Final (2-15)

The nurse demonstrates effective communication by ensuring all of the following except

making sure that unilateral information is exchanged between clients and nurses.

A preoperative assessment shows that a client's hemoglobin level is dropping. The anesthetist orders 3 units of blood to be administered

a negligent act

Which of the following is a violation of client confidentiality?

client data to a colleague in a nonprofessional setting

A 16-year-old trauma victim arrives in the emergency department with a life-threatening condition that requires emergency surgery. The nurse knows that

surgery can be performed without consent

In regard to informed consent, which of the following statements is true?

consent must be voluntary

The client has a living will in which he states he does not want to be kept alive by artificial means. The client's family wants to disregard the client's wishes and have him maintained on artificial life support. The most appropriate initial course of action for the nurse would be to

allow the family to verbalize their feelings and concerns, while maintaining the role of client advocate

The nurse collects both objective and subjective data. An example of subjective data is

"I have a headache"

The nurse observes a client pacing the floor. The nurse validates an inference when speaking to the client by stating

"You seem anxious. Will you tell me what is going on?"

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

anxiety related to fear of postoperative pain as evidenced by pacing

Which of the following is an outcome for a client with a broken leg?

client will develop an ambulation program within 1 month

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

reception failure

When setting goals with a client, the nurse demonstrates which step of the nursing process?

planning

When the nurse identifies a health problem or alteration in a client's health status that requires a nursing intervention, the nurse is performing which step of the nursing process?

diagnosis

When evaluating the client's progress toward goal achievement, the nurse should ask which of the following questions?

“ were the goals realistic?”

The plan of care serves as the structural framework for

providing safe, high-quality care

The nurse is caring for a client whose health has suddenly worsened. The nurse calls the health care provider. What is the best example of the nurse communicating to the health care provider using the situation part of SBAR communication?

"The patient has developed dyspnea with audible crackles in the lungs bilaterally; oxygen saturation is 86% on room air."

During a routine visit, the nurse notes that a child has several bruises at various stages of healing. The child reports having fallen down. Failure to report these findings is an example of

negligence

Which of the following types of thinking reflects the nursing process?

inquiry

Which of the following personality characteristics is a barrier to critical thinking?

stereotyping

The ethical decision-making model where good is defined as maximum welfare or happiness is known as the

utilitarian model

Which of the following case examples represents the ethical concept of distributive justice?

an older adult who has government insurance is denied standard cancer treatment.

Personal values are defined as

values shaped by family, religious beliefs, and years of experience

A nurse values autonomy and self-determination as well as the preservation of life. This is an example of

cognitive dissonance

Which of the following statements is true about the critical thinking process?

it is goal directed

Which of the following best describes the critical thinking skills of a novice nurse and an expert nurse?

the expert nurse organized data more efficiently than the novice nurse

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 can't help that; I have to treat you the way I think is best." The client's nurse may experience

moral distress

Characteristics of a critical thinker include all but which of the following?

Haphazardly seeking solutions

The best method for nurse educators to teach professional values is

role modeling

Which of the following describes the first step in acquisition of a value?

the value should be the result of the conscious choice

The client's values

influence the nurse's interventions

Values clarification can be incorporated within the intervention phase of the nursing process by

identifying care guidelines

During the third step in the critical thinking process

existing information is compared with past knowledge

The student nurse can best learn the steps in critical thinking through

repeated practice

The bioethical principle of autonomy refers to

the client’s right to self-determination

When therapeutically communicating with a client who has just found out he is HIV- positive, the nurse should focus on

achieving identified health-related goals.

The nurse demonstrates understanding of the concept of metacommunication through

actively listening with good eye contact

When communicating with a client, the nurse recognizes that a barrier to effective communication is

thinking ahead to the next question

When communicating with clients, the nurse actively uses listening responses. Which of the following types of listening response should the nurse use?

paraphrasing

The nurse enters a client's 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

administer an analgesic and postpone the interaction

A nurse is conducting a medication education group for mentally ill clients. One of the clients states, "I don't think everyone needs medications. What about psychotherapy? Can you tell me about that?" What is an appropriate response by the nurse?

Acknowledge the question, but explain the time limitations and focus of that particular group

When teaching a client how to administer insulin, the nurse recognizes that the best method of communicating therapeutically with the client is to

face the client while leaning slightly forward

When conducting an assessment interview, which of the following is the best communication technique for the nurse to use?

use short, unambiguous listening responses focused on current health issues and client concerns

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

allow clients latitude in telling their story

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?

begin with open-ended questions and proceed to focused questions

A client is admitted to the hospital for unsteady gait resulting in frequent falls. Which of the following is a circular question that the nurse could ask this client?

"How will this hospitalization affect your family?"

A client states, "I can't sleep all night because the nurses are noisy." Which of the following responses by the nurse best represents the nurse's recognition of the client's theme?

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

A client states, "I don't know about taking this medicine the doctor is putting me on. I've never had to take medication before, and now I have to take it twice a day." The nurse's response is, "It sounds like you don't know what to expect from taking the medication." The nurse's response is an example of which of the following?

paraphrasing

The student nurse is working on an assignment in which she has to interview a fellow student nurse for 30 minutes. The fellow student nurse talks about career plans, possible jobs after graduation, and her part-time work. After 10 minutes, she has stopped talking and both student nurses sit in silence. Which of the following is the best response by the interviewing student nurse?

"What impact will these plans have on your life?"

As the nurse communicates with a client, the feedback provided by the nurse should be

specific and focused on observed behavior

A client tells the nurse, "I am having a tough time and I am scared about the future." Which of the following responses by the nurse is the best feedback?

"You are having a tough time and you are scared."

When caring for a hospitalized client, the nurse demonstrates effective communication when

putting ideas in a logical sequence of relate material.

Which of the following is true in relation to the use of humor?

humor and laughter have healing purposes.

Which of the following is a description of metacommunication?

nonverbal and verbal communication.

The nurse puts his arm around an older adult client when assisting her to transfer to a chair. The client could interpret the nurse's touch as

a positive gesture only

A description of denotation is

a generalized meaning assigned to a word

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

connotation

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?

tone of voice

Communication is a combination of

verbal and nonverbal behaviors

The majority of person-to-person communication is

nonverbal

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

incongruence

An adult client responds to questions inappropriately. The nurse should do which of the following?

observe the client's nonverbal behavior

The nurse is assessing a newly admitted Native American client. When assessing the client's perception of touch, the nurse should

ask the client for permission to touch

When communicating with a client, which of the following best demonstrates the use of nonverbal communication?

holding the client's hand

A client states he is feeling fine, but the nurse observes that he has a tense body posture and a frown on his face. The nurse suspects that he is experiencing pain based on knowledge of

kinesics

In relation to gender differences in communication, which of the following is true?

women smile more often

Social cognitive competency refers to

the ability to interpret message content with interactions from the point of view of each participant

Which of the following messages would validate the worth of the individual?

"I would like to meet your family and we could talk to them about your aftercare."

A communication style the nurse can use to ensure that the message sent is the same as the one received is to

establish a common vocabulary

Message competency refers to which phase of the nursing process?

intervention

Which of the following examples indicates adherence to client confidentiality?

sharing client information with other members of the health care team as needed

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

"tell me more about what you're feeling"

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?

the client will alternate activity with rest throughout the day

A nurse whose father was an alcoholic is assigned to care for a client who is in alcohol withdrawal. The nurse's best therapeutic action would be to

examine personal vulnerabilities, strengths, and limitations

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

overinvolvement

The professional relationship goes through a developmental process characterized by overlapping yet distinct stages, which are

preinteraction, orientation, working phase, and termination phase

Which of the following personality characteristics can affect the nurse's ability to function in a therapeutic manner, if disclosed to the client?

the nurse becomes angry when criticized

In the preinteraction phase of the nurse-client relationship

the nurse develops the appropriate physical and interpersonal environment for an optimal relationship

Which of the following is a nontherapeutic statement during the orientation phase of a relationship?

"My job is to make you better."

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

orientation

Self-disclosure by the nurse refers to the intentional revealing of personal experiences or feelings that are similar to or different from those of the client. The purpose of self-disclosure is to

deepen trust, to be a role model of self-disclosure as a beneficial mode of communicating

The client becomes more self-directed during which of the following phases of the nurse-client relationship?

working

Which stage of the nursing process corresponds to the exploitation part of the working phase of the therapeutic relationship?

implementation

When should the nurse first start planning for termination of the nurse-client relationship?

from the initial encounter

A primary difference between a therapeutic helping relationship and a social relationship is

the focus

Which of the following is true about the helping relationship?

the health care provider takes responsibility for maintaining appropriate boundaries

An appreciative client offers the nurse a box of chocolates. The nurse should

accept or refuse based on the uniqueness of the relationship

The nurse has been working in a long-term care facility for several years. The nurse has decided to leave the facility to work elsewhere. When terminating her relationship with clients, the nurse should

prepare clients for termination

The student nurse has finished her rotation on the outpatient psychiatric unit. Her client, who was diagnosed with borderline personality disorder, suddenly displays superficial scratches to both forearms. Which of the following is a nursing diagnosis for the client related to losses and endings in the nurse-client relationship?

anxiety related to impending termination of nurse-client relationship

Which of the following describes caring?

It is an ethical responsibility.

Which of the following should be achieved first in establishing the nurse-client relationship?

trust

Which of the following describes mutual goals?

Mutuality is based on client goals.

Which of the following is a violation of client confidentiality?

Discussing private information about the client casually with others

Stereotypes are learned during

childhood and reinforced by life experiences.

Which of the following describes proxemics?

Study of an individual's use of space

Which of the following is a barrier to communication?

Intrusion into personal space

Which of the following is true about trust?

The trusting client feels comfortable revealing needs.

The nurse demonstrates an understanding of mutuality when stating to the client,

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

When entering a client's 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?

Severe

Which of the following situations is an example of the nurse using empathy?

Sitting quietly and holding a client's hand while she cries following the news that she has inoperable cancer

The nurse knocks on the client's door and waits for the client to answer before entering the room. The nurse is demonstrating

respect for the client's personal space.