Watson's theory of caring also includes instilling faith and hope. This provides a direction to the patient when trying to find the meaning of the illness. The theory also includes developing a trusting relationship between the nurse and the patient. Suppressing negative feelings and denying that a problem exists may lead to undertreatment and complications.

A patient is admitted to the hospital for treatment of breast cancer. The nurse assigned to this patient decides to practice implementing Watson's caring theory. Which are carative factors of this theory? Select all that apply. 1 Expressing feelings 2 Instilling faith and hope 3 Suppressing negative feelings 4 Denying that a problem exists 5 Developing a trusting relationship

2, 3, 5 The nurse should always follow the caring principles when caring for any patient. The patient who is suffering from lymphoma may get depressed at times. The nurse must be patient enough to handle such patients. The nurse should greet the patient warmly and touch the patient's shoulder gently to acknowledge the patient's presence. Making good eye contact and sitting next to the patient gives the impression that the nurse is interested in listening to the patient's problems. Asking about the patient's concerns and listening patiently is an important principle of caring, which makes the patient feel that the nurse is not there just for her task but connects with the patient on a personal level. Greeting the patient does not imply that the nurse is disturbing the patient. The patient may feel uncared for if the nurse leaves the room without speaking.

A patient is admitted to the hospital for treatment of lymphoma. The nurse enters the patient's room to find the patient worried and depressed. According to the caring principles, what should the nurse do? Select all that apply. 1 Leave the patient alone. 2 Greet the patient and gently touch the patient's shoulder. 3 Make good eye contact and sit next to the patient. 4 Do necessary work and leave without speaking. 5 Ask the patient about any concerns and listen to complaints patiently.

1 Caring touch is an extremely important aspect of nursing. Because the patient is depressed, the nurse should hold the patient's hand and talk to him or her. The nurse should participate in the conversation and help the patient to feel better. Touching the forehead to assess temperature does not indicate caring touch. Holding the arm to start an intravenous (IV) line does not indicate caring touch. Touching the back to give a massage is task-oriented.

A patient is depressed due to chronic illness and disability and reports being unable to sleep. The nurse uses caring touch. Which is an example of caring touch? 1 Holding the patient's hand 2 Touching the forehead to assess warm skin 3 Holding the arm to start an IV line 4 Touching the back to give a massage

4 Providing a clean and pleasant environment soothes the mind, body, and spirit. The nurse should ensure that the patient's room is clean and uncluttered. The effects of hypnotism are short-lived, and hypnotism is not a medically acceptable measure to relieve body pains. Behavioral therapy and psychiatric counseling are not helpful for relieving physical pain due to cancer. They are used when the illness has a psychological cause.

A patient is disabled due to cancer-related pain. Which nonpharmacological intervention can help enhance the patient's comfort, dignity, and peace? 1 Hypnotism 2 Behavioral therapy 3 Psychiatric counseling 4 A clean and pleasant environment

4 Spirituality offers a sense of connectedness intrapersonally (connected with oneself), interpersonally (connected with others and the environment), and transpersonally (connected with the unseen, God, or a higher power). In a caring relationship the patient and nurse come to know one another, so both move toward a healing relationship.

A patient is fearful of upcoming surgery and a possible cancer diagnosis. The patient discusses love for the Bible with the nurse, who recommends a favorite Bible verse. Another nurse disagrees with this recommendation. Which would be an appropriate response to the nurse who states that there is no place in nursing for spiritual caring? 1 "Spiritual care should be left to a professional." 2 "You are correct; religion is a personal decision." 3 "Nurses should not force their religious beliefs on patients." 4 "Spiritual, mind, and body connections can affect health."

4 Swanson's theory of caring is comprised of five processes of nursing. Maintaining belief is sustaining faith in the other person's ability to get through an event. Knowing is striving to understand an event as it has meaning in the life of the other. The nurse tries to understand the patient's life conditions. Doing for is performing for others as the patient would have done for herself if it were possible. Being with refers to being emotionally present for the patient. Enabling is facilitating the patient's passage through changes in life.

A patient is suffering from a hormonal disorder. The nurse tries to retain a hope-filled positive attitude for this patient. The nurse also offers realistic optimism to the patient. Which component of Swanson's caring theory is the nurse applying? 1 Knowing 2 Doing for 3 Being with 4 Maintaining belief

3 Touch signifies that the nurse understands the patient's concerns. It means being with the patient and listening to the patient whenever needed. Enabling is facilitating the patient's passage through life stages. Doing for is performing for the patient as the patient would do for him-or herself if possible. Maintaining belief is sustaining faith.

A patient is talking to the nurse about being upset after receiving a cancer diagnosis. The nurse attentively listens and touches the patient gently. Which component of Swanson's theory does this action fulfill? 1 Enabling 2 Doing for 3 Being with 4 Maintaining belief

2 Holding a patient to avoid a fall is an example of protective touch. The use of touch is often a comforting approach while dealing with patients. Touch is classified into different categories based on the type of touch. Protective touch is used to protect the patient or the nurse. Caring touch helps to comfort the patient and establish a personal connection between the nurse and the patient. Noncontact touch mainly involves eye contact, not physical touch. Task-oriented touch is the touch that takes place while the nurse is performing a nursing task or procedure.

A patient loses balance, and the nurse holds the patient to avoid a fall. Which kind of touch is this? 1 Caring 2 Protective 3 Noncontact 4 Task-oriented

2 Doing for is the process in which the nurse carries out tasks for patients as they would do for themselves, if possible. The quadriplegic patient is unable to cover himself; hence the nurse does the task. Knowing is getting to know the patient. Being with refers to being present emotionally for the patient. Maintaining belief is instilling hope and faith in the patient.

A patient who is quadriplegic complains of being cold and asks for an extra blanket. The nurse covers the patient and draws the room's curtains. Which process did the nurse follow? 1 Knowing 2 Doing for 3 Being with 4 Maintaining belief

4 Listening is powerful. It conveys the nurse's full attention and interest. A true caring presence involves listening. Listen to what is important to another person and the meaning of a situation to that person. Listening includes "taking in" what a patient says, interpreting and understanding what the patient is saying, and then giving back that understanding to the patient. It does not include incorporating the views of the physician, correcting the errors in the patient's understanding, or injecting the nurse's personal views and statements.

Listening is multifaceted. Besides taking in what a patient says, what else does listening include? 1 Incorporating the views of the physician 2 Correcting any errors in the patient's understanding 3 Injecting the nurse's personal views and statements 4 Interpreting and understanding what the patient means

3 Knowing the context of a patient's illness helps the nurse choose and individualize interventions that will actually help the patient. The nurse should strive to understand an event as it has meaning in the life of the other. Knowing the patient is essential when providing patient-centered care. Two elements that facilitate knowing are continuity of care and clinical expertise.

Of the five caring processes described by Swanson, which describes knowing the patient? 1 Anticipating a patient's cultural preferences 2 Determining which physician a patient prefers 3 Establishing an understanding of a specific patient 4 Gathering task-oriented information during assessment

1 Caring touch is a form of nonverbal communication used to connect with the patient physically and emotionally to enhance a patient's comfort and security, self-esteem, confidence in the caregivers, and mental well-being. Protective touch protects the nurse and/or the patient to prevent physical or emotional harm. Nurses use task-oriented touch when performing a task or procedure. Touch can enhance interpersonal relationships, but there is no category of touch called interpersonal touch.

The hospice nurse sits at the bedside of a male patient in the final stages of cancer. He and his parents made the decision that he would move home and they would help him in the final stages of his disease. The family participates in his care, but lately the nurse has increased the amount of time she spends with the family. Whenever she enters the room or approaches the patient to give care, she touches his shoulder and tells him that she is present. Which type of touch is this? 1 Caring touch 2 Protective touch 3 Task-oriented touch 4 Interpersonal touch

2, 3, 4 The caring processes of Swanson's theory of caring include knowing, doing for, and being with. Knowing helps to understand an event and adds meaning to life. Doing for a patient is comforting to the patient. Being with a patient provides emotional support to the patient. Bias and randomization are not part of Swanson's theor

The nurse decides to use Swanson's theory of caring in clinical practice. Which caring processes are included in this theory? Select all that apply. 1 Bias 2 Knowing 3 Doing for 4 Being with 5 Randomization

2, 3, 4 The caring processes of Swanson's theory of caring include knowing, doing for, and being with. Knowing helps to understand an event and adds meaning to life. Doing for a patient is comforting to the patient. Being with a patient provides emotional support to the patient. Bias and randomization are not part of Swanson's theory.

The nurse decides to use Swanson's theory of caring in clinical practice. Which caring processes are included in this theory? Select all that apply. 1 Bias 2 Knowing 3 Doing for 4 Being with 5 Randomization

3 Nurses use task-orientated touch when performing a task or procedure. An expert nurse learns that any procedure is more effective when administered carefully and in consideration of any patient concern. Caring touch is holding a patient's hand, giving a back massage, gently positioning a patient, or participating in a conversation to enhance a patient's comfort and security, self-esteem, confidence in the caregivers, and mental well-being. Protective touch protects the nurse and/or the patient to prevent physical or emotional harm. Touch can enhance interpersonal relationships, but there is no category of touch labeled interpersonal touch.

The nurse enters a patient's room, arranges the supplies for a Foley catheter insertion, explains the procedure to the patient, and tells the patient what to expect. Just before inserting the catheter, the nurse tells the patient to relax and says that, once the catheter is in place, the patient will not feel the bladder pressure. The nurse then proceeds to skillfully insert the Foley catheter. Which type of touch is this? 1 Caring touch 2 Protective touch 3 Task-oriented touch 4 Interpersonal touch

1 In this scenario, the nurse practices caring touch. Caring touch is a form of nonverbal communication. It helps to improve a patient's comfort and security, enhances self-esteem, increases confidence in the caregivers, and improves mental well-being. Protective touch is used to protect the patient from any harm. Task-oriented touch occurs when the nurse is performing nursing duties. Healing touch is a type of energy therapy used for healing certain diseases.

The nurse gently touches the shoulder of a patient lying with eyes closed. When the patient opens his eyes, the nurse smiles and asks how he is feeling. Which kind of touch is this? 1 Caring 2 Protective 3 Task-oriented 4 Healing touch

3 Having long conversations helps the nurse provide the patient with social, emotional, and spiritual resources. Such conversations will not necessarily distract the nurse from important tasks because conversation can be held while the nurse performs routine care tasks. These conversations extend the healing relationship so that the patient's recovery will be faster, and it may build the patient's confidence in the nurse. Usually patients are happy to reveal personal information to professionals involved in providing health care.

The nurse has long conversations with a patient about the patient's health, family, religious, and cultural practices. What impact will such a conversation likely have on the healing relationship? 1 It may distract the nurse from important nursing tasks. 2 It will have no impact on the patient's healing. 3 It will help to assist the patient in using social resources. 4 It will make the patient uncomfortable to reveal personal information.

3 Task-oriented touch is the touch that the nurse uses while performing nursing procedures. In this scenario, inserting the tube skillfully is task-oriented touch. Listening to the patient's concerns and making good eye contact ensure the patient's comfort but are not task-oriented touch. Holding the patient's hand is an example of caring touch.

The nurse has to insert a nasogastric tube in a patient. The nurse explains the procedure to the patient and uses task-oriented touch. Which action by the nurse would be considered task-oriented touch? 1 The nurse listens to the patient's concerns. 2 The nurse makes good eye contact with the patient. 3 The nurse skillfully inserts the tube and positions it. 4 The nurse holds the patient's hand and comforts the patient.

4 It is very important for the nurse to have a therapeutic relationship with the patient. By holding the patient's hands, the nurse extends caring touch to the patient, which in turn enhances the self-esteem and mental health of the patient. The patient is likely to feel more connected to the nurse rather than isolated. Caring touch increases comfort and security in the patient. The patient and the patient's caregivers may or may not feel embarrassed by holding hands.

The nurse holds the hands of a patient when talking to the patient during rounds. Which is a likely impact of the nurse's behavior? 1 The patient feels isolated. 2 It enhances the patient's physical discomfort. 3 The patient's caregivers feel embarrassed. 4 It enhances the self-esteem and mental health of the patient.

4 When the nurse is unable to deal with a patient's suffering, distancing oneself from the patient can help. This is a form of protective touch that protects the nurse emotionally. Continuing to care for and comforting the patient will not protect the nurse and would further increase the emotional turmoil. Distracting oneself from the symptoms is not a healthy practice and may result in symptoms becoming severe.

The nurse is caring for a patient who is in the terminal stage of a fatal disease. This is taking a toll on the nurse's emotional well-being. Which action is an example of protective touch that nurses can employ for their own well-being? 1 Continue caring for the patient. 2 Comfort and instill belief in the patient. 3 Encourage the patient to distract self from the symptoms. Correct 4 Distance oneself from this patient.

3 Attentive listening lets the nurse hear the patient's story and then correctly summarize it. Attentive listening does not occur when the nurse is distracted by equipment or other personnel. The importance of listening is not to distract the patient or solve the problem but rather to hear what the patient has to say and understand what the situation means to the patient.

The nurse is caring for an older adult who needs to enter an assisted-living facility following discharge from the hospital. Which is an example of listening that displays caring? 1 The nurse encourages the patient to talk about concerns while reviewing the computer screen in the room. 2 The nurse sits at the patient's bedside, listens as he relays his fear of never seeing his home again, and then asks if he wants anything to eat. 3 The nurse listens to the patient's story while sitting on the side of the bed and then summarizes the story. 4 The nurse listens to the patient talk about his fears of not returning home and then tells him to think positively.

3 The nurse asks the patient to keep faith in herself and reassures the patient that she will be the best mother. This indicates that the nurse is sustaining faith and encouraging optimism. Therefore, this indicates that the nurse is providing the caring process of maintaining belief, according to Swanson's theory of caring. Asking the patient about her feelings about her condition to determine her state of mind would indicate that the nurse is providing the caring process of knowing. Informing the patient about a proper diet during pregnancy would indicate that the nurse is providing the caring process of enabling. Encouraging the patient to attend all follow-up visits to ensure proper care would indicate that the nurse is providing the caring process of doing for.

The nurse is examining a pregnant American Indian patient. Which statement by the nurse indicates that the nurse is providing the caring process of maintaining belief, according to Swanson's theory of caring? 1 "You should eat a nutritious diet during pregnancy." 2 "You should tell me what you think about your illness." 3 "You need to keep faith that you will be the best mother." 4 "You need to attend all of your follow-up appointments without fail."

3 Knowing the patient is a very important component of nursing. Knowing the patient happens over time. This involves knowing and understanding the patient as a whole, including knowing the patient's disease and the needed interventions. Instilling faith is a component of nursing but not part of knowing the patient. Similarly, helping the patient perform daily activities is a part of nursing but not part of knowing the patient. Knowing the interventions and performing them skillfully depends on the nurse's understanding and ability.

The nurse is following Swanson's theory in caring for a patient. Which actions are included in knowing the patient? 1 Instilling faith in this patient 2 Helping the patient perform daily activities 3 Understanding the patient and the patient's suffering as a whole 4 Knowing the interventions that should be performed with the patient

2 The nurse is promoting transpersonal learning, as well as self-dependence and responsibility, by teaching a physically handicapped patient to acquire self-care skills. Encouraging the patient to express feelings helps to support the patient, and forming a human-altruistic value system helps to form a comfortable relationship with the patient but these carative factors do not promote transpersonal learning. Providing for existential-phenomenological-spiritual forces helps the nurse to understand the patient in a better way. However, this carative factor does not address teaching the patient self-care skills.

The nurse is teaching a physically handicapped patient to acquire self-care skills and to perform basic care. Which of Watson's carative factors does this illustrate? 1 Promoting expression of feelings 2 Promoting transpersonal learning 3 Forming a human-altruistic value system 4 Allowing for existential-phenomenological-spiritual forces

3 The nurse should try to understand the patient. The nurse should sit beside the patient, comfort the patient, and ask about any concerns. This helps the patient feel that the nurse is genuinely interested in caring. If the nurse continues the nursing tasks without speaking to the patient, it shows the nurse's indifference towards the patient. Similarly, leaving the room or asking somebody else to comfort the patient signifies the nurse's indifference.

The nurse needs to insert an intravenous (IV) line and measure urine output for a patient. The nurse enters the patient's room and finds the patient weeping. What should the nurse do first? 1 Finish any nursing tasks and leave the room. 2 Do not disturb the patient and come back later. 3 Sit down beside the patient and ask what's wrong. 4 Call any available family members to console the patient while the nurse finishes the tasks.

2 Visiting the patient every morning and evening for a chat helps in effective communication and the formation of a caring relationship. This is an example of the carative factor of developing a human caring relationship. An example of the carative factor of creative problem solving would be to help the patient with decision making. An example of the carative factor of promoting transpersonal teaching and learning would be to teach the patient proper skills for self-care. Caring for the patient from a spiritual aspect would address Watson's carative factor of providing for existential-phenomenological-spiritual forces

The nurse visits the patient for a chat every morning and evening. Which carative factor does this illustrate, according to Watson's theory of care? 1 Applying creative problem solving 2 Developing a human caring relationship 3 Promoting transpersonal teaching-learning 4 Allowing for existential-phenomenological-spiritual forces

1

The nurse wants to care for a patient using Swanson's theory of caring. Which is not one of the five processes of Swanson's theory of caring? Select all that apply. 1 Touching 2 Knowing 3 Being with 4 Enabling 5 Maintaining belief

1, 2, 4, 5 Watson's 10 carative factors are based on a transformative model that focuses on the relationship between the nurse and the patient. The components of this theory include cultivating sensitivity toward each other to help understand each other better. The theory also includes instilling faith and hope about the prognosis to promote healing. Another component of the theory is promoting transpersonal teaching and learning between the nurse and the patient to help build a trusting relationship. In Watson's view, caring preserves human dignity in the technological, cure-dominated health care system. Withholding the negative outcomes of a disease is not part of Watson's theory.

The nurse wants to follow Watson's 10 carative factors while caring for patients. Which are the characteristic features of this theory? Select all that apply. 1 Cultivating sensitivity toward each other 2 Instilling faith and hope about the prognosis to the patient 3 Withholding negative outcomes of the disease from the patient 4 Promoting transpersonal teaching and learning between the nurse and the patient 5 Preserving the patient's human dignity

3 Providing presence is a person-to-person encounter conveying closeness and a sense of caring. It involves being there and being with. Being there is not only a physical presence but also includes communication and understanding. Presence is an interpersonal process that is characterized by sensitivity, holism, intimacy, vulnerability, and adaptation to unique circumstances.

Which best describes presence? 1 A person-to-person encounter that enables patients to care for self. 2 A person-to-person encounter that provides personal care to a patient. 3 A person-to-person encounter that conveys closeness and a sense of caring. 4 A person-to-person encounter that describes being in close contact with a patient.

4 Caring for the family takes into consideration the context of the patient's illness and the stress it imposes on all family members. Making health care decisions for patients, having family members provide hygiene for the patient, and injecting the nurse's perceptions about the level of care provided are inappropriate behaviors.

Which example of caring behavior is considered important to the patients' well-being by families of acutely ill patients? 1 Making health care decisions for patients 2 Having family members provide a patient's total personal hygiene 3 Injecting the nurse's perceptions about the level of care provided 4 Asking permission before performing a procedure on a patient

1, 3, 4, 5 Watson's theory of caring comprises 10 carative factors: 1) expressing all positive and negative feelings, 2) instilling faith and hope, 3) developing a trusting relationship between the nurse and the patient, 4) forming a human value system, 5) cultivating sensitivity to others, 6) using creative problem-solving processes, 7) promoting transpersonal teaching-learning, 8) providing for a supportive and spiritual environment, 9) meeting human needs, and 10) allowing for existential spiritual forces. Withholding expression of negative emotions is not a carative factor.

Which factor in Watson's carative theory could the nurse utilize in any setting? Select all that apply. 1 Cultivating sensitivity to others 2 Withholding expression of negative emotions 3 Instilling faith and hope 4 Providing for a supportive and spiritual environment 5 Developing a trusting relationship between the nurse and patient

3 Encouraging flexibility and autonomy increases nursing satisfaction. When nurses' job satisfaction is high, they have a greater connectedness with their patients and believe that caring practices are part of the nursing culture. Increasing the working hours of staff usually decreases nursing satisfaction. Encouraging increased input concerning nursing functions from physicians decreases nursing autonomy and thus decreases nursing satisfaction. Decreasing salary benefits usually decreases job satisfaction.

Which is a strategy for creating work environments that enable nurses to demonstrate more caring behaviors? 1 Increasing the working hours of the staff 2 Decreasing salary benefits of the staff 3 Creating a setting that allows flexibility and autonomy for staff 4 Encouraging increased input concerning nursing functions from physicians

4 The risk of falls is high in patients with injuries from an accident. Therefore, the nurse holds the patient while walking and protects the patient from falling. This indicates that the nurse is using a protective touch. The nurse touches the patient's shoulder while talking to provide comfort or to convey presence to the patient. Shaking the patient's hand when being introduced or while greeting indicates a professional touch. Holding the patient's hand while completing a procedure indicates a task-oriented touch.

Which nursing intervention indicates a protective touch for a patient with a major injury after an accident? 1 Shaking the patient's hand while meeting for the first time 2 Touching the patient's shoulder while explaining a medication 3 Holding the patient's hand while starting an intravenous catheter 4 Holding the patient while assisting with walking

4 Active listening involves paying attention to the patient's words, expression, tone, and body language. Therefore, it is the best way to know the patient because it can provide insight into the patient's thought process. The nurse tries to provide comfort by his or her presence, but this is not a suitable method to properly understand the patient. Touching the patient may be either professional, protective, or comforting. However, it does not provide insight into the patient's thought process. Making eye contact with the patient is a nonverbal mode of communication that provides reassurance or comfort; however, it does not provide proper understanding about the patient's thoughts.

Which type of intervention is the best way to know the patient? 1 Presence 2 Touching 3 Eye contact 4 Active listening

1 By providing a hygienic environment, proper diet, and recreational facilities, the nurse is seeking to meet human needs, according to Watson's carative factors. Forming a caring relationship with the patient through effective communication is an example of applying Watson's carative factor of developing a trusting relationship. Applying the nursing process for decision making is an example of the carative factor of creative problem solving. The nurse promotes transpersonal teaching and learning when teaching the patient proper skills for self-care.

While caring for a patient in the home, the nurse ensures a hygienic environment, a proper diet, and recreation. Which of Watson's carative factors is the nurse following through this intervention? 1 Meeting human needs 2 Using creative problem solving 3 Developing a trusting relationship 4 Promoting transpersonal teaching-learning

4 The patient is in pain, so holding the patient's hand and sitting beside the patient will reduce the patient's pain and provide comfort, demonstrating the comforting approach. Stepping back to give the patient space would facilitate a protective approach and ensure that the patient does not come to harm, but it would not provide comfort. Speaking in a loud voice may startle the patient and increase the patient's pain. Therefore, that is not a comforting intervention. Smiling while communicating does not reduce the patient's pain, is not as beneficial as holding the patient's hand, and is not an example of the comforting approach.

While caring for a patient who is in severe pain, the nurse uses a comforting approach. Which nursing intervention is most beneficial in this situation? 1 Stepping back to give the patient space 2 Speaking to the patient in a loud and cheerful voice 3 Smiling and writing notes while listening to the patient 4 Sitting beside the patient and holding the patient's hand