Professional Nursing Concepts & Challenges 8th Edition Test bank

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Professional Nursing Concepts & Challenges 8th Edition Test bank

Description

Chapter 12: Communication and Collaboration in Professional Nursing Practice
Black: Professional Nursing: Concepts & Challenges, 8th Edition

MULTIPLE CHOICE

1. Which of the following best describes Peplaus theory on therapeutic use of self?
a.
Putting patients needs ahead of your own
b.
Providing excellent clinical skills to improve patients health status
c.
Using excellent interpersonal skills to help patients improve their health status
d.
Self-protection through avoidance of a relationship with the patient

ANS: C

Feedback
A
Putting patients needs ahead of your own is not the best answer because although it is true that the patients needs, not the nurses, are met during the therapeutic relationship, nurses should not necessarily put all patient needs ahead of their own.
B
The theory focuses on therapeutic communication, not clinical skills.
C
Peplaus theory described using ones personality and communication skills to help patients improve their health status as therapeutic use of self.
D
The focus is the patient, not the nurse.

DIF: Cognitive Level: Comprehension REF: Page 232

2. Therapeutic use of self involves
a.
forming a relationship based on the nurses knowledge, attitudes, and skills to communicate effectively.
b.
providing a safe environment based on the use of environmental manipulation and verbal limit setting.
c.
evaluation of nurse-patient interactions and the creation of social alliances.
d.
determining whether it is necessary to listen to the patient and provide feedback.

ANS: A

Feedback
A
Therapeutic use of self as defined by Peplau included using communication skills to help patients.
B
Therapeutic use of self does not involve the manipulation of the environment.
C
Therapeutic use of self does not involve the creation of social alliances.
D
Therapeutic use of self involves listening and providing feedback to the patient.

DIF: Cognitive Level: Comprehension REF: Page 232

3. What is the most important information the nurse should share with the patient during the orientation phase?
a.
Name, credentials, extent of responsibility
b.
Plan for the day, times the nurse will be unavailable, how to contact the nurse
c.
Nurses name, physicians name, possible discharge date
d.
Plan for discharge, teaching needs, goals for the day

ANS: A

Feedback
A
During the orientation phase the nurse shares his or her name, credentials, and extent of responsibilities.
B
Sharing information about the plan for the day, times the nurse will be unavailable and how to contact the nurse is not primary during the orientation phase.
C
Determining a discharge date would be the responsibility of the entire treatment team.
D
The nurse does not share the plan for discharge and teaching needs during the orientation phase.

DIF: Cognitive Level: Knowledge REF: Pages 232-233

4. One of the most important outcomes of the orientation phase of the nurse-patient relationship is the development of mutual
a.
communication.
b.
understanding.
c.
acceptance.
d.
trust.

ANS: D

Feedback
A
The entire relationship requires excellent communication, not just the orientation phase.
B
All phases of the therapeutic relationship require understanding.
C
All phases require nonjudgmental acceptance.
D
The purpose of the orientation phase is to establish trust.

DIF: Cognitive Level: Comprehension REF: Page 232

5. Which behaviors help patients develop trust in the nurse?
a.
Answering questions with authority
b.
Sharing personal information to indicate openness
c.
Conveying acceptance of the patient and a nonjudgmental attitude
d.
Meeting with the patient spontaneously because that indicates caring

ANS: C

Feedback
A
Although answering questions as fully as possible and admitting the limits of knowledge facilitates trust, answering questions with authority implying that this is the entire answer does not help develop trust.
B
The sharing of personal information does not help develop trust.
C
Accepting the patients thoughts and feelings without judgment helps develop trust in the nurse.
D
Meeting at designated times helps the patient develop trust that the nurse will follow through with what is promised.

DIF: Cognitive Level: Comprehension REF: Page 232

6. The nurse says to a newly diagnosed diabetic patient, I will be working with you during your 3-day stay to help you practice insulin injections and to review your new diet. Im wondering if we could find a time of day to begin the teaching sessions that is good for us. This conversation would occur in which phase of the nurse-patient relationship?
a.
Acquaintance phase
b.
Orientation phase
c.
Working phase
d.
Termination phase

ANS: B

Feedback
A
The phases of the nurse-patient relationship do not include an acquaintance phase.
B
During the orientation phase the time frame of the relationship is established, the problems to be worked on are identified, and a time to meet is established.
C
The working phase is when the nurse and patient address the problems.
D
The termination phase is when the relationship is ending.

DIF: Cognitive Level: Application REF: Pages 232-233

7. Which of the following suggests that a successful contract has been established between the nurse and patient in the orientation phase of the nurse-patient relationship?
a.
Patient has agreed to learn to change his colostomy bag.
b.
Patient ambulates in the hall without assistance.
c.
Patient allows the nurse to inject his daily insulin.
d.
Patient asks the charge nurse to verify that the staff nurses teaching is correct.

ANS: A

Feedback
A
The successful completion of a planned intervention signifies the successful establishment of the therapeutic relationship.
B
The patient is acting independently of the nurses instructions.
C
The patient is not moving toward goals of independence.
D
Trust has not been established.

DIF: Cognitive Level: Application REF: Page 233

8. A newly diagnosed diabetic patient states I have very definite likes and dislikes when it comes to food. Am I going to have to eat only certain foods, or will I have some choice? The nurse responds, Why dont you give me a list of your likes and dislikes? I will consult with the dietitian about how to include your preferences and still come up with a good diet for you. What phase of the nurse-patient relationship is this?
a.
Relationship phase
b.
Orientation phase
c.
Working phase
d.
Termination phase

ANS: C

Feedback
A
The phases of the nurse-patient relationship do not include a relationship phase.
B
The orientation phase is when the relationship is established, the problems to be worked on are identified, and a time to meet is established.
C
The working phase is when the nurse and patient address the problems that have been identified.
D
The termination phase is when the relationship is ending.

DIF: Cognitive Level: Comprehension REF: Page 233

9. A patient demonstrates obvious regression in ability to perform self-care during the working phase. Which response by the nurse is most appropriate?
a.
Frustration because the patient does not appear to be motivated to achieve goals
b.
Persistence in demonstrating the importance of achieving goals
c.
Patience and understanding because regression is a defense mechanism
d.
Ignoring it because the nurse realizes the patient is exhibiting childlike behavior

ANS: C

Feedback
A
The nurse needs to show patience and maturity, not frustration.
B
Regression may be a necessary defense mechanism against stress, and the nurse needs patience during this time.
C
Patience and understanding are necessary because the patients progress toward goal achievement may not be smooth. Regression is a defense mechanism that may precede positive outcomes.
D
Understanding of regression is needed during this time.

DIF: Cognitive Level: Analysis REF: Page 233

10. When should the preparation for the termination phase of the nurse-patient relationship begin?
a.
In the orientation phase
b.
During the working phase
c.
As part of the termination phase
d.
Right before termination

ANS: A

Feedback
A
During the orientation phase, the nurse gives the patient an estimated time frame for their relationship. This begins the preparation for termination.
B
Preparation for termination of the nurse-patient relationship begins in the orientation phase.
C
Preparation for termination of the nurse-patient relationship begins in the orientation phase.
D
Preparation for termination of the nurse-patient relationship begins in the orientation phase.

DIF: Cognitive Level: Knowledge REF: Page 233

11. The nurse and patient may experience sadness during the termination phase. How can the nurse help the patient be successful in the termination phase of the nurse-patient relationship?
a.
Providing personal contact information so the patient can contact the nurse if needed
b.
Visiting the patient at home during off-duty time to help the transition to self-care
c.
Emphasizing the achievements the patient has made, including the ability for self-care
d.
Exchanging goodbye gifts as a sign that the relationship is terminated

ANS: C

Feedback
A
Nurses should not maintain personal communication with patients after discharge.
B
The nurse respects professional boundaries.
C
Emphasizing the patients achievement of goals and the reasons he or she does not need the nurse anymore is effective in the termination process.
D
Nurses should not exchange gifts with patients but should instead respect professional boundaries.

DIF: Cognitive Level: Comprehension REF: Page 233

12. A patient is being discharged from the hospital. Which statement by the nurse is appropriate for the termination phase of the nurse-patient relationship?
a.
You must be happy to be going home. Here are the written diet and medication instructions.
b.
It has been wonderful getting to know you. The best of luck when you get home.
c.
During the past 3 days, you have learned how to inject insulin and how to make appropriate food choices. Remember that you have the unit telephone number if you have any questions.
d.
You have done well learning a lot of new material and should be able to do well at home.

ANS: C

Feedback
A
This response does not summarize what has occurred, which is an important part of the termination phase.
B
This response does not include a summary of the progress the patient has made, which is an important part of the termination phase.
C
Summarizing the gains the patient has made is important during the termination phase.
D
This response gives false reassurance about success at home.

DIF: Cognitive Level: Application REF: Page 233

13. Which of the following is an effective way to maintain safe professional boundaries?
a.
Never accepting small gifts from patients
b.
Finding ways to satisfy your needs through personal relationships outside of nursing
c.
Avoiding caring for patients who ask personal questions about you
d.
Sharing your personal stories so that patients will feel understood and trusting

ANS: B

Feedback
A
There are many other possibilities for violating professional boundaries; gifts are only one small way and, on occasions when the gift is not valuable and can be shared with the entire staff, may be accepted.
B
Respecting professional boundaries means that the nurse recognizes the vulnerability of the patient and the power that comes from the nurses personal knowledge about the patient. Finding ways to satisfy personal needs outside of the professional relationship will prevent the nurse from becoming inappropriately involved with the patient.
C
Avoidance is not a helpful response to any nurse-patient problem.
D
The nurse should stay focused on the patient.

DIF: Cognitive Level: Comprehension REF: Page 234

14. Which of the following is most important in order for a new staff nurse to communicate therapeutically with patients?
a.
Focusing interactions on educating patients about their treatments
b.
Becoming aware of own feelings about illness and death
c.
Sharing information about the intimate details of ones own life
d.
Presenting himself or herself as a knowledgeable and experienced clinician

ANS: B

Feedback
A
Although education is important for patients, this does not help the nurse understand his or her feeling and responses.
B
Reflection will allow the nurse to develop self-awareness, which will help him or her become a better advocate for the patients.
C
Sharing intimate personal information is not therapeutic.
D
As a new nurse, knowledge and experience may be limited; portraying more knowledge and experience than one has is deceitful.

DIF: Cognitive Level: Application REF: Page 235

15. During report, a nurse complains about a 3-year-old boy, saying He sure knows when to pour on the tears. Theres nothing wrong until he sees you; then the tears start, but they stop as soon as you leave or his mother comes. Hes just spoiled because they have a nanny at home who waits on him hand and foot. This is an example of
a.
lack of understanding of child development.
b.
frustration that the mother is not present.
c.
assessment of the childs behavior.
d.
stereotyping because the child has a nanny.

ANS: D

Feedback
A
The response does not reflect lack of knowledge about child development, assessment of the behavior, or a response to the mothers not being present.
B
The response does not reflect lack of knowledge about child development, assessment of the behavior, or a response to the mothers not being present.
C
The response does not reflect lack of knowledge about child development, assessment of the behavior, or a response to the mothers not being present.
D
Stereotypes are simplistic and illogical images used to describe groups of people.

DIF: Cognitive Level: Analysis REF: Page 236

16. A nurse comments in private about a patient: That lady with six kids is pregnant again! It makes me sick to see these people on welfare taking away from our tax dollars. I dont know how she can continue to do this. The best response by a nurse peer is to
a.
ignore the biased statements.
b.
accept the comments as self-disclosure.
c.
offer neutral responses.
d.
convey acceptance of the patient.

ANS: D

Feedback
A
To ignore the statements will not help this nurse become aware of stereotypes.
B
These statements do not qualify as self-disclosure.
C
Offering neutral responses will not help the nurse become aware of stereotyping.
D
Acceptance conveys neither approval nor disapproval of personal beliefs. Nonjudgmental acceptance means that the nurse acknowledges that all people have rights to be different and to express their differences. Nurses should convey acceptance of people as they are even if they disagree with specific beliefs and/or practices.

DIF: Cognitive Level: Application REF: Page 236

17. Which of the following best illustrates nonjudgmental acceptance by the nurse?
a.
Using professional influence to change a patients morality to be more in keeping with societal norms
b.
Changing your assignment if you discover that you have negative feelings toward your patients lifestyle
c.
Demonstrating caring behavior in spite of negative feelings
d.
Avoiding all negative feelings about the patient

ANS: C

Feedback
A
The nurse should not attempt to change a patients belief system or morality.
B
We cannot control our feelings but need to be able to control our behaviors.
C
Acceptance indicates neither approval nor disapproval of patients beliefs, behaviors, or lifestyles.
D
Prejudices are strong, and we may be unaware of them. It is impossible to control all negative feelings, but it is professional to acknowledge them and continue to provide safe and effective care.

DIF: Cognitive Level: Analysis REF: Page 236

18. Using Hagerty and Patuskys theory of human relatedness (2003), the nurse-patient relationship has been reconceptualized by approaching
a.
each patient contact as one step in a lengthy relationship-building process.
b.
patients with a sense of the patients autonomy, choice, and participation.
c.
the relationship as one in which the nurse has the power.
d.
the nurse-patient contact as an opportunity to streamline caregiving.

ANS: B

Feedback
A
Each contact should be approached as an opportunity for connection and goal achievement and not a lengthy process.
B
The relationship between the nurse and the patient is on a more equitable basis than the traditional nurse-patient relationship.
C
The relationship should be equitable.
D
The reconceptualization does not streamline caregiving.

DIF: Cognitive Level: Comprehension REF: Page 237

19. Which is true of verbal and nonverbal communication?
a.
Verbal messages are more important than nonverbal cues.
b.
Individuals can exercise more control over nonverbal communication.
c.
Verbal and nonverbal communication always match.
d.
The nonverbal communication may be a more reliable message.

ANS: D

Feedback
A
The nonverbal message may tell much more than the verbal one.
B
Individuals can exercise more control over verbal communication than nonverbal communication.
C
Verbal and nonverbal communication are not always congruent.
D
Nonverbal communication includes gestures, posture, facial expressions, eye contact, and actions, among other things. Although the verbal message using words may be short, the nonverbal message can tell much more about the persons feelings.

DIF: Cognitive Level: Comprehension REF: Pages 237-238

20. Which of the following could be considered congruent communication?
a.
The nurse manager states, Come by my office anytime. Then she keeps her door closed and does not answer phone calls.
b.
As a co-worker hurries down the hall, he asks, Is there anything you need help with?
c.
As she drops a stack of charts loudly on the desk, a co-worker states, This is going to be a wonderful day.
d.
The nurse manager sits with you in the nurses lounge and asks, Is there anything you would like to talk about?

ANS: D

Feedback
A
The verbal message is that she is available, but the closed door indicates otherwise.
B
The verbal message is willingness to help; the nonverbal message is, I hope you do not ask.
C
The dropping of the charts loudly indicates frustration and is incongruent with the message This is going to be a wonderful day. Sarcasm is incongruent communication.
D
The nurse managers verbal message matches the nonverbal message. This is the definition of congruent communication.

DIF: Cognitive Level: Application REF: Page 238

21. A nurse is irrigating pressure ulcers on a patients coccyx. When the patient asks how they are healing, the nurse grimaces and says, Oh, theyre doing just fine. This is
a.
incongruence between verbal and nonverbal messages.
b.
a confirming statement.
c.
objectivity in responding to the question.
d.
the therapeutic use of humor.

ANS: A

Feedback
A
The words say, Its OK, but the facial grimaces say it is not.
B
The verbal and nonverbal messages do not match.
C
Objectivity is not found in the statement.
D
There is no use of humor.

DIF: Cognitive Level: Application REF: Page 238

22. Context is one of the five major elements of communication identified by Ruesch. Which of the following is part of the context of communication?
a.
Information about the sender
b.
Attitude of the receiver
c.
Response of the receiver
d.
Content of the message

ANS: B

Feedback
A
Information about the sender is not part of the context of the communication.
B
Context refers to the environment in which the interaction occurs. This includes the mood and the relationship between the sender and receiver.
C
The response of the receiver is not part of the context of communication.
D
The content of the message is not part of the context of communication.

DIF: Cognitive Level: Comprehension REF: Page 238

23. A new mother says to the nurse, It really hurts me to breastfeed. I think I should wean my baby. The most appropriate response by the nurse is,
a.
It is good to wean the baby early because it is easier on you.
b.
If I understand you, it hurts when you breastfeed. Tell me how and when it hurts.
c.
It is your decision to make whether you breastfeed.
d.
You should continue to breastfeed because it is much better for the baby.

ANS: B

Feedback
A
Saying It is good to wean the baby early because it is easier on you gives a response before the situation is clarified and closes off continued communication.
B
The nurse is gaining feedback that helps the nurse understand more about the situation from the patients perspective and keeps communication open.
C
Saying It is your decision to make whether you breastfeed gives a response before the situation is clarified and closes off continued communication.
D
Saying You should continue to breastfeed because it is much better for the baby gives a response before the situation is clarified and closes off continued communication.

DIF: Cognitive Level: Application REF: Page 238

24. A new mother says to the nurse, It really hurts me to breastfeed. I think I should wean my baby. The nurse responds, If I understand you, it hurts when you breastfeed. Tell me how and when it hurts. This response best represents which criterion of successful communication?
a.
Appropriateness
b.
Efficiency
c.
Feedback
d.
Flexibility

ANS: C

Feedback
A
Appropriateness relates to whether the reply fits the circumstances and matches the message.
B
Efficiency means using simple, clear words that are timed at a pace suitable to the patient.
C
The nurse seeks to clarify the hurt before intervening further.
D
Flexibility means the message is based on the immediate situation and not preconceived expectations.

DIF: Cognitive Level: Application REF: Page 240

25. When a co-worker tells the nurse, I am not sure I will be able to give the right answers in the job interview, the nurse replies, I know what you mean. Interviews have always been a problem for me, too. This response can be evaluated as lacking
a.
appropriateness.
b.
efficiency.
c.
feedback.
d.
flexibility.

ANS: A

Feedback
A
Appropriateness relates to whether the reply fits the circumstances and matches the message. The nurses response related to his own issue does not deal with the co-workers issue, which should be the focus of the interaction.
B
Efficiency means using simple, clear words that are timed at a pace suitable to the patient.
C
Feedback means the nurse seeks to clarify what the patient has said and gain understanding.
D
Flexibility means the message is based on the immediate situation and not preconceived expectations.

DIF: Cognitive Level: Application REF: Page 240

26. A new mother says, My baby is being kept in the nursery. Im really worried about him. Im also worried that the separation will interfere with breastfeeding. The most appropriate response by the nurse is,
a.
Well, thats not my territory. Youll have to deal with the nursery staff about breastfeeding.
b.
As a nurse on this unit, I can assure you that we will do all we can to help you.
c.
I can see youre upset about this, but to be honest with you, Im a new nurse here, and Im not sure how I can help you.
d.
I can see this is a problem for you. I will go to the nursery and see if I can get some answers for you.

ANS: D

Feedback
A
Telling the mother that she will need to deal with the nursery staff does not address the concern of the mother.
B
Saying that the staff of the hospital will do all they can to help does not address the concern of the mother.
C
The nurse telling the mother that he is new and does not know how to help does not address the concern of the mother.
D
The nurses response fits the circumstances and matches the mothers message of being concerned about the separation and breastfeeding.

DIF: Cognitive Level: Application REF: Page 240

27. Using simple, clear words to explain the details of a colonoscopy procedure shows sensitivity to which successful communication criterion?
a.
Appropriateness
b.
Efficiency
c.
Feedback
d.
Flexibility

ANS: B

Feedback
A
Appropriateness relates to whether the reply fits the circumstances and matches the message.
B
Efficiency means using simple, clear words that are timed at a pace suitable to the patient.
C
Feedback means the nurse seeks to clarify what the patient has said and gain understanding.
D
Flexibility means the message is based on the immediate situation and not preconceived expectations.

DIF: Cognitive Level: Application REF: Page 240

28. A 4-year-old child is going to have an abdominal x-ray examination. The child asks, Why do they have to do this? Will it hurt? Which of the following is the most appropriate response by the nurse?
a.
The doctor needs you to have the x-ray so she knows what is wrong with you.
b.
You will go to the x-ray department so they can take pictures of your tummy to find out why you have a tummy ache. The bed you lie on may be cool, but you will have a blanket to keep you warm. The test will not hurt.
c.
You will go downstairs on a stretcher. You will need to lie very still on a hard table while the x-ray machine goes over you. It will not take very long.
d.
X-rays do not hurt. The machine takes a picture but will not touch you.

ANS: B

Feedback
A
Telling the child that he will need an x-ray to determine what is wrong with him does not provide a clear explanation that addresses the childs concerns.
B
The nurses response explains the procedure in clear and simple words that are suitable to a 4-year-old child.
C
Explaining the x-ray procedure in terms that may not be easy to understand for a 4-year-old does not provide a clear explanation that addresses the childs concerns.
D
Telling the child that x-rays do not hurt and that they take pictures does not provide a clear explanation that addresses the childs concerns.

DIF: Cognitive Level: Application REF: Page 240

29. Which of the following examples illustrates the nurses failure to use flexibility effectively in professional communication?
a.
Asking on the admission assessment, You dont smoke, do you?
b.
When updating a family member on a patients condition stating, Your wifes ABG report indicates significant hypoxia.
c.
Continuing to follow the agenda in a staff meeting when people are obviously upset by a recent death on the unit
d.
Requiring nurses to read back phone orders to physicians

ANS: C

Feedback
A
You dont smoke, do you? is an example of value judgment.
B
This is an example of poor communication, because the message is not geared to the receivers level of understanding.
C
Continuing to follow an established agenda when the emotional state of the group needs to be addressed indicates inflexibility on the part of the leader.
D
Requiring nurses to read back phone orders to physicians is an example of feedback.

DIF: Cognitive Level: Analysis REF: Page 241

30. The nurse plans to teach a patient about the care of her mastectomy site. The nurse finds the patient crying. The best response by the nurse is,
a.
It is time to discuss how to care for the surgical site.
b.
You seem upset. You should start looking forward to going home and being a wife and mother again.
c.
I see you are upset. Is there something on your mind youd like to talk about?
d.
Dr. Abrams said you can go home tomorrow, and we need to talk about the care of your surgical site.

ANS: C

Feedback
A
This statement follows the established agenda and does not respond to the emotional state of the patient.
B
This statement follows the established agenda and does not respond to the emotional state of the patient.
C
The nurses response demonstrates flexibility. The response identifies the emotional state of the patient and requires deviation from the established agenda.
D
This statement follows the established agenda and does not respond to the emotional state of the patient.

DIF: Cognitive Level: Application REF: Page 241

31. The patient says to the nurse, The staff treats me like Im a child. Everyone tells me what to do. No one ever asks my opinion. After all, it is my body. Which response by the nurse indicates active listening?
a.
Well, youre sick. Dont you think you should let us take care of you?
b.
I dont think I can help you with this. This is a personal matter between you and the rest of the staff.
c.
It makes you angry not to be included in your health care decisions. Lets talk about how you can vent your anger appropriately.
d.
Let me see if I understand. It bothers you not to be recognized for your abilities to handle your life. I can discuss this with the staff if you wish so that everyone involves you in planning your care.

ANS: D

Feedback
A
This statement indicates a lack of interest in what the patient was saying and is paternalistic.
B
This statement indicates a lack of interest in what the patient was saying and an unwillingness to help the patient.
C
This statement shows an assumption by the nurse that should be verified.
D
The nurses response recognizes the patients feelings and concerns. The nurse verifies the patients feelings and suggests an action which gives the patient the desired control.

DIF: Cognitive Level: Application REF: Page 243

32. In which of the following examples is the nurse demonstrating empathy for the postoperative mastectomy patient?
a.
With todays advanced reconstruction techniques, youll quickly forget you ever had surgery.
b.
Youll be back to your busy routine sooner than you think.
c.
This must be a very difficult time for you.
d.
I know how you feel; I also had breast cancer.

ANS: C

Feedback
A
Saying With todays advanced reconstruction techniques, youll quickly forget you ever had surgery discounts the patients feelings and is false reassurance.
B
The nurse is making an assumption that the patient wants to return to a busy routine. This is false reassurance based on a faulty assumption about the patient.
C
The nurse acknowledges the patients feelings and uses an open-ended statement to encourage the patient to verbalize further.
D
The nurse should never assume to know how the patient feels. The focus should be on the patient, not the nurse. The nurses experience is not germane to the nurse-patient relationship.

DIF: Cognitive Level: Application REF: Page 243

33. Which of the following demonstrates giving information versus opinion?
a.
Mrs. Khan, lets practice together the breathing techniques you learned in Lamaze classes. That will help us to work together more effectively later when your labor is stronger.
b.
You learned breathing techniques in Lamaze classes. I really believe the breathing techniques make labor easier.
c.
Mrs. Khan, have you been practicing the breathing techniques you learned? It is very important to practice if you wish to use them effectively in labor.
d.
Using breathing techniques in labor is really to your benefit because you feel in control.

ANS: A

Feedback
A
Saying Mrs. Khan, lets practice together the breathing techniques you learned in Lamaze classes. That will help us to work together more effectively later when your labor is stronger does not offer an opinion.
B
Saying You learned breathing techniques in Lamaze classes. I really believe the breathing techniques make labor easier offers the nurses opinion regarding the breathing techniques.
C
Saying Mrs. Khan, have you been practicing the breathing techniques you learned? It is very important to practice if you wish to use them effectively in labor offers the nurses opinion regarding the breathing techniques.
D
Saying Using breathing techniques in labor is really to your benefit because you feel in control offers the nurses opinion regarding the breathing techniques.

DIF: Cognitive Level: Application REF: Page 243

34. How would a nurses use of the technique of reflection help a person?
a.
Showing an awareness of the persons feelings
b.
Causing the person to answer more fully than yes or no
c.
Showing knowledge the person is not expected to know
d.
Encouraging the person to think through problems for himself or herself

ANS: D

Feedback
A
Reflection may involve the person becoming aware of his or her feelings but does not require the nurses awareness.
B
Reflection is not related to the answers provided by the patient.
C
Reflection is related to the insight the person gains, not information provided to him or her.
D
Reflection implies respect for the patient and his or her ability to solve his or her problems.

DIF: Cognitive Level: Comprehension REF: Page 244

35. Within nurse-patient communication, the use of silence can
a.
block further therapeutic communication.
b.
allow the patient to not feel pressured to provide information.
c.
demonstrate trust.
d.
provide the nurse with an opportunity to complete the patients care.

ANS: B

Feedback
A
Using silence actually encourages communication because it allows the patient to organize his or her thoughts.
B
Using silence means allowing periods of quiet thought during the nurse-patient interaction when the patient does not feel pressure to provide conversation.
C
Using silence does not relate to trust.
D
Using silence is not a requirement for completing patient care.

DIF: Cognitive Level: Comprehension REF: Page 244

36. A patient states, The harder I try to get along with my son, the more I feel he just wants to be left alone, and the nurse responds, I guess parents have to expect these problems as children get older. The nurses response is an example of a communication breakdown known as
a.
failing to see the uniqueness of the individual.
b.
failing to recognize levels of meaning.
c.
using value statements.
d.
failing to clarify unclear messages.

ANS: A

Feedback
A
The nurses response has put the patient into a group, parents, and therefore does not respond to the patient as a unique individual.
B
There is no meaning under the surface content in the patients remark.
C
There are no value statements in the nurses response.
D
The patients remark was not unclear.

DIF: Cognitive Level: Application REF: Page 246

37. A patient states, The thing that scares me the most about surgery is the spinal anesthesia. Im afraid itll leave me paralyzed, and the nurse responds, Everything will be fine. The anesthesiologists are very skilled in administering spinal anesthesia. The nurses response is an example of a communication breakdown known as
a.
failing to see the uniqueness of the individual.
b.
failing to recognize levels of meaning.
c.
using value statements.
d.
using false assurance.

ANS: D

Feedback
A
The nurse does not fail to respond to the patient as a unique individual.
B
The nurse does not fail to take into account the meaning under the surface content.
C
The nurse does not use value statements.
D
The nurse offers false assurance.

DIF: Cognitive Level: Application REF: Page 247

38. Collaboration in health care settings involves
a.
professionals respected for their unique knowledge and abilities.
b.
professionals educated in a collaborative model of education.
c.
recognition of individual professional accomplishments.
d.
a multitiered system hierarchy.

ANS: A

Feedback
A
Collaboration implies working jointly with other professionals, all of whom are respected for their unique knowledge and skills in the situation.
B
Currently most professionals are not educated in a collaborative model of education, although they are expected to work in collaboration.
C
In collaboration the accomplishments of the total group are recognized, not individuals.
D
Collaboration implies that everyone on the interdisciplinary team can make valuable contributions.

DIF: Cognitive Level: Comprehension REF: Page 250

39. Collaboration among health care professionals most importantly results in
a.
the development of esprit de corps.
b.
benefits to the organization alone.
c.
positive patient outcomes.
d.
maintenance of employee satisfaction.

ANS: C

Feedback
A
Although esprit de corps develops, the ultimate result is for positive patient outcomes.
B
Collaboration benefits the individuals involved, as well as the organization.
C
Making the most of collaborative opportunities enhances positive patient outcomes.
D
Employee satisfaction is greater with more collaboration, but the ultimate value of collaboration is positive patient outcomes.

DIF: Cognitive Level: Comprehension REF: Page 250

MULTIPLE RESPONSE

1. Which behaviors foster active listening? (Select all that apply.)
a.
Encouraging the speaker by saying, Tell me more
b.
Limiting verbal ventilation because it is not focused
c.
Sitting in an open posture such as leaning forward
d.
Engagement in a task
e.
Good eye contact at eye level and nodding of the head

ANS: A, C, E

Feedback
Correct
Active listening is a method of communicating interest and attention. Encouraging the speaker, using an open posture, eye contact, and nodding the head all communicate interest and attention.
Incorrect
Limiting verbal expression is likely to decrease the sharing of information by the patient. A task may serve as a distraction for the nurse and patient and may limit active listening.

DIF: Cognitive Level: Comprehension REF: Page 242

2. Which of the following are examples of open-ended questions? (Select all that apply.)
a.
Ms. Goode, did you have a productive therapy session?
b.
How are you?
c.
How do you feel about staying with your daughter?
d.
What would you like to discuss today while we take a walk?
e.
Are you having that problem with arthritis in your hand again?

ANS: B, C, D

Feedback
Correct
The questions How are you? How do you feel about staying with your daughter? and What would you like to discuss today while we take a walk? require the patient to answer by providing data and not just a yes or no answer.
Incorrect
The statements Ms. Goode, did you have a productive therapy session? and Are you having that problem with arthritis in your hand again? do not require more than yes or no answers.

DIF: Cognitive Level: Analysis REF: Page 243

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