Communications - Exam 1

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When does most miscommunication errors occur?

during handoff reporting

offering general leads

encourage the patient to continue

termination phase

ends the relationship, includes discharge planning, agency referrals, arranging follow up appointments

most important strategy for empowerment

establish mutual goals for health care

social relationships

established and maintained to meet mutual need and or friendship purposes

trust

establishing this is the foundation of all relationships, development of a sense of interpersonal trust, a sense of feeling safe, is the keystone in the nurse patient relationship

when patients lose control over personal space they may ....

experience a loss of identity and self-esteem

moderate pitch and tone in vocalization

expressing in a voice that sounds rushed, high pitched or harsh versus soft, unhurried voiced that expresses genuine interest "I would like to hear more about what you are feeling"

Mary Mahoney

first African American nurse

Patient centered care

focus fully with patient to provide care that incorporates his or her values and preferences to give safe, caring, compassionate effective care

storming

focuses on poor and control issues, my way or the highway

helping relationships

has a specific health-related purpose and goals

what are the three major religion groups?

hindus, buddists, and muslims

Touch

important for elderly, immediately acknowledges a dementia patients stress, calls an agitated patient, provides a sense of security

Children ages 3-5 communication:

interpret language in a literal way, "being out to sleep" may mean death for a child who has lost an animal, PROVIDE OPTIONS

buddists believe:

1. all life is suffering 2. suffering can be extinguished by eliminating desire 3. eliminate desire by living a virtuous life

secondary groups

represent time limited relationships with an established beginning and end

three aspects to bridges to patient relationships

respect, caring, and empowerment

Team collaborative communication strategies

shared responsibility for maintaining open communication and engaging in mutual problem solving, decision making, and coordination of care

medical jargon

should be limited, the words we use should have similar meaning to us and the patient

slang and jargon

should not be used, different age groups and cultures my attribute different meanings to phrases

SBAR

situation, background, assessment and recommendation

Best way to provide information to elderly :

small segments

proxemics

the study of an individuals use of space, affected by culture, past experiences, time of day and age

validate patients worth

these communications are learned, convey caring send a message of individual worth, responses that affirm the right of the individual to be treated with respect, autonomy

caring

this behavior is not an emotional feelings, rather it is a chosen response to need

responsiveness to participants

use active listening, demonstration of empathy, and acknowledgment of the content and feelings of messages

children ages 1-3 communication:

use phrases rather than long sentences, repeat words for emphasis

summarization

used to review content and process, TELL ME

Minimal cues and leads

using phrases like "uh hu" and "go on" to further discussion

making observations

verbalizing what is observed or perceived

encourage patient involvement

we expect and encourage patients to assume responsibility for their own health, we do not say "I will tell you what to do"

advocate for patient when necessary

we must often have to assume an assertive style of communication to obtain the best care or services for out patients

Care of a culturally diverse patient includes:

1. calling patient by first and last name 2. speak clearly and spend time with them 3. explain treatment always 4. ask permission before doing anything

social loafing

when individual group members fail to do their part of work or skip or come late to group project meetings

Clinical decision making

1. Process information -seek more information if needed 2. Auto apply clinical knowledge - implement interventions 3. Reflect

General systems theory

Focused on interrelationships existing with a given system, collaboration with patients and other professionals, ask patient "what goal do you want to work on today together to meet?"

Giving recognition

Acknowledging; indicating awareness.

restating

Asking the patient to compare similarities or differences in ideas, experiences, or interpersonal relationships. Letting the patient know whether an expressed statement has been understood or not.

Dorothea Dix

Became the union army's superintendent of female nurses

Accepting

Conveying positive regard.

Important reflection question:

Have you shared your feelings with your family?

Communication deficit comment:

I understand that it is frustrating for you because you are unable to speak

Foundations of professional nursing practice

Nursing is as old as human kind, women practiced nursing informally, female family caregivers, no formal education, religious theme to caring for the sick, not always been identifiable as a distinct occupation

reflecting

Referring questions or feelings back to the patient so they may be recognized and accepted.

Innovations that foster safety

Support of effective health care teamwork, team culture of collaboration and cooperation, creating a non punitive culture

Harriet Tubman

known as the Moses of her people

paraphrasing

listening response used to check whether the nurses translation is correct, allows the nurse to summarize or streamline a statement made by the patient

Clarification

a brief question or a request for validation, for example "you stated earlier .....tell me more......"

Miscommunication is ....

a major causative agent in sentinel events, errors resulting in unnecessary death and serious injury

therapeutic use of self

a self-reflective practice empowers me to continually assess my communication skills

What may be the consequences for a simple patient privacy violation through social media? Select all that apply. a. State Board of Nursing censure b. Jail time c. Dismissal from nursing school d. Revocation of nursing license e. Monetary fine

a, c, d, e

The nurse demonstrates an understanding of mutuality when stating to the patient, a. "Mr. Jones, I thought we agreed that you would return to bed at this time." b. "Mr. Jones, I don't think you should sit in the chair." c. "Mr. Jones, I think you should go to bed now." d. "Mr. Jones, I would like you to go to bed now."

a. "Mr. Jones, I thought we agreed that you would return to bed at this time."

The nurse is caring for a patient who has just received biopsy reports that indicate recurrence of metastatic stage IV breast cancer. Which patient's statement best indicates the acceptance stage of death and dying? a. "The test results are positive." b. "The test results will be repeated next week." c. "The test results are negative." d. "The test results are incredible."

a. "The test results are positive."

Conveying genuine respect for his patients assists a nurse in doing what? a. Building a professional relationship b. Eliminating the sense of devaluation most nurses begin to feel c. Avoiding feelings of helplessness and inadequacy d. Avoiding the casualness depicted in bad TV shows

a. Building a professional relationship

Which of the following is NOT a specific way interpersonal health communication impacts health care service quality? a. Each communicator constructs a mental picture of the other during the conversation. b. Development of a workable treatment partnership. c. Better understanding of the patient's condition. d. More effective diagnosis and earlier recognition of health changes.

a. Each communicator constructs a mental picture of the other during the conversation.

When should the nurse first start planning for termination of the nurse-patient relationship? a. From the initial encounter b. After goals have been achieved c. When the patient requests it d. During the working phase of the relationship

a. From the initial encounter

Which of the following is true in relation to the use of humor? a. Humor and laughter have healing purposes. b. Humor is most effective when building rapport. c. Humor should focus on the patient's personal characteristics. d. Humor should dominate the situation.

a. Humor and laughter have healing purposes.

Which of the following best describes anticipatory grief? a. It can be colored by ambivalent feelings. b. It occurs after the actual death. c. It occurs when death was sudden and unexpected. d. Only the family of the dying patient experiences it.

a. It can be colored by ambivalent feelings.

The nurse is caring for an older adult patient who has recently experienced losses associated with deaths of important people in her life. The nurse recognizes that this type of problem challenges which of Maslow's hierarchy of needs? a. Love and belonging b. Physiological integrity c. Self-actualization d. Safety and security

a. Love and belonging

The nurse understands that as patients age, they are more likely to have vision problems that may interfere with the communication process, including the lens of the eyes becoming less flexible, making it difficult to accommodate shifts from far to near vision. The nurse recognizes that this condition is known by what term? a. Presbyopia. b. Receptive aphasia. c. autism d. Presbycusis.

a. Presbyopia.

Which of these statements is NOT true regarding nurses' use of social media? a. Privacy laws apply to photos, but not to videos if you avoid showing a face. b. A state board may act on complaints of privacy violations. c. Clicking "restricted access" does not quality as a private site. d. Confidentiality and privacy laws, such as HIPAA, apply to online postings.

a. Privacy laws apply to photos, but not to videos if you avoid showing a face.

Which of the following best describes the critical thinking skills of a novice nurse and an expert nurse? a. The expert nurse organizes data more efficiently than the novice nurse. b. The expert nurse is able to diagnose faster than the novice nurse. c. The expert nurse does not need to question and reassess like the novice nurse. d. The novice nurse uses past knowledge, whereas the expert nurse stays in the here and now.

a. The expert nurse organizes data more efficiently than the novice nurse.

Which of the following best describes the critical thinking skills of a novice nurse and an expert nurse? a. The expert nurse organizes data more efficiently than the novice nurse. b. The novice nurse uses past knowledge, whereas the expert nurse stays in the here and now. c. The expert nurse is able to diagnose faster than the novice nurse. d. The expert nurse does not need to question and reassess like the novice nurse.

a. The expert nurse organizes data more efficiently than the novice nurse.

A patient has been informed by her physician that she requires emergency surgery. The patient tells the nurse, "I will have the surgery after I attend my family vacation." Which of the following is the most appropriate mutual goal for the patient? a. The patient will alternate activity with rest throughout the day. b. The patient will accept the recommended medical regimen. c. The patient will check her blood pressure four times a day. d. The patient will take a leave of absence from her work schedule

a. The patient will alternate activity with rest throughout the day.

While professional values can be transmitted by tradition in nursing classes and clinical experiences, or modeled by expert nurses and assimilated as part of the role socialization process, which is perhaps the best method of acquiring them? a. The value should be the result of conscious choice. b. The value must be acted upon in a pattern of behavior consistent with the choice. c. The value must be chosen after careful consideration of each alternative. d. There must be pride in and happiness with the choice.

a. The value should be the result of conscious choice.

When conducting an assessment interview, which of the following is the best communication technique for the nurse to use? a. Use short, unambiguous listening responses focused on current health issues and patient concerns. b. Ask multiple questions at the same time. c. Ensure that all questions are answered immediately in order to avoid the need for related follow-up questions to clarify. d. Offer limited time for the patient to respond to each question that is asked.

a. Use short, unambiguous listening responses focused on current health issues and patient concerns.

A patient diagnosed with dementia is becoming increasingly unable to express complete thoughts and is having difficulty engaging in simple conversations. When communicating with this patient, the nurse should implement what intervention to help maintain communication skills a. Use words directly applicable to the patient's daily routine. b. Refrain from validating the meaning of the patient's responses. c. Ask the patient questions that require more than a yes or no answer. d. Restate ideas using different words in a different sequence.

a. Use words directly applicable to the patient's daily routine.

The nurse puts his arm around an older adult patient when assisting her to transfer to a chair. The patient could interpret the nurse's touch as a. a positive gesture only. b. denotation. c. paralanguage. d. a threat.

a. a positive gesture only.

The nurse enters a patient's room with the intent of allowing the patient to express feelings in relation to her new cancer diagnosis. The nurse notices that the patient is crying and guarding her incision site. After validating physical discomfort, the nurse should a. administer an analgesic and postpone the interaction. b. explain that pain is expected following surgery but that it is b. important to increase activity to avoid complications. c. acknowledge the physical pain but state that it is a priority to immediately address the emotional pain. d. sit with the patient and hold her hand

a. administer an analgesic and postpone the interaction.

The nurse is caring for a patient who is experiencing a crisis situation. The nurse recognizes that after feeling a sense of shock, the patient will go through a period of recoil in which the patient a. behaviors can appear normal to outsiders. b. experiences variations in emotions. c. achieves at least precrisis functioning. d. takes constructive actions to face and resolve the reality issues present.

a. behaviors can appear normal to outsiders.

Maria was told she looks older than she is, this is an example of a. biological age b. psychological age c. chornological age d. social age

a. biological age

What tool for safer care is designed to increase cognitive decision-making skills, increase technical proficiency, and enhance teamwork, including communication skills? a. clinical simulation situations b. team training models c. SBAR d. checklists

a. clinical simulation situations

In order to reduce clinical bias in nursing practice, the nurse should a. develop unconditional acceptance. b. recognize that individuals of the same religion share the same characteristics. c. memorize beliefs held by different cultures. d. generalize beliefs based on ethnic membership.

a. develop unconditional acceptance.

The nurse performs a dressing change using sterile technique. This is an example of which pattern of knowledge? a. empirical b. ethical c. personal d. aesthetic

a. empirical

Nonverbal communication transcends all cultures. a. true b. false

a. true

Restatement

active listening strategy used to broaden a patients perspective, example "let me see if I have this right ......."

sundowning in dementia patients

agitated behavior symptoms, usually occurring later in the day, common behaviors include fretfulness, anxiety, and demanding behaviors, days and nights are reversed, sleep is disturbed, keep patient active during the day

Communication can be affected by (select all that apply) a. location b. time of day or season c. physical proximity

all of the above

Self awareness of personal vulnerabilities and prejudices -

allow nurses to maintain neutrality and understanding needed for therapeutic exploration of patient issues

giving broad opening

allowing the patient to chose the topic themselves

Using silence

allowing the patient to take control of the discussion if they so desire

Palliative care

as a patients life limiting condition progresses, palliative care supports living while dying as comfortably as possible

encouraging comparison

asking client to compare similarities and differences in ideas, experiences, or interpersonal relationships

When communicating with a patient's physician, the nurse suggests ordering a STAT chest X-ray for a patient who is experiencing dyspnea. This is an example of which component of the SBAR format for communicating with the patient's physician? a. assesment b. recomendation c. background d. situation

b. recomendation

A nurse is required to provide all information specific to a prescribed treatment, and offer the chance to ask questions or share concerns before requesting a signature on a consent form to which client? a. An emancipated minor. b. A physically disabled 30-year-old c. A 17 year old child a sudden life-threatening injury. d. An adult who fell and fractured a femur whose blood alcohol level is 0.13%

b. A physically disabled 30-year-old

Which of the following statements does NOT adequately describe evidence-based practice? a. Translating knowledge into practice using findings from multiple empirical studies to help solve clinical problems. b. Application of standards of professional communication necessitates use of critical thinking and problem-solving skills in all aspects of care. c. Guidelines to clinical behaviors compiled from the best current research evidence available and the expertise of clinicians. d. A conscious choice to use the most current research to provide "best care."

b. Application of standards of professional communication necessitates use of critical thinking and problem-solving skills in all aspects of care.

An individual is getting married and just mapped out a career path plan with a mentor. This individual is most likely in the _____________ stage of development. a. Emerging adulthood b. Early adulthood c. Adolescence d. Middle adulthood

b. Early adulthood

When working on a psychiatric unit, the nurse recognizes that indicators of potential violence include which of the following? (Select all that apply.) a. Coherent speech b. Exaggerated gestures d. Orientation d. Prolonged eye contact e. Confusion

b. Exaggerated gestures d. Prolonged eye contact e. Confusion

When should the nurse first start planning for termination of the nurse-patient relationship? a. When the patient requests it b. From the initial encounter c. During the working phase of the relationship d. After goals have been achieved

b. From the initial encounter

A breast cancer support group is the best example of what type of group structure? a. Heterogeneous b. Homogeneous c. Private d. Closed

b. Homogeneous

What intervention should the nurse use to assess the cognition of an illiterate patient? a. Have the patient spell the word "world" forwards. b. Instruct the patient to state the days of the week backwards. c. Ask the patient to perform serial 7s. d. Have the patient spell the word "world" backwards.

b. Instruct the patient to state the days of the week backwards.

When caring for a preschooler, the nurse understands that this child tends to interpret language in a literal way and that the child will not ask for clarification, leading to a misunderstanding of messages. The nurse recognizes a preschooler is in which of Piaget's cognitive stages of development? a. Concrete operations b. Preoperational c. Sensorimotor d. Formal operations

b. Preoperational

The group leader states, "Today we discussed some of the issues about taking medications, and each one of you developed a goal in relation to some of the problems you were experiencing. I think it was helpful that some of you were able to share your experiences with other group members." The leader's statement is an example of what leadership technique? a. Harmonizing b. Summarizing c. Compromising d. Encouraging

b. Summarizing

The nurse is assigned to provide a bed bath to a patient who cannot speak English. Which of the following communication tools or strategies should the nurse use? a. Family member as interpreter b. Trained interpreter c. Other staff member who speaks the same language d. Nonverbal communication

b. Trained interpreter

Immediately after making a medication error, the nurse seeks out the nurse manager and self-reports the error. a. autonomy b. accountability c. veracity d. non-maleficence

b. accountability

The nurse asks a newly admitted patient, "Can you tell me what brought you to the hospital today?" The purpose of an open-ended question is to a. influence the direction of an acceptable response. b. allow patients latitude in telling their story. c. allow the patient to engage in a passive relationship with the nurse. d. encourage the patient to answer the question with a one-word response.

b. allow patients latitude in telling their story.

The nurse performs hand hygiene before providing client care a. Autonomy b. beneficence c. confidentially d. justice

b. beneficence

The nurse performs the "Rights" of medication administration prior to administering the client's medication. a. Autonomy b. beneficence c. confidentially d. justice

b. beneficence

Ethel, who is 80 years old, lost her husband last year, and her children hardly ever come to visit. She looks back on her life with a lot of regret. According to Erik Erikson she is experiencing: a. stagnation b. despair c. isolation d. depression

b. despair

When the nurse asks a patient, "How are you?" the patient states, "I am fine." As the patient turns away, she is crying. This is an example of a. nonverbal communication. b. incongruence. c. congruence. d. proxemics.

b. incongruence.

During the preoperational period the nurse recognizes that children a. can process auditory information quickly. b. misunderstand messages quite easily. c. can clearly distinguish between fantasy and reality. d. ask numerous questions to clarify a message.

b. misunderstand messages quite easily.

A patient with schizophrenia has been stabilized on long-acting haloperidol, an antipsychotic medication that is administered by injection every 3 weeks. The physician switches the medication to Seroquel, a new antipsychotic oral medication that is administered twice a day. The patient complains that he cannot afford the new medication and will not be able to remember to take it. The physician replies, "I can't help that; I have to treat you the way I think is best." The patient's nurse may experience a. paternalism. b. moral distress. c. nonmaleficence. d. cognitive dissonance.

b. moral distress.

The nurse is caring for a child with a severe illness who is demonstrating behaviors that are reminiscent of an earlier stage of development. When the child has toileting accidents, the nurse should a. recommend a urology consult. b. reassure the child's parents that this is common. c. eliminate all fluids after dinner. d. obtain a urine sample and send it to the lab

b. reassure the child's parents that this is common.

The nurse is caring for a family that is experiencing a crisis. The nurse recognizes that interventions for initial family responses to crisis include a. providing the family with information that is lengthy and abstract. b. repeating and frequently reinforcing information. d. minimizing the family's sense of control within the hospital environment. d. prohibiting extreme expression of feelings.

b. repeating and frequently reinforcing information.

When communicating with a patient, the nurse recognizes that a barrier to effective communication is a. cultural sensitivity. b. thinking ahead to the next question. c. completion of physical care in a nonhurried manner. d. focusing on the current questions asked by the patient.

b. thinking ahead to the next question.

Culture competence has nothing to do with being .....

bilingual and communicating better

During a support group meeting, a group member makes several sexually provocative remarks toward the group leader. What is the best response made by the group leader? a. "I don't appreciate what you are saying, you are excused from the group until you are more respectful." b. "What do you think your fellow group member is trying to tell us?" c. "Our group work is of the highest priority; please align your remarks with the group purpose." d. "I want to discuss your sexually provocative remarks privately after this meeting."

c. "Our group work is of the highest priority; please align your remarks with the group purpose."

The nurse while providing bedside care for an unconscious patient, is overheard stating, "I wouldn't want to live in this condition." What did this nurse not realize about the patient's capabilities? a. The patient has the right to respect regardless of condition. b. The standard of care has not been met with regards to this nurse's actions. c. Hearing can remain acute in patients who are not fully alert. d. The nurse has a duty to act as the patient's advocate.

c. Hearing can remain acute in patients who are not fully alert.

A nursing student has been attending a session on proper therapeutic communication techniques. Which of the following indicates a correct understanding of the term giving recognition? a. Throughout the conversation, I should clarify the timeline of events. b. When speaking to the client, I should encourage the client to continue speaking. c. I should indicate awareness of what the client is saying and feeling. d.Periodically, I should express what I have perceived as being said.

c. I should indicate awareness of what the client is saying and feeling

An older adult patient is admitted to the hospital with terminal cancer. The patient expresses acceptance of impending death and states, "I am very satisfied with the life I had." The nurse recognizes the patient is in Erikson's stage of psychosocial development known as which of the following? a. Intimacy vs. Isolation b. Autonomy vs. Shame and Doubt c. Integrity vs. Despair d. Identity vs. Identity Diffusion

c. Integrity vs. Despair

The nurse is caring for a Hispanic patient. When communicating with the patient's family about the patient's illness, which family member should the nurse contact? a. Oldest female family member b. Oldest daughter of patient c. Oldest male family member d. Oldest son of patient

c. Oldest male family member

Which of the following statements about communication theory is true? a. Primates are able to learn new languages to share ideas and feelings. b. Past experience does not influence communication. c. Perceptions are clarified through feedback. d. Concepts include only verbal communication.

c. Perceptions are clarified through feedback.

Which of these statements is NOT true regarding nurses' use of social media? a. Confidentiality and privacy laws, such as HIPAA, apply to online postings. b. Clicking "restricted access" does not quality as a private site. c. Privacy laws apply to photos, but not to videos if you avoid showing a face. d. A state board may act on complaints of privacy violations.

c. Privacy laws apply to photos, but not to videos if you avoid showing a face.

A patient insistence on being transferred to a new facility at another hospital. The patient is demanding a second opinion stating, "They must have made a mistake." The nurse recognizes that the best communication technique to use with this patient is to do what? a. Acknowledge the patient's feelings. b. Summarize the patient's behavior. c. Reflect the patient's behavior. d. Clarify the patient's response.

c. Reflect the patient's behavior.

When a night shift nurse completes a shift, she gives a report about her patients to the oncoming day shift nurse. When beginning the report, the night shift nurse introduces herself and states her role, states the patient's name, identifiers, age, sex, and location. Which of the following should the nurse do next? a. Talk about any anticipated changes in the plan of care b. List current medications and patient's family history c. Relate patient's chief complaint, vital signs, symptoms, and diagnosis d. State critical lab reports, allergies, and alerts

c. Relate patient's chief complaint, vital signs, symptoms, and diagnosis

Group members are encouraged to express their feelings about one another and suggestions for future growth when which phase of group development is reached? a. Engagement b. Active intervention c. Termination d. Formative phase

c. Termination

What is the primary difference between a therapeutic helping relationship and a social relationship? a. The amount of listening that is needed. b. The degree of worth to participants. c. The focus of the relationship. d. The enjoyment derived.

c. The focus of the relationship.

A patient with a history of violence is admitted to a psychiatric unit. The nurse observes the patient pacing the halls and speaking to other patients in a menacing way. The nurse is concerned that the patient will become physically violent. The nurse should initially a. enocurgage the patient to stop pacing and sit down b. increase environmental stimuli by promoting more sensory input. c. call the patient by name using a low, calm tone of voice. d. refrain from medicating the patient.

c. call the patient by name using a low, calm tone of voice.

When visiting a patient, the home health nurse notes that the patient frequently shifts the conversation to reminisce. Which communication techniques would be most effective for the nurse to use with this patient? a. providing infromation b. changing the subject c. infromation gathering d. restating

c. infromation gathering

Message competency refers to which phase of the nursing process? a. planning b. assessment c. intervention d. evaluation

c. intervention

An individual who is 8 years-old but has the mental capacity of a 3 year-old is an example of a. biological age. b. social age. c. psychological age d. chronological age

c. psychological age

In the circular transactional model of communication, a. the context of the communication is unimportant. b. people take only complementary roles in the communication. c. questions are framed in order to recognize the context of the message d. the purpose of communication is to influence the receiver.

c. questions are framed in order to recognize the context of the message

When communicating with a patient's physician, the nurse suggests ordering a STAT chest X-ray for a patient who is experiencing dyspnea. This is an example of which component of the SBAR format for communicating with the patient's physician? a. background b. situation c. recommendation d. assessment

c. recommendation

The nurse is caring for a patient who is becoming increasingly short of breath. The nurse decides to call the physician. Which of the following should the nurse initially do when speaking with the physician? a. tell what is needed b. state the patients allergies c. state the problem d. relate the patients backgrounds

c. state the problem

The nurse is caring for a patient who has just experienced the death of a parent. How can the nurse best demonstrate support for the patient during this period of grief? a. I'll have the institution's chaplain spot in to visit with you b. Gently reminding the patient that the parent lived a long life. c. the patient how they can best be supported. d. Sitting quietly with the patient and not discussing the loss.

c. the patient how they can best be supported.

The nurse is caring for a postpartum patient who is African American. The nurse recognizes that an essential component for successful communication when interacting with this patient is the use of a. folk-healing strategies. b. only simple language strategies. c. trust development. d. clergy in treatment plans.

c. trust development.

primary groups

characterized by an informal structure and close personal relationships

placing the event in time or sequence

clarifying the relationship of events in time

Quality improvement

collect data common outcome measures of our care to compare with accepted outcomes

The joint commission states that most sentinel events are caused by .....

communication errors

When educating a student nurse about the definition of a crisis state, the nurse recognizes that additional instruction is needed when the student nurse states a. "A crisis state creates a temporary disconnect from attachment to others." b. "A crisis state is a mental illness." d. "A crisis state represents a personal response." d. "A crisis state is an acute normal human response."

d. "A crisis state is an acute normal human response."

When you are administering medications to a patient with human immunodeficiency virus (HIV), the patient states, "I should just stop taking them and get it over with." A therapeutic response by the nurse would be a. "You're just feeling depressed right now. You'll feel better later." b. "You have to take these! If you stop you will get very sick." c. "You have the right to refuse treatment." d. "Tell me more about what you're feeling."

d. "Tell me more about what you're feeling."

A patient states, "I can't sleep all night because the nurses are noisy." Which of the following responses by the nurse best represents the nurse's recognition of the patient's theme? a. "I will speak to the supervisor about your complaint." b. "I will tell the night nurses that you complained." c. "You need to understand that nurses communicate with other patients during the night." d. "You cannot sleep because of the noise level at night?"

d. "You cannot sleep because of the noise level at night?"

A school-aged child is admitted to the hospital because of an accident during gymnastics. The child complains of not feeling her legs. The child's parents ask the nurse, "What is going to happen to our daughter? Will she walk again?" The best response by the nurse is a. "I'm sure everything will be okay. She is in good hands." b. "You will have to ask the doctor; he is in surgery right now." c. "The best thing you can do for your child is to act like everything is alright." d. "You must have several fears and concerns. We will let you know the test results as soon as they are available."

d. "You must have several fears and concerns. We will let you know the test results as soon as they are available."

The history of nursing and nursing education is rich. Nursing was quick to allow people of all races, however was slow to allow men into the fold. The first man to be accepted into the military nursing services was a. Joe Hogan b. Luther Christman c. Steve Miller d. Edward T. Lyon

d. Edward T. Lyon

A nurse attends an in-service aimed to educate staff about reporting hospital errors. The nurse demonstrates understanding when listing which of the following as being NOT consistent with creating a culture of safety? a. Installing a nonpunative reporting system b. Creating a way to advise and compensate harmed patients c. Supporting care providers after adverse events d. Ensuring the negative consequences of disclosing errors serve as a guide

d. Ensuring the negative consequences of disclosing errors serve as a guide

The nurse recognizes an effective group includes which of the following characteristics? a. Power resides in the leader and is not shared to assure focus on goals. b. Member are encouraged to express feelings when they align with group goals. c. Communication is guarded to assure group time is used effectively. d. Goals are clearly identified and collaboratively developed to assure group focus

d. Goals are clearly identified and collaboratively developed to assure group focus

Characteristics of a critical thinker include all but which of the following? a. Anticipating consequences b. Revising actions based on new input c. Considering alternative solutions d. Haphazardly seeking solutions

d. Haphazardly seeking solutions

When members of a group experience controversy, conflict, and disagreements, the nurse leading the group recognizes the importance of leadership role? a. Having members introduce themselves and share a little of their background or their reason for coming to the group. b. Focusing on working together and participating in another person's personal growth. c. Encouraging member contributions and emphasizing cooperation in recognizing each person's talents related to group goals. d. Helping members in accepting differences in member perceptions as being normal and growth producing.

d. Helping members in accepting differences in member perceptions as being normal and growth producing.

Which of the following is a description of metacommunication? a. Nonverbal communication b. Communication style c. Verbal communication d. Nonverbal and verbal communication

d. Nonverbal and verbal communication

Identify the type of perceptual alteration represented in the following example: Jim, a 12-year-old, states, "I am different from others in my physical education class because I am the class dunce." a. Cognitive distortion b. Selective attention c. Distorted reality d. Self-fulfilling prophecy

d. Self-fulfilling prophecy

Which of the following should be achieved first in establishing the nurse-patient relationship? a. Empathy b. Mutuality c. Empowerment d. Trust

d. Trust

A patient is admitted to a psychiatric unit for crisis intervention. When caring for this patient, the nurse recognizes that crisis intervention is a. a system for focusing on future problem-solving skills. b. a time-limited treatment focused on the immediate problem and its resolution. c. a long-term treatment to improve coping skills. d. a method of intervention with a goal of returning the patient to a level of functioning higher than their precrisis level.

d. a method of intervention with a goal of returning the patient to a level of functioning higher than their precrisis level.

A nurse values autonomy and self-determination as well as the preservation of life. This is an example of a. operative values. b. commitment. c. conceptions of the ideal. d. cognitive dissonance

d. cognitive dissonance

The nurse refuses to provide client information by telephone to a caller who claims to be the client's relative. a. Justice b. beneficence c. veracity d. confidentiality

d. confidentiality

When providing care for a client, the nurse should utilize the therapeutic technique of restating. This technique is expressed through the action of a. conveying positive regard b. delving further into a subject c. acknowledging or indicating awareness d. letting the patient know if a statement has been understood

d. letting the patient know if a statement has been understood

The nurse is teaching a patient who is alert and oriented about the medication, warfarin. When teaching the patient about this drug, the nurse emphasizes the need to be consistent with Vitamin K intake, which is found primarily in green leafy vegetables. When the patient's spouse comes to visit, the patient states, "I can no longer consume green leafy vegetables." This is an example of what type of failure caused by a communication problem? a. global aphasia b. system failure c. transmission failure d. reception failure

d. reception failure

As the nurse communicates with a patient, the feedback provided by the nurse should be a. descriptive, general, and content focused. b. well-timed and general. c. patient focused and evaluative. d. specific and focused on observed behavior.

d. specific and focused on observed behavior.

Muslims believe:

death is a part of Allah's plan, fighting the dying process is wrong, BATHE THE BODY (MEN BATHE MEN AND WOMEN BATHE WOMEN)

offering seld

making ones self available

The overly quiet child who does not complain may be ....

more frightened than the child who screams or cry

Focusing

nurses and patients select the most pressing or relevant health care topics for discussion

nurses self-awareness

nurses must be aware of their personal feelings about death and previous end of life experiences

the future of nursing; leading change and advancing health charcterisitics

nurses should practice to the full extent of their training, nurses should achieve higher levels of education and training, nurses should be full partners with physicians and other health care professionals

reflection

offers nurses a way to empathetically mirror their sense of how the patient may feel, "you sound happy when you talk about your grandson"

vary vocalization

orient ourselves to the characteristic voice tones associated with other cultures

establishing trust is done in which phase

orientation Phase

Florence nightingale

performed research necessary to prove that good hygiene positively impacted patient health, use of statistical date to document the need for hand washing to prevent infection during the crimean war

supporting EOL decision making

process in which health care providers, patient, and patients families go through when considering what treatments will or will not be used to treat a life threatening illness

Spiritual rituals and practices are used to ....

promote hope, support, and relieve anxiety for a patient experiencing cultural pain


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