Interpersonal Relationships Professional Communication Skills for Nurses 7th Edition, Arnold Test Bank

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Interpersonal Relationships Professional Communication Skills for Nurses 7th Edition, Arnold Test Bank


Test Bank Interpersonal Relationships Professional Communication Skills Nurses 7th Edition, Arnold


Chapter 1: Theory Based Perspectives and Contemporary Dynamics
1. When describing nursing to a group of nursing students, the nursing instructor lists all of the following characteristics of nursing except
a. historically nursing is as old as mankind.
b. nursing was originally practiced informally by religious orders dedicated to care of the sick.
c. nursing was later practiced in the home by female caregivers with no formal education.
d. nursing has always been identifiable as a distinct occupation.
2. The nursing professions first nurse researcher, who served as an early advocate for high-quality care and used statistical data to document the need for handwashing in preventing infection, was
a. Abraham Maslow.
b. Martha Rogers.
c. Hildegard Peplau.
d. Florence Nightingale.
3. Today, professional nursing education begins at the
a. undergraduate level.
b. graduate level.
c. advanced practice level.
d. administrative level.
4. Nursings metaparadigm, or worldview, distinguishes the nursing profession from other disciplines and emphasizes its unique functional characteristics. The four key concepts that form the foundation for all nursing theories are
a. caring, compassion, health promotion, and education.
b. respect, integrity, honesty, and advocacy.
c. person, environment, health, and nursing.
d. nursing, teaching, caring, and health promotion.
5. When admitting a client to the medical-surgical unit, the nurse asks the client about culturalissues. The nurse is demonstrating use of the concept of
a. person.
b. environment.
c. health.
d. nursing.
6. A young mother tells the nurse, Im worried because my son needs a blood transfusion. I dont know what to do, because blood transfusions cause AIDS. Which central nursing construct is represented in this situation?
a. Environment
b. Caring
c. Health
d. Person
7. The nurse performs a dressing change using sterile technique. This is an example of which pattern of knowledge?
a. Empirical
b. Personal
c. Aesthetic
d. Ethical
8. The nurse-client relationship as described by Hildegard Peplau
a. would not be useful in a short-stay unit.
b. allows personal and social growth to occur only for the client.
c. facilitates the identification and accomplishment of therapeutic goals.
d. focuses on maintaining a personal relationship between the nurse and client.
9. The identification phase of the nurse-client relationship
a. sets the stage for the rest of the relationship.
b. correlates with the assessment phase of the nursing process.
c. focuses on therapeutic goals to enhance client and family well-being.
d. uses community resources to help resolve health care issues.
10. Abraham Maslows needs theory is a framework that
a. begins with meeting basic psychosocial needs first.
b. ensures essential needs are satisfied, then people move into higher physiological areas of development.
c. proposes that people are motivated to meet their needs in a descending order.
d. nurses use to prioritize client needs and develop relevant nursing approaches.

Chapter 2: Professional Guides for Nursing Communication
1. The nurse demonstrates effective communication by ensuring all of the following except
a. two-way exchange of information among clients and health providers.
b. making sure that unilateral information is exchanged between clients and nurses.
c. making sure that the expectations and responsibilities of all are clearly understood.
d. recognizing that effective communication is an active process for all involved.
2. A preoperative assessment shows that a clients hemoglobin level is dropping. The anesthetist orders 3 units of blood to be administered. The nurse administers the first unit before discovering that the client is a Jehovahs Witness, as documented in the record. This is an example of
a. professional conduct.
b. a negligent act.
c. physical abuse.
d. breaching client confidentiality.
3. Which of the following is a violation of client confidentiality? Reporting
a. certain communicable diseases.
b. child abuse.
c. gunshot wounds.
d. client data to a colleague in a nonprofessional setting.
4. A 16-year-old trauma victim arrives in the emergency department with a life-threatening condition and requires emergency surgery. The nurse knows that
a. a parent/guardian must give consent.
b. the client can give consent if she provides proof of emancipation.
c. the client must first be evaluated for competency before obtaining consent.
d. surgery can be performed without consent.
5. In regard to informed consent, which of the following statements is true?
a. Only legally incompetent adults can give consent.
b. Only parents can give consent for minor children.
c. It is not required that the client be told about costs and alternatives to treatment.
d. Consent must be voluntary.
6. The client has a living will in which he states he does not want to be kept alive by artificial means. The clients family wants to disregard the clients wishes and have him maintained on artificial life support. The most appropriate initial course of action for the nurse would be to
a. tell the family that they have no legal rights.
b. tell the family that they have the right to override the living will because the patient cannot speak.
c. report the situation to the hospital ethics committee.
d. allow the family to verbalize their feelings and concerns, while maintaining the role of client advocate.
7. The nurse collects both objective and subjective data. An example of subjective data is
a. BP 140/80.
b. skin color jaundiced.
c. I have a headache.
d. history of seizures.
8. The nurse observes a client pacing the floor. The nurse validates an inference when speaking to the client by stating,
a. You are anxious, so lets talk about it.
b. Lets try some deep breathing to help you relax.
c. You seem anxious. Will you tell me what is going on?
d. Clients who pace usually need to talk to a physician. Should I call yours?
9. A client who is scheduled for a bilateral inguinal hernia repair the next day is observed pacing the unit. After validating that the client is anxious about his upcoming surgery because he is afraid of pain, a relevant nursing diagnosis would be
a. anxiety related to surgery.
b. pain related to anxiety about surgery as evidenced by pacing.
c. anxiety related to fear of postoperative pain as evidenced by pacing.
d. pacing related to fear of postoperative pain.
10. Which of the following is an outcome for a client with a broken leg?
a. Client will develop an ambulation program within 1 month.
b. Encourage client to ambulate with cast using crutches.
c. Client asks, When will I walk again?
d. Client experiences alteration in mobility related to a broken leg.

Chapter 3: Clinical Judgment and Ethical Decision Making
1. Which of the following types of thinking reflects the nursing process?
a. Habits
b. Inquiry
c. Mnemonic
d. Practice
2. Which of the following personality characteristics is a barrier to critical thinking?
a. Accepting change
b. Being open minded
c. Stereotyping
d. Going with the flow
3. The ethical decision-making model where good is defined as maximum welfare or happiness is known as the
a. utilitarian model.
b. human rights based model.
c. duty-based model.
d. Kants model.
4. Which of the following case examples represents the ethical concept of distributive justice?
a. A famous baseball player receives a heart transplant.
b. An older adult who has government insurance is denied standard cancer treatment.
c. During a visit to his physicians office, a client demands antibiotics for his cold and is given a prescription.
d. A client suffering from cirrhosis of the liver is placed on a transplant list.
5. Personal values are defined as
a. values shaped by family, religious beliefs, and years of experience.
b. altruism.
c. two values that are in conflict.
d. values determined by commitment.
6. A nurse values autonomy and self-determination as well as the preservation of life. This is an example of
a. conceptions of the ideal.
b. cognitive dissonance.
c. operative values.
d. commitment.
7. Which of the following statements is true about the critical thinking process?
a. It is a linear process.
b. The skills are inborn.
c. It is goal directed.
d. It assists nurses to criticize the health care system.
8. Which of the following best describes the critical thinking skills of a novice nurse and an expert nurse?
a. The expert nurse is able to diagnose faster than the novice nurse.
b. The expert nurse does not need to question and reassess like the novice nurse.
c. The novice nurse uses past knowledge, whereas the expert nurse stays in the here and now.
d. The expert nurse organizes data more efficiently than the novice nurse.
9. A client 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 client complains that he cannot afford the new medication and will not be able to remember to take it. The physician replies, I cant help that; I have to treat you the way I think is best. The clients nurse may experience
a. paternalism.
b. cognitive dissonance.
c. nonmaleficence.
d. moral distress.
10. Characteristics of a critical thinker include all but which of the following?
a. Haphazardly seeking solutions
b. Anticipating consequences
c. Considering alternative solutions
d. Revising actions based on new input

Chapter 4: Clarity and Safety in Communication
1. A nurse manager is teaching a group of nurses about client safety. The nurse manager teaches the nurses that safety is defined as avoidance, prevention, and amelioration of adverse outcomes or injuries stemming from the process of health care itself. What is the source of this definition?
a. Hippocratic oath
b. National Patient Safety Foundation
c. American Association of Colleges of Nursing
d. American Nurses Associations Code of Ethics
2. When conducting an in-service on serious medical errors, the nurse teaches that nearly 70% of sentinel events are related to
a. lack of education.
b. inadequate resources.
c. minimal rest periods.
d. miscommunication.
3. When working on a nursing unit, the nurse recognizes that incomplete communication errors most often occur during
a. staff meetings.
b. the night shift.
c. a handoff procedure.
d. medication administration.
4. A student nurse is learning about how to reduce errors and increase safety. The nursing instructor recognizes that further teaching is warranted when the student nurse states which of the following?
a. When communicating with clients, I will be clear.
b. I will be timely in my communication with clients.
c. I will promote communication with clients that is ambiguous.
d. When communicating with clients, I will ensure the client understood.
5. The nurse manager sets a goal to establish a new safety culture on a hospital unit. The nurse manager recognizes that basic components in establishing a new safety culture include
a. support of effective health care teamwork.
b. encouragement of individualism.
c. discouragement of new concepts.
d. promotion of a hierarchical system.
6. 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 consistent with error reporting within the United States?
a. Error reporting is transparent
b. Errors are overreported
c. Errors are underreported
d. Providers are not concerned about consequences of reporting errors
7. When educating a newly diagnosed client about management of diabetes mellitus, the nurse recognizes that health carerelated communication
a. does not lead to errors within the hospital.
b. is generally well understood by most clients.
c. is not an important component of client care.
d. can cause clients to misunderstand information.
8. A nurse manager encourages staff to improve error and near miss event reporting. The nurse manager recognizes that as error reporting improves,
a. the severity of errors increases.
b. better, safer systems can be developed.
c. the likelihood of other errors increases.
d. error detection rates and severity remain unchanged.
9. When educating a student nurse about safety communication improvement solutions, the nursing instructor recognizes that additional teaching is warranted when the student nurse lists which of the following as a safety communication improvement solution?
a. Adopting technology-oriented tools
b. Using standardized verbal and electronic communication tools
c. Disempowering clients to be partners in safer care
d. Participating in team training communication seminars
10. The nurse is teaching the student nurse about how to use SBAR when calling a physician. The student nurse verbalizes understanding of SBAR when stating that SBAR is
a. used as a situational briefing.
b. utilized strictly within the hospital setting.
c. not used in e-mails due to HIPAA rules.
d. never recorded within the clients chart.

Chapter 5: Developing Therapeutic Communication Skills
1. When therapeutically communicating with a client who has just found out he is HIV- positive, the nurse should focus on
a. professional needs.
b. an unlimited time frame for communication.
c. verbal communication only between the client and the nurse.
d. achieving identified health-related goals.
2. The nurse demonstrates understanding of the concept of metacommunication through
a. recognizing the impact of communication on others.
b. actively listening with good eye contact.
c. implementing barriers to effective communication.
d. ensuring that verbal and nonverbal messages are incongruent.
3. When communicating with a client, 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 client.
4. When communicating with clients, the nurse actively uses listening responses. Which of the following types of listening response should the nurse use?
a. Moralizing
b. Giving advice
c. False reassurance
d. Paraphrasing
5. The nurse enters a clients room with the intent of allowing the client to express feelings in relation to her new cancer diagnosis. The nurse notices that the client is crying and guarding her incision site. After validating physical discomfort, the nurse should
a. administer an analgesic and postpone the interaction.
b. sit with the client and hold her hand.
c. explain that pain is expected following surgery but that it is important to increase activity to avoid complications.
d. acknowledge the physical pain but state that it is a priority to immediately address the emotional pain.
6. A nurse is conducting a medication education group for mentally ill clients. One of the clients states, I dont think everyone needs medications. What about psychotherapy? Can you tell me about that? What is an appropriate response by the nurse?
a. Talk to the group about the benefits of psychotherapy.
b. Tell the group that psychotherapy is ineffective and they need medication.
c. Acknowledge the question, but explain the time limitations and focus of that particular group.
d. Explain that it is the physicians decision what type of treatment modality is for each client
7. When teaching a client how to administer insulin, the nurse recognizes that the best method of communicating therapeutically with the client is to
a. talk to the client in the visitors lounge.
b. talk to the client within his personal space.
c. communicate with the client using touch.
d. face the client while leaning slightly forward.
8. When conducting an assessment interview, which of the following is the best communication technique for the nurse to use?
a. Ask multiple questions at the same time
b. Offer limited time for the client to respond to each question that is asked
c. Use short, unambiguous listening responses focused on current health issues and client concerns
d. Ensure that all questions are answered immediately in order to avoid the need for related follow-up questions to clarify
9. The nurse asks a newly admitted client, 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. encourage the client to answer the question with a one-word response.
c. allow clients latitude in telling their story.
d. allow the client to engage in a passive relationship with the nurse.
10. Which of the following is the best questioning sequence during a client interview in which the client is communicative and not in an emergency situation?
a. Begin with focused questions and proceed to open-ended questions.
b. Begin with open-ended questions and proceed to focused questions.
c. Begin with closed questions and proceed to open-ended questions.
d. Begin with open-ended questions and proceed to closed questions.

Chapter 6: Variation in Communication Styles
1. Which of the following is a description of metacommunication?
a. Communication style
b. Nonverbal communication
c. Verbal communication
d. Nonverbal and verbal communication
2. The nurse puts his arm around an older adult client when assisting her to transfer to a chair. The client could interpret the nurses touch as
a. a positive gesture only.
b. a threat.
c. denotation.
d. paralanguage.
3. A description of denotation is
a. a personalized meaning of a word or phrase.
b. a generalized meaning assigned to a word.
c. a meaning shared by families.
d. a meaning generally shared within a specific culture.
4. When communicating about a client with a health care provider from another culture, the nurse states, The client stopped taking his medications last week when he fell off the wagon. The health care provider looks at the nurse blankly. This is an example of
a. connotation.
b. information processing.
c. time span between messages.
d. nonverbal cultural variations.
5. The nurse is assigned to care for a client who has been diagnosed with multiple sclerosis. Which communication behavior will have the most impact on the client?
a. What is said
b. Tone of voice
c. Sense of confidence
d. Verbal message
6. Communication is a combination of
a. verbal and nonverbal behaviors.
b. pitch, tone, and paralanguage.
c. proxemics, touch, and kinesics.
d. eye contact, facial expressions, and nonverbal messages.
7. The majority of person-to-person communication is
a. verbal.
b. process.
c. nonverbal.
d. content.
8. When the nurse asks a client, How are you? the client states, I am fine. As the client turns away, she is crying. This is an example of
a. nonverbal communication.
b. incongruence.
c. proxemics.
d. congruence.
9. An adult client responds to questions inappropriately. The nurse should do which of the following?
a. Assume that the client is depressed and seek further information.
b. Ask other staff members whether the client is sick.
c. Leave the client alone for now and return to reassess.
d. Observe the clients nonverbal behavior.
10. The nurse is assessing a newly admitted Native American client. When assessing the clients perception of touch, the nurse should
a. casually touch the client.
b. use timing with touch.
c. ask the client for permission to touch.
d. shake the clients hand.

Chapter 7: Intercultural Communication
1. Cultural competence
a. involves a lack of acceptance of cultural differences in others.
b. requires self-awareness of ones own cultural values.
c. is a nonessential skill set required for health care providers.
d. begins with developing knowledge and acceptance of cultural differences in others.
2. Which of the following best describes cultural diversity?
a. Encompasses variations between cultural groups
b. A smaller group of people living within the dominant culture who have adopted a cultural lifestyle distinct from that of the mainstream population
c. Groups in which members share a cultural heritage from one generation to another
d. Heterogeneous society in which diverse cultural worldviews can coexist
3. When communicating with a client from Thailand who speaks limited English, the nurse should
a. use technical jargon and complex sentences.
b. recognize nodding as an indicator the client agrees with what the nurse is saying.
c. speak quickly and concisely, using complex words.
d. provide advice in a matter-of-fact, concise manner.
4. When practicing cultural awareness, the nurse recognizes that cultural patterns
a. are socially transmitted through ethnic groups.
b. are nonessential parts of personal identity.
c. are minor determinants of health-related attitudes.
d. are important determinants of health-related beliefs.
5. The nurse is performing an admission assessment on an Asian client. The intake includes a cultural assessment. The nurse should ask the client,
a. Does a minister, priest, or rabbi visit you?
b. Do you feel understood and loved?
c. What language do you prefer to speak?
d. Does life have meaning and value for you?
6. The nurse is caring for a Hispanic client. When communicating with the clients family about the clients illness, which family member should the nurse contact?
a. Oldest female family member
b. Oldest male family member
c. Oldest daughter of client
d. Oldest son of client
7. A nursing instructor is teaching a group of student nurses about culture. When teaching the students nurses about the concept of ethnocentrism, the student nurses demonstrate cultural sensitivity when they state that their culture
a. is superior to others.
b. has the right to impose its standards of correct behavior and values on another.
c. is a culture that warrants a sense of pride.
d. should be the norm because it is considered better or more enlightened than others.
8. When caring for a client from a different culture, which of the following is the best assessment approach by the nurse?
a. Are there any special cultural beliefs about your illness that might help me give you better care?
b. Describe to me your position of greatest relief from pain and discomfort.
c. I will return shortly to give you a pain medication. Is there anything else that you need?
d. I will roll your bed down and place a pillow between your legs.
9. The nurse is assigned to provide a bed bath to a client who cannot speak English. Which of the following communication tools or strategies should the nurse use?
a. Nonverbal communication
b. Trained interpreter
c. Family member as interpreter
d. Other staff member who speaks the same language
10. The nurse is caring for a postpartum client who is African American. The nurse recognizes that an essential component for successful communication when interacting with this client is the use of
a. clergy in treatment plans.
b. only simple language strategies.
c. folk-healing strategies.
d. trust development.

Chapter 8: Therapeutic Communication in Groups
1. Which of the following is a characteristic of a secondary group?
a. There is not a designated leader.
b. They have a prescribed structure.
c. They lack identified specific goals.
d. The group remains together even when goals are achieved.
2. The nurse is caring for a client who has a large extended family. The nurse recognizes the client is part of a group known as a
a. focus group.
b. educational group.
c. primary group.
d. secondary group.
3. Which of the following describes group think?
a. A member of a corporate executive committee states, You could be making a big mistake.
b. Members of a corporate executive committee fail to inform the chairperson that some middle managers do not support the decision.
c. A corporate executive committee cancels a press conference in light of poor market survey results.
d. Members demonstrate a willingness to take interpersonal risks
4. Which of the following statements is true in relation to task functions?
a. When task functions predominate, member satisfaction increases.
b. When maintenance functions predominate, goals are achieved.
c. They are behaviors used to move toward goal achievement.
d. They are behaviors designed to ensure personal satisfaction.
5. When leading a group meeting, the nurse notices two group members talking. Which of the following represents the best intervention by the nurse?
a. Ask the group, Have you noticed who is talking at this time?
b. Tell the two group members, I would like you to stop talking.
c. Provide the two group members with a verbal summary of what the group has been discussing.
d. Ask the two group members, Would you share your comments with the group?
6. 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 is using the technique of
a. harmonizing.
b. summarizing.
c. encouraging.
d. compromising.
7. The nurse notices that a group member is quiet during support group meetings. What is the best intervention by the nurse for involving the quiet group member in the group process?
a. Ask the group if they have noticed that a group member never talks.
b. Ask the group what can be done to involve the quiet group member more.
c. Set up a private meeting with the quiet group member to discuss group participation.
d. Ask the quiet group member if he or she would like to comment on what another group member has just said.
8. A breast cancer support group is an example of a
a. closed group.
b. private group.
c. homogeneous group.
d. heterogeneous group.
9. During the first session of an Alzheimer disease support group for family members, the nurse recognizes the need to
a. encourage member contributions and emphasize cooperation in recognizing each persons talents related to group goals.
b. accept differences in member perceptions as being normal and growth producing.
c. encourage group members to introduce themselves and share a little of their background or their reason for coming to the group.
d. link constructive themes while stating the nature of the disagreement.
10. When members of a group experience controversy, conflict, and disagreements, the nurse leading the group recognizes the importance of
a. encouraging member contributions and emphasizing cooperation in recognizing each persons talents related to group goals.
b. focusing on working together and participating in another persons personal growth.
c. having members introduce themselves and share a little of their background or their reason for coming to the group.
d. accepting differences in member perceptions as being normal and growth producing.

Chapter 9: Self Concept in Professional Interpersonal Relationships
1. Which of the following represents the role of the nurse in helping a client reframe a potentially incapacitating sense of self into one with more hope and broader options when faced with a health-related difficulty?
a. They can take a passive approach.
b. They can negate potential possibilities.
c. They can focus on personal weaknesses.
d. They can reframe the clients sense of self.
2. An older adult client is admitted to the hospital with terminal cancer. The client expresses acceptance of impending death and states, I am very satisfied with the life I had. The nurse recognizes the client is in Eriksons stage of psychosocial development known as which of the following?
a. Integrity vs. Despair
b. Autonomy vs. Shame and Doubt
c. Intimacy vs. Isolation
d. Identity vs. Identity Diffusion
3. The nurse is caring for an adolescent client who has had an amputation of his right leg. The client states, Im really worried my girlfriend might not want to be with me anymore. I dont look the same. Which of the following concepts is represented in this situation?
a. Role performance
b. Body image
c. Self-esteem
d. Personal identity
4. Which of the following statements about perception is true?
a. Perception is a function of the senses.
b. Perception is an interpersonal process.
c. Positive images are retained longer than negative ones.
d. Personal identity is constructed through cognitive processes of perception.
5. 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. Distorted reality
b. Selective attention
c. Self-fulfilling prophecy
d. Cognitive distortion
6. A client states, I am an obese, compulsive person. The nurse demonstrates how to conduct a perceptual check when stating which of the following?
a. Can you tell me more about this?
b. Is it difficult for you to be this way?
c. I wouldnt worry about being very neat.
d. It is okay to be this way; you are not hurting anyone.
7. When learning about the Johari Window, the student nurse recognizes that the model consists of four areas, and that the hidden self can best be described as
a. what is known to self and others.
b. what is known by others, but not by self.
c. what is known by self, but not by others.
d. what is unknown to self and also unknown to others.
8. When giving a class presentation on self-concept, a student nurse notices that a classmate has fallen asleep. The student nurse immediately decides that the presentation must be boring and that she will fail this assignment and subsequently obtain a poor grade in the course. This is an example of
a. selective attention.
b. negative self-talk.
c. self-fulfilling prophecy.
d. negative feedback.
9. Which of the following statements is true about self-esteem?
a. It is an objective emotional process.
b. Achievements lead to high self-esteem.
c. It is the emotional value a person places on his or her self-concept.
d. It is a concept that becomes fixed.
10. When directing the behavior of clients, it is important for the nurse to
a. understand the dimensions of self-concept.
b. become personally involved with each client.
c. learn to control ones feelings.
d. offer limited guidance and support.

Chapter 10: Developing Therapeutic Relationships
1. Which of the following examples indicates adherence to client confidentiality?
a. Talking about the clients symptoms in front of family members
b. Using the clients name in a social conversation
c. Sharing client information with other members of the health care team as needed
d. Reading a friends chart on another hospital unit
2. When your are administering medications to a client with human immunodeficiency virus (HIV), the client states, I should just stop taking them and get it over with. A therapeutic response by the nurse would be
a. You have to take these! If you stop you will get very sick.
b. Youre just feeling depressed right now. Youll feel better later.
c. Tell me more about what youre feeling.
d. You have the right to refuse treatment.
3. A client has been informed by her physician that she requires emergency surgery. The client 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 client?
a. The client will accept the recommended medical regimen.
b. The client will alternate activity with rest throughout the day.
c. The client will take a leave of absence from her work schedule.
d. The client will check her blood pressure four times a day.
4. A nurse whose father was an alcoholic is assigned to care for a client who is in alcohol withdrawal. The nurses best therapeutic action would be to
a. request another assignment.
b. deliver care in short intervals to avoid projecting negativity.
c. examine personal vulnerabilities, strengths, and limitations.
d. monitor the clients physical status closely.
5. A nurse returns to work to find that a substitute nurse has changed the treatment plan of her favorite client. In the presence of the client, the nurse becomes angry and critical of the other nurse. This is an example of
a. overinvolvement.
b. client-centered approach.
c. professional focus.
d. disengagement.
6. The professional relationship goes through a developmental process characterized by overlapping yet distinct stages, which are
a. confidentiality, trust, and empathy.
b. listening, hearing, and feeling.
c. preinteraction, orientation, working phase, and termination phase.
d. getting details, thoughts, and answers.
7. Which of the following personality characteristics can affect the nurses ability to function in a therapeutic manner, if disclosed to the client?
a. The nurse is shy.
b. The nurse becomes angry when criticized.
c. The nurse has difficulty handling conflict.
d. The nurse struggles with getting up in the morning.
8. In the preinteraction phase of the nurse-client relationship
a. professional goals are communicated directly to the client.
b. the content of the interaction is vital; the environment has little importance.
c. the nurse develops the appropriate physical and interpersonal environment for an optimal relationship.
d. it is the nurses knowledge of principles and responsibilities that guarantees a successful relationship.
9. Which of the following is a nontherapeutic statement during the orientation phase of a relationship?
a. I am the nurse who will be caring for you today.
b. My job is to make you better.
c. I will be talking with you while I provide care.
d. You will be receiving care from an assistant and myself.
10. The nurse practices here and now focus on problem identification, with an emphasis on quickly understanding the context in which the problem is embedded during which of the following phases of the nurse-client relationship?
a. Orientation
b. Preinteraction
c. Termination
d. Working

Chapter 11: Bridges and Barriers in Therapeutic Relationships
1. Which of the following describes caring?
a. It is difficult to demonstrate professionally.
b. It is an ethical responsibility.
c. It is an intuitive process.
d. It is not influenced by past experience.
2. Which of the following should be achieved first in establishing the nurse-client relationship?
a. Trust
b. Empathy
c. Mutuality
d. Empowerment
3. Which of the following describes mutual goals?
a. Mutuality is based on client goals.
b. Mutuality is based on interdisciplinary health team goals.
c. Mutuality is based on the nurses goals.
d. Mutuality is based on the physicians goals.
4. Which of the following is a violation of client confidentiality?
a. Sharing of information about a communicable disease
b. Stating clients diagnosis during change of shift report
c. Photographing a clients wound to monitor the healing process
d. Discussing private information about the client casually with others
5. Stereotypes are learned during
a. exposure to early education.
b. childhood and reinforced by life experiences.
c. limited contact with other cultures.
d. uncomfortable experiences with culturally diverse clients.
6. Which of the following describes proxemics?
a. Study of relationship between message and topic at hand
b. Study of implied meanings within individuals
c. Study of an individuals use of space
d. Study of the emotional personal space boundary
7. Which of the following is a barrier to communication?
a. Intrusion into personal space
b. Unconditional acceptance
c. Self-awareness
d. Gender differences
8. Which of the following is true about trust?
a. The sender feels it.
b. It is difficult to demonstrate professionally.
c. It is an intuitive process.
d. The trusting client feels comfortable revealing needs.
9. The nurse demonstrates an understanding of mutuality when stating to the client,
a. Mr. Jones, I think you should go to bed now.
b. Mr. Jones, I would like you to go to bed now.
c. Mr. Jones, I dont think you should sit in the chair.
d. Mr. Jones, I thought we agreed that you would return to bed at this time.
10. When entering a clients room, the nurse notices the client standing while wringing her hands and wearing street clothes over pajamas. On further examination, it is noted that the client is hyperventilating with elevated vital signs. Which level of anxiety is the client experiencing?
a. Mild
b. Moderate
c. Severe
d. Panic

Chapter 12: Communicating with Families
1. Regardless of how uniquely they are defined, strong emotional ties and durability of membership characterize
a. family function.
b. family process.
c. family relationships.
d. family ecomap.
2. When focusing on family interrelationships and the impact a serious health alteration has on individual family members and the equilibrium of the family system, the nurse should use
a. equifinality.
b. diffuse boundaries.
c. circular questions.
d. morphostasis.
3. A family systems theory that conceptualizes the family as an interactive emotional unit in which family members assume reciprocal family roles, develop automatic communication patterns, and react to each other in predictable, connected ways, particularly when family anxiety is high, was created by
a. Evelyn Duvall.
b. Murray Bowen.
c. McCubbin & McCubbin.
d. Salvador Minuchin.
4. The nurse is caring for a client who is extremely dependent on the approval of others, causing them to discount their own needs. The nurse recognizes that the client is demonstrating
a. self-differentiation.
b. emotional cutoff.
c. poor self-differentiation.
d. rigid boundaries.
5. The nurse is caring for a client who reports having marital difficulties. When experiencing heightened anxiety related to his health issues, the client chooses to discuss his feelings with a female friend rather than with his spouse. The nurse recognizes the clients actions as a defensive way of reducing, neutralizing, or defusing heightened anxiety known as
a. systems thinking.
b. triangles.
c. feedback loops.
d. multigenerational transmission.
6. When performing an admission assessment on a client, the nurse asks about sibling position based on the knowledge that sibling position can shape relationships and influence a persons expression of behavioral characteristics. The concept that each sibling position has its own strengths and weaknesses is based on the work of:
a. Murray Bowen.
b. Walter Toman.
c. Medalie & Cole-Kelly.
d. McCubbin & McCubbin.
7. When performing an assessment that focuses on a set of standardized connections to graphically record basic information about family members and their relationships over three generations, the nurse uses
a. an ecomap.
b. a gendergram.
c. family time lines.
d. a genogram.
8. When interviewing the family of a client newly diagnosed with Alzheimer disease, the nurses primary goal is to help the family members sort out their personal fears and identify family strengths through the use of
a. interventive questioning.
b. genogram.
c. ecomap.
d. offering commendations.
9. When interviewing the family of a client who is suffering from alcoholism, the communication technique used by the nurse is called circular questioning. The advantage of this technique is that it
a. examines relationships.
b. aids the nurse in establishing a diagnosis.
c. focuses on the equilibrium of the family system.
d. helps the nurse gain specific information.
10. Which of the following describes the dyad family unit?
a. A father and mother with one or more children living together
b. Second- and third-generation members related by blood or marriage but not living together
c. Divorced, never married, separated, or widowed male or female and at least one child
d. Husband and wife or other couple living alone without children

Chapter 13: Resolving Conflicts between Nurse and Client
1. The nurse is caring for an intoxicated client who has been admitted to the emergency department. The client appears very angry and frequently shouts at the nurse and demands to see the physician. The best response by the nurse is to use
a. blaming.
b. empathy.
c. competition.
d. I statements.
2. When working in situations that involve conflict, the nurse recognizes that which of the following is true in relation to conflict?
a. Conflict always leads to impaired relationships.
b. Conflict arises from compatible goals and needs.
c. Most people experience conflict as a lack of discomfort.
d. Conflict serves as a warning that something in the relationship needs closer attention.
3. A nurse manager is educating nurses about the risk of violence experienced by nurses and social workers in their workplace when compared to other professionals. The nurse manager states that nurses and social workers are at
a. three times greater risk to experience violence in their workplace than are other professionals.
b. four times greater risk to experience violence in their workplace than are other professionals.
c. no greater risk to experience violence in their workplace than are other professionals.
d. two times greater risk to experience violence in their workplace than are other professionals.
4. The most effective problem-solving style for genuine resolution that creates a win-win situation is
a. accommodation.
b. avoidance.
c. competition.
d. collaboration.
5. When a physician writes an order for the nurse to withhold life-saving treatment from a terminally ill client, the nurse is faced with two different choices, each supported by a different ethical principle. This type of conflict is known as
a. covert conflict.
b. overt conflict.
c. interpersonal conflict.
d. intrapersonal conflict.
6. Which of the following best describes the goal of assertiveness?
a. Offering responses that contain you statements
b. Indirect communication
c. Standing up for ones personal rights
d. Ignoring the rights of others
7. Which of the following is true about assertion communication?
a. Components include the ability to say no and to ask for what you want.
b. It includes a demonstration of deference to the demands of others.
c. It consistently violates the needs of others.
d. It includes the expression of only positive thoughts and feelings.
8. A client yells at the nurse frequently and uses profane language. Which of the following is the most appropriate response by the nurse?
a. Remain silent and do not respond
b. Use an I statement when speaking to the client
c. Tell the client, You make me angry.
d. Ignore the behavior and walk away
9. A client states to the nurse in a hostile voice, I am sick of being poked at and stuck with needles. Go away and leave me alone. Which of the following is the best statement by the nurse?
a. I am not surprised that you wish to be left alone.
b. Im so sorry you are feeling so upset.
c. You feel vulnerable and depressed as a result of all these treatments.
d. Okay, I will go away.
10. A client on a psychiatric unit is found pacing the halls and angrily punching at the wall. The nurses primary goal should be to
a. assertively tell the client to stop the behavior.
b. suggest that the client write in a journal to help relieve anxiety.
c. speak in a loud voice in order to alert other staff members.
d. maintain safety while helping the client.

Chapter 14: Communicating to Encourage Health Literacy, Health Promotion, and Prevention of Disease
1. When conducting an initial assessment, a client informs the nurse about difficulty getting to doctors appointments due to lack of transportation. When considering examples of PRECEDE Diagnostic Behavioral Factors, the nurse recognizes this as what type of factor?
a. Reinforcing factor
b. Epidemiologic factor
c. Enabling factor
d. Predisposing factor
2. The concept of well-being consists entirely of the ability to
a. work at producing an income.
b. perform activities of daily living.
c. define ones subjective experience of life satisfaction.
d. partner with a health professional.
3. Which of the following is an example of tertiary prevention?
a. Mammogram
b. Smoking cessation
c. Safe sex counseling
d. Diabetic meal planning class
4. A client who is recovering from her second myocardial infarction refuses to give up smoking. She states, Ive smoked so long now theres no point quitting as the damage is done. This statement is best understood in the context of which of the following?
a. Social learning theory
b. Penders health promotion model
c. The transtheoretical model of change
d. Healthy People 2010
5. A client who has an elevation in serum cholesterol continues to eat red meat and fried foods. Which stage of change is this client experiencing?
a. Determination
b. Action
c. Precontemplation
d. Contemplation
6. A client who overeats and is overweight is admitted to the hospital for shortness of breath. Which of the following statements by the nurse reflects Banduras social theory?
a. Your cardiac studies reveal an enlarged heart. This is a sign of cardiac problems.
b. I know you love to eat, but your current lifestyle is not conducive to good health.
c. Can you remember what it was like to get up and go to work every day? Your buddies miss you.
d. If you were to lose weight, you would no longer experience shortness of breath. Just think about how much better you would feel to breathe normally.
7. When caring for a client who is a newly diagnosed diabetic and who requires teaching about self-administration of insulin, the nurse recognizes that teaching will be most effective when
a. passive involvement of the learner is encouraged.
b. there is little focus on practicing essential skills.
c. optimizing engagement in only one sense in the learning process is encouraged.
d. encouraging teach-back feedback when demonstrating new skills.
8. Which of the following is the best intervention for a client who is illiterate?
a. Speak loudly and clearly.
b. Use symbols and images.
c. Personalize speech by using first name.
d. Use touch with speech.
9. The nurse is caring for an older adult client who is newly diagnosed with diabetes and has a low literacy level. Which of the following guidelines for teaching low-literacy clients should the nurse use when working with this client?
a. Teach the largest amount possible in each teaching session.
b. Sequence key behavior information last when teaching the client.
c. Use symbols and images with which the client is familiar.
d. Use words that are abstract and provide teaching in long sentences.
10. When caring for clients, the nurse recognizes that which of the following statements is true related to developmental level?
a. Developmental level affects only teaching strategies.
b. All clients are at the beginning level of the learning spectrum.
c. Developmental learning capacity is always age related.
d. Social and emotional development does not always parallel cognitive maturity.

Chapter 15: Health Teaching and Coaching
1. Educational standards requiring health care agencies to provide systematic health education and training for clients were established by
a. American Nurses Association.
b. State Nurse Practice Acts.
c. The Joint Commission.
d. Medicare.
2. When initiating health teaching, the nurse recognizes that readiness to learn
a. is the same as the cognitive ability to learn.
b. involves a smooth and linear developmental process.
c. requires the nurse to consistently challenge the clients learning pattern.
d. involves incorporation of the clients learning pattern into new opportunities for learning.
3. When the nurse formulates a goal that the client will be able to accurately draw up the correct dose of insulin, the nurse recognizes this goal as referring primarily to health teaching in which domain?
a. Changing attitudes
b. Psychomotor
c. Understanding content
d. Promoting acceptance
4. The nurse is caring for a client who has a history of alcohol abuse. When formulating a goal that the client will be able to identify three physical effects of alcohol abuse, the nurse recognizes this goal as referring primarily to health teaching in which domain?
a. Cognitive
b. Affective
c. Psychomotor
d. Promoting acceptance
5. A theoretical foundation for the use of teaching methodologies in which a learner-centered approach engages clients as active partners in the learning process and helps them to take responsibility for their own learning to whatever extent possible is known as
a. Skinners behavioral approach.
b. Premacks principle.
c. modeling.
d. client-centered health teaching.
6. When planning an education class for clients suffering from addiction, the nurse recognizes that a format that encourages empowerment is an important goal of health teaching. Which of the following is a strategy that could be viewed as disempowering?
a. Providing the client with sufficient information
b. Providing the client with emotional support
c. Placing the learner in charge of his or her learning
d. Having the nurse assume primary responsibility for the learning process
7. A nurse is working with a client in a drug rehabilitation center. The nurse provides positive reinforcement each time the client demonstrates behavior that moves him closer to accomplishing the goal of remaining drug free. The nurse recognizes this type of reinforcement will motivate the client to engage in the desired behavior. This type of reinforcement is known as
a. empowerment.
b. chaining.
c. modeling.
d. shaping.
8. The concept that the teacher must start where the learner is was proposed by whom?
a. Skinner
b. Premack
c. Rogers
d. Taylor
9. The nurse is caring for a client who is suffering from schizophrenia and cocaine abuse. The client remains isolated in his room, refusing to attend unit activities. When implementing a behavioral approach, what is the first step the nurse should take?
a. Define specific consequences.
b. Describe the behavior requiring change.
c. Reframe the problem as a solution statement.
d. Identify the tasks in sequential order.
10. A client is newly diagnosed with diabetes mellitus. When planning a teaching session to review insulin administration with this client, the nurse should
a. pick times for teaching when energy levels are low.
b. schedule teaching sessions during hospital visiting hours.
c. reserve a block of time for health teaching.
d. provide the client with extensive information during 30-minute intervals.

Chapter 16: Empowerment-Oriented Communication Strategies to Reduce Stress
1. Current research suggests that men and women respond to stress in which of the following ways?
a. Men use nurturing activities to reduce stress.
b. Women use a tend and befriend approach to stress.
c. Men and women respond to stress in a similar manner.
d. Women respond to stress with patterns of fight or flight.
2. Which of the following is true in relation to stress?
a. Men and women respond to stress in the same fashion.
b. Culture does not affect the stress experience.
c. Stress is always a negative experience.
d. Stress can have protective and adaptive functions.
3. The nurse is conducting a family assessment in which alcoholism by the parents is suspected. When assessing the children within this family for symptoms of stress, the nurse recognizes that
a. the children will most likely verbalize their feelings about the stressor.
b. the children will demonstrate the ability to sort out the meaning of the illness.
c. signs of distress can include academic decline, gastric distress, and headaches.
d. physical complaints by the children can only be related to a physiological etiology.
4. A short-term mild level of stress that acts as a positive stress response with protective and adaptive functions and is perceived as being within the persons ability to manage is known as
a. stress.
b. eustress.
c. stressor.
d. distress.
5. A three-stage progressive pattern of nonspecific physiologic responses known as alarm, resistance, and exhaustion is based on
a. Cannons scientific physiologic response theory.
b. Selyes General Adaptation Syndrome.
c. Holmes and Rahes stimuli stress model.
d. Lazarus and Folkmans transactional model of stress.
6. A client is experiencing anxiety related to hospitalization. When assessing this client, the nurse anticipates which assessment finding?
a. Increased socialization
b. Improved sleep
c. Greater recall ability
d. Disengagement from the stressor
7. A clients spouse becomes anxious and demonstrates hostility toward the nurse. The best response by the nurse is to
a. recognize the spouse feels a sense of control.
b. view the hostility as a personal attack.
c. become stoic and refrain from listening to the spouse.
d. respond empathetically to contributory themes and feelings.
8. A client tells the nurse, I think Im losing my mind. The best response by the nurse is
a. Tell me what you are experiencing right now.
b. You should take a nap now; it will help you to feel better.
c. If you say that youre losing mind, you really will lose your mind.
d. I dont think you really feel that you are losing your mind.
9. A client who has been diagnosed with cancer asks the nurse, If I take the chemotherapy, will I be cured, or am I going to die anyway? The nurses best response is
a. Tell me what prompted your question.
b. I dont think you should have chemotherapy; it will harm you more than help you.
c. Lets not talk about dying; Im sure you will be cured.
d. I really dont think you should worry about such things; it isnt something you can control.
10. A nurse consistently works extra shifts in the hope of earning a promotion. The nurse is becoming increasingly fatigued and frustrated because the promotion has not occurred. The nurse is experiencing
a. distress.
b. burnout.
c. eustress.
d. primary appraisal.

Chapter 17: Communicating with Clients Experiencing Communication Deficits
1. Which of the following is true in relation to communication deficits?
a. Communication deficits occur only as a result of physical disabilities.
b. Communication deficits can arise from sensory deprivation.
c. Individuals who are equally impaired are equally disabled.
d. The primary nursing goal is to minimize the clients independence.
2. The nurse is caring for an older adult client who has recently withdrawn from relationships, appears depressed, and appears reluctant to seek information from the nurse. The nurse suspects the client is experiencing hearing loss. The nurse recognizes that
a. the client will readily acknowledge that this is the problem if asked.
b. the client may try to hide deficits and withdraw from relationships.
c. decreased hearing ability is not related to conversational style.
d. older adults, as a group, have better consonant discrimination.
3. The nurse is caring for a client who has experienced a stroke. The client has aphasia. The nurse recognizes that aphasia is a
a. neurological linguistic deficit.
b. cognitive comprehension deficit.
c. sensory deprivation deficit.
d. mental disorder deficit.
4. When communicating with a client diagnosed with a serious mental disorder, it is important for the nurse to recognize which of the following?
a. Clients with mental disorders never have intact sensory channels
b. Clients with a flat affect are easier to understand
c. Clients with mental disorders are always very talkative
d. Clients with mental disorders may suffer from social isolation and impaired coping
5. When caring for a hearing-impaired client, the nurse should
a. face the interpreter when speaking to the client.
b. use gestures that reinforce verbal content.
c. speak distinctly while exaggerating words.
d. communicate in a dimly-lit room.
6. When caring for the client with macular degeneration, the nurse should
a. face the client directly.
b. stand to the clients side.
c. hold the clients arm when walking.
d. refrain from touching the client.
7. Which of the following clients with a communication deficit requires the use of touch during a therapeutic encounter?
a. Vision-impaired client
b. Client with a hearing loss
c. Mentally ill client
d. Client with schizophrenia
8. The nurse is caring for an older adult client who is recovering from a stroke. When the nurse speaks to the client, the client nods her head and responds using incoherent words. Which type of aphasia does this client exhibit?
a. Expressive
b. Receptive
c. Global
d. Cognitive
9. The nurse is caring for a client who has experienced global aphasia secondary to a stroke. Which of the following interventions is most appropriate for this client?
a. Refrain from exploiting any language skills that are preserved
b. Frequently remind the client they cannot be understood
c. Encourage short, positive sessions to communicate
d. Spend long periods of time talking with the client to provide stimulation
10. The nurse is caring for an unconscious client. The clients family member reports that a nurse at the clients bedside stated, I wouldnt want to live in this condition. What did this nurse not realize about the clients capabilities?
a. The client can read lips
b. Hearing can remain acute in clients who are not fully alert
c. The client can respond to statements through written communication
d. The client can be sensitive to the nurses nonverbal behavior

Chapter 18: Communicating with Children
1. In mastering QSEN competency of patient-centered care, effective tools need to be
a. cognitive, developmentally appropriate, and educational.
b. cultural, educational, interpersonal, and societal.
c. attitudinal, cognitive, and developmentally appropriate.
d. attitudinal, cultural, and developmentally appropriate.
2. 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 Piagets cognitive stages of development?
a. Concrete operations
b. Formal operations
c. Preoperational
d. Sensorimotor
3. When communicating with a preschooler who is admitted to the hospital for a fractured arm, which is the best method for the nurse to describe the preschoolers impending surgery?
a. Encourage the preschooler to put a bandage on a teddy bears arm.
b. Explain what surgery will be like, using abstract terminology.
c. Explain to the preschooler how long the surgery will take and that it will be done by noon.
d. Inform the preschooler that fixing the fractured arm will make it possible to play sports in the future.
4. When assessing a childs reaction to illness, it is important for the nurse to
a. observe the interaction between parent and child.
b. recognize that chronological age matches cognitive level.
c. realize that children are more comfortable with female health care providers.
d. recognize that the childs behavior will be age appropriate.
5. 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. obtain a urine sample and send it to the lab.
c. reassure the childs parents that this is common.
d. eliminate all fluids after dinner.
6. A pediatric nurse is educating parents about how children cope with hospitalization. Which of the following statements by the nurse is correct?
a. The quiet, compliant child who never complains is comfortable on the nursing unit.
b. The child who screams and cries is much more frightened of hospitalization than the quiet child.
c. The 2-year-old child who asks for a bedtime bottle is showing signs of regression.
d. The child who screams and cries may be less frightened than the quiet, overly compliant child who never complains.
7. When communicating with hospitalized infants and toddlers, the nurse knows
a. she should use long sentences with soothing words.
b. she cannot communicate with a preverbal infant.
c. moving to the childs eye level and maintaining eye contact are important.
d. she should pick up an 18-month-old infant immediately.
8. During the preoperational period the nurse recognizes that children
a. ask numerous questions to clarify a message.
b. can process auditory information quickly.
c. can clearly distinguish between fantasy and reality.
d. misunderstand messages quite easily.
9. The nurse is caring for a postoperative preschooler who is crying and has been refusing to eat. The best communication strategy for the nurse to use is to
a. avoid providing the child with simple explanations.
b. assign the child to a different nurse in order to optimize socialization.
c. give the child some clay, crayons, and paper.
d. encourage the child to express complex thoughts and feelings.
10. Which of the following is true in relation to the stress of having an ill child?
a. Coping with uncertainty over the outcome is the most stressful factor for parents.
b. Factors connected with the childs illness causes more stress than alleviation of the childs pain.
c. Uncertainty about a critically ill childs current condition is considered to be a minor source of stress.
d. The parents inability to comfort the child is more stressful than factors connected with the illness.

Chapter 19: Communicating with Older Adults
1. The nurse is caring for an older adult client. The nurse recognizes that the factor most closely associated with the older adults inability to live independently is
a. chronological age.
b. functional status.
c. relationship needs.
d. social functioning.
2. An older adult client tells th

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