Comm. 2
The nurse manager decides to initiate a mentoring program for new graduate nurses on a medical unit. The nurse manager should consider asking which of the following three nurses to serve as mentors? (Select all that apply) A. A nurse who excels in nursing knowledge and skills and has a positive attitude. B. A nurse who has excellent communication skills and a positive outlook. C. A nurse who is certified in psychiatric care and works in a mental health setting. D. A nurse who excels as a manager and has an advanced degree in administration. E. A nurse who is warm, empathetic, and has a passion for nursing and helpingothers.
A. A nurse who excels in nursing knowledge and skills and has a positive attitude. B. A nurse who has excellent communication skills and a positive outlook. E. A nurse who is warm, empathetic, and has a passion for nursing and helping others.
A nurse manager seeks to reduce staff nurses' stress and promote retention. It is most important for the nurse manager to take which action? A. Develop a mentoring program to provide cognitive and affective support. B. Focus on cognitive support instead of affective or physical support. C. Limit affective support to annual recognition of nurses' accomplishments. D. Place the highest priority on purchasing equipment to provide for physicalsupport.
A. Develop a mentoring program to provide cognitive and affective support.
The nurse manager of a critical care unit initiates a 360-degree feedback as a tool to aid in the development of the staff nurses. Who will provide feedback on each nurse's performance? A. Nurse manager, other staff nurses, and nursing assistants B. Patients, family members, and hospital volunteers C. Physicians, respiratory therapists, and other specialists D. Chief executive officer, nursing director, and nurse manager
A. Nurse manager, other staff nurses, and nursing assistants
A licensed practical/vocational nurse (LPN/LVN) consistently forgets to administer medications and asks the registered nurse (RN) for specific advice. It is most appropriate for the RN to make which statement? A. "Buy a digital watch with an alarm, and you will never forget again." B. "Something that helps me is to set the alarm on my watch as a reminder." C. "You should set the alarm on your watch as a reminder to give medications." D. "It is best if you set the alarm on your watch when the next medication is due."
B. "Something that helps me is to set the alarm on my watch as a reminder."
Several studies have demonstrated that perceived social support is related to improved outcomes. When assessing your patients, you remembered that the textbook author had described research involving several different groups that had greater outcomes when social support was present. Which of the following was not one of those groups? A. Secondary school teachers B. Neighbors C. Veterans D. Stroke survivors
B. Neighbors
Strongly supporting your peers on a nursing unit builds trust and camaraderie. In fact, it is the relationship that is built during the quiet days that we draw upon during stressful times, such as a cardiac code. Whether you are a manager or a peer, you can strengthen your team by all of the following except: A. Saying thank you B. Pointing out mistakes in front of others C. Looking for what is going well D. Sharing how much they are appreciated
B. Pointing out mistakes in front of others
A nurse is breastfeeding but has no private, sanitary area to pump breast milk while working. She also discovers that at least 10 other employees at the hospital have the same problem. Which action by the nurse would most likely result in acquiring a clean, private area to pump breast milk as required by law? A. The nurse demands that the nursing director provide a private area within 1 week. B. The nurse develops a clear, detailed plan and suggests several possible private areas. C. The nurse sends an e-mail to the nursing supervisor with a description of the problem. D. The nurse writes a letter to the nurse manager and asks others to add their signatures.
B. The nurse develops a clear, detailed plan and suggests several possible private areas.
he nurse cares for a patient who is admitted to the medical unit. The patient has type 2 diabetes mellitus, a blood glucose of 420 mg/dL, and a foot ulcer. Which statement, if made by the nurse, is appropriate when giving feedback to this patient? A. "I am going to tell you what you are doing wrong because I know about diabetes." B. "You have this foot ulcer because you did not follow your diet and exercise plan." C. "From my perspective, the foot ulcer occurred because your blood sugars are high." D. "I know you don't want to hear this, but uncontrolled diabetes leads to complications."
C. "From my perspective, the foot ulcer occurred because your blood sugars are high."
hree emergency department (ED) nurses are interested in initiating a new policy related to family presence during cardiopulmonary resuscitation (CPR). The steps a nurse would utilize to request support for initiation of this policy are listed below. What is the first step? A. The nurses review literature and survey ED nurses about family presence during CPR. B. The nurses practice their presentation to the nurse manager. C. The nurses identify the need to gain support from the nurse manager for thispolicy. D. The nurses decide to approach the nurse manager with their idea. E. The nurses develop a specific strategy to present the information to the nursemanager.
C. The nurses identify the need to gain support from the nurse manager for thispolicy.
A new graduate nurse feels that the staff nurses are not empathetic and do not provide reassurance or positive feedback. Which action by the graduate nurse is appropriate? A. Use an antagonistic approach to seek support from a nurse who is a mentor. B. Use a nonassertive approach to seek physical support from the staff nurses. C. Use an assertive approach to seek affective support from the nurse manager. D. Use an aggressive approach to seek cognitive support from other graduate nurses.
C. Use an assertive approach to seek affective support from the nurse manager.
A new nurse wants feedback from the other more experienced nurses on the unit. Which request for feedback, if made by the new nurse, would be most appropriate? A. "How do you think I am doing?" B. "I would like to know my strengths and weaknesses." C. "I still feel incompetent but would like some feedback." D. "What do you think about the accuracy of my assessments?"
D. "What do you think about the accuracy of my assessments?"
Which statement, if made by the nurse, could positively affect the course of the patient's situation by suggestibility? a. "Breastfeeding will provide time to bond with your baby." b. "Breastfeeding will take longer than giving your baby a bottle." c. "You will need to be careful about taking medications while breastfeeding." d. "Breastfeeding mothers can develop infections that are serious."
a. "Breastfeeding will provide time to bond with your baby."
Which three nurse statements are examples of expressing opinions in an assertive way with colleagues? (Select all that apply) a. "Do you think this project will help you learn about evidence-based practice?" b. "I will tell you about the evidence-based project, and you will want to help." c. "I recently attended an evidence-based conference. Can I share the highlights?" d. "I think we should be paid because this project will save money. What do you think?" e. "I really think you should read more evidence-based journal articles."
a. "Do you think this project will help you learn about evidence-based practice?" c. "I recently attended an evidence-based conference. Can I share the highlights?" d. "I think we should be paid because this project will save money. What do you think?"
The nurse is a member of a quality improvement project team to improve communication when a patient is transferred to another unit. Which statement by the nurse is appropriate to demonstrate positive regard for the team members? a. "We have done an excellent job." b. "We still have so much work to do." c. "Most of our suggestions did not work." d. "We won't win a prize for our work."
a. "We have done an excellent job."
The hospital nurse educator develops an educational session for staff nurses on how to clearly record data in a patient's electronic medical record. Which key point should the nurse educator include in the teaching plan? (Select all that apply) a. A patient who is at high risk for falls will require more frequent documentation. b. The nurse should avoid labels (e.g., good, drug seeking, and lazy) to describe patients. c. Detailed and specific documentation is only required if a malpractice suit is expected. d. Each entry by the nurse in the electronic medical record should be clear and concise. e. Documentation cannot be used to determine reimbursement for healthcare services. f. Exact statements (in quotations) from patients are more accurate than paraphrasing.
a. A patient who is at high risk for falls will require more frequent documentation. b. The nurse should avoid labels (e.g., good, drug seeking, and lazy) to describe patients. d. Each entry by the nurse in the electronic medical record should be clear and concise. f. Exact statements (in quotations) from patients are more accurate than paraphrasing.
A nurse who frequently corrects other staff nurses is trying to avoid making comments when it really does not matter. In which three situation(s) would it be appropriate for the nurse to remain silent and not share an opinion? (Select all that apply) a. A staff nurse reports a blood pressure as 110/60, but it is recorded in the chart as 114/62. b. A staff nurse takes a lunch break for 33 minutes instead of 30 minutes. c. A staff nurse gives a medication orally instead of by injection. d. A staff nurse reports no discrepancy for the narcotic count, but one is missing. e. A staff nurse does not pronounce the generic name of a medication correctly.
a. A staff nurse reports a blood pressure as 110/60, but it is recorded in the chart as 114/62. b. A staff nurse takes a lunch break for 33 minutes instead of 30 minutes. e. A staff nurse does not pronounce the generic name of a medication correctly.
As an experienced staff nurse, you have been asked to create a teaching guide for nursing orientation on respect. Accessing the list from Ehow about being genuine, you would include all of the following. (Select all that apply) a. Acting natural around others b. Listening when others are speaking c. Denying your mistakes d. Compliment only when you sincerely mean it e. Lying to make friends f. Skipping invitations to event you wouldn't genuinely enjoy
a. Acting natural around others b. Listening when others are speaking d. Compliment only when you sincerely mean it f. Skipping invitations to event you wouldn't genuinely enjoy
The author describes the patient journey as driving down a country road and somehow getting lost. At that moment and time, all that is needed is clear directions about how to get to your destination, not about types of entertainment in the area. The same is true for patients. Accordingly, a part of each nursing assessment should include: a. Patient's need for information and level of understanding b. Detailed overview of disease process c. Specific examples from other patients with same disease d. Nurse's feelings about newest treatment modality
a. Patient's need for information and level of understanding
One study of Italian primary care physicians caring for diabetic patients showed that those scoring highest on the empathy test had patients with: a. Significantly fewer acute diabetic complications b. Statistically fewer acute diabetic complications c. Higher rates of chronic diabetic complications d. Statistically higher poor outcomes for patients with diabetes
a. Significantly fewer acute diabetic complications
A teacher at a local elementary school asks a nurse to talk to the students about nutrition. Which response by the nurse is most appropriate? a. "I will teach the students how to read nutrition labels." b. "What would you like the students to learn about nutrition?" c. "The students need to know about the consequences of obesity." d. "I will enjoy teaching the students everything I know about nutrition."
b. "What would you like the students to learn about nutrition?
Which individual is displaying thoughts or actions that are genuine? a. A nurse who advocates for clients in order to qualify for a raise in personal hourly pay. b. A nurse who takes action to increase awareness of the need for cultural sensitivity. c. A nurse who supports a change in a project in front of supervisors but complains to staff. d. A nurse who verbally supports a new policy but does not follow the policy in practice.
b. A nurse who takes action to increase awareness of the need for cultural sensitivity.
n which situation(s) would it be appropriate for the nurse to communicate with empathy? (Select all that apply) a. An acquaintance who seeks a long-standing social relationship that is superficial. b. A patient who is anxious about a change in body image after a mastectomy. c. A supervisor who is searching for approval and recognition from staff. d. A colleague who expected a promotion but was not awarded the promotion. e. A client who has been alienated from family because of sexual orientation.
b. A patient who is anxious about a change in body image after a mastectomy. d. A colleague who expected a promotion but was not awarded the promotion. e. A client who has been alienated from family because of sexual orientation.
The nurse cares for a patient who becomes confused and a vest restraint is applied. The nurse should take which action when notifying the patient's family? a. Avoid discussing the treatment plan to reduce anxiety and worry. b. Ask another nurse who has rapport with the family to be present. c. Use medical terms to demonstrate competence. d. Assume that the family wants a detailed explanation
b. Ask another nurse who has rapport with the family to be present
Andy Andrews, a well-known author and speaker, was once homeless and lived on the streets for a season of his life. Discussing the lessons learned as he looked back over his journey, he was quoted as recommending one of the following as a key to moving forward: a. Ruminating about alternatives b. Asking proper questions c. Utilizing negative self-talk d. Increasing your self-advocacy
b. Asking proper questions
The nurse cares for a patient with a terminal illness. Which way would be the most therapeutic for the nurse to communicate with this patient? a. Use an honest, judgmental attitude. b. Demonstrate understanding with empathy. c. Acknowledge hope by expressions of sympathy. d. Consistently evaluate the patient's feelings.
b. Demonstrate understanding with empathy.
REAL conversations, as described by John Stoker (2013), should contain multiple facets. As a nurse, we know when approaching patients, our care should be REAL, meaning we should do all of the following except: a. Recognize judgments b. Express biased thoughts c. Ask questions d. Listen for verbal and nonverbal messages
b. Express biased thoughts
The nurse plans to use self-disclosure to aid a mother and father in the grieving process after the death of their child. The steps of a helpful self-disclosure appear below. What is the first step? a. Succinctly share a personal experience that is a similar grieving experience. b. Listen to the parents talk about their child and observe their movements and gestures. c. Reflect upon the parent's statements to communicate understanding. d. Seek verification that the self-disclosure was helpful to the child's parents.
b. Listen to the parents talk about their child and observe their movements and gestures.
A nurse is uncomfortable when asking patients about their sexual practices and behaviors. It is most appropriate for the nurse to take which action? a. Avoid asking these questions unless the patient initiates a discussion on sexual behaviors. b. Practice asking these types of questions in a simulated situation with a colleague. c. Ask a nurse who is comfortable with these types of questions to interview the patient. d. Tell the patient that asking sexual questions is difficult and uncomfortable for a nurse.
b. Practice asking these types of questions in a simulated situation with a colleague.
Which three technique(s) should be avoided when the nurse questions patients? (Select all that apply) a. Use questions that are worded clearly with words the patient understands. b. Provide a detailed explanation to introduce the rationale for the questions. c. Offer the patient options and tell the patient which option is preferred. d. Avoid asking a patient "why" by rephrasing the question if possible. e. Ask three to five questions at a time, and then allow the patient to answer.
b. Provide a detailed explanation to introduce the rationale for the questions. c. Offer the patient options and tell the patient which option is preferred. e. Ask three to five questions at a time, and then allow the patient to answer
A nurse openly and genuinely discusses thoughts and feelings about sexually transmitted infections with a group of college students. Which benefit(s) may occur for these college students? (Select all that apply) a. The college students are reluctant to continue discussions with the nurse. b. The college students develop a trusting relationship with the nurse. c. The college students question the nurse's credibility. d. The college students believe the information is reliable and accurate. e. The college students are able to express important concerns.
b. The college students develop a trusting relationship with the nurse d. The college students believe the information is reliable and accurate. e. The college students are able to express important concerns.
The nurse cares for an elderly patient in a long-term care center. Which would be inappropriate for the nurse to share with the client? a. Reminisce about birthday celebrations and inquire about the client's traditions. b. Use high levels of intimacy to help the client feel more comfortable with the nurse. c. Establish a helping relationship based on trust by sharing a personal story with the client. d. Share with the client how meditation decreased nausea during chemotherapy treatment.
b. Use high levels of intimacy to help the client feel more comfortable with the nurse.
An experienced nurse is supervising a student nurse in an acute care setting. Which statement, if made by the experienced nurse, would be most appropriate to help the student nurse establish credibility with other nurses on the unit? a. "It is impossible to be credible when you are a student because you lack experience." b. "Try to hide your feelings of inadequacy and portray a sense of confidence." c. "Be honest with the nurses about your strengths and about areas that need improvement." d. "It would help if you bring special treats for the nurses so that they will like you
c. "Be honest with the nurses about your strengths and about areas that need improvement
A nurse manager has set a goal to improve professional communication on the unit. The staff nurses have attended a session on how to distinguish between expressing opinions and giving advice. Which statement, if made by a staff nurse, indicates that further teaching is needed? a. "Nurses who express opinions give patients the opportunity to make choices." b. "Patient safety is enhanced if nurses have confidence in their ability to communicate." c. "Giving advice leads to independent decision making by patients." d. "Expressing opinions or recommendations is an assertive behavior."
c. "Giving advice leads to independent decision making by patients
The nurse instructs the nursing assistant to obtain temperatures on four patients and report abnormal findings immediately. Two hours later the nurse discovers that one of the patients had a fever that was not reported. The nurse is upset with the nursing assistant. Which statement, if made by the nurse, is concrete and specifically explains the nurse's feelings? a. "I am not dissatisfied with your performance, because we all make mistakes." b. "You must have misunderstood. I wanted to know about any elevated temperatures." c. "I am disappointed because you did not follow my directions." d. "You have made me so angry. Why did you not report the fever to me?"
c. "I am disappointed because you did not follow my directions."
A patient asks the nurse to make a decision for her about whether or not to continue taking hormone replacement therapy (estrogen). Which response by the nurse is most appropriate? a. "You should check with a doctor; I cannot give you advice about drugs." b. "My friend has taken estrogen for more than 5 years without any problems." c. "I can answer any questions you have but it is up to you to make this decision." d. "Herbal supplements were much better for me than prescription-strength estrogen."
c. "I can answer any questions you have but it is up to you to make this decision."
A new blood glucose bedside monitoring system is introduced at a staff meeting. A nurse who has previously used this system remembers that the meter would show error messages frequently. Which statement by the nurse demonstrates assertiveness? a. "Why did no one ask for my opinion? I should have been involved in this decision." b. "This meter does not work like it should, and I refuse to use this system ever again." c. "I had problems with this meter before, but I will use it and let you know what I think." d. "I have experience with this system, and there were never any serious problems."
c. "I had problems with this meter before, but I will use it and let you know what I think."
The nursing supervisor instructs a group of novice nurses about the appropriate use of self-disclosure with patients. The nursing supervisor determines that teaching was successful if the novice nurse makes which statement? a. "Self-disclosure provides an opportunity for the patient to understand the nurse." b. "It is better to disclose stories about others to maintain professional boundaries." c. "Self-disclosure may be used to build a trusting relationship with the patient." d. "A fabricated personal experience can be shared if the patient remains the main focus."
c. "Self-disclosure may be used to build a trusting relationship with the patient."
The nurse questions a patient with hypertension before developing a teaching plan. Which question, if asked by the nurse, is most appropriate? a. "How long have you had hypertension?" b. "Are you taking any blood pressure medications?" c. "What do you know about hypertension?" d. "Do you understand why salt is bad for you?"
c. "What do you know about hypertension?"
A young mother who fractured her leg is sobbing with her face hidden behind her hands. She says to the nurse, "I will not be able to work for at least 2 months. Without my job, I cannot pay my bills or take care of my baby. I am alone and do not have anyone to help me." Which response by the nurse accurately conveys empathy? a. "Why do you think that no one cares about you or will refuse to help you?" b. "I can see that you are hesitant about relying on others because of low self-esteem." c. "You seem worried about how you will be able to take care of yourself and your baby." d. "I am sorry that you are uncomfortable with asking others for help right now."
c. "You seem worried about how you will be able to take care of yourself and your baby."
A patient is attracted to the nurse and attempts to initiate a social relationship. It is most appropriate for the nurse to take which action? a. Encourage the client's behavior to develop a trusting nurse-client relationship. b. Inform the charge nurse of the situation and ask for a different patient assignment. c. Tell the patient that the relationship must remain professional at all times. d. Determine if the patient can be transferred to another nursing care unit.
c. Tell the patient that the relationship must remain professional at all times.
An experienced nurse supervises a novice nurse interviewing a patient. The experienced nurse should intervene if which is observed? a. The novice nurse uses simple language instead of medical terms. b. The novice nurse avoids asking the patient "why" questions. c. The novice nurse leaves the patient without providing feedback. d. The novice nurse asks mostly open-ended health history questions.
c. The novice nurse leaves the patient without providing feedback.
The nurse cares for a patient who complains of back pain. Which question should the nurse ask to obtain specific information about the back pain? a. "Would you like medication for the pain?" b. "What have you been doing in the last few days?" c. "Do you have a family history of osteoporosis?" d. "What do you think caused the back pain?"
d. "What do you think caused the back pain?"
According to the NCSBN, appropriate self-disclosure is a part of maintaining professional boundaries. Appropriate self-disclosure includes the following: a. Discussing intimate or personal values with patients b. Keeping secrets with a patient or for a patient c. Expressing you are the only one who truly understands patient d. Brief, focused, and only used if experience is similar
d. Brief, focused, and only used if experience is similar
According to a study by Robinson (2014), three parts of our true presence (how we connect with patients) are found in being: a. Friendly, kind, and sweet b. Genuine, gifted, and creative c. Humorous, partial, and grateful d. Genuine, attentive, and immersed
d. Genuine, attentive, and immersed
Which demonstrates the nurse's genuine concern for clients? a. Tell a patient who has a terminal illness that everything will be fine. b. Delay notifying the patient about the death of a dependent child. c. Provide a placebo to a patient in severe pain to assess for substance abuse. d. Inform the patient about a medication error along with symptoms to report.
d. Inform the patient about a medication error along with symptoms to report.
The nurse cares for the mother of a child who died in the emergency room as a result of an accidental poisoning. Which response by the nurse is appropriate? a. Place a greater emphasis on nonverbal aspects of empathy over verbal. b. Accurately reflect on the mother's feelings to convey understanding and concern. c. Repeat exact phrases stated by the mother to aid in expressions of grief. d. Reflect on the expressed feelings of the mother but with the nurse's own words.
d. Reflect on the expressed feelings of the mother but with the nurse's own words.
