Test Bank NURS 2900 Nurse-Client Relationships Questions and Answers 1. Which of the following is one of the four categories of client needs identified by the National Council of State Boards of Nurs... ing? A) Maintenance of function B) Restoration of wellness C) Psychosocial integrity D) Reduction of fear and worry Ans: C Feedback: The National Council of State Boards of Nursing identifies four categories of client needs as the structure for its test plan: safe and effective care environment, health promotion and maintenance, psychosocial integrity, and physiologic integrity. Nursing care provides skills that help restore wellness, especially during an acute illness, or maintain as much function as possible. The supportive relationship that develops reduces fear and worry. 2. Which of the following is a component of nonverbal communication? A) Paralanguage B) Hearing acuity C) Interpersonal attitudes D) Listening Ans: A Feedback: Nonverbal communication consists of components such as kinesics, paralanguage (vocal sounds that communicate a message), proxemics (use of space when communicating), touch, and silence. Hearing acuity, interpersonal attitudes, and listening are variables that affect verbal communication. 3. Which of the following is a purpose of affective touch in the context of nursing? A) Demonstrating concern B) Providing contact for performing procedures C) Encouraging verbal communication D) Providing brief periods for response Ans: A Feedback: Affective touch is touch used to demonstrate concern or affection. Task-oriented touch involves the personal contact that is needed for performing nursing procedures. Silence is the art of remaining quiet. Encouraging verbal communication and providing a brief period during which clients can respond to a question are therapeutic uses of silence. 4. Which of the following means of comprehending new information best describes a cognitive learner? A) The learner learns through information that appeals to feelings. B) The learner likes to learn by doing. C) The learner learns by combining three styles of learning. D) The learner processes information by listening to facts. Ans: D Feedback: The cognitive learner processes information best by listening to or reading facts and descriptions. The affective learner is more attuned to learning when presented with information that appeals to his or her feelings. The psychomotor learner typically likes to learn by doing. A combination of the three styles tends to optimize learning, although most people favor one style of learning. 5. Which of the following is a reason why silence is considered therapeutic? A) It demonstrates concern or affection. B) It communicates caring and support. C) It encourages a client's verbal communication. D) It is therapeutic when a client is uncomfortable. Ans: C Feedback: Silence is the art of remaining quiet. One of its therapeutic uses is to encourage a client's verbal communication. Affective touch is typically used to demonstrate concern or affection. Its intention is to communicate caring and support. The nurse use affective touch therapeutically in many situations, including when a client is uncomfortable. 6. Advocacy and support are activities associated with which learning style? A) Cognitive B) Cultural C) Psychomotor D) Affective Ans: D Feedback: The affective learner learns best when presented with information that appeals to his or her feelings, beliefs, and values. Cognitive learners process information best by listening to or reading facts and descriptions. The psychomotor learner prefers to learn by doing. There is no learning style classified as cultural. 7. Which of the following is a person's intellectual ability to remember and apply new information? A) Learning style B) Learning needs C) Motivation D) Learning capacity Ans: D Feedback: Learning capacity is a person's intellectual ability to understand, remember, and apply new information. Learning style is the manner in which a person best comprehends new information. Learning needs are the skills and concepts that the client and family must acquire to restore, maintain, or promote health. Motivation is the desire to acquire new information. 8. Which of the following is a positive interpretation of body language? A) Clenched jaw B) Tilt of head C) Arms crossed D) Rubbing nose Ans: B Feedback: An example of a positive interpretation of body language is the tilt of the head. Negative examples of body language include a clenched jaw, crossed arms, and rubbing the nose. 9. Which type of learner processes information more adequately by listening or reading facts? A) Social B) Psychomotor C) Affective D) Cognitive Ans: D Feedback: Cognitive learners process information best by listening to or reading facts and descriptions. There is no category of social learner. The psychomotor learner prefers to learn by doing. The affective learner learns best when presented with information that appeals to his or her feelings, beliefs, and values. 10. Which of the following is a client responsibility in the nurse–client relationship? A) Remain nonjudgmental. B) Comply with the therapeutic regimen. C) Function as an advocate. D) Perform prescribed skill safely. Ans: B Feedback: Complying with the therapeutic regimen is a client responsibility. Remaining nonjudgmental, functioning as an advocate, and performing a prescribed skill safely are nurse responsibilities. 11. The nurse is caring for a client who is hard of hearing. The nurse is in the room during client and physician discussion and will relate the information to the client's power of attorney. Which term best describes the role the nurse is assuming? A) Friend B) Caregiver C) Leader D) Coach Ans: B Feedback: When the nurse assists the client is relaying information to the family, the nurse is in the role of the caregiver. The caregiving role includes a close relationship and becomes a client's guide, companion, and interpreter. The nurse loses perspective when in the role of the friend. The nurse can be a leader and a coach; however, in the situation stated, the best answer is caregiver. 12. The nurse enters the client's room and assesses that the client's affect appears sad. The client is sitting near the window, staring into the distance with a tear in the eye. The nurse approaches and places a hand on the client's shoulder asking for client thoughts. What type of emotion is the nurse projecting? A) Sympathy B) Empathy C) Ambivalence D) Pity Ans: B Feedback: The nurse is projecting empathy. Empathy is an intuitive awareness of what the client is experiencing. Nurses perceive the client's emotional state and provide support. Sympathy is the projection of understanding the way one may feel, many times by having gone through the experience as well. Ambivalence projects conflicting feelings and uncertainty. Pity is projects a feeling of sorrow. 13. Which of the following is least effective in encouraging a client to follow a medication regimen? A) Provide information on the medications prescribed B) Instruct the family members on treatment regimen C) Discuss perspective from the nurse's personal experience D) State potential consequences if medication regimen in not followed Ans: C Feedback: When encouraging a client to follow a medically prescribed medication regiment, the nurse is least effective when including personal experiences and the nurse's own choices. The most effective strategy is providing information on the medication regimen, including family member in the treatment regimen to support the client and to provide information on the consequence if the medication regimen is not followed. Ensuring that clients have all of the information to make an informed decision is a nursing role. 14. The charge nurse delegates the administration of a pain medication to a practical nurse. Which statement, made by the charge nurse, indicates that the final step in the delegation process has been completed? A) “Did you document the administration of the pain medication on the medication record?” B) “Is the physician aware of the client's need for pain medication?” C) “What is the client's pain level since administering the pain medication 30 minutes ago?” D) “Have you ever administered this type of pain medication previously?” Ans: C Feedback: The final step in the delegation process is to ensure that the task has been completed and determine the resulting outcome of the action. In this case, it is ensuring the medication is giving and assessing for pain relief. The other steps may be completed in the delegation process, but they are not completed last. 15. The nurse has been caring for a client and family for 6 months in the long-term care facility. Which of the following nursing actions is appropriate during the terminating phase of the nurse–client relationship? Select all that apply. A) Teaching the client and family about care needs at home B) Providing personal contact information if further guidance is needed C) Accepting personal gifts of gratitude from the client D) Relaying well wishes from the staff E) Arranging health related services to support home care F) Coordinating medication regimen for home care Ans: A, D, E, F Feedback: The terminating phase occurs when the client's health problems have improved and nursing services in the long-term care facility are no longer necessary. The nurse's role becomes transitioning the client and family to home care. Teaching about needs, arranging health related services, and coordinating medication regimen for home care are all appropriate. Also, relaying well wishes from the staff shows the caring nature of the staff and highlights the nurse–client relationship while in the facility. It is typically not appropriate to accept personal gifts or exchange personal contact information with the client. 16. Which of the following nurse statements is completed in the working phase of the nurse– client relationship? A) “Tell me about your religious beliefs during this season of the year.” B) “I will put a chair in the bathroom so you can begin personal care. I will return to assist you as needed.” C) “I understand that you are feeling anxious about going home. Let me assess you before we talk.” D) “Let's talk about a way to assist you to a standing position so you can walk in the hall.” Ans: B Feedback: During the working phase of the nurse–client relationship, the nurse and the client puts the mutually developed plan into action. Each person shares in performing the task that leads to the desired outcome, which supports the client's independence. In the introductory phase, the nurse should be gathering information regarding religious beliefs. In the terminating phase, the client may feel apprehensive about assuming independent activity or self-care. Developing the plan with activities such as assisting to a standing position to walk in the hall is completed in the introductory phase. 17. The nurse is caring for a client and family who are awaiting the results of a diagnostic test. Which of the following acts, made by the nurse, best demonstrate therapeutic nonverbal communication? A) The nurse listens to the client's frustration of waiting for test results. B) The nurse smiles and rubs the shoulder of the client. C) The nurse is silent while caring out her nursing duties. D) The nurse shrugs the shoulders when asked when testing results will return. Ans: B Feedback: A smile and rub of the client's shoulder is a nonverbal gesture that the nurse understands the client's situation. Listening to client frustration is an activity that affects verbal communication because, therapeutically, there is a response. Silence can be therapeutic when the attention is with the client, not the nursing duties. Shrugging the shoulders can be perceived as indifferent and not caring. 18. The nurse is instructing a client in a crowded semiprivate room. The nurse approaches and moves equipment to allow for a comfortable conversation. At which distance should the nurse stand? A) Within 1 feet B) 2 to 3 feet C) At least 5 feet D) Over 6 feet Ans: B Feedback: Proxemics refers to the use of space when communicating. Most Americans feel comfortable when individuals are 2 to 3 feet away. 19. Which nursing action is most therapeutic when a client says, “My daughter wants me to go to a nursing home to get rid of me; I am just a burden.” A) Pull up a chair and sit down to talk. B) Offer self and discuss family behaviors the nurse sees. C) Explore past relationship issues using reminiscence therapy. D) Offer to call the daughter in to discuss the issues. Ans: A Feedback: The nurse must respond delicately to an emotional client. The most therapeutic action for the nurse is to pull up a chair and sit down to talk. When assuming a seated position, it allows the nurse to be at eye level instead of overhead, which places the client in the position of vulnerability. Offering of self is therapeutic but not to discuss the family through the nurse's eye. Exploring past relationships does not focus on the issues today. Offering to call the daughter would not be done until further information is obtained. 20. The nurse cares for multiple ethnic populations. Which of the following examples best demonstrates a facility adhering to The Joint Commission requirements that healthcare workers facilitate communication with all clients? A) The facility requires a family member of a non–English-speaking client be present to discuss healthcare issues with a physician and member of social service. B) Language dictionaries are placed in the facility library with open access for staff. C) The facility requests bilingual staff and community members to voluntarily provide contact information for interpreter services. D) The facility subscribes to an online interpreting service. Ans: C Feedback: It is a requirement of The Joint Commission that agencies develop a system to provide aids and services to any client with literacy needs and also to provide language interpreting and translation services. The best way to demonstrate this requirement is by reaching out to staff and community members to provide personal interpreting services. It is not appropriate to require a family member, if available, to be present. The other options may be helpful in communicating with clients, but personal services are optimal. 21. The nurse is caring for a client who has been diagnosed with a cerebral vascular accident and subsequent expressive aphasia. In which manner does the nurse best promote communication? A) Ask open-ended questions and allow time for the client to respond. B) Use head nods and shakes to convey answers to questions. C) Use hand gestures to facilitate nursing care. D) Use a picture board with common responses. Ans: D Feedback: For clients with aphasia, it is most helpful to have a picture board with responses to convey meaning. This decreases some frustration and allows the client to have some control over care. Asking closed-ended questions with limited responses and allowing for additional response time is appropriate. Head nods and hand gestures are limited ways of communication. 22. The nurse is caring for a client who is newly diagnosed with atrial fibrillation. The client states he has many questions. At what point in the client contact experience does assessment for learning begin? A) During a morning assessment B) When presenting the client with a brochure C) Once the physician confirms the diagnosis D) At the time of arrival to the hospital for care Ans: D Feedback: The time of the initial assessment for learning begins when the client arrives at the hospital. Even when the client is in the emergency department, doctors and staff are explaining testing and procedures. As a new medical diagnosis is confirmed, teaching continues with information about the disease process, new medication, and treatment regimen. 23. The nurse is discharging a client with an indwelling Foley catheter. Which instructional method is best when teaching a psychomotor learner about the care necessary? A) Provide a booklet that outlines directions. B) Provide the phone number of a nursing agency to assist with care. C) Provide testimonials of others who have had a Foley catheter at home. D) Provide the Foley catheter and equipment to handle and practice care. Ans: D Feedback: A psychomotor learner prefers to learn by doing. Providing equipment enables the learner to use the equipment and reinforces the necessary care. The booklet would be appropriate for the cognitive learner. A nursing agency is most often ordered by a physician for nursing care but is not a daily service. Testimonials are effective for affective learners. 24.A nurse is caring for a client who is newly diagnosed with cancer and receiving a peripherally inserted central catheter (PICC). Upon analysis, the nurse determines that the client is an affective learner. Which type of learning situation would the client learn from best? A) Having the client make a poster with the equipment from the PICC line B) Having the client prepare notes related to the PICC line to be discussed with the physician C) Having the client attend a group support meeting of people with PICC lines D) Having the client look online for information related to the PICC line Ans: C Feedback: An affective learner learns best when the information is presented with consideration of the client's thoughts/feelings, values, or beliefs. Having a client attend a group support meeting with individuals having similar life struggles provides the opportunity for the client to learn how best to live with the new diagnosis and care for themselves. Making a poster with equipment is helpful for a psychomotor learner. Preparing notes and learning online is helpful for a cognitive learner. 25.A wound care nurse approaches a client to instruct in home care needs. In which clinical scenario would the nurse delay teaching due to learning readiness? A) The client says that a grandchild will be in soon. B) The client is eating breakfast. C) The client is anxious about physical therapy. D) The client is meeting with the priest. Ans: C Feedback: Learning readiness pertains to the optimal time for learning. This occurs when a client is in a state of physical and psychological well-being. Being anxious about an upcoming activity distracts the client from learning. Waiting until after the activity allows the client to be more focused on the teaching. Nurses may decide to delay teaching due to visiting family, eating breakfast, and meeting with a priest, but it is not from learning readiness. 26. The nurse is evaluating the comprehension of a client's knowledge of the administration of Lovenox, an anticoagulant. Which method provides the best feedback? A) Having the client explain the medication and injection site B) Having the client demonstrate the injection technique on an orange C) Having the client watch the nurse prepare the medication and administer it D) Having the client prepare the syringe and independently administer the injection Ans: D Feedback: Having the client prepare the syringe and independently administer the injection is the “show back” portion of learning comprehension because it includes demonstrating the skill. By independently demonstrating, the nurse is able to evaluate the knowledge base and skill. Having the client watch the nurse administer the medication is in the teaching process. Having the client explain the medication and injection site or administer the injection into an orange demonstrates parts of the skill but does not allow the nurse to evaluate the entire skill. 27. The nurse is employed at a diabetic clinic and is assisting a client with maintenance of blood glucose status. When assessing nurse–client responsibilities, which responsibility does the nurse most expect of the client? A) Be courteous to others. B) Comply with the set regimen. C) Be nonjudgmental. D) Possess knowledge. Ans: B Feedback: The nurse most expects the client to comply with the set regimen. The other options are nursing responsibilities. 28. The nurse is preparing a community education program about a new treatment for prostate cancer. At what level would the nurse prepare the distributed educational materials? A) Upper grade school, 4th to 6th grade level B) High school, 10th to 12th grade level C) Middle school, 7th to 9th grade level D) College, over the 12th grade level Ans: C Feedback: When preparing educational materials for the general population, the language or words used should be at the middle school, 7th to 9th grade level. 29. The nurse is caring for a geriatric client who has decided to move to a skilled nursing facility. The nurse assisted with the arrangements and, when leaving the room, touched the client on the shoulder. Which therapeutic technique was the nurse demonstrating? A) Therapeutic communication B) Affective touch C) Silence D) Task-oriented contact Ans: B Feedback: Affective touch is used to demonstrate concern or affection. Its intention is to communicate caring and support. Therapeutic communication and silence can be helpful in this situation but does not it into the scenario. Task-oriented “touch” involves the personal contact that is required when performing nursing procedures. 30. Which of the following teaching scenarios best illustrates the nurse providing informal teaching on a low-sodium diet? A) The nurse discusses dietary guidelines while the client watches a cooking show on television. B) The nurse, client, and spouse review dietary orders on the discharge instructions. C) The nurse and client discuss the sodium contained in prepared canned soup. D) The nurse and client meet with a dietician to discuss ways of limiting sodium. Ans: A Feedback: Informal teaching is unplanned and occurs spontaneously such as when the client is watching television and a teaching moment occurs. The remaining options were formal teaching to meet the goal of dietary teaching on a low-sodium diet. 31. An experienced nurse is evaluating a new nurse to the unit who is providing discharge instructions to an adult client. The experienced nurse views the following: The nurse approaches and decreases the volume on the television and then sits beside the client, presenting the information to the client and spouse. The nurse states, “You are to take Cipro 250 mg, two tablets b.i.d. A regular diet is ordered, and you are to follow up with your physician in 2 weeks. Here is printed information on the medication ordered.” The nurse obtains appropriate signatures and leaves. Which point would the experienced nurse address? A) The nurse should use shorter sentences when teaching. B) The nurse should improve professionalism and stand. C) The nurse should minimize medical terms when teaching. D) The nurse should continue with the same method without changes. Ans: C Feedback: When teaching adult clients, it is best to minimize technical terms and medical jargon (“bid” for example) whenever able. The nurse used appropriate sentence length. Sitting beside the client is appropriate, and it is best to reduce noise and distraction by decreasing the volume of the television. With minimal change, the new nurse can improve her teaching skill. 32. The charge nurse in a long-term facility is addressing a breach in care with a client's family. Which body language would the family interpret as being sincere in the statement? A) Open hands B) Downcast eyes C) Shifting from foot to foot D) Steepled fingers Ans: A Feedback: Open hands is a form of body language representing sincerity. This body language shows that the staff and facility care for the quality of care of the client and are open about the details of care. Downcast eyes denotes remorse. Shifting from foot to foot denotes a desire to get away or avoid the discussion. Steepled fingers is interpreted as an authoritative approach. 33. The nurse is providing therapeutic communication while changing a client's linen. The client states, “Every time I urinate, I still feel the need to urinate again. This is so disappointing.” The nurse states, “You don't feel that you are emptying your bladder.” Which communication technique has the nurse used? A) Open-ended questioning B) Paraphrasing C) Reflecting D) Broad opening Ans: B Feedback: Paraphrasing restates what the client is saying to demonstrate listening. This communication technique also allows the client to offer further information on the subject. Open-ended questioning provides an open-ended question for the client to provide further information. Reflecting states the content back to the client and confirms that the nurse is following the conversation. A broad opening starts the interaction and relieves tension before addressing other issues. 34. The nurse is caring for a client who received a poor prognosis when the physician made rounds. The client is quiet, tearful at times, and prefers to be in a darkened room. The nurse observes a nursing assistant entering the room, turning on the lights, and stating “Are we ready to get out of bed yet, the day is half over?” When addressing the statement of the nursing assistant, which communication technique would the nurse be most correct to discuss? A) Giving disapproval B) Belittling C) Using clichés D) Patronizing Ans: D Feedback: Patronizing treats the client condescendingly as if incapable of making a decision. Giving disapproval holds the client to a rigid standard and is sarcastic in response. Belittling disregards how the client is responding as an individual and groups him or her with others in the similar position. Using clichés provides worthless advice and curtails exploring alternatives. 35. The student nurse is providing skilled care for a palliative care client. The client is bedbound, requiring skin care during bathing, oral care, and every 2 hours positioning. Which NCLEX-PN test category would the student anticipate finding questions related to this clinical care situation? A) Health promotion and maintenance B) Psychosocial integrity C) Physiologic integrity D) Safe and effective care environment Ans: C Feedback: The role of the NCLEX-PN is to ensure that the student has sufficient knowledge to progress to a competent entry-level practitioner. Linking clinical experiences to classroom knowledge base is essential. This content falls under the physiologic integrity subcategory of basic care and comfort. This category tests the skill of the nurse in a clinical situation completing basic care needs. The health promotion and maintenance category has content areas including caring for individuals through life transitions. Psychosocial integrity includes caring for mental health needs and using therapeutic communication. Safe and effective care environment ensures appropriate nursing care and infection control. 36. Which of the following nursing statements, made to the client, best provides an example of a broad opening? A) “Wow, the weather is looking nice outside.” B) “Would you like your pills whole or cut in half?” C) “So you live in a ranch-style home with a bathroom off your bedroom.” D) “Oh, your daughter lives within walking distance of your home.” Ans: A Feedback: A broad opening is intended to open communication on a common topic and relieve tension. Focusing on the weather provides that common topic to initiate communication. Further communication and specific topics flow from this point. Inquiring about medication administration is on a specific topic and in need of a specific response. The other options deal with specific topic points presented during a discussion. [Show More]
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