Question 1

The nurse is caring for a client who received analgesic medication via central line to treat pain associated with cancer. After reassessing the client's response, which section of the PIE record will the nurse use when documenting the client's care?
A)Evaluation
B)Progress notes
C)Problem
D)Intervention

Accepted Answer

A)The PIE documentation model groups information into three categories: problems (P), interventions (I), and evaluation (E)of nursing care. Reassessing the client's pain level after medication administration is considered evaluation and would be documented under "E." Interventions such as medication administration would labeled "I," whereas the problem statement would be labeled "P." Progress notes are not part of the identified labels of PIE charting.
B)The PIE documentation model groups information into three categories: problems (P), interventions (I), and evaluation (E)of nursing care. Reassessing the client's pain level after medication administration is considered evaluation and would be documented under "E." Interventions such as medication administration would labeled "I," whereas the problem statement would be labeled "P." Progress notes are not part of the identified labels of PIE charting.
C)The PIE documentation model groups information into three categories: problems (P), interventions (I), and evaluation (E)of nursing care. Reassessing the client's pain level after medication administration is considered evaluation and would be documented under "E." Interventions such as medication administration would labeled "I," whereas the problem statement would be labeled "P." Progress notes are not part of the identified labels of PIE charting.
D)The PIE documentation model groups information into three categories: problems (P), interventions (I), and evaluation (E)of nursing care. Reassessing the client's pain level after medication administration is considered evaluation and would be documented under "E." Interventions such as medication administration would labeled "I," whereas the problem statement would be labeled "P." Progress notes are not part of the identified labels of PIE charting.

Question 2

A nurse educator is teaching a group of students about therapeutic touch. In which situation is it appropriate to use therapeutic touch as a means of communication?
A)When a client's family member is making inappropriate comments to the nurse
B)When an upset spouse is alone and the client has just expired
C)When speaking to a client with a history of physical abuse
D)When a young male client asks a young student nurse for a hug

Accepted Answer

A)Therapeutic touch may be an appropriate means for communication when providing nursing care. However, nurses must use therapeutic touch with caution and intention. People from different cultures may view the use of touch differently. Similarly, clients with a history of physical or sexual abuse and/or certain mental illnesses may misinterpret the use of touch. Furthermore, touch is not appropriate when a client's family member is making inappropriate comments to the nurse or when a client asks a student nurse for a hug. Thus, of the options listed, the only one in which therapeutic touch is appropriate is the situation involving the grieving spouse.
B)Therapeutic touch may be an appropriate means for communication when providing nursing care. However, nurses must use therapeutic touch with caution and intention. People from different cultures may view the use of touch differently. Similarly, clients with a history of physical or sexual abuse and/or certain mental illnesses may misinterpret the use of touch. Furthermore, touch is not appropriate when a client's family member is making inappropriate comments to the nurse or when a client asks a student nurse for a hug. Thus, of the options listed, the only one in which therapeutic touch is appropriate is the situation involving the grieving spouse.
C)Therapeutic touch may be an appropriate means for communication when providing nursing care. However, nurses must use therapeutic touch with caution and intention. People from different cultures may view the use of touch differently. Similarly, clients with a history of physical or sexual abuse and/or certain mental illnesses may misinterpret the use of touch. Furthermore, touch is not appropriate when a client's family member is making inappropriate comments to the nurse or when a client asks a student nurse for a hug. Thus, of the options listed, the only one in which therapeutic touch is appropriate is the situation involving the grieving spouse.
D)Therapeutic touch may be an appropriate means for communication when providing nursing care. However, nurses must use therapeutic touch with caution and intention. People from different cultures may view the use of touch differently. Similarly, clients with a history of physical or sexual abuse and/or certain mental illnesses may misinterpret the use of touch. Furthermore, touch is not appropriate when a client's family member is making inappropriate comments to the nurse or when a client asks a student nurse for a hug. Thus, of the options listed, the only one in which therapeutic touch is appropriate is the situation involving the grieving spouse.

Question 3

A novice nurse is working with a client who is admitted to a medical-surgical unit. The nurse is establishing a therapeutic relationship with the client by conveying empathy. Which statement by the nurse best exemplifies empathy?
A)"I wouldn't be afraid if I were you."
B)"You shouldn't have done it that way."
C)"You seem to be frightened by the procedure. Tell me how you are feeling."
D)"I know just how you feel, because my mother has the same illness."

Accepted Answer

A)To be able to empathize with patients, the nurse must be able to understand and acknowledge the ideas that the patient is expressing or that the patient feels are important to the situation. By stating that the client seems frightened and asking the client to describe his or her feelings, the nurse is demonstrating empathy. The nurse should not say he or she knows how the client feels; such a statement will likely be met with disbelief, because one individual never knows how another individual is feeling unless that individual tells them. Telling the client not to be afraid is demeaning; instead, the nurse should ascertain the source of the client's fear and provide appropriate teaching. Saying the client should not have done something is passing judgment and inappropriate.
B)To be able to empathize with patients, the nurse must be able to understand and acknowledge the ideas that the patient is expressing or that the patient feels are important to the situation. By stating that the client seems frightened and asking the client to describe his or her feelings, the nurse is demonstrating empathy. The nurse should not say he or she knows how the client feels; such a statement will likely be met with disbelief, because one individual never knows how another individual is feeling unless that individual tells them. Telling the client not to be afraid is demeaning; instead, the nurse should ascertain the source of the client's fear and provide appropriate teaching. Saying the client should not have done something is passing judgment and inappropriate.
C)To be able to empathize with patients, the nurse must be able to understand and acknowledge the ideas that the patient is expressing or that the patient feels are important to the situation. By stating that the client seems frightened and asking the client to describe his or her feelings, the nurse is demonstrating empathy. The nurse should not say he or she knows how the client feels; such a statement will likely be met with disbelief, because one individual never knows how another individual is feeling unless that individual tells them. Telling the client not to be afraid is demeaning; instead, the nurse should ascertain the source of the client's fear and provide appropriate teaching. Saying the client should not have done something is passing judgment and inappropriate.
D)To be able to empathize with patients, the nurse must be able to understand and acknowledge the ideas that the patient is expressing or that the patient feels are important to the situation. By stating that the client seems frightened and asking the client to describe his or her feelings, the nurse is demonstrating empathy. The nurse should not say he or she knows how the client feels; such a statement will likely be met with disbelief, because one individual never knows how another individual is feeling unless that individual tells them. Telling the client not to be afraid is demeaning; instead, the nurse should ascertain the source of the client's fear and provide appropriate teaching. Saying the client should not have done something is passing judgment and inappropriate.

Question 4

Four groups of nurses are attempting to determine which methods are most effective for teaching patients about proper self-care. Which of these groups is least likely to arrive at a successful decision in a timely manner?
A)The group that launches a pilot project to determine which teaching methods are most effective
B)The group that uses scenario planning to evaluate the potential results of various teaching methods
C)The group that uses trial and error to gauge the effectiveness of various teaching methods
D)The group that uses a decision tree to visualize the potential results of various teaching methods

Accepted Answer

A)Trial-and-error techniques are the most haphazard method for decision making. Managers and groups who use these techniques are typically seen as poor problem solvers, especially in a healthcare context. Use of pilot projects, scenario planning, or decision trees is more likely to result in successful decision making because these methods all involve proposal and analysis of various alternatives prior to taking action.
B)Trial-and-error techniques are the most haphazard method for decision making. Managers and groups who use these techniques are typically seen as poor problem solvers, especially in a healthcare context. Use of pilot projects, scenario planning, or decision trees is more likely to result in successful decision making because these methods all involve proposal and analysis of various alternatives prior to taking action.
C)Trial-and-error techniques are the most haphazard method for decision making. Managers and groups who use these techniques are typically seen as poor problem solvers, especially in a healthcare context. Use of pilot projects, scenario planning, or decision trees is more likely to result in successful decision making because these methods all involve proposal and analysis of various alternatives prior to taking action.
D)Trial-and-error techniques are the most haphazard method for decision making. Managers and groups who use these techniques are typically seen as poor problem solvers, especially in a healthcare context. Use of pilot projects, scenario planning, or decision trees is more likely to result in successful decision making because these methods all involve proposal and analysis of various alternatives prior to taking action.

Question 5

The nurse is caring for a school-age client who is scheduled to have major heart surgery the next morning. The nurse enters the room to administer a medication and finds the client crying. Which response by the nurse is most therapeutic?
A)"Would you like some toys from the playroom?"
B)"I'm going to go get the doctor."
C)"You shouldn't cry. You are not in pain."
D)"It is okay to cry. I know this is scary."

Accepted Answer

A)Assertive communication is appropriate in the group setting, but for this client, the nurse should be accepting of the client's feelings of fear. Telling the client not to cry invalidates the client's feelings. Leaving to get the doctor could be seen by the child as abandonment and would signal that the nurse is uncomfortable with the child. Distraction is not appropriate when the client is clearly upset, so the nurse should not ask whether the client wants toys. Instead, the nurse should attempt to seek more information about what the child is feeling.
B)Assertive communication is appropriate in the group setting, but for this client, the nurse should be accepting of the client's feelings of fear. Telling the client not to cry invalidates the client's feelings. Leaving to get the doctor could be seen by the child as abandonment and would signal that the nurse is uncomfortable with the child. Distraction is not appropriate when the client is clearly upset, so the nurse should not ask whether the client wants toys. Instead, the nurse should attempt to seek more information about what the child is feeling.
C)Assertive communication is appropriate in the group setting, but for this client, the nurse should be accepting of the client's feelings of fear. Telling the client not to cry invalidates the client's feelings. Leaving to get the doctor could be seen by the child as abandonment and would signal that the nurse is uncomfortable with the child. Distraction is not appropriate when the client is clearly upset, so the nurse should not ask whether the client wants toys. Instead, the nurse should attempt to seek more information about what the child is feeling.
D)Assertive communication is appropriate in the group setting, but for this client, the nurse should be accepting of the client's feelings of fear. Telling the client not to cry invalidates the client's feelings. Leaving to get the doctor could be seen by the child as abandonment and would signal that the nurse is uncomfortable with the child. Distraction is not appropriate when the client is clearly upset, so the nurse should not ask whether the client wants toys. Instead, the nurse should attempt to seek more information about what the child is feeling.

Question 6

The nurse is caring for an older adult client in a long-term care facility. Which behavior by the nurse conveys physical attending when communicating with this client?
A)Facilitating and taking action when needed
B)Maintaining a proper social distance when speaking with the client
C)Leaning toward the client during conversation
D)Being concrete about actions that need to be taken during client care

Accepted Answer

A)The nurse best conveys physical attending by leaning toward the client, which communicates involvement. Facilitating and taking action and maintaining social distance do not convey physical attending. Being concrete is a method of communicating information to the client, not a method of conveying physical attending.
B)The nurse best conveys physical attending by leaning toward the client, which communicates involvement. Facilitating and taking action and maintaining social distance do not convey physical attending. Being concrete is a method of communicating information to the client, not a method of conveying physical attending.
C)The nurse best conveys physical attending by leaning toward the client, which communicates involvement. Facilitating and taking action and maintaining social distance do not convey physical attending. Being concrete is a method of communicating information to the client, not a method of conveying physical attending.
D)The nurse best conveys physical attending by leaning toward the client, which communicates involvement. Facilitating and taking action and maintaining social distance do not convey physical attending. Being concrete is a method of communicating information to the client, not a method of conveying physical attending.

Question 7

Which of the following statements by the nurse is an example of the therapeutic communication technique of offering self?
A)"Would you like to talk with me about your emotions right now?"
B)"I'm not sure I understand. Please tell me more about the situation."
C)"I don't know the answer to your question, but I will check with the physician."
D)"I'll stay here with you until your family arrives."

Accepted Answer

A)Offering self involves suggesting one's presence, interest, or wish to understand the client without making any demands or attaching conditions that the client must comply with to receive the nurse's attention. The nurse's offer to stay with the client until the family arrives is an example of offering self. In comparison, asking whether the client wants to talk about his or her emotions is an example of providing general leads; asking the client to provide more details about a situation is an example of using open-ended questions; and offering to get answers from the physician is an example of giving information.
B)Offering self involves suggesting one's presence, interest, or wish to understand the client without making any demands or attaching conditions that the client must comply with to receive the nurse's attention. The nurse's offer to stay with the client until the family arrives is an example of offering self. In comparison, asking whether the client wants to talk about his or her emotions is an example of providing general leads; asking the client to provide more details about a situation is an example of using open-ended questions; and offering to get answers from the physician is an example of giving information.
C)Offering self involves suggesting one's presence, interest, or wish to understand the client without making any demands or attaching conditions that the client must comply with to receive the nurse's attention. The nurse's offer to stay with the client until the family arrives is an example of offering self. In comparison, asking whether the client wants to talk about his or her emotions is an example of providing general leads; asking the client to provide more details about a situation is an example of using open-ended questions; and offering to get answers from the physician is an example of giving information.
D)Offering self involves suggesting one's presence, interest, or wish to understand the client without making any demands or attaching conditions that the client must comply with to receive the nurse's attention. The nurse's offer to stay with the client until the family arrives is an example of offering self. In comparison, asking whether the client wants to talk about his or her emotions is an example of providing general leads; asking the client to provide more details about a situation is an example of using open-ended questions; and offering to get answers from the physician is an example of giving information.

Question 8

The nurse is conducting a health history on a client who is being admitted to a medical-surgical unit for the treatment of chronic pain. The client is concerned about privacy and asks why it is necessary for the nurse to ask for private information and then document it in the medical record. Which response by the nurse is most appropriate?
A)"You will be able to read the record and review your care."
B)"Documentation decreases the likelihood that you will have to repeat this information to others who will care for you."
C)"Your family can review the record and ensure that your care is appropriate."
D)"A record ensures there are no breaches of confidentiality."

Accepted Answer

A)A client's record serves as a vehicle by which different health professionals who interact with the client communicate with one another. This prevents fragmentation, repetition, and delays in client care, and it relieves the client from having to repeat information to each provider offering care. The client can read the record, but that is not a reason to keep one. The client's family does not have access to the record. Recordkeeping does not prevent breaches of confidentiality.
B)A client's record serves as a vehicle by which different health professionals who interact with the client communicate with one another. This prevents fragmentation, repetition, and delays in client care, and it relieves the client from having to repeat information to each provider offering care. The client can read the record, but that is not a reason to keep one. The client's family does not have access to the record. Recordkeeping does not prevent breaches of confidentiality.
C)A client's record serves as a vehicle by which different health professionals who interact with the client communicate with one another. This prevents fragmentation, repetition, and delays in client care, and it relieves the client from having to repeat information to each provider offering care. The client can read the record, but that is not a reason to keep one. The client's family does not have access to the record. Recordkeeping does not prevent breaches of confidentiality.
D)A client's record serves as a vehicle by which different health professionals who interact with the client communicate with one another. This prevents fragmentation, repetition, and delays in client care, and it relieves the client from having to repeat information to each provider offering care. The client can read the record, but that is not a reason to keep one. The client's family does not have access to the record. Recordkeeping does not prevent breaches of confidentiality.

Question 9

Which of the following statements is true with regard to monopolizing in the group setting?
A)Group members who engage in monopolizing behavior do so intentionally.
B)When one member of a group engages in monopolizing behavior, the other group members may become angry or frustrated with the group's leader.
C)Monopolizing behavior may be motivated by anxiety or a need for attention, recognition, and approval.
D)One useful strategy for dealing with monopolizing is to simply and directly interrupt the individual who is engaging in this behavior.

Accepted Answer

A)Monopolizing is the domination of a discussion by one member of a group. When this behavior occurs, a sense of resentment may develop within the group, and some members may direct their frustration and anger toward the group leader, whom they expect to do something to stop the monopolizer's behavior. Monopolizing behavior may be motivated by anxiety or a need for attention, recognition, and approval, although many compulsive talkers are unaware of their behavior and its effect on others. One useful strategy for dealing with monopolizing is to interrupt the monopolizer simply, directly, and supportively.
B)Monopolizing is the domination of a discussion by one member of a group. When this behavior occurs, a sense of resentment may develop within the group, and some members may direct their frustration and anger toward the group leader, whom they expect to do something to stop the monopolizer's behavior. Monopolizing behavior may be motivated by anxiety or a need for attention, recognition, and approval, although many compulsive talkers are unaware of their behavior and its effect on others. One useful strategy for dealing with monopolizing is to interrupt the monopolizer simply, directly, and supportively.
C)Monopolizing is the domination of a discussion by one member of a group. When this behavior occurs, a sense of resentment may develop within the group, and some members may direct their frustration and anger toward the group leader, whom they expect to do something to stop the monopolizer's behavior. Monopolizing behavior may be motivated by anxiety or a need for attention, recognition, and approval, although many compulsive talkers are unaware of their behavior and its effect on others. One useful strategy for dealing with monopolizing is to interrupt the monopolizer simply, directly, and supportively.
D)Monopolizing is the domination of a discussion by one member of a group. When this behavior occurs, a sense of resentment may develop within the group, and some members may direct their frustration and anger toward the group leader, whom they expect to do something to stop the monopolizer's behavior. Monopolizing behavior may be motivated by anxiety or a need for attention, recognition, and approval, although many compulsive talkers are unaware of their behavior and its effect on others. One useful strategy for dealing with monopolizing is to interrupt the monopolizer simply, directly, and supportively.

Question 10

The nurse completes a teaching session on wound care for a client who will require dressing changes after discharge. The nurse then evaluates the effectiveness of the teaching session and determines that more education is required. Which statement by the nurse is appropriate in this situation?
A)"Let me clarify again some of the steps that are required during wound care."
B)"You didn't pay attention, did you?"
C)"Here, let me do it for you."
D)"I don't think you understood me correctly the first time."

Accepted Answer

A)Responding with some clarifications indicates that the client understood some of the teaching and preserves the client's dignity and trust in the nurse. Saying that the client did not understand the information is belittling. Beginning a negative phrase with "you" is assigning blame, which impedes the therapeutic relationship. Telling the client that the nurse can take care of the task defeats the goal of feedback; the nurse would want to instill self-confidence in the client, and this type of action will hurt that goal.
B)Responding with some clarifications indicates that the client understood some of the teaching and preserves the client's dignity and trust in the nurse. Saying that the client did not understand the information is belittling. Beginning a negative phrase with "you" is assigning blame, which impedes the therapeutic relationship. Telling the client that the nurse can take care of the task defeats the goal of feedback; the nurse would want to instill self-confidence in the client, and this type of action will hurt that goal.
C)Responding with some clarifications indicates that the client understood some of the teaching and preserves the client's dignity and trust in the nurse. Saying that the client did not understand the information is belittling. Beginning a negative phrase with "you" is assigning blame, which impedes the therapeutic relationship. Telling the client that the nurse can take care of the task defeats the goal of feedback; the nurse would want to instill self-confidence in the client, and this type of action will hurt that goal.
D)Responding with some clarifications indicates that the client understood some of the teaching and preserves the client's dignity and trust in the nurse. Saying that the client did not understand the information is belittling. Beginning a negative phrase with "you" is assigning blame, which impedes the therapeutic relationship. Telling the client that the nurse can take care of the task defeats the goal of feedback; the nurse would want to instill self-confidence in the client, and this type of action will hurt that goal.

Question 11

The nurse is providing care to a client who is newly diagnosed with human immunodeficiency virus (HIV). Which statements by the nurse could inhibit the development of therapeutic communication with this client? Select all that apply.
A)"I am so happy today! I just found out that I got accepted into nurse practitioner school!"
B)"Well, I guess your lifestyle finally caught up to you."
C)"One of my cousins has AIDS. It is hard to watch him die."
D)"Tell me your feelings about the diagnosis."
E)"Would you like to talk about the new medications you've been prescribed?"

Accepted Answer

A)Various obstacles to attentive listening can inhibit the development of therapeutic communication. Being concerned with oneself, assuming, and identifying are all common obstacles to attentive listening. In contrast, using open-ended questions and providing general leads-in are actions that enhance therapeutic communication.
B)Various obstacles to attentive listening can inhibit the development of therapeutic communication. Being concerned with oneself, assuming, and identifying are all common obstacles to attentive listening. In contrast, using open-ended questions and providing general leads-in are actions that enhance therapeutic communication.
C)Various obstacles to attentive listening can inhibit the development of therapeutic communication. Being concerned with oneself, assuming, and identifying are all common obstacles to attentive listening. In contrast, using open-ended questions and providing general leads-in are actions that enhance therapeutic communication.
D)Various obstacles to attentive listening can inhibit the development of therapeutic communication. Being concerned with oneself, assuming, and identifying are all common obstacles to attentive listening. In contrast, using open-ended questions and providing general leads-in are actions that enhance therapeutic communication.
E)Various obstacles to attentive listening can inhibit the development of therapeutic communication. Being concerned with oneself, assuming, and identifying are all common obstacles to attentive listening. In contrast, using open-ended questions and providing general leads-in are actions that enhance therapeutic communication.

Question 12

A nurse is providing teaching for an inpatient support group meeting. Which group behavior indicates that the teaching was effective?
A)The group members appear relaxed and interested in the topic.
B)The group members are tentative in expressing their feelings.
C)The group avoids discussion about their signs and symptoms.
D)The group members appear self-conscious when asked questions about their condition.

Accepted Answer

A)To be effective, a group must accomplish its goals, maintain cohesion, and develop/modify its structure to improve effectiveness. The features of an effective group include an informal, comfortable, and relaxed atmosphere; goals, tasks, and objectives that are clear and understood; leader and member participation; an emphasis on goals; open, two-way communication; appropriate decision-making procedures; cohesion; conflict tolerance; and shared power.
B)To be effective, a group must accomplish its goals, maintain cohesion, and develop/modify its structure to improve effectiveness. The features of an effective group include an informal, comfortable, and relaxed atmosphere; goals, tasks, and objectives that are clear and understood; leader and member participation; an emphasis on goals; open, two-way communication; appropriate decision-making procedures; cohesion; conflict tolerance; and shared power.
C)To be effective, a group must accomplish its goals, maintain cohesion, and develop/modify its structure to improve effectiveness. The features of an effective group include an informal, comfortable, and relaxed atmosphere; goals, tasks, and objectives that are clear and understood; leader and member participation; an emphasis on goals; open, two-way communication; appropriate decision-making procedures; cohesion; conflict tolerance; and shared power.
D)To be effective, a group must accomplish its goals, maintain cohesion, and develop/modify its structure to improve effectiveness. The features of an effective group include an informal, comfortable, and relaxed atmosphere; goals, tasks, and objectives that are clear and understood; leader and member participation; an emphasis on goals; open, two-way communication; appropriate decision-making procedures; cohesion; conflict tolerance; and shared power.

Question 13

The nurse is providing care to a client who is diagnosed with hypertension. Which response by the nurse is an appropriate example of informational confrontation with the client?
A)"I noticed you rubbing your head and your eyes. Are you hurting? Let's take your blood pressure."
B)"I heard raised voices when I was coming down the hall to your room. Are you upset?"
C)"It is 3 p.m. and time to take your blood pressure before I give you your medication."
D)"Is the blood pressure medication making your head hurt?"

Accepted Answer

A)An informational confrontation describes the visible behavior of another individual, whereas an interpretive confirmation expresses thoughts and feelings about behavior and draws inferences. Of the options provided, only the one that begins with "I noticed you rubbing your head and your eyes" is an example of an informational confrontation.
B)An informational confrontation describes the visible behavior of another individual, whereas an interpretive confirmation expresses thoughts and feelings about behavior and draws inferences. Of the options provided, only the one that begins with "I noticed you rubbing your head and your eyes" is an example of an informational confrontation.
C)An informational confrontation describes the visible behavior of another individual, whereas an interpretive confirmation expresses thoughts and feelings about behavior and draws inferences. Of the options provided, only the one that begins with "I noticed you rubbing your head and your eyes" is an example of an informational confrontation.
D)An informational confrontation describes the visible behavior of another individual, whereas an interpretive confirmation expresses thoughts and feelings about behavior and draws inferences. Of the options provided, only the one that begins with "I noticed you rubbing your head and your eyes" is an example of an informational confrontation.

Question 14

Which of the following situations is an example of countertransference in the group setting?
A)After failing at an assigned task, the members of a group place all blame for this failure on a single group member.
B)A group member reveres the group's leader, largely because the leader possesses many similarities to the member's mother, whom he adores.
C)The members of a group become so caught up in the group's current beliefs and actions that they fail to recognize simple changes that would greatly improve the group's efficiency.
D)The leader of a group distrusts one of the group members solely because the member reminds him of his ex-wife.

Accepted Answer

A)Countertransference occurs when leaders respond to group members because of reactions from earlier relationships. The leader who distrusts the group member because of similarities to his ex-wife is exhibiting countertransference. The scenario in which the members of a group place all blame on one person is an example of scapegoating. The scenario in which a group member reveres the leader because she reminds him of his mother is an example of transference. The scenario in which the group members become excessively caught up in group processes is an example of groupthink.
B)Countertransference occurs when leaders respond to group members because of reactions from earlier relationships. The leader who distrusts the group member because of similarities to his ex-wife is exhibiting countertransference. The scenario in which the members of a group place all blame on one person is an example of scapegoating. The scenario in which a group member reveres the leader because she reminds him of his mother is an example of transference. The scenario in which the group members become excessively caught up in group processes is an example of groupthink.
C)Countertransference occurs when leaders respond to group members because of reactions from earlier relationships. The leader who distrusts the group member because of similarities to his ex-wife is exhibiting countertransference. The scenario in which the members of a group place all blame on one person is an example of scapegoating. The scenario in which a group member reveres the leader because she reminds him of his mother is an example of transference. The scenario in which the group members become excessively caught up in group processes is an example of groupthink.
D)Countertransference occurs when leaders respond to group members because of reactions from earlier relationships. The leader who distrusts the group member because of similarities to his ex-wife is exhibiting countertransference. The scenario in which the members of a group place all blame on one person is an example of scapegoating. The scenario in which a group member reveres the leader because she reminds him of his mother is an example of transference. The scenario in which the group members become excessively caught up in group processes is an example of groupthink.

Question 15

A nurse is caring for a client with cancer who is struggling with chronic pain. The nurse tells the client, "It is normal to feel frustrated about the discomfort." Which skill associated with the working phase of the nurse-client relationship does the nurse's statement best reflect?
A)Confronting
B)Respect
C)Concreteness
D)Genuineness

Accepted Answer

A)Respect is correct because the nurse is validating the client's feelings. This situation is not an example of genuineness because the nurse is giving information versus making a personal statement. Rather than being confrontational by pointing out discrepancies between thoughts, feelings, and actions that inhibit the client's self-understanding or exploration of specific areas, the nurse is being supportive by respecting the client's feelings. Concreteness involves assisting the client by giving specific examples rather than speaking in generalities.
B)Respect is correct because the nurse is validating the client's feelings. This situation is not an example of genuineness because the nurse is giving information versus making a personal statement. Rather than being confrontational by pointing out discrepancies between thoughts, feelings, and actions that inhibit the client's self-understanding or exploration of specific areas, the nurse is being supportive by respecting the client's feelings. Concreteness involves assisting the client by giving specific examples rather than speaking in generalities.
C)Respect is correct because the nurse is validating the client's feelings. This situation is not an example of genuineness because the nurse is giving information versus making a personal statement. Rather than being confrontational by pointing out discrepancies between thoughts, feelings, and actions that inhibit the client's self-understanding or exploration of specific areas, the nurse is being supportive by respecting the client's feelings. Concreteness involves assisting the client by giving specific examples rather than speaking in generalities.
D)Respect is correct because the nurse is validating the client's feelings. This situation is not an example of genuineness because the nurse is giving information versus making a personal statement. Rather than being confrontational by pointing out discrepancies between thoughts, feelings, and actions that inhibit the client's self-understanding or exploration of specific areas, the nurse is being supportive by respecting the client's feelings. Concreteness involves assisting the client by giving specific examples rather than speaking in generalities.

Question 16

Use of flow sheets would be most appropriate during which phase of the nursing process?
A)Evaluation
B)Diagnosis
C)Implementation
D)Planning

Accepted Answer

A)Flow sheets use specific assessment criteria in a particular format. They are frequently used on a client's chart to record routine nursing tasks and assessment data. Examples of flow sheets include a graphic record, fluid balance record, daily nursing assessments record, patient teaching record, patient discharge record, and skin assessment record. Typically, flow sheets are used during the assessment and implementation portions of the nursing process.
B)Flow sheets use specific assessment criteria in a particular format. They are frequently used on a client's chart to record routine nursing tasks and assessment data. Examples of flow sheets include a graphic record, fluid balance record, daily nursing assessments record, patient teaching record, patient discharge record, and skin assessment record. Typically, flow sheets are used during the assessment and implementation portions of the nursing process.
C)Flow sheets use specific assessment criteria in a particular format. They are frequently used on a client's chart to record routine nursing tasks and assessment data. Examples of flow sheets include a graphic record, fluid balance record, daily nursing assessments record, patient teaching record, patient discharge record, and skin assessment record. Typically, flow sheets are used during the assessment and implementation portions of the nursing process.
D)Flow sheets use specific assessment criteria in a particular format. They are frequently used on a client's chart to record routine nursing tasks and assessment data. Examples of flow sheets include a graphic record, fluid balance record, daily nursing assessments record, patient teaching record, patient discharge record, and skin assessment record. Typically, flow sheets are used during the assessment and implementation portions of the nursing process.

Question 17

A nurse has just been hired as a medical information system (MIS)trainer at a hospital where an electronic medical record system is being installed. The nurse has been asked to assess the security of clients' medical records. According to HIPAA's Security Rule, which recommendations by the nurse will enhance security? Select all that apply.
A)Assign each staff member a unique username and password.
B)Install a firewall.
C)Store computer-generated worksheets in a locked vault.
D)Turn monitors away from view when unattended.
E)Assign each unit unique passwords.

Accepted Answer

A)To comply with HIPAA's Security Rule, institutions should assign individual passwords to each staff member for logging on and off computer files. Firewalls should be installed to enhance the security of client records. Client information should not be displayed on unattended terminals, regardless of which direction the monitor faces, and computer-generated worksheets should be shredded when no longer needed.
B)To comply with HIPAA's Security Rule, institutions should assign individual passwords to each staff member for logging on and off computer files. Firewalls should be installed to enhance the security of client records. Client information should not be displayed on unattended terminals, regardless of which direction the monitor faces, and computer-generated worksheets should be shredded when no longer needed.
C)To comply with HIPAA's Security Rule, institutions should assign individual passwords to each staff member for logging on and off computer files. Firewalls should be installed to enhance the security of client records. Client information should not be displayed on unattended terminals, regardless of which direction the monitor faces, and computer-generated worksheets should be shredded when no longer needed.
D)To comply with HIPAA's Security Rule, institutions should assign individual passwords to each staff member for logging on and off computer files. Firewalls should be installed to enhance the security of client records. Client information should not be displayed on unattended terminals, regardless of which direction the monitor faces, and computer-generated worksheets should be shredded when no longer needed.
E)To comply with HIPAA's Security Rule, institutions should assign individual passwords to each staff member for logging on and off computer files. Firewalls should be installed to enhance the security of client records. Client information should not be displayed on unattended terminals, regardless of which direction the monitor faces, and computer-generated worksheets should be shredded when no longer needed.

Question 18

A nurse manager is educating staff nurses about the types and frequency of documentation required for clients being cared for in long-term care facilities. These requirements originate from which of the following laws and regulatory bodies? Select all that apply.
A)Problem-Oriented Medical Record (POMR)Act
B)Omnibus Budget Reconciliation Act (OBRA)
C)Health Care Financing Administration (HCFA)
D)Minimum Data Set (MDS)Act
E)American Recovery and Reinvestment Act (ARRA)

Accepted Answer

A)Long-term care facilities must comply with documentation requirements set forth in the Omnibus Budget Reconciliation Act (OBRA)of 1987 and the American Recovery and Reinvestment Act (ARRA)of 2009, as well as with regulations established by the Health Care Financing Administration (HCFA). The POMR is a system of medical recordkeeping, not a law or regulatory body. The Minimum Data Set (MDS)is an effort to establish standards for collecting standardized, essential nursing data for inclusion in computer databases. Although established under OBRA, the MDS is not a specific law or regulatory body.
B)Long-term care facilities must comply with documentation requirements set forth in the Omnibus Budget Reconciliation Act (OBRA)of 1987 and the American Recovery and Reinvestment Act (ARRA)of 2009, as well as with regulations established by the Health Care Financing Administration (HCFA). The POMR is a system of medical recordkeeping, not a law or regulatory body. The Minimum Data Set (MDS)is an effort to establish standards for collecting standardized, essential nursing data for inclusion in computer databases. Although established under OBRA, the MDS is not a specific law or regulatory body.
C)Long-term care facilities must comply with documentation requirements set forth in the Omnibus Budget Reconciliation Act (OBRA)of 1987 and the American Recovery and Reinvestment Act (ARRA)of 2009, as well as with regulations established by the Health Care Financing Administration (HCFA). The POMR is a system of medical recordkeeping, not a law or regulatory body. The Minimum Data Set (MDS)is an effort to establish standards for collecting standardized, essential nursing data for inclusion in computer databases. Although established under OBRA, the MDS is not a specific law or regulatory body.
D)Long-term care facilities must comply with documentation requirements set forth in the Omnibus Budget Reconciliation Act (OBRA)of 1987 and the American Recovery and Reinvestment Act (ARRA)of 2009, as well as with regulations established by the Health Care Financing Administration (HCFA). The POMR is a system of medical recordkeeping, not a law or regulatory body. The Minimum Data Set (MDS)is an effort to establish standards for collecting standardized, essential nursing data for inclusion in computer databases. Although established under OBRA, the MDS is not a specific law or regulatory body.
E)Long-term care facilities must comply with documentation requirements set forth in the Omnibus Budget Reconciliation Act (OBRA)of 1987 and the American Recovery and Reinvestment Act (ARRA)of 2009, as well as with regulations established by the Health Care Financing Administration (HCFA). The POMR is a system of medical recordkeeping, not a law or regulatory body. The Minimum Data Set (MDS)is an effort to establish standards for collecting standardized, essential nursing data for inclusion in computer databases. Although established under OBRA, the MDS is not a specific law or regulatory body.

Question 19

The nurse is providing care for a client who is newly diagnosed with chronic obstructive pulmonary disease (COPD). In this scenario, which action by the nurse would be considered an example of therapeutic communication?
A)The nurse asks appropriate questions about the client's medical history.
B)The nurse closes the conversation with an anecdote about breathing.
C)The nurse plans to tell the client about a COPD support group.
D)The nurse bonds with the client by describing her own experiences living with COPD.

Accepted Answer

A)Attentive or "mindful" listening is a therapeutic communication technique that involves listening and absorbing the content and feeling of what an individual is conveying, without selectivity. This technique requires paying attention to the client's total message, both verbal and nonverbal, and noting whether these communications are congruent. During attentive listening, the nurse focuses not on the nurse's own needs but rather on the client's needs. By asking appropriate questions about the client's medical history and carefully noting the client's responses, the nurse is engaging in attentive listening and thus in therapeutic communication.
B)Attentive or "mindful" listening is a therapeutic communication technique that involves listening and absorbing the content and feeling of what an individual is conveying, without selectivity. This technique requires paying attention to the client's total message, both verbal and nonverbal, and noting whether these communications are congruent. During attentive listening, the nurse focuses not on the nurse's own needs but rather on the client's needs. By asking appropriate questions about the client's medical history and carefully noting the client's responses, the nurse is engaging in attentive listening and thus in therapeutic communication.
C)Attentive or "mindful" listening is a therapeutic communication technique that involves listening and absorbing the content and feeling of what an individual is conveying, without selectivity. This technique requires paying attention to the client's total message, both verbal and nonverbal, and noting whether these communications are congruent. During attentive listening, the nurse focuses not on the nurse's own needs but rather on the client's needs. By asking appropriate questions about the client's medical history and carefully noting the client's responses, the nurse is engaging in attentive listening and thus in therapeutic communication.
D)Attentive or "mindful" listening is a therapeutic communication technique that involves listening and absorbing the content and feeling of what an individual is conveying, without selectivity. This technique requires paying attention to the client's total message, both verbal and nonverbal, and noting whether these communications are congruent. During attentive listening, the nurse focuses not on the nurse's own needs but rather on the client's needs. By asking appropriate questions about the client's medical history and carefully noting the client's responses, the nurse is engaging in attentive listening and thus in therapeutic communication.

Question 20

What is the first phase in the therapeutic nurse-client relationship?
A)Introductory phase
B)Working phase
C)Preinteraction phase
D)Anticipatory phase

Accepted Answer

A)The therapeutic nurse-client relationship can be described in terms of four sequential phases: the preinteraction phase, introductory phase, working (maintaining)phase, and termination phase. During the preinteraction phase, the nurse plans for the initial face-to-face meeting with the client.
B)The therapeutic nurse-client relationship can be described in terms of four sequential phases: the preinteraction phase, introductory phase, working (maintaining)phase, and termination phase. During the preinteraction phase, the nurse plans for the initial face-to-face meeting with the client.
C)The therapeutic nurse-client relationship can be described in terms of four sequential phases: the preinteraction phase, introductory phase, working (maintaining)phase, and termination phase. During the preinteraction phase, the nurse plans for the initial face-to-face meeting with the client.
D)The therapeutic nurse-client relationship can be described in terms of four sequential phases: the preinteraction phase, introductory phase, working (maintaining)phase, and termination phase. During the preinteraction phase, the nurse plans for the initial face-to-face meeting with the client.

Quiz 38: Communication

The nurse is caring for a client who received analgesic medication via central line to treat pain associated with cancer. After reassessing the client's response, which section of the PIE record will the nurse use when documenting the client's care?

A nurse educator is teaching a group of students about therapeutic touch. In which situation is it appropriate to use therapeutic touch as a means of communication?

A novice nurse is working with a client who is admitted to a medical-surgical unit. The nurse is establishing a therapeutic relationship with the client by conveying empathy. Which statement by the nurse best exemplifies empathy?

Four groups of nurses are attempting to determine which methods are most effective for teaching patients about proper self-care. Which of these groups is least likely to arrive at a successful decision in a timely manner?

The nurse is caring for a school-age client who is scheduled to have major heart surgery the next morning. The nurse enters the room to administer a medication and finds the client crying. Which response by the nurse is most therapeutic?

The nurse is caring for an older adult client in a long-term care facility. Which behavior by the nurse conveys physical attending when communicating with this client?

Which of the following statements by the nurse is an example of the therapeutic communication technique of offering self?

Which of the following statements is true with regard to monopolizing in the group setting?

The nurse completes a teaching session on wound care for a client who will require dressing changes after discharge. The nurse then evaluates the effectiveness of the teaching session and determines that more education is required. Which statement by the nurse is appropriate in this situation?

The nurse is providing care to a client who is newly diagnosed with human immunodeficiency virus (HIV) . Which statements by the nurse could inhibit the development of therapeutic communication with this client? Select all that apply.

A nurse is providing teaching for an inpatient support group meeting. Which group behavior indicates that the teaching was effective?

The nurse is providing care to a client who is diagnosed with hypertension. Which response by the nurse is an appropriate example of informational confrontation with the client?

Which of the following situations is an example of countertransference in the group setting?

A nurse is caring for a client with cancer who is struggling with chronic pain. The nurse tells the client, "It is normal to feel frustrated about the discomfort." Which skill associated with the working phase of the nurse-client relationship does the nurse's statement best reflect?

Use of flow sheets would be most appropriate during which phase of the nursing process?

A nurse manager is educating staff nurses about the types and frequency of documentation required for clients being cared for in long-term care facilities. These requirements originate from which of the following laws and regulatory bodies? Select all that apply.

The nurse is providing care for a client who is newly diagnosed with chronic obstructive pulmonary disease (COPD) . In this scenario, which action by the nurse would be considered an example of therapeutic communication?

What is the first phase in the therapeutic nurse-client relationship?