BASIC NURSING ESSENTIALS FOR PRACTICE 7TH EDITION BY POTTER-Test Bank

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BASIC NURSING ESSENTIALS FOR PRACTICE 7TH EDITION BY POTTER-Test Bank

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WITH ANSWERS
BASIC NURSING ESSENTIALS FOR PRACTICE 7TH EDITION BY POTTER-Test Bank

Potter: Basic Nursing, 7th Edition

 

Chapter 02: The Health Care Delivery System

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A nurse is teaching the importance of self-breast examination to a group of 20-year-old women. The nurse is promoting _____ care.
A. primary
B. secondary
C. tertiary
D. restorative

 

 

ANS:   A

Secondary and tertiary care is administered after an illness has been diagnosed. Restorative care occurs after a patient is recovering from an acute illness or for those who have chronic illnesses. Primary care is centered on prevention of disease.

 

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    21

OBJ:    Describe the six levels of health care

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. A patient who needs nursing and rehabilitation after a stroke would benefit most by receiving care at a(n):
A. primary care center.
B. restorative care setting.
C. assisted living center.
D. respite center.

 

 

ANS:   B

In primary care centers, health promotion is the major theme. Assisted living centers offer long-term assistance with activities of daily living. Respite centers offer short-term relief to persons who provide full-time care to an older adult. Restorative care settings provide rehabilitation and nursing care.

 

PTS:    1                      DIF:    Cognitive Level: Comprehension       REF:    23

OBJ:    Describe the six levels of health care

TOP:    Nursing Process: Implementation

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. A patient states that he cannot afford health care insurance. What is the best form of insurance available to him?
A. Medicaid
B. Medicare
C. Private insurance
D. A managed care organization

 

 

ANS:   A

Medicare is a federally funded health insurance program. Private insurance is a fee-for-service plan. A managed care organization (MCO) provides care to a specific group of voluntarily enrolled patients. Medicaid is for those who cannot afford insurance.

 

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    19

OBJ:    Compare the various methods for financing health care

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. A managed care system focuses on:
A. customer service and patient choices.
B. admissions, diagnostic testing, and treatments.
C. control over primary health services of a defined population.
D. comprehensive rather than fragmented approaches to health.

 

 

ANS:   C

Managed care focuses on control over primary services of a defined population. The remaining answers describe levels of health care.

 

PTS:    1                      DIF:    Cognitive Level: Knowledge             REF:    18

OBJ:    Explain the advantages and disadvantages of managed health care

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. A nurse admits an older adult patient who states that she has no living relatives and only friends of her own age. One of the nurses immediate considerations for this patient will be to implement a:
A. critical pathway.
B. discharge plan.
C. patient-focused care model.
D. resource utilization group.

 

 

ANS:   B

A critical pathway is a multidisciplinary treatment plan for the hospitalized patient. A discharge plan begins the moment a patient is admitted to a health care facility. A resource utilization group is used in long-term care settings to manage patient costs.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    22

OBJ:    Explain the advantages and disadvantages of managed health care

TOP:    Nursing Process: Planning

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. Technological advances in health care:
A. make a nurses job easier.
B. depersonalize bedside patient care.
C. threaten the integrity of the health care industry.
D. do not replace sound personal judgment.

 

 

ANS:   D

Technological advances influence how and where nurses provide patient care; however, technology does not replace a nurses critical eye and clinical judgment.

 

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    30, 32

OBJ:    Discuss the implications of issues in the health care system on nursing

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. In 1983 Congress established the Prospective Payment System (PPS) to:
A. establish cost-based reimbursement for health care.
B. provide reimbursement for patient medications.
C. establish reimbursement rates based upon diagnosis-related groups (DRGs).
D. establish quality improvement measures.

 

 

ANS:   C

Established by Congress in 1983, the PPS eliminated cost-based reimbursement. Hospitals serving patients using Medicare were no longer paid for all costs incurred in delivering care to a patient. Instead, inpatient hospital services for patients using Medicare were combined into 468 diagnosis-related groups (DRGs).

 

PTS:    1                      DIF:    Cognitive Level: Knowledge             REF:    18

OBJ:    Compare the various methods for financing health care

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. A 74-year-old man was admitted to the hospital with diabetic ketoacidosis. The hospital where he was admitted will be reimbursed by Medicare according to:
A. his diagnostic-related group.
B. the cost of his care.
C. his length of stay.
D. his clinical outcome.

 

 

ANS:   A

Established by Congress in 1983, the PPS eliminated cost-based reimbursement. Hospitals serving patients using Medicare were no longer paid for all costs incurred to deliver care to a patient. Instead, inpatient hospital services for patients using Medicare were combined into 468 diagnosis-related groups.

 

PTS:    1                      DIF:    Cognitive Level: Comprehension       REF:    18

OBJ:    Compare the various methods for financing health care

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. Capitation is the payment mechanism in which health care providers receive a fixed amount of money for each patient. What is the purpose of capitation?
A. To balance the quality of care with the cost of providing care
B. To provide the least expensive care for patients
C. To build a payment plan that includes professional standards of care
D. To ensure that all patients receive the same care for the same cost

 

 

ANS:   C

The purpose of capitation is to build a payment plan for select diagnoses or surgical procedures that includes the best standards of care.

 

PTS:    1                      DIF:    Cognitive Level: Knowledge             REF:    18

OBJ:    Compare the various methods for financing health care

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. A single mother with three children utilizes the public health department services in her county to immunize her children. Which of the following best describes this level of health care?
A. Continuing care
B. Preventative care
C. Secondary acute care
D. Restorative care

 

 

ANS:   B

Preventative care includes services such as immunizations, screenings, poison control information, mental health counseling and crisis prevention, and community legislation.

 

PTS:    1                      DIF:    Cognitive Level: Comprehension       REF:    21

OBJ:    Describe the six levels of health care

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. A registered nurse working as a school nurse for a small poor rural school district has noticed an increase in children arriving at school without having eaten breakfast. She has discussed this issue with the school principle and is working on a proposal to ask the school district to explore a school breakfast program. This is an example of which of the following?
A. Primary care
B. Continuing care
C. Restorative care
D. Tertiary care

 

 

ANS:   A

In the settings that deliver preventive and primary care, such as schools, physicians or health care providers offices, occupational health clinics, and nursing centers, health promotion is a major theme.

 

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    21

OBJ:    Describe the six levels of health care

TOP:    Nursing Process: Planning

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. A small business owner has consulted with an occupational health nurse regarding health promotion activities for his employees. The registered nurse explores with him the possibility of providing an area outside the new office complex where employees can walk during their breaks. This an example of which of the following?
A. Continuing care
B. Restorative care
C. Primary care
D. Tertiary care

 

 

ANS:   C

In the settings that deliver preventive and primary care, such as schools, physicians or health care providers offices, occupational health clinics, and nursing centers, health promotion is a major theme.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    21

OBJ:    Describe the six levels of health care

TOP:    Nursing Process: Planning

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. A 43-year-old grocery store clerk does not have a family health care provider. She has had a sore throat for the past week and recently began running a fever. Her husband takes her to the local community hospitals emergency room for treatment. This is an example of what level of care?
A. Continuing care
B. Restorative care
C. Primary care
D. Tertiary care

 

 

ANS:   D

Hospital emergency departments, urgent care centers, critical care units, and inpatient medical-surgical units are sites that provide secondary and tertiary levels of care.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    21

OBJ:    Describe the six levels of health care

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. A retired high school teacher has been admitted to the hospital with complications of his diabetes. The hospital where he has been admitted uses a case management model to coordinate care. His discharge planning will be coordinated by which of the following?
A. Physician
B. Insurance company representative
C. Case manager
D. Dietitian

 

 

ANS:   C

In a case management model of care, a case manager, usually a nurse or a social worker, coordinates the efforts of all disciplines to achieve the most efficient and appropriate plan of care for the patient.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    22

OBJ:    Explain the advantages and disadvantages of managed health care

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. Discharge planning is a centralized, coordinated, multidisciplinary process that ensures that a patient has a plan for continuing care after leaving a health care agency. What is the most appropriate time to begin discharge planning?
A. The day of patient discharge from the health care agency
B. As soon as the insurance provider has been identified
C. When the health care provider writes the discharge order
D. When the patient is admitted to the health care agency

 

 

ANS:   D

Discharge planning begins the moment a patient is admitted to a health care facility.

 

PTS:    1                      DIF:    Cognitive Level: Knowledge             REF:    22

OBJ:    Explain the advantages and disadvantages of managed health care

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. Which of the following patients is most in need of discharge planning?
A. 29-year-old mother with a healthy newborn
B. 59-year-old patient after appendectomy
C. 43-year-old patient with heart failure
D. 56-year-old patient after hysterectomy

 

 

ANS:   C

Some patients are more in need of discharge planning because of the risks they have. For example, some patients have limited financial resources or limited family support;

others may have long-term disabilities or chronic illnesses. Early discharge teaching is especially important as a way to decrease readmission to the hospital.

 

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    22

OBJ:    Explain the advantages and disadvantages of managed health care

TOP:    Nursing Process: Implementation

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. Which of the following is considered the most expensive place to deliver care?
A. Rehabilitation unit
B. Long-term care facility
C. Intensive care unit
D. Private hospital room

 

 

ANS:   C

An intensive care unit is the most expensive delivery site for medical care because each nurse is usually assigned to care for only one or two patients at a time and because of the types of treatments and procedures the patients in the intensive care unit typically require.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    23

OBJ:    Compare the various methods for financing health care

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. A 23-year-old college student with severe depression was recently admitted to the psychiatric ward of a local hospital. His family is concerned about him finishing his college term. Which of the following is the best information for the nurse to give regarding how long psychiatric patients are typically hospitalized?
A. A relatively short inpatient stay is followed by outpatient treatment.
B. A long inpatient hospitalization is normal.
C. Patients with emotional or behavioral problems generally are not hospitalized.
D. Most are automatically placed in a long-term care facility.

 

 

ANS:   A

Patients who have emotional and behavioral problems, such as depression, violent behavior, and eating disorders, often require special counseling and treatment in psychiatric facilities. Hospitalization involves relatively short stays with the purpose of stabilizing patients before transfer to outpatient treatment centers.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    23

OBJ:    Discuss the types of settings in which professionals provide various levels of health care    TOP:    Nursing Process: Assessment

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. A 17-year-old girl was seriously injured in a motor vehicle accident and has been transferred from an acute care hospital to a rehabilitation facility. Which of the following options will ensure the best outcome for her?
A. Making sure that she gets enough rest
B. Pushing her beyond her limits
C. Requesting that the family not visit for the first few days
D. Involving her family early in the rehabilitation process

 

 

ANS:   D

In restorative settings, nurses recognize that success is dependent on effective and early partnering with patients and their families.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    25

OBJ:    Discuss the types of settings in which professionals provide various levels of health care    TOP:    Nursing Process: Assessment

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. A 54-year-old businessman who experienced a stroke four days ago has been discharged from the hospital and will be undergoing outpatient rehabilitation. He should expect which of the following with this level of care?
A. Admission to the rehabilitative unit of the hospital
B. Scheduled appointment times for therapy
C. Home visits from all members of the multidisciplinary team
D. House calls from his primary health care provider

 

 

ANS:   B

When patients receive rehabilitation services in outpatient settings, patients get treatment at specified times during the week but remain at home the rest of the time.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    25

OBJ:    Describe the six levels of health care

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. The Omnibus Budget Reconciliation Act of 1987 is also referred to as the _____ Act.
A. Medicaid
B. Nursing Home Reform
C. Diagnostic Related Group
D. Universal Healthcare

 

 

ANS:   B

The nursing center industry has become one of the most highly regulated industries in the United States. The Omnibus Budget Reconciliation Act of 1987, also known as the Nursing Home Reform Act, raised the standard of services provided by nursing centers.

 

PTS:    1                      DIF:    Cognitive Level: Comprehension       REF:    25

OBJ:    Compare the various methods for financing health care

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. A new registered nurse who recently began working in a nursing center has been asked to complete a Resident Assessment Instrument (RAI) on a newly admitted resident. She knows the purpose of this instrument is to:
A. provide a database to better understand the healthcare needs of this population.
B. provide the nursing staff with an overall physical assessment of the resident.
C. provide statistical evidence to support a universal healthcare policy.
D. determine how many health care resources this population consumes.

 

 

ANS:   A

The facility needs to complete the RAI on all residents. The RAI consists of the Minimum Data Set (MDS) (Box 2-4), Resident Assessment Protocols (RAPs), and utilization guidelines of each state. The RAI ultimately provides a national database for nursing facilities so that policy makers will better understand the health care needs of the long-term care population.

 

PTS:    1                      DIF:    Cognitive Level: Comprehension       REF:    26

OBJ:    Discuss the types of settings in which professionals provide various levels of health care    TOP:    Nursing Process: Assessment

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. Gladys, an 81-year-old widow with dementia, recently moved in with her daughter Cecilia, a 46-year-old working mother with three children. In considering how to have care for her mother when she is working, what is the most appropriate option?
A. A rehabilitation center
B. A nursing center
C. An adult day care center
D. Respite care

 

 

ANS:   C

Services offered by adult day care centers allow family members to maintain their lifestyles and employment and still provide home care for their relatives.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    27

OBJ:    Discuss the types of settings in which professionals provide various levels of health care    TOP:    Nursing Process: Assessment

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. A 78-year-old widow needs assistance with her medications, housekeeping, and laundry. She would like to maintain her independence. Of the following, which is the best option for her to consider?
A. Assisted living
B. Respite care
C. Nursing center
D. Rehabilitation center

 

 

ANS:   A

Assisted living provides independence, security, and privacy at the same time. These facilities promote independence and physical and psychosocial health. Services in an assisted living facility include medication management, exercise and educational activities, social activities, laundry, assistance with meals and personal care, 24-hour oversight, and housekeeping.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    26

OBJ:    Discuss the types of settings in which professionals provide various levels of health care    TOP:    Nursing Process: Assessment

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. Which of the following patients is most suitable for admission into a hospice?
A. 63-year-old man with a fractured femur
B. 45-year-old woman with end-stage renal failure
C. 14-year-old patient with leukemia
D. 78-year-old patient with dementia

 

 

ANS:   B

A patient entering a hospice is at the terminal phase of illness, and the patient, family, and physician agree that no further treatment will reverse the disease process.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    27

OBJ:    Discuss the types of settings in which professionals provide various levels of health care    TOP:    Nursing Process: Assessment

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. A registered nurse has been working for an oncology unit for the past year. She has a passion for caring for oncology patients undergoing chemotherapy. Whose responsibility is it for the nurse to become competent in administering chemotherapy?
A. The hospital where she works
B. The charge nurse
C. Her own
D. The oncologist who admits patients to the unit where she works

 

 

ANS:   C

A nurses responsibility is to follow policies and procedures and to know the most current practice standards. As a nurse progresses in a career, it becomes his or her responsibility to obtain necessary continued education and to earn certifications when he or she chooses to practice in specialty areas.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    27

OBJ:    Discuss opportunities for nursing within the changing health care delivery system

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Health Promotion and Maintenance

 

SHORT ANSWER

 

  1. Changes in the health care delivery system are being driven by _____________________.

 

ANS:

increasing health care costs

 

Changes in health care are being driven by increasing health care costs.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    33

OBJ:    Discuss opportunities for nursing within the changing health care delivery system

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Health Promotion and Maintenance

 

MULTIPLE RESPONSE

 

  1. A registered nurse working in a restorative care setting will focus on which of the following? Select all that apply.
A. Providing extensive supportive care
B. Providing one-on-one care to patients
C. Promoting patient self-care
D. Promoting independence

 

 

ANS:   C, D

A secondary care setting provides in-depth diagnosis and treatment of illnesses that require extensive, one-on-one complex treatments.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    23

OBJ:    Describe the six levels of health care

TOP:    Nursing Process: Evaluation

MSC:   Client Needs: Health Promotion and Maintenance

Potter: Basic Nursing, 7th Edition

 

Chapter 10: Communication

 

Test Bank

 

MULTIPLE CHOICE

 

  1. A student nurse who works for an oncology unit is preparing to bathe a patient who recently underwent surgery to remove an abdominal tumor. Before beginning the bath, the student nurse explains what she intends to do. Which of the following best describes her communication role?
A. Channel
B. Receiver
C. Referent
D. Sender

 

 

ANS:   D

The sender is the person who delivers the message. The roles of sender and receiver change back and forth as two persons interact.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    167

OBJ:    Describe the three levels of communication and their uses in nursing

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. A patient is being cared for by a student nurse. The patient has questions regarding what time her surgery is scheduled. When the student nurse responds to the question, she is assuming which of the following communication roles?
A. Channel
B. Receiver
C. Referent
D. Sender

 

 

ANS:   D

The sender is the person who delivers the message. The roles of sender and receiver change back and forth as two persons interact.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    167

OBJ:    Describe the three levels of communication and their uses in nursing

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. A registered nurse is a new nurse manager who needs to council an employee regarding her attendance. Because the nurse manager is new to the position, she is rehearsing what she plans to say to the employee before the meeting. Which of the following best describes this form of communication?
A. Interpersonal
B. Intrapersonal
C. Public
D. Private

 

 

ANS:   B

Intrapersonal communication, also called self-talk, is a powerful form of communication that occurs within an individual. People talk to themselves by forming thoughts internally that strongly influence perceptions, feelings, behavior, self-concept, and performance. Self-talk is a mental rehearsal for difficult tasks or situations so that individuals deal with them more effectively.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    167

OBJ:    Describe behaviors and techniques that affect communication

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. A student nurse is working in a busy emergency department of an urban hospital. The family of a patient brought in by ambulance asks the student nurse what the doctor meant when she said that the patient was coding. In this situation, the word coding is an example of which of the following?
A. Denotative meaning
B. Connotative meaning
C. Intonation
D. Descriptive meaning

 

 

ANS:   A

A single word sometimes has several meanings. Individuals who use a common language share the denotative meaning of a word. The word baseball has the same meaning for all individuals who speak English, but the word code denotes cardiac arrest primarily to health care providers.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    168

OBJ:    Describe the elements of the communication process

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. Mrs. Bath asked a student nurse when she could expect her health care provider to make rounds. The student nurse was on her way to take a patient for a stat test and replied very quickly, I have no idea. Mrs. Bath most likely interpreted the student nurse as uncaring due to which of the following?
A. Vocabulary
B. Intonation
C. Timing
D. Eye contact

 

 

ANS:   B

Tone of voice dramatically affects a messages meaning, and emotions directly influence tone of voice. A simple question or statement can express enthusiasm, anger, or concern. Be aware of intonation to avoid sending unintended messages. If the patient interprets a message as uncaring or condescending, communication is blocked.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    168

OBJ:    Differentiate aspects of verbal and nonverbal communication

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. A 9-year-old patient who is hospitalized for bowel surgery appeared very frightened. To appear less threatening to the child, which of the following would be best for the nurse to do?
A. Stand over his bed when talking to him.
B. Sit in a chair next to his bed when talking to him.
C. Maintain constant eye contact with him.
D. Stay within 12 inches of him when talking to him.

 

 

ANS:   B

Looking down on a person establishes authority, but interacting at the same eye level indicates equality in the relationship. A nurse appears less dominant and less threatening when interacting at the patients eye level.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    169

OBJ:    Discuss effective communication for patients of varying developmental levels

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. Mary, a student nurse, went into Mrs. Doers room at 0900, shortly after she was told that she had liver cancer. Mrs. Doer asked Mary if she had a few minutes because she did not want to be alone. Mary stood very close to Mrs. Doer, held her hand and told her she had plenty of time. A few minutes later, Mary thought she should check the time on her watch because she was supposed to take another patient for a test at 0945. Mrs. Doer saw Mary look at her watch and told Mary that she now was okay to be alone. Why did Mrs. Doer most likely request to be alone?
A. Invasion of personal space
B. Verbal communication
C. Marys gesture
D. Intonation

 

 

ANS:   C

Gestures alone carry specific meanings, or they may create messages with other communication cues.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    169

OBJ:    Describe behaviors and techniques that affect communication

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. A registered nurse is caring for a postoperative patient who is experiencing respiratory distress after the administration of pain medication. The nurse called the patients health care provider immediately. The information regarding the patient was conveyed using the SBAR format. What does SBAR stand for?
A. Situation, background, assessment, recommendation
B. STAT, background, assessment, recommendation
C. Status, background, analysis, recommendation
D. Situation, belief, assessment, requirement

 

 

ANS:   A

Use of common language when communicating critical information helps prevent misunderstandings. SBAR is a popular communication tool that helps standardize communication between health care providers. SBAR stands for situation, background, assessment, and recommendation.

 

PTS:    1                      DIF:    Cognitive Level: Knowledge             REF:    171

OBJ:    Describe the elements of the communication process

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. A student nurse is considered to project a professional image by her peers. Which of the following behaviors would be considered most professional?
A. Addressing a patient by dear
B. Wearing small earrings
C. Being task-oriented
D. Avoiding troublesome patients

 

 

ANS:   B

The patients acceptance of a nurse as a professional often depends on the manner in which he or she presents a professional and caring image. Verbal and nonverbal behaviors influence the helping relationship. Professional appearance, demeanor, and behavior are important in establishing trustworthiness and competence.

 

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    168

OBJ:    Differentiate aspects of verbal and nonverbal communication

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. When caring for a patient from another culture, what is the best strategy for the nurse to use in communicating with the patient?
A. Using a cultural joke to break the ice
B. Stereotyping the patient within their culture
C. Considering the context of the patients background
D. Assuming the patient speaks English

 

 

ANS:   C

Accept patients rights to adhere to cultural customs and norms. Persons of different cultures use different types of verbal and nonverbal cues to convey meaning. A nurse h should make a conscious effort not to interpret messages through his or her own cultural perspective; instead, a nurse considers the context of the other individuals background. Avoid stereotyping persons from other cultures or making jokes about them.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    175

OBJ:    Explain techniques used to assist patients with special communication needs

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. A 67-year-old patient had a stroke that left her aphasic. A student nurse is working on a plan of care. What is the best nursing diagnosis to use for the patients aphasia?
A. Impaired verbal communication
B. Anxiety
C. Impaired social interaction
D. Ineffective coping

 

 

ANS:   A

Impaired verbal communication is the nursing diagnostic label to describe a patient who has limited or no ability to communicate verbally. This diagnosis is useful for a wide variety of patients with special problems and needs related to communication. It is defined as decreased, delayed, or absent ability to receive, process, transmit, and use a system of symbols.

 

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    175-176

OBJ:    Explain techniques used to assist patients with special communication needs

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. A 67-year-old patient recently had a stroke that left her aphasiac. The nurse has planned to take a multidisciplinary approach to her care. Who would be most appropriate for the nurse to collaborate with regarding the patients aphasia?
A. Interpreter
B. Speech therapist
C. Physical therapist
D. Psychiatric nurse specialist

 

 

ANS:   B

The nurse should collaborate with other health care providers who have expertise in communication strategies. Speech therapists help patients with aphasia. Interpreters are invaluable when a patient speaks a foreign language. Psychiatric nurse specialists help in communicating with angry or highly anxious patients.

 

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    176

OBJ:    Explain techniques used to assist patients with special communication needs

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. Marsha, a student nurse, is spending time with her patient, Mrs. James, who has recently been diagnosed with breast cancer. Mrs. James expresses that she is frightened about the diagnosis and feels overwhelmed. Marshas responds, It sounds to me like you are feeling very scared right now. This is an example of which of the following?
A. Sympathy
B. Empathy
C. Focusing
D. Self-disclosure

 

 

ANS:   B

Empathy is the ability to understand and accept another persons perspective. Although no one can never totally know anothers experiences, a nurse can try to understand what the person is going through.

 

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    176

OBJ:    Describe a nurses focus within each phase of a therapeutic nurse-patient helping relationship        TOP:            Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. A patient has just been admitted to the hospital with a broken hip from a fall in her home. She is concerned that she might not be able to return home after surgery because she lives in a second-floor apartment without an elevator. The nurse admitting her is practicing active listening. Which of the following behaviors best conveys to the patient that the nurse is listening to her?
A. Keeping arms crossed
B. Sitting facing the patient
C. Leaning away from the patient
D. Standing facing the patient

 

 

ANS:   B

Active listening enhances trust because the nurse communicates acceptance and respect for the patient. Several nonverbal skills facilitate attentive listening, which are identified by the acronym SOLER:

Sit facing the patient.

Observe and open posture.

Lean toward the patient.

Establish can maintain eye contact.

Relax.

 

PTS:    1                      DIF:    Cognitive Level: Application             REF:    177

OBJ:    Describe a nurses focus within each phase of a therapeutic nurse-patient helping relationship        TOP:            Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. Graham is a nursing student who is working evenings for a busy medical unit. He is caring for one patient who is having abdominal pain and is experiencing difficulty sleeping. Graham sits at the bedside of this patient and takes her hand. The patient quickly pulls back her hand. What is the most likely cause for this behavior?
A. She is uncomfortable with being touched.
B. She is in too much pain to be touched.
C. She has impaired social skills.
D. She has difficulty with nonverbal communication.

 

 

ANS:   A

Nurses need to remain sensitive to their own responses and to patients feelings. If a patient refuses to hold a nurses hand while in pain or pulls away from physical contact, this signals that the patient is uncomfortable with being touched by the nurse.

 

PTS:    1                      DIF:    Cognitive Level: Analysis                  REF:    180

OBJ:    Describe a nurses focus within each phase of a therapeutic nurse-patient helping relationship        TOP:            Nursing Process: Assessment

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. A student nurse who is assisting in the admission of a patient to the orthopedic unit of the hospital is obtaining information for the database. She is using therapeutic communication to gain information from the patient. Which of the following is the best way for the student nurse to obtain information from the patient?
A. Asking personal questions in order to show interest
B. Using medical vocabulary to appear competent
C. Asking why he waited so long to get his knee replaced
D. Using silence while he gathers his thoughts

 

 

ANS:   D

Nontherapeutic techniques discourage further expression of feelings and ideas and engender negative responses or behaviors in others.

 

PTS:   

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