Sunteți pe pagina 1din 14


Chapter 19 : Key points to remember

1. Functional status is the factor most closely associated with the older adult's inability to live
2. An older adult client tells the nurse, "My life has been a waste." This statement is an example of
ego despair of the psychosocial development
3. When educating the client and the daughter of a new medication, the nurse should not direct
instructions to the client's daughter
4. The nurse is caring for an older adult client who has recently experienced losses associated with
deaths of important people in her life. This type of problem challenges which of Maslow's hierarchy
of needs?
Love and belonging
5. When communicating with older adult clients, hearing problems can diminish an older person's
ability to interact with others.
6. When assessing an older adult client who has a significant hearing loss, The most appropriate
intervention by the nurse is to check the hearing aid batteries.
7. The nurse has just completed a care plan on a visually impaired client. An intervention that is most
appropriate for this client is to ensure the client's room has bright lighting with no glare.
8. The nurse is caring for a frail older adult client who is admitted to the hospital after falling. The client
has been living alone independently and appears reluctant to accept assistance. The nurse
recognizes that the client's reluctance to accept assistance is most likely caused by fear of
relinquishing independent living.
9. Asking about the client's life history is the communication technique that would be most effective for
the nurse to use when visiting a client at home.
10. Apraxia is the inability to take purposeful action even when the muscles, senses, and vocabulary
appear to be intact. The client appears to register on a command but acts in a way that suggests
little understanding of what transpired verbally.
11. The nurse is caring for an older adult client who has early moderate cognitive impairment and has
been diagnosed with dementia. When interacting with the client's family, the nurse should teach
family members that reminiscing about the past can be a means of connecting.
12. The nurse is performing an admission assessment on a client with cognitive impairment. When
developing a plan of care for this client, the nurse should plan to provide instructions one step at a
13. A client diagnosed with dementia is becoming increasingly unable to express complete thoughts and
is having difficulty engaging in simple conversations. When communicating with this client, the nurse
should use words directly applicable to the client's daily routine.
14. The nurse is caring for an older adult client who has been diagnosed with dementia. The nurse
recognizes that the use of touch with this client
Clients with dementia can become more anchored in the present time, space, and humanity when
15. When caring for an older adult client who is experiencing memory loss, the nurse notes that the
client emotionally overreacts to situations, appearing as if having temper tantrums when responding
to real or perceived frustration. The nurse recognizes the client is experiencing a catastrophic
reaction. When caring for this client, the nurse should use distraction to move the client away from
the offending environmental stimuli.

Read; Table 19-1 page 378

Box 19-8 page 379
Box 19-9 page 381Table 19-2 page 383

Chapter 7 Intercultural Communication

1. Cultural competence requires self-awareness of one's own cultural values.
2. Cultural diversity encompasses variations between cultural groups
3. When communicating with a client from Thailand who speaks limited English, the nurse
should provide advice in a matter-of-fact, concise manner
4. When practicing cultural awareness, the nurse recognizes that cultural patterns 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 on what language do you prefer to
6. The nurse is caring for a Hispanic client. When communicating with a Hispanic client, the
nurse should contact the oldest male family member about the client's illness.
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 is a culture that warrants a sense of pride.
8. When caring for a client from a different culture, an example of a good assessment
approach by the nurse is :"Are there any special cultural beliefs about your illness that might
help me give you better care?"
9. Trained interpreter is a communication tool or strategy to provide a bed bath to a client who
cannot speak English.
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 trust development.
11. Which of the following statement is true : Hispanic clients make small talk before discussing
their health problems.
12. When assessing a 5-year-old Asian client in the emergency department, the nurse observes
welts on the client's body. The nurse's first course of action should be to question the family
about cultural practices.
13. When performing a newborn bath demonstration for the mother of a Native American infant,
the nurse should deliver verbal instructions in a story-telling format.
14. Poverty is the lack of essential resources is associated with political and personal
15. When caring for the poor client, a major component of care is maintaining respect for human
Page 114 – box 7-1

Page 116- table 7-1

Page 120 building rapport

Page 121- table 7-2 page 123- LEARN

Chapter 13 Resolving Conflicts between Nurse and clients

1. Empathy is the best response by the nurse to use when caring for an intoxicated client who
has been admitted to the emergency department.
2. When working in situations that involve conflict, the nurse recognizes that which of the following is
true in relation to conflict? Conflict serves as a warning that something in the relationship needs
closer attention.
3. 3.ID: 3850951829
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 three times greater risk to experience violence in their workplace
than are other professionals.
4. Collaboration is the most effective problem-solving style for genuine resolution that creates a win-win
situation .
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 intrapersonal conflict.
6. Assertiveness is standing up for one's personal rights
7. assertive communication includes the ability to say no and to ask for what you want.
8. A client yells at the nurse frequently and uses profane language. Which of the following is the most
appropriate response by the nurse? Use an "I" statement when speaking to the client
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." The best statement by the nurse? "I'm so sorry you are feeling so upset
10. A client on a psychiatric unit is found pacing the halls and angrily punching at the wall. The nurse's
primary goal should be to maintain safety while helping the client.
11. After fasting from 10 p.m. the previous evening, a client learns that the procedure has been
cancelled. The client curses at the nurse and accuses the nurse of being incompetent. The nurse's
best response would be "I can understand that you're upset, but I feel uncomfortable when I am
cursed at."
12. When providing home health care to a client suffering from Alzheimer disease who fell and broke his
hip 3 weeks ago, the nurse teaches the client's family correct use of the walker. This represents
which stage of the nurse-caregiver relationship? Worker-worker
13. A client yells, "Take this mess away from here. How could anyone eat this food? What kind of place
are you running here?" The nurse uses skills of assertiveness to promote change that is focused on
14. When interacting with the nurse, a client makes several condescending remarks directed toward the
nurse. The nurse recognizes this behavior as an example of :a verbal clue to anger.
15. The nurse's first response in dealing with a conflict situation that involves a client is to gain a clear
understanding of one's own personal response
16. The initial interpersonal strategy to help the client reduce strong emotion to a workable level involves
providing a neutral, accepting, interpersonal environment.
17. Strategies the nurse should use when dealing with an angry client?
A. Defuse hostility
B. Avoid responding to a client's anger by getting angry
C. Use empathy when communicating with the client

Page 243 – figure 13-1

Page 244- box 13-1

Page 244-245- conflict management style

Page 247 box 13-2

Pages 250-251 techniques for conflict resolution

Page 252 – box 13-3

Page 254 table 13-1

Page 257 signs of anger

1. Chapter 8 Therapeutic Communication in Groups
1. a secondary group has a prescribed structure.
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 primary group
3. Group think :Members of a corporate executive committee fail to inform the chairperson that some
middle managers do not support the decision.
4. Task functions They are behaviors used to move toward goal achievement:
5. When leading a group meeting, the nurse notices two group members talking. Which of the following
represents the best intervention by the nurse? Ask the two group members, "Would you share your
comments with the group?"
6. Summarizing : 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."
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? 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 homogeneous group
9. During the first session of an Alzheimer disease support group for family members, the nurse
recognizes the need to encourage group members to introduce themselves and share a little of their
background or their reason for coming to the group.
10. When members of a group experience controversy, conflict, and disagreements, the nurse leading
the group recognizes the importance of accepting differences in member perceptions as being
normal and growth producing.
11. Norm: A long-standing group therapy meeting has been in process for 1/2 hour when a member
arrives late. Another member says, "I thought we agreed as a group to come on time."
12. During a support group meeting, a group member makes several sexually provocative remarks
toward the group leader. The best response by the group leader is,: Our group work is of the highest
priority; please align your remarks with the group purpose."
13. When a group leader encourages the group members to express their feelings about one another
with the stipulation that any concerns the group may have about an individual member or
suggestions for future growth should be stated in a constructive way and the group leader
summarizes goal achievement, the group has reached Termination phase of group development
14. A staff nurse is assigned to lead a community group meeting comprised mostly of psychotic clients.
When setting up this type of group meeting, the nurse recognizes that choosing a fellow staff
member to help co-lead the group is recommended.
15. A member of a support group is concerned that the group has not been ending on time and that
some members have been pairing off to discuss group issues after the meetings. The concerned
group member expresses these concerns during a group meeting. This is an example of which
maintenance function? Setting standards
16. A member of a support group frequently whispers to other members of the group and appears
indifferent and passive during group meetings. Which of the following nonfunctional self-roles is
represented in this situation? Avoider
17. An effective group includes Goals are clearly identified and collaboratively developed.

Chapter 16 Questions
1. Current research suggests that men and women respond to stress in which of the following ways?
Women use a "tend and befriend" approach to stress.
2. 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 signs of
distress can include academic decline, gastric distress, and headaches.
4. Eustress is 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 person's ability to manage
5. A three-stage progressive pattern of nonspecific physiologic responses known as alarm, resistance,
and exhaustion is based on Selye's General Adaptation Syndrome.
6. A client is experiencing anxiety related to hospitalization. When assessing this client, the nurse
anticipates which assessment finding? Disengagement from the stressor
7. A client's spouse becomes anxious and demonstrates hostility toward the nurse. The best response
by the nurse is to respond empathetically to contributory themes and feelings.
8. A client tells the nurse, "I think I'm losing my mind." The best response by the nurse is “Tell me what
you are experiencing right now
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 nurse's best response is "Tell me what prompted your
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 g burnout.
11. The nurse is caring for a client who works as a boxer. The client states, "I was picked on a lot when I
was little, so I got really angry and now I work through the anger by boxing." The nurse recognizes
the client is demonstrating which ego defense mechanism ? Sublimation
12. Mobilize resources is an interventions classified as secondary prevention for stress
1. Chapter 21
1. Grief is a Recurring, wavelike feelings of sadness and loss are common feelings in a client who is
2. Anticipatory grief can be colored by ambivalent feelings.
3. The nurse is caring for a client who is expected to die within a month. The client states, "I can't go on
anymore, help me!" Which of the following best describes this client's stage of dying? Depression
4. Chronic sorrow is a normal grief response associated with an ongoing living loss that is permanent,
progressive, recurring, and cyclic in nature?
5. The nurse is caring for a client who has just received biopsy reports that indicate recurrence of
metastatic stage IV breast cancer. The client's statement that indicates the acceptance stage of
death and dying is "The test results are positive."
6. Stoicism and denial of grief are examples of how a family coping with death is affected by culture.
7. A client has just been transferred to a new facility from another hospital at his insistence. The client
is demanding a second opinion because he feels that "They must have made a mistake." The nurse
recognizes that the best communication technique to use with this client is to reflect the client's
8. The nurse is caring for an 8-year-old child in the school nurse's office because the child received a
bloody nose in a scuffle with another child during recess. The nurse discovers that the child's
parents have recently divorced. The nurse recognizes that the child demonstrates behavior that is a
common response when grieving.
9. When evaluating care of dying clients, the nurse recognizes that interventions have been
unsuccessful if the nurse refuses to allow the client to be sad.
10. The nurse is caring for a 15-year-old client who is dying. The client tells the nurse, "I know I am not
going home again. I think it is harder for my parents than me. Will you talk to them for me?" Which of
the following is the best response by the nurse? "Yes, I will talk to your parents, but you need to talk
to them also. I will help you with that."
11. Which of the following is an inappropriate intervention for communicating with terminally ill clients
: Offering automatic responses and trite
12. Which of the following is a dimension of palliative care? It intends neither to hasten nor postpone
13. An 89-year-old client recently lost his wife of 69 years to cancer. He reports "I had the strangest
thing happen to me last night. I woke up and saw my wife sitting in her chair." The nurse's best
response would be: "Hearing or seeing things that are not real can be a normal response to extreme
14. A 21-year-old client informs the nurse that he is not sleeping. The nurse learns that the client's
girlfriend was killed in a car accident 1 month ago. Which statement would be of most concern to the
nurse? "I am moving on and plan to start dating again."
15. Which of the following individuals is most likely experiencing a delayed grief reaction?
A 54-year-old man suffering from alcoholism who just completed a 28-day inpatient rehabilitation
talking about the death of his wife 3 years

1. Chapter 17 Communication FN
1. What characterizes nurses who make the best communicators?
Developing critical thinking skills.
2. Mutuality :A nurse believes that the nurse–patient relationship is a partnership and that both are
equal participants. Which term should the nurse use to describe this belief?

3. Public: A nurse wants to present information about flu immunizations to older persons in the
4. Which technique is being used most effectively in which scenario?
Transpersonal communication to enhance meditation

5. Personal space: A nurse is sitting at the patient’s bedside documenting a nursing history.
6. A smiling patient angrily states, “I will not cough and deep breathe.” How will the nurse interpret this
finding? The patient’s affect is inappropriate.
7. A patient has been admitted to the hospital numerous times. The nurse asks the patient to share a
personal story about the care that has been received. Which interaction is the nurse using?
A. Narrative.

8. Before meeting the patient, a nurse talks to other caregivers about the patient. The nurse is in which
phase of the helping relationship?
A. Preinteraction.
9. During the initial home visit, a home health nurse lets the patient know that the visits are expected to
end in about a month. The nurse is in which phase of the helping relationship?
A. Preinteraction.

10. A nurse and patient take action to meet health-related goals. The nurse is in which phase of the
helping relationship?
A. Working
11. The nurse is in the process of conducting an admission interview with the patient. At one point in the
discussion, the patient has provided information that the nurse would like to clarify. Using the
technique of clarification, how does the nurse respond?
A. “I’m not sure that I understand what you mean by that statement.”
12. The patient draws back when the nurse reaches over the side rails to take his blood pressure. What
should the nurse do first to promote effective communication?

A. Apologize for startling the patient and explain the need for contact.

13. A patient has trouble speaking words, and the patient’s speech is garbled. Which nursing diagnosis
is most appropriate for this patient?
A. Impaired verbal communication.

14. Which person is the best referral for a patient who speaks a foreign language?

A. An interpreter.
15. A nurse is using SOLER to facilitate active listening. Which technique should the nurse use for “R”?
A. Relax.

16. An older patient is wearing a hearing aid. Which technique should the nurse use to facilitate
A. Turn off the television.
17. When making rounds, the nurse finds a patient who is not able to sleep because of anticipation of
surgery in the morning. Which therapeutic response is most appropriate?

A. “It must be difficult not to know what the surgeon will find. What can I do to help?”

18. Which situation will cause the nurse to intervene and follow up on the unregulated care provider’s
A. The unregulated care provider is calling the older patient “honey.”

19. A confused older person is wearing thick glasses and a hearing aid. Which intervention is priority to
facilitate communication?
Allow time for the patient to respond.

20. The staff is having a hard time getting an older person to communicate. Which technique should the
nurse suggest the staff use?
A. Allow the patient to reminisce.
21. Which of the following patients will cause the greatest communication concerns for a nurse?

A. . A patient who is dyspneic, has a tracheostomy, and is anxious

22. A patient is aphasic, and the nurse notices that the patient’s hands shake intermittently. Which
nursing action is most appropriate to facilitate communication?
A. Use a picture board.
23. What is characteristic of a nurse using critical thinking to enhance communication with patients?

A. Self-examining personal communication skills.

1. Chapter 11 Nrsng Leadership

1. Which of the following is a requirement for a new nurse in delegating tasks to an unregulated care
provider (UCP)?
A. Communicating the task in understandable terms.
2. To be able to meet the needs of assigned patients and the responsibilities associated with the
position, nurses must be aware of time management techniques. A time management skill for the
nurse is which of the following?
A. Planning effectively and being aware of competing priorities
3. Nursing management in a facility is considering a nursing care delivery model that involves the
division of tasks, with each nurse assuming the responsibility for particular tasks. What is this model
referred to as?
A. Functional nursing.
4. The medical centre has changed its overall management philosophy from centralized to
decentralized management. What is one advantage of a decentralized management structure over a
centralized structure for the nursing units?
A. Each staff member is actively involved.
5. Which of the following is one of the four elements of decision making?
A. Responsibility.
6. The charge nurse asks an experienced nurse to admit a critically ill patient who arrives in the
emergency department. What does this action exemplify?
A. Assignment.

7. The nursing management team in a facility is investigating a nursing care delivery model that
involves staff members working under the direction of an RN leader. What does this model reflect?
A. Team nursing.
8. Accountability is a critical aspect of nursing care. Which of the following is an example of a specific
decision-making process of accountability?
A. Evaluating the patient’s outcomes after implementation of care.

9. The student nurse is seeking to learn skills associated with priority setting. Among the different
priorities of care, which of the following is an example of an intermediate priority?
A. The need to urinate.
10. The nurse on the unit is determining which activities may be delegated to an unregulated care
provider (UCP). A number of factors are included in the nurse’s decision. Assuming that the UCP is
competent, the RN may safely delegate which of the following activities?
A. Ambulation of stable patients.

11. UCPs are allowed to perform tasks with patients in which situation?
A. When tasks are delegated by an RN.
12. One type of nursing model is an emerging model among intraprofessional nursing teams and other
health care providers who are members of the interprofessional team. What is this model called?

A. Collaborative practice model

13. A management structure in which traditional units are reorganized into business units is called what?
A. Matrix.
14. Which term characterizes the duties and activities that an individual is employed to perform?
A. Responsibility.

15. What is a nursing manager’s greatest challenge?

A. Communication
16. Creating a culture of patient safety includes which of the following
A. Awareness of health care error Ensuring feedback on safety issues
B. Promotion of a systems approach to care.
C. Reporting of adverse events.

17. A nurse has delegated a task to an unregulated care provider (UCP). Which of the following is the
nurse responsible for?

A. Maintaining accountability of the task. Ensuring the task is within the UCP’s job
description. Supervising the UCP if required
B. Providing clear instructions when delegating a task.
1. Chapter 28 Spirituality
1. The word spirituality derives from the Latin word spiritus, which refers to breath or wind. Today,
spirituality can be described as which of the following?
Transcendence beyond self, everyday living, and suffering.

2. The nurse is caring for a patient who claims that he does not believe in God and does not believe in
an “ultimate reality.” The nurse realizes what about this patient?

The patient is an atheist/agnostic.

3. The nurse is caring for a patient who is terminally ill with very little time left to live. The patient states,
“I always believed that there was life after death. Now, I’m not so sure. Do you think there is?” The
nurse states, “I believe there is.” What has the nurse attempted to do? Provide hope
4. When discussing spirituality with adolescent patients, of what should the nurse be aware?
That many adolescents question religious practices and values.
5. The nurse is admitting a patient to the hospital. The patient states that he is a very spiritual person
but does not practise any specific religion. What should the nurse understand about these
That they are reasonable.
6. Which of the following is an intervention that will facilitate connectedness?
Placing memorabilia in the patient’s view
7. Which statement about religion and spirituality is true?
Spirituality is unique to the individual.

8. What is the best statement by a nurse who is assessing the spiritual needs of a 76-year-old patient
who was just admitted to the nursing unit with terminal cancer of the liver?
“I notice you have a Bible. Is that a source of spiritual strength to you?” “
9. The nurse’s initial action while working with a patient to assess and support the patient’s spirituality
is which of the following?
Determining the patient’s perceptions and belief system.
10. If a patient is identified as following the traditional health care beliefs of Judaism, while planning
patient care, which of the following should be incorporated in nursing care?
Observance of the Sabbath.

11. Which of the following attributes of spiritual care in nursing practice is described as a direction to
place patients’ needs first and protect vulnerability?

12. The patient is admitted with chronic back pain. The nurse who is caring for this patient should do
which of the following?

Look at how pain influences the patient’s ability to function.

13. In caring for the patient’s spiritual needs, what should the nurse understand?
Establishing presence is part of the art of nursing
14. When asked about his religious affiliation, a patient responds, “That’s personal; why do you want to
know?” Which of the following is the most appropriate nursing response?
“By knowing your religious preferences, I can best meet your spiritual needs.”

15. Which of the following can nurses used to develop their own spiritual awareness while facilitating the
spiritual practices of others?
. Engaging in mindfulness.
16. The patient is having a difficult time dealing with his diagnosis of acquired immune deficiency
syndrome (AIDS). He states, “It’s not fair. I’m totally isolated from my family because of this. Even
my father hates me for this. He won’t even speak to me.” What does the nurse need to do?
Use therapeutic communication to establish trust and caring.

17. The nurse is caring for a patient who is in the final stages of his terminal disease. The patient is very
weak but refuses to use a bedpan and wants to get up to use the bedside commode. What should
the nurse do? Enlist assistance from family members if possible and assist the patient to get up.
18. In assessing the spiritual health of her patients, what should the nurse understand?
Spiritual beliefs change as patients grow and develop.
19. When a patient’s risk for spiritual crises is evaluated, which of the following are part of the evaluation
Reviewing the patient’s self-perception regarding spiritual health.
A. Reviewing the patient’s view of his or her purpose in life.
B. Discussing with family and associates the patient’s connectedness.
C. Asking whether the patient’s expectations are being met
20. five Cs of relational practice?
A. Compassion.
B. Curiosity.
C. Commitment.
D. Competence.
E. Corresponding.