NURS 1100 test 1 review questions
6. A nurse is preparing medications for a patient. The nurse checks the name of the medication on the label with the name of the medication on the health care provider's order. At the bedside, the nurse checks the patient's name against the medication order as well. The nurse is following which critical thinking attitude? 1. Responsibility 2. Humility 3. Accuracy 4. Fairness
1
1. When working with an older adult who is hearing-impaired, the use of which techniques would improve communication? (Select all that apply.) 1. Check for needed adaptive equipment. 2. Exaggerate lip movements to help the patient lip-read. 3. Give the patient time to respond to questions. 4. Keep communication short and to the point. 5. Communicate only through written information.
1, 3, 4
5. One element of clinical decision making is knowing the patient. Which of the following activities affect a nurse's ability to know patients better? (Select all that apply.) 1. Caring for similar groups of patients over time 2. Reading the evidence-based practices appropriate to patients 3. Learning how patients typically respond to their clinical situations 4. Observing patients 5. Engaging with patients experiencing illness
1, 3, 4, 5
9. A nurse is caring for a patient who has poor pain control. The patient has a history of opioid abuse. During the day, the patient made frequent requests for a pain medication. To make an effective clinical decision about this patient, the nurse needs to ask questions about the data available on the patient to make a thorough and thoughtful decision. The nurse asks herself, "How does my view about the patient's pain tolerance compare with the patient's, and does that pose a problem?" This is an example of: 1. A question about assumptions 2. A question about evidence 3. A question about procedure 4. A question about perspective
4
Which communication behavior would the nurse expect when assessing an 18 month old toddler? a. saying about 10 words b. pointing while grunting c. using four-word sentences d. making babbling sounds
a. saying about 10 words
Which quality is the most important tool the nurse brings to the therapeutic nurse-client relationship? a. the self and a desire to help b. knowledge of psychopathy c. advanced communication skills d. years of experience in psychiatric nursing
a. the self and a desire to help
When learning about the rules of leaders, which action of the nurse indicates effective implementation of the rules? Select all that apply. -communicating in a simple language with followers -giving an opportunity to the followers to express their views -instructing followers to decide the actions to be performed -avoiding communicating clear boundaries with followers -ensuring proper eye contact while communicating with followers
communicating in a simple language with followers, giving an opportunity to the followers to express their views, ensuring proper eye contact while communicating with followers
Which of the following rights of the "Five Rights of Delegation" would be considered the most important right of delegation? a. right person b. right supervision c. right circumstance d. right communication and direction
d. right communication and direction
Which consideration is most important for the nurse when planning to communicate with a preschool child? a.state of health b. developmental level c. ability for self expression d. fear of authoritarian figures
developmental level
The RN is communicating with the health care team regarding the delegation of tasks. Which factors can determine the quality of communication between the RN and the health care team? Select all that apply. -accuracy -effectiveness -responsiveness -meaningfulness -understandability
effectiveness, meaningfulness, understandability
Which nursing actions best promote communication when obtaining a nursing history? Select all that apply. -establishing eye contact -paraphrasing the client's message -asking "why" and "how" questions -using broad, open-ended questions -reassuring the client that there is no cause for alarm -asking questions that can be answered with a "yes" or "no"
establishing eye contact, paraphrasing the client's message, using broad open-ended questions
Which action should the nurse manager take when it becomes apparent that communication between the nurse and the client is consistently superficial? a. assess the client's ability to understand the nurse b. evaluate how well the nurse uses active listening c. reinforce to the client the importance of sharing d. review the nurse's use of questioning techniques
evaluate how well the nurse uses active listening rationale: effective active listening is critical to the development of meaningful, therapeutic communication between the nurse and the client. A lack of effective listening on the part of the nurse commonly results in superficial, ineffective communication.
Which nursing interventions would the nurse use to communicate effectively with the client who has undergone surgical treatment for laryngeal cancer? Select all that apply. -asking the client open-ended questions -providing the client with praise and encouragement -collaborating with a speech and language pathologist -using a high-pitched tone of voice to speak with the client -asking the client to make noise when immediate attention is required
providing the client with praise and encouragement, collaborating with a speech and language pathologist, asking the client to make noise when immediate attention is required rationale: after a surgery for laryngeal cancer, a client may not be able to talk because of removal of the vocal cords. praising or encouraging the client may help motivate the client to communicate more effectively. collaborating with a speech and language pathologist can help make the client aware of different ways to communicate effectively.
5. A nurse prepares to contact a patient's health care provider about a change in the patient's condition. Put the following statements in the correct order using SBAR (Situation, Background, Assessment, and Recommendation) communication. 1. "She is a 53-year-old woman who was admitted 2 days ago with pneumonia and was started on levofloxacin at 5 p.m. yesterday. She states she has a poor appetite; her weight has remained stable over the past 2 days." 2. "The patient reported feeling very nauseated after her dose of levofloxacin an hour ago." 3. "Is it possible to make a change in antibiotics, or could we give her a nutritional supplement before her medication?" 4. "The patient started to complain of nausea yesterday evening and vomited several times during the night."
4S, 1B, 2A, 3R
Which initial response would the nurse make to a 67 year old man with type 2 diabetes who sadly confides in the nurse that he has been unable to have an erection for several years? a. "at your age, sex isn't that important" b. "that is a natural occurrence at your age" c. "you sound upset about not being able to have an erection" d. "maybe its time for you to speak to your primary health care provider about this"
c. "you sound upset about not being able to have an erection"
Which example is a one-on-one communication between the nurse and another person? a. small-group communication b. intrapersonal communication c. interpersonal communication d. transpersonal communication
interpersonal communication
3. A nurse is using motivational interviewing with a patient. What outcomes does the nurse expect? (Select all that apply.) 1. Gain an understanding of the patient's health goals. 2. Direct the patient to avoid poor health choices. 3. Recognize the patient's strengths and support the patient's efforts. 4. Provide assessment data that can be shared with families to promote change. 5. Identify differences in patient's health outcomes and current behaviors.
1, 3, 5
2. Match the concepts for a critical thinker on the left with the application of the term on the right, Concepts for Critical Thinkers ___ 1. Truth seeking ___ 2. Open-mindedness ___ 3. Analyticity ___ 4. Systematicity Term Application a. Anticipate how a patient might respond to a treatment. b. Organize assessment on the basis of patient priorities. c. Be objective in asking patient questions. d. Be tolerant of the patient's views and beliefs.
1. C 2. D 3. A 4. B
9. Which strategies should a nurse use to facilitate a safe transition of care during a patient's transfer from the hospital to a skilled nursing facility? (Select all that apply.) 1. Collaboration between staff members from sending and receiving departments 2. Requiring that the patient visit the facility before a transfer is arranged 3. Using a standardized transfer policy and transfer tool 4. Arranging all patient transfers during the same time each day 5. Relying on family members to share information with the new facility
1. Collaboration between staff members from sending and receiving departments, 3. Using a standardized transfer policy and transfer tool
6. A patient states, "I don't have confidence in my doctor. She looks so young." What is the nurse's therapeutic response? 1. Tell me more about your concern. 2. You have nothing to worry about. Your doctor is perfectly competent. 3. You can go online and see how others have rated your doctor. I do that. 4. You should ask your doctor to tell you her background.
1. Tell me more about your concern.
3. A nurse has seen many cancer patients struggle with pain management because they are afraid of becoming addicted to the medicine. Pain control is a priority for cancer care. By helping patients focus on their values and beliefs about pain control, a nurse can best make clinical decisions. This is an example of: 1. Creativity 2. Fairness 3. Clinical reasoning 4. Applying ethical criteria
4
Which action would the nurse implement when assessing a client with a new diagnosis of syphilis? Select all that apply. -ask the client about med allergies -use the fingers of one hand to palpate the lesion -examine the client's lymph nodes for enlargement -gather info about any ulcers or rashes -perform a papanicolaou (Pap) test (smear) of the cervix -ask about the clients sexual activity and protection methods
ask the client about med allergies, examine the client's lymph nodes for enlargement, gather info about any ulcers or rashes, ask about the clients sexual activity and protection methods
The registered nurse is evaluating the statements made by a student nurse after teaching about the delegation communication template. Which statement made by the student nurse indicates a need for correction? a. "the delegation communication template would identify the priorities" b. "the delegation communication template would specify the deviations" c. "the delegation communication template would identify the appropriate resources" d. "the delegation communication template would include only the work that is to be delegated"
d. "the delegation communication template would include only the work that is to be delegated" rationale: the delegation communication template would emphasize the work that is not to be delegated. The delegation communication template would identify the priorities, such as what is to be done first. It would specify deviations, such as when to take an immediate action. It would identify the appropriate resources, including the individual consultants.
A child who recently suffered from a 3-day camping trip over spring vacation is brought to the clinic after a rash, chills, and low-grade fever develop. Which is most important info for the nurse to assess when taking the child's history? Select all that apply. - date of return to school - sports played on camping trip - history of allergic reactions - recent exposure to poison oak or ivy - number of children on trip
history of allergic reactions, recent exposure to poison oak or ivy
10. A nurse is giving a patient a medication and notices the dosage. From the nurse's experience, the dosage is higher than what is normally given. Which of the following steps should the nurse take to ensure a safe outcome for the patient? (Select all that apply.) 1. Wait until end of shift when there is time to check dosage with pharmacy reference. 2. Recognize how the nursing team communicates problems, and consult with charge nurse. 3. Hold the dose and confer with the ordering health care provider now. 4. Assess patient knowledge of what has been the routine dose for this medication. 5. Administer the medication and closely monitor patient response.
2, 3, 4
2. A patient has gone through a number of treatment changes during a shift of care. During the hand-off report, the nurse plans to communicate effectively with the nurse who will be caring next for the patient for which of the following reasons? (Select all that apply.) 1. To improve the nurse's status with the health team members 2. To reduce the risk of errors to the patient 3. To provide an optimum level of patient care 4. To improve patient outcomes 5. To prevent issues that need to be reported to outside agencies
2, 3, 4
8. A nurse is assigned to care for a woman who is expecting her first child. The nurse organizes herself and plans to gather data about the patient by applying Pender's health promotion model, including the patient's characteristics and experiences and situational influences. She plans to observe patient behavior and consider the patient's psychosocial issues. Such data will offer a clear understanding to help the nurse identify the patient's needs. This is an example of which of the following concepts? (Select all that apply.) 1. Diagnostic reasoning 2. Deductive reasoning 3. Inductive reasoning 4. Assessment 5. Problem solving
2, 4
8. A nurse works with a patient using therapeutic communication during all phases of the therapeutic relationship. Place the nurse's statements in order according to these phases. 1. The nurse states, "Let's work on learning injection techniques." 2. The nurse is mindful of biases and knowledge in working with the patient with B12 deficiency. 3. The nurse summarizes progress made during the nursing relationship. 4. After providing introductions, the nurse defines the scope and purpose of the nurse-patient relationship.
2, 4, 1, 3
A nurse enters a patient's room at the beginning of a shift to assess his condition following a blood transfusion. The nurse cared for the patient on the previous day as well. The patient has several issues he wishes to share with the nurse, who takes time to explore each issue. The nurse also assesses the patient and finds no signs or symptoms of a reaction to the blood product. The nurse observed the patient the prior day and sees a change in his behavior—a reluctance to get out of bed and ambulate. Which of the following actions improve the nurse's ability to make clinical decisions about this patient? (Select all that apply.) 1. Working the same shift each day 2. Spending time during the patient assessment 3. Knowing the early mobility protocol guidelines 4. Caring for the patient on consecutive days 5. Knowing the pattern of patient behavior about ambulation
2, 4, 5
4. Which techniques demonstrate a therapeutic response to an adult patient who is anxious? (Select all that apply.) 1. Matching the rate of speech to be the same as that of the patient 2. Providing good eye contact 3. Demonstrating a calm presence 4. Spending time attentively with the patient 5. Assuring the patient that all will be well
2. Providing good eye contact 3. Demonstrating a calm presence 4. Spending time attentively with the patient
4. The REFLECT model can improve learning after providing patient care. Place the steps of this model in the correct order: 1. Think about your thoughts and actions at the time of a situation. 2. Review the knowledge you gained from the experience. 3. Review the facts of the situation. 4. Set a schedule for completing your plan of action. 5. Consider options for handling a similar situation in the future. 6. Recall any feelings you had at the time of the situation. 7. Create a plan for future situations.
3, 1, 6, 2, 5, 7
7. A nurse has been caring for a patient with a chronic wound that has not been healing. The nurse talks with a nurse specialist in wound care to find alternative approaches from what the health care provider ordered for dressing the wound. The two decide that because of the patient's allergy to tape, a nonallergenic dressing will be used. The nurse obtains an order from the health care provider for the new dressing. After 2 days there is improvement in the wound. This is an example of which critical thinking standards? (Select all that apply.) 1. Clarity 2. Broadness 3. Relevance 4. Risk taking 5. Creativity
3, 4, 5
10. What outcome demonstrates the effective use of silence as a therapeutic communication technique? 1. The nurse feels like there was enough time to be therapeutic when communicating with the patient. 2. The patient states a preference to talk with another staff member. 3. The patient perceives having gained insight into the issue after the conversation. 4. The patient was able to drift off to sleep more easily.
3. The patient perceives having gained insight into the issue after the conversation.
7. The nurse applying effective communication skills throughout the nursing process should: (Place the following interventions in the correct order.) 1. Validate health care needs through verbal discussion with the patient. 2. Compare actual and expected patient care outcomes with the patient. 3. Provide support through therapeutic communication techniques. 4. Complete a nursing history using verbal communication techniques.
4, 1, 3, 2
A client is placed on a restricted diet. Which communication is best for the nurse to use when beginning to teach the client about the diet? a. asking about what type of foods the client usually eats b. telling the client that the diet must be followed exactly as written c. telling the client that the intake of foods on the list must be limited d. asking what the client knows about the diet that was prescribed
asking what the client knows about the diet that was prescribed
Which responsibility would the nurse manager assume when leading a case-management system? Select all that apply. -assessing the quality improvement constantly -coordinating communication among all systems -providing client care according to direct care nurse specifications -assisting clients in overcoming obstacles from screening to treatment -educating the staff of other departments about nursing care management (NCM)
assessing the quality improvement constantly, coordinating communication among all systems, educating the staff of other departments about nursing care management (NCM)
A client is admitted to the hospital with a tonic-clonic seizure after his seizures had been well controlled by phenytoin for 6 months. The client states, "I am so upset. I didn't think I was going to have any more seizures." Which response would the nurse make to the client? a. "Did you forget to take your medication" b. "You are worried about having more seizures?" c. "You must be under a lot of stress right now" d. "Don't be concerned, your medication can be increased"
b. "You are worried about having more seizures?" rationale: This response addresses the clients feelings and encourages communication.
Which step by the nursing student indicates a need for additional training regarding communicating with older adults with hearing problems? a. "refrain from speaking extremely slowly" b. "speak clearly by exaggerating his or her lip movements" c. "allow the client to ask questions when necessary" d. "ensure that the client knows that the nurse is talking"
b. "speak clearly by exaggerating his or her lip movements"
Which strategy would the nurse use to help a depressed, withdrawn client who exhibits sadness through nonverbal behavior? a. increase structured physical activity b. cope with painful feelings by sharing them c. decide which unit activities the client can perform d. improve the ability to communicate with significant others
b. cope with painful feelings by sharing them Rationale: sharing painful feelings reduces the isolation and sense of uniqueness that these feelings can cause; sharing of these feelings usually decreases depression. Increasing structured physical activity or deciding which unit activities the client can perform will do little to decrease the client's ability to communicate with significant others may be important for the future, if a problem exists, but the sharing of painful feelings is more important than improving communication with significant others
Which therapeutic communication technique is a coping strategy to help the nurse and client adjust to stress? a. sharing hope b. sharing humor c. sharing empathy d. sharing observations
b. sharing humor rationale: sharing humor is a therapeutic communication technique that involves using a coping strategy that adds and helps the nurse and client adjust to stress.
Which communication method would the nurse leader anticipate using when speaking to a group of clients about personal hygiene? Select all that apply -giving abundant info -being sensitive to nonverbal communication -providing the opportunist for dialogue and feedback -presenting information that addresses the listener's self interest -using primarily written methods, such as email and text messages
being sensitive to nonverbal communication, providing the opportunist for dialogue and feedback, presenting information that addresses the listener's self interest
When evaluating a group of nurses after teaching how leaders would maintain balance, which statement by the nurse indicates effective learning? a. "New leaders, in their zeal, keep control of their lives" b. "Good leaders use sophisticated methods of communication" c. "A good strategy for retaining control is to get control over communication" d. "Effective leaders provide time for balance of followers rather than having balance in their work lives"
c. "A good strategy for retaining control is to get control over communication" rational: maintaining balance is one of the rules of a leader. one good strategy for retaining control is to get control of communication.
During labor a client states that she does not want eye drop for ointment placed in her baby's eyes immediately after birth. How would the nurse respond? a. "the medicine protects your baby-thats why its used" b. "you'll have to check with your babysitter doctor about this c. "lets talk about why you don't want the medicine to be put in your baby's eyes d. "this medicine is required by law and should be administered right after the baby is born
c. "lets talk about why you don't want the medicine to be put in your baby's eyes
Which strategies will promote safety and quality of client care on the unit? Select all that apply. -communicate with clarity and precision when designing multidisciplinary plans of care -create a safety huddle so all health care professionals are aware of the clinical objectives -emphasize electronic communication is quick and most effective means of sharing information in all situations -conduct communication simulations to increase knowledge about expertise of other health care disciplines -explain effective communication will take more time and effort compared with ineffective communication
communicate with clarity and precision when designing multidisciplinary plans of care, create a safety huddle so all health care professionals are aware of the clinical objectives, conduct communication simulations to increase knowledge about expertise of other health care disciplines
Which response would the nurse make to a depressed client who asks, "do you think they'll ever let me out of here?" a. "we should ask your primary health care provider" b. "everyone says you're doing fine" c. "do you think you're ready to leave?" d. "how do you feel about leaving here?"
d. "how do you feel about leaving here?" rationale: this urges the client to reflect on feelings and encourages communication
Which assessment finding for a client with pneumonia would be most important for the nurse to communicate to the health care provider? a. cough productive of rust-colored sputum b. sharp chest pain with deep inspiration c. oral temp 103F (39.4C) d. respiratory rate 38 breaths per minute
d. respiratory rate 38 breaths per minute rationale: this indicates respiratory distress and the nurse would communicate the rate immediately to the provider and anticipate implementation of actions such as oxygen administration using a nonrebreather mask or mechanical ventilation. A cough productive with rust-colored sputum is typical with pneumonia. Sharp chest pain with deep inspiration may occur with inflammation of the parietal pleura. Fever is frequently seen with pneumonia.
To achieve the goal of effective communication while explaining changes to hospital rules to team members, which approach would the nurse leader follow? Select all that apply. -providing all the info related to the topic -explaining the reason behind the change -providing the opportunity for dialogue and feedback -using complex terms while addressing a diverse group -giving info that addresses the listeners self interest
explaining the reason behind the change, providing the opportunity for dialogue and feedback, giving info that addresses the listeners self interest
What activity would the nurse working in the fertility clinic perform with clients to help ease the feeling of isolation? a. teach them about infertility and its treatment b. identify activities that are interesting and satisfying c. explore ways to promote communication with family and friends d. explain to them that men and women cope differently with stressful situations.
explore ways to promote communication with family and friends
The nurse is getting ready to perform an initial assessment interview of an older adult who does not speak English and is hard of hearing. Which should be available before starting the interview to minimize communication problems that may lead to health disparity? a. wheelchair and hearing aid b. hearing aid and interpreter c. interpreter and sphygmomanometer d. wheelchair and sphygmomanometer
hearing aid and interpreter