Fundamentals- Communication
The nurse is explaining to colleagues the meaning of caring in nursing. Which statement by a colleague requires clairification?
"Caring is reflected when viewing the patient's illness as being of central importance."
The nurse explains to a colleague the relationship of compassion with competence. Which information, when stated by the colleague, would require correction by the nurse?
"Compassion can exist well without competence in nursing."
The nurse hears an unlicensed assistive personnel (UAP) speaking to an older adult patient in the home. The nurse should follow up with the UAP after hearing which statement?
"Drink this juice. It is good for you."
Which statement by the nurse reflects ethical knowing?
"Ethical knowing applies to every intentional nursing action that may be subject to being judged right or wrong."
Which nurse's statement illustrates awareness of the importance of culture to Boykin and Schoenhofer's nursing as caring theory?
"I need to actively engage in the caring process; cultural influences may positively or negatively affect the extent of my engagement."
The nurse is providing care to a pregnant client who has type 2 diabetes mellitus. The client has asked about how the medications she is taking will affect her fetus. How should the nurse respond?
"If you have any concerns about how your medication will affect your fetus, you should talk to your primary care physician."
The nurse preceptor explains ethical knowing to a nurse who has recently graduated. Which statement by the recently graduated nurse requires further teaching about ethical knowing?
"It is primarily concerned with moral codes."
Which statement by the nurse describes personal knowing?
"Knowledge is a journey toward self-actualization."
The patient asks the nurse about ways to decrease anxiety. Which is the best response from a nurse to implement presencing?
"Let me share several options with you, and you can choose."
The nurse manager is teaching the staff about substance abuse among nurses. Which statement by a nurse about risk factors requires further teaching?
"Nurses who are substance abusers feel they are vulnerable to addiction."
Which statement by the nurse indicates correct understanding of the principles of self-awareness? (Select all that apply.
"Self-awareness increases emotional control." "Self-awareness improves my self-esteem." "Nurses who practice holistic care are self-aware."
The nurse is discussing with a colleague how to apply Roach's theory of caring to clinical practice. Which statement represents the colleague's correct understanding of how confidence can affect cultural influences?
"The nurse's lack of confidence could interfere with patient trust, causing cultural barriers to be more challenging."
A client asks the nurse if the staff members make many mistakes because there are so many posters and signs about safety on the walls. Which response by the nurse is best?
"There is a potential for errors in all healthcare settings. The posters remind the staff and the clients of the need to work together to prevent them."
Which nurse's statement most accurately reflects self-awareness?
"When I'm challenged, I do not react emotionally."
A nurse is collecting data from a client for an admission nursing history. Which question by the nurse is best to open the discussion? A. "What brought you to the hospital?" B. "Would it help to discuss your feelings?" C. "Do you want to talk about your concerns?" D. "Would you like to talk about why you are here?"
A. "What brought you to the hospital?"
A client is admitted to the hospital with cirrhosis of the liver caused by long-term alcohol misuse. Which is the best response by the nurse when the client says "I really don't believe that my drinking a couple of beers a day has anything to do with my liver problem"? A. "you find it hard to believe that beer can hurt the liver" B. "how long is it that you have been drinking several beers a day?" C. "each beer is equivalent to one shot of liquor, so it's just as damaging to the liver as hard liquor" D. "do you believe that beer is not harmful even though research shows that it is just as bad for you as hard liquor?"
A. "you find it hard to believe that beer can hurt the liver"
Which interviewing skill is used when the nurse says "you mentioned before that you are having a problem with your colostomy?" A. focusing B. clarifying C. paraphrasing D. Acknowledging
A. focusing
When the nurse shows empathy to a patient in pain, which way of knowing is demonstrated?
Aesthetic
In caring for a deceased Jewish patient, the nurse understands that, according to the patient's religious beliefs, the deceased person must not be left alone. Realizing that other patients require intervention, the nurse assigns an unlicensed assistive personnel (UAP) to stay with the deceased patient until the family arrives. Which two knowing ways are demonstrated in the care of this patient?
Aesthetic and ethical
Which way of knowing encompasses the "art of nursing"
Aesthetic knowing
The nurse is comparing aesthetic knowing with ethical knowing. Which statement should the nurse identify as true about aesthetic and ethical knowing?
Aesthetic knowing is the art of nursing, while ethical knowing transcends mere following of moral codes
Which intervention is appropriate for caring for preschool children?
Allowing the patient's parents to stay during an examination
The nurse is planning care for an older adult client diagnosed with age-related macular degeneration (AMD) that is nonexudative. Which therapies should the nurse anticipate for this client? Select all that apply
Antioxidants Zinc
What nursing intervention is appropriate for a client with dry and cracked feet?
Apply lotion to the client's feet after bathing
A client who has had postoperative complications appears upset and agitated yet withdrawn. Which is the most appropriate statement by the nurse? A. "you seem distressed. Tell me why you are upset" B. "you've been having a pretty rough time recovering since surgery" C. "it's not uncommon to have complications after the kind of surgery that you had" D. "I'm not sure that I know everything that has been happening. Tell me what has happened to you since surgery"
B. "you've been having a pretty rough time recovering since surgery"
Which is the nurse doing when using the interviewing technique of attentive listening? A. Identifying the patient's concerns and exploring them with why questions B. Determining the content and feeling of the patient's message C. Employing silence to encourage the patient to talk D. Using nonverbal skills to display interest
B. determining the content and feeling of the patient's message
Which statement describes the following proverb? What you do speaks so loudly I cannot hear what you say. A. hearing ability is an important factor in communicating B. nonverbal messages are often more meaningful than words C. listening to what people have to say requires attention to what is being said D. when people talk too loudly, it is hard to understand what is being said.
B. nonverbal messages are often more meaningful than words
Which stage of the interview establishes the relationship between the nurse and the client? A. preinteraction stage B. orientation stage C. examining stage D. working staged
B. orientation stage
The nurse working in a healthcare setting is charged with inappropriate delegation after asking an unlicensed assistive personnel (UAP) to change the IV bag for a client. To which agency should this action be reported?
Board of nursing
According to Watson, which statement reflects the meaning of "transpersonal"?
Both nurse and client seek out meaning and connectedness.
A young adult who had a leg amputated because of trauma says, "no one ever choose to love a person with one leg". Which is the best response by the nurse? A. "you are a good-looking person, and you will have no trouble meeting someone who cares" B. "you may feel that way now, but you will feel differently as time passes" C. "do you feel that no one will marry you because you have one leg?" D. "how do you see your situation at this point"
C. "do you feel that no one will marry you because you have one leg?" -example of paraphrasing-
A client with chest pain is being admitted to the ED. When asked about next of kin, the client states "don't bother calling my daughter, she is always too busy". Which response is best? A. "your daughter might be upset if you don't call" B. "what does your daughter do that makes her so busy?" C. "is there someone else besides your daughter that I can call?" D. "I think that your daughter would want to know that you are sick"
C. "is there someone else besides your daughter that I can call?"
A client says "I am really nervous about having a spinal tap tomorrow". Which is the best response by the nurse? A. "i'll ask the doctor for a little medication to help you relax" B. "clients who have had a spinal tap say it is not that uncomfortable" C. "it's alright to be nervous, and I don't remember anyone who wasn't" D. "your physician is excellent and is very careful when spinal taps are done"
C. "it's alright to be nervous, and I don't remember anyone who wasn't" Therapeutic statement- recognizes clients feelings and give the client permission to feel nervous
A nurse must conduct a focused interview to complete an admission history. Which interviewing technique should the nurse use? A. probing B. clarification C. direct questions D. paraphrasing statements
C. direct questions
Which is being communicated when the nurse leans forward during the client interview? A. aggression B. anxiety C. interest D. privacy
C. interest
A nurse is changing a client's dressing over an abdominal wound. Which level of space around the client is entered during the dressing change? A. public B. social C. intimate D. personal
C. intimate
Which is the purpose of the use of humor by a nurse when interacting with a client? A. diminish feelings of anger B. refocus the client's attention C. maintain a balanced perspective D. delay dealing with the inevitable
C. maintain a balanced perspective
Which statement illustrates Jean Watson's theory of human care?
Caring relationships can have a positive impact on a patient's health.
The nurse is evaluating current practices that affect the self-esteem of staff members. Which behavior should the nurse address?
Comparing self with others
The nurse has recently returned to work after recovering from surgery. Having recently been a patient, which aspect about postsurgical patients would the nurse most likely have developed?
Compassion
Which is an example of empirical knowing?
Conducting an experiment
Several nurses are discussing the Joint Commission's 2016 National Patient Safety Goals during a staff meeting. Which element of performance should the nurses implement to meet the goal of identifying clients correctly?
Consistently using two methods to identify the client
A client is extremely upset and mentions something about a work-related issue that the nurse cannot understand. Which is the nurse's best response? A. "It's natural to worry about your job" B. "Your job must be very important to you" C. "Calm down so that I can understand what you are saying" D. "I'm not quite sure I heard what you were saying about your work"
D. "I'm not quite sure I heard what you were saying about your work"
A mother whose young daughter has died of leukemia is crying and is unable to talk about her feelings. Which is the best response by the nurse? A. "Everyone will remember her because she was so cute. She was one of our favorites." B. "As hard as this is, it is probably for the best because she was in a lot of pain." C. "She put up the good fight but now she is out of pain and in heaven." D. "It must be hard to deal with such a precious loss."
D. "it must be hard to deal with such a precious loss"
A client is exhibiting anxious behavior and states, "I just found out that I have cancer everywhere, and I don't have very long to live. My life is over." Which is the best response by the nurse? A. "it might be good if your family were here right now. Shall I call them?" B. "what might be the best way to approach this terrible news?" C. "that is so sad. You must feel like crying" D. "it sounds like you feel hopeless"
D. "it sounds like you feel hopeless" A) is an erroneous assumption and abdicates the nurse's responsibility to explore the patient's concerns immediately
Which statement about communication should the nurse consider to be accurate? A. Verbal communication is essential for human relationships B. Hands are the most expressive part of the body C. Behavior clearly reflects feelings D. Communication is inevitable
D. communication is inevitable
A nurse is caring for a client who is blind in the left eye and visually impaired in the right eye. Which actions should the nurse employ to promote communication with this client? A. touch the client's left arm before initiating a conversation B. ensure that the door to the client's room is on the client's left side C. close the window curtains and dim the lights before speaking with the client D. knock on the door and request permission to enter before approaching the client
D. knock on the door and request permission to enter before approaching the client
Which behavior would be considered a hinderance to self-awareness and thus self-care?
Denying prejudices
In which type of knowing are nurses engaging when going to the library to explore scientific research to help direct patient care?
Empirical
The patient tells the 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 patient describing?
Empowerment
In the context of Leininger's theory of culture care diversity and universality, which nursing action represents culture care accommodation and/or negotiation?
Encouraging the patient to tell the surgeon that she wants to speak with her tribal healer before deciding whether to have surgery
A hospital has created a culture of safety by providing organizational support for safety initiatives and by training and encouraging healthcare employees in the area of safety. What other step is needed to promote safety for everyone in the healthcare environment?
Engage clients in their own safety
The nurse manager promotes healthy nutrition for self-care. Which snacks should the manager encourage on the unit?
Fresh fruit and unsalted peanuts
A novice nurse has accepted a position on a medical-surgical unit at a local university hospital. In order to provide safe care to clients, the nurse should plan to develop which competency?
Functioning as a member of the healthcare team
Which nursing intervention is an example of confidence?
Getting promised information for the patient
The nurse is providing teaching on the recommended hearing tests for older adults. Which information should be included in this teaching?
Have a hearing test every 10 years until age 50 and then every 3 years.
While reviewing safety precautions with the staff in a long-term care facility, which step should the nurse emphasize that helps to promote a safe environment for the clients?
Have the client wear shoes with rubber skid-resistant soles.
The nurse is caring for a 3-year-old child who is in the hospital for the first time. The child appears frightened and is clinging to her parents. What action can the nurse take to help the child feel more secure if the child needs to stay at the hospital without her parents?
Have the parents bring comfort items from home to leave with the child
A client who is terminally ill says to the hospice nurse, "I'm afraid to die. Just thinking about it scares me so much." Which response by the nurse demonstrates compassion? (Select all that apply.)
Holding the client's hand Using attentive listening as a communication technique Maintaining eye contact with the client
The nurse is exploring strategies to improve safety on the unit. Which scheduling policy would be appropriate?
Implementing self scheduling
The nurse manager uses self-scheduling as a staffing model for the unit. Which benefit should the manager expect from this model?
It empowers nurses, allow for more rest, and improves safety.
The nurse is conducting a prenatal assessment on a client. Which finding indicates a risk of sensory impairment in the unborn child?
Lack of immunity to rubella
A client in the intensive care unit is combative and pulling at the endotracheal tube, which must remain in place. After exhausting all alternatives, the nurse applies soft restraints to protect the client's airway. Which action should the nurse take next?
Notify the primary healthcare provider.
There is a severe staffing shortage at the hospital. Which is the primary reason that nurses should support each other?
Nurses are inspired to care for others when they are cared for themselves.
A community nurse is teaching a group of graduate nurses about holistic care. Which statement by a graduate nurse requires additional teaching?
Nurses who are practicing the holistic approach seek to give clients information so that they may choose between traditional medicine solely and alternative medicine solely."
A complaint about unsafe working conditions should be reported to which agency?
Occupational Safety and Health Administration
The home healthcare nurse is traveling to a client's home for the first time. What observation would suggest a safety hazard for the nurse?
Porch steps that are broken and rotting
Reducing the risk of functional decline in older adults can help prevent which complication?
Pressure ulcers
A hospital has had higher than average reports of client handling and movement injuries. What could the nurse advocate for that could most help reduce the number of client handling injuries?
Purchase lifting devices
Which action by a nurse would require immediate intervention by another healthcare team member?
Recapping a needle while holding the cap
What are the two components of the sensory process?
Reception and perception
A client is experiencing visual overstimulation. What can the nurse do immediately to reduce this client's visual sensory overload?
Reduce the amount of light in the room by lowering shades and turning off overhead lights.
A client tells the nurse about having increasing difficulty seeing the print while reading a newspaper. Which tool should the nurse select to assess this client?
Rosenbaum eye chart
A client slams his fist against the wall and then silently stares out the window after being informed that he has incurable cancer. Which nursing behavior reflects the nurse's use of presencing in the client's care? (Select all that apply.)
Speaking with the client face to face and quietly sitting in the client's room
The nurse suspects that a peer is impaired. Which peer behavior should help alleviate the nurse's concern about possible impairment?
Steady gait
The nurse is providing care to a 12-year-old child with special needs and his caregiver. What strategies should the nurse help the caregiver teach the child to improve the child's safety?
Teach the child how to use a telephone to call for help
The nurse is caring for a 43-year-old client. What education should the nurse implement to best address the overall health promotion needs of someone in this age group?
Teach the client about age-appropriate medical screenings
Where does perception, or the awareness and interpretation of stimuli, take place?
The brain
Which nursing consideration reflects the nurse's application of Benner and Wrubel's theory of caring? (Select all that apply.)
The nurse is aware that caring is dependent on the context of the situation. The nurse acknowledges that their training influences caring. The nurse knows that caring is dependent on the client's capacities.
The experienced nurse teaches the newly graduated nurse about personal knowing. Which is an example of the use of self?
The nurse seeks a genuine relationship of trust between the nurse and patient
Which statement is an example of caring as an evolutionary process?
Throughout the life of the nurse, the nurse finds different ways to express caring.
The nurse preceptor is helping a new graduate care for an older adult patient in the clinic. Which behavior by the new graduate would require follow-up with the colleague?
Using simplified speech, with shorter sentences and words
The nurse is caring for a client with a self-reported latex allergy. Which strategy can the nurse use to ensure the safety of this client?
Wash hands after taking gloves off
Which nursing action is most appropriate when communicating with a client who has a hearing deficit?
Writing ideas or pantomiming as appropriate in order for the client to understand
A nurse is caring for a client with a genetic nerve disorder who has difficulty when attempting to move her tongue. The nurse recognizes that this may indicate a deficit in the functioning of which cranial nerve?
XII
The nurse is caring for a 230-lb client who needs to be repositioned every 2 hours. While repositioning the client, the nurse injured a muscle in her back. To prevent the injury and ensure safety for both the nurse and client, what should the nurse have done differently in this situation?
ask for help from another nurse
Which caring behavior or process is sometimes used interchangeably with other characteristics, such as sympathy, empathy, or caring?
compassion
The nurse frames a research study in Roach's theory of caring as the human mode of being. Which attribute should the nurse include in the six Cs of caring? (Select all that apply.)
compassion, competence, confidence,
The nurse seeks to prevent burnout and turnover in new graduates by using the Maslach Burnout Inventory. Which category is measured in the inventory? (Select all that apply.)
depersonalization, emotional exhaustion, and personal accomplishment.
After completing an assessment, the nurse determines a client is at risk for safety issues. Which data supports the nurse's conclusion?
dizziness with walking
Which nursing action reflects the principle of aesthetic knowing? (Select all that apply.)
empathy, holistic thinking, compassion, and sensitivity.
Which caring behavior or process reflects the client's development of the ability to autonomously identify their own health needs in lieu of being instructed on how to do so?
empowerment
What is vertigo?
feeling of rotation or imbalance.
The nurse is selecting sensory aids for a client with deficits in hearing and sight. Which aid would address both sensory deficits?
flashing alarm clock
A client who is living independently but needs skilled nursing services may take advantage of what type of healthcare?
home healthcare
An experienced nurse has accepted a new position in the mental health unit after working in the medical-surgical floor for the past 4 years. What training would be beneficial for the nurse to refresh before starting her new position?
how to manage aggressive behaviors
Which diagnostic test should the nurse use to assess hearing in an infant?
otoacoustic emissions test
The nurse is conducting a physical assessment on a client. Before placing the diaphragm of the stethoscope on the client's abdomen, the nurse states, "I'm going to listen to your stomach now. My stethoscope might be a little bit cold." Which way of knowing is reflected by the nurse's action?
personal
The nurse is presenting Mayeroff's theory on caring to colleagues. Which statement by a colleague indicates the need for further teaching?
"Caring requires the caregiver to inflict a specific direction in the growth of the other."
The nursing instructor asks the class to describe empirical knowing. Which statement by the nurse describing empirical knowing is accurate? (Select all that apply.
"It incorporates nursing-related facts." "It can be developed through ongoing academic education." "It includes observations related to nursing." "It is also called the science of nursing."