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Professional Nursing 6th Edition Black Chitty Test Bank

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Professional Nursing 6th Edition Black Chitty Test Bank

  • ISBN-10: 143770719X
  • ISBN-10: 143770719X

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Professional Nursing 6th Edition Black Chitty Test Bank

  • ISBN-10: 143770719X
  • ISBN-10: 143770719X

 

 

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Free Nursing Test Questions:

Chitty: Professional Nursing: Concepts and Challenges, 6th Edition

 

Chapter 9: Communication and Collaboration in Nursing

 

Test Bank

 

MULTIPLE CHOICE

 

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

 

 

ANS:   C

 

 

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

 

 

DIF:    Cognitive Level: Comprehension      REF:    Page 193

 

  1. Therapeutic use of self involves
a. Forming a relationship based on the nurse’s knowledge, attitudes, and skills to communicate effectively
b. Providing a safe environment based on the use of environmental manipulation and verbal limit setting
c. Evaluation of nurse-patient interactions and the creation of social alliances
d. Determining whether it is necessary to listen to the patient and provide feedback

 

 

ANS:   A

 

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

 

 

DIF:    Cognitive Level: Application             REF:    Page 193

 

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

 

 

ANS:   A

 

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

 

 

DIF:    Cognitive Level: Knowledge             REF:    Page 194

 

  1. One of the most important outcomes of the orientation phase of the nurse-patient relationship is the development of mutual
a. Communication
b. Understanding
c. Acceptance
d. Trust

 

 

ANS:   D

 

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

 

 

DIF:    Cognitive Level: Comprehension      REF:    Page 194

 

  1. Which behaviors help patients develop trust in the nurse?
a. Answer questions with authority.
b. Share personal information to indicate openness.
c. Convey acceptance of the patient and a nonjudgmental attitude.
d. Meet with patient spontaneously as it indicates caring.

 

 

ANS:   C

 

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

 

 

DIF:    Cognitive Level: Comprehension      REF:    Page 195

 

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

 

 

ANS:   B

 

  Feedback
A The preinteraction phase occurs before the orientation phase and involves the nurse’s preparation to meet with the patient.
B During the orientation phase the time frame of the relationship is established, the problems to be worked on are identified, and a time to meet is established.
C The working phase is when the nurse and patient address the problems.
D The termination phase is when the relationship is ending.

 

 

DIF:    Cognitive Level: Application             REF:    Page 194

 

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

 

 

ANS:   A

 

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

 

 

DIF:    Cognitive Level: Application             REF:    Page 194

 

  1. Mr. Walter says, “About the diet, I have very definite likes and dislikes when it comes to food. Am I going to have to eat only certain foods or will I have some choice?” The nurse responds, “I think we can work in enough of your preferences to make this a diet you can live with. Why don’t you give me a list of your likes and dislikes? I will consult with the dietitian about how to include your preferences and still come up with a good diet for you.” What phase of the nurse-patient relationship is this?
a. Preinteraction phase
b. Orientation phase
c. Working phase
d. Termination phase

 

 

ANS:   C

 

  Feedback
A The preinteraction phase occurs before the orientation phase and involves the nurse’s preparation to meet with the patient.
B The orientation phase is when the relationship is established, the problems to be worked on are identified, and a time to meet is established.
C The working phase is when the nurse and patient address the problems of learning how to give insulin injections and developing a diet.
D The termination phase is when the relationship is ending.

 

 

DIF:    Cognitive Level: Application             REF:    Page 194 – 195

 

  1. The correct response by the nurse to a patient’s obvious regression in ability to perform self-care during the working phase is
a. Frustration, to motivate the patient to achieve goals
b. Persistence, to demonstrate the importance of achieving goals
c. Patience and understanding that regression is a defense mechanism for the patient
d. Ignoring it because the nurse realizes the patient is exhibiting childlike behavior

 

 

ANS:   C

 

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

 

 

DIF:    Cognitive Level: Analysis                  REF:    Page 195

 

  1. Mr. Walter says, “About the diet, I have very definite likes and dislikes when it comes to food. Am I going to have to eat only certain foods or will I have some choice?” The most appropriate response for the nurse is
a. “The diabetic diet contains certain foods in order to maintain control of your diabetes.”
b. “I understand you have likes and dislikes when it comes to food. I am sure that the diet will contain some of your likes.”
c. “I think we can work enough of your preferences into the diet. Why don’t you give me a list of your likes and dislikes and I will consult with the dietitian about how to include your preferences into the diet.”
d. “The usual diabetic diet is a good diet. I’m sure you will like it.”

 

 

ANS:   C

 

  Feedback
A The response indicates the nurse is not hearing the patient’s concern.
B The response gives false reassurance when the nurse does not know what the preferences are.
C The response by the nurse indicates that she is willing to work with the patient to make the alterations in his life to live with diabetes successfully.
D The response again offers reassurance without knowing what the preferences are and whether they are in the diet.

 

 

DIF:    Cognitive Level: Application             REF:    Page 194 – 195

 

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

 

 

ANS:   C

 

 

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

 

 

DIF:    Cognitive Level: Comprehension      REF:    Page 195

 

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

 

 

ANS:   C

 

 

  Feedback
A The response “Mr. Walter, you must be happy to be going home. Here are the written diet and medication instructions” does not summarize what has occurred.
B “It has been wonderful getting to know you. The best of luck when you get home” gives false reassurance about success at home.
C Summarizing the gains the patient has made is important during the termination phase.
D “Mr. Walter, you have done well learning a lot of new material and should be able to do well at home” gives false reassurance about success at home.

 

 

DIF:    Cognitive Level: Application             REF:    Page 195

 

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

 

 

ANS:   B

 

 

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

 

 

DIF:    Cognitive Level: Comprehension      REF:    Page 196 – 197

 

  1. In order for Tyler, a new staff nurse on a cancer unit, to communicate therapeutically with his patients, he must
a. Focus interactions on educating patients about their chemotherapy
b. Become aware of his own feelings about death and responses to death
c. Share information about the intimate details of his life
d. Present himself as a knowledgeable cancer clinician

 

 

ANS:   B

 

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

 

 

DIF:    Cognitive Level: Application             REF:    Page 197 – 198

 

  1. During report, Mrs. Simeth complains about the 3-year-old boy she is assigned; she says, “He sure knows when to pour on the tears. There’s nothing wrong until he sees you; then the tears start, but they stop as soon as you leave or his mother comes. He’s just spoiled because they have a nanny at home who waits on him hand and foot.” This is an example of
a. Lack of understanding of child development
b. Frustration that the mother is not present
c. Assessment of the child’s behavior
d. Stereotyping because the child has a nanny

 

 

ANS:   D

 

  Feedback
A The response does not reflect lack of knowledge about child development, assessment of the behavior, or a response to the mother’s not being present.
B The response does not reflect lack of knowledge about child development, assessment of the behavior, or a response to the mother’s not being present.
C The response does not reflect lack of knowledge about child development, assessment of the behavior, or a response to the mother’s not being present.
D Stereotypes are attitudes developed about people different from themselves.

 

 

DIF:    Cognitive Level: Analysis                  REF:    Page 198 – 199

 

  1. Mrs. Donald, a maternity nurse who believes in birth control, comments about one of her patients, “Mrs. Horres is pregnant again, the one with six kids already! It makes me sick to see these people on welfare taking away from our tax dollars. I don’t know how she can continue to do this.” The best response to Mrs. Donald by a nurse peer is
a. Ignore the biased statements
b. Accept Mrs. Donald’s comments as self-disclosure
c. Offer neutral responses
d. Convey acceptance of Mrs. Donald but not her beliefs

 

 

ANS:   D

 

 

  Feedback
A To ignore the statements will not help Mrs. Donald become aware of her stereotypes.
B Mrs. Donald’s statements do not qualify as self-disclosure.
C Offering neutral responses will not help Mrs. Donald become aware of her stereotyping.
D Acceptance conveys neither approval nor disapproval of personal beliefs. However, nonjudgmental acceptance means that the nurse acknowledges that all people have rights to be different and to express their differences. Therefore, the nurse should alert Mrs. Donald that she is showing bias based on stereotyping.

 

 

DIF:    Cognitive Level: Application             REF:    Page 200

 

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

 

 

ANS:   C

 

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

 

 

DIF:    Cognitive Level: Analysis                  REF:    Page 200

 

  1. Using the Theory of Human Relations, the nurse-patient relationship has been reconceptualized by approaching
a. Each patient contact as one step in lengthy relationship-building process
b. Patients with a sense of the patient’s autonomy, choice, and participation
c. The relationship as one in which the nurse has the power
d. The nurse-patient contact as an opportunity to streamline caregiving

 

 

ANS:   B

 

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

 

 

DIF:    Cognitive Level: Comprehension      REF:    Page 200

 

  1. Which is true of verbal and nonverbal communication?
a. Verbal messages are more important than nonverbal cues.
b. Individuals can exercise more control over nonverbal communication.
c. Verbal and nonverbal communication always match.
d. Up to sixty-five percent of a message consists of nonverbal communication.

 

 

ANS:   D

 

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

 

 

DIF:    Cognitive Level: Comprehension      REF:    Page 201

 

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

 

 

ANS:   D

 

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

 

 

DIF:    Cognitive Level: Application             REF:    Page 201

 

  1. Ms. Keller is irrigating decubitus ulcers on Mrs. Gobell’s coccyx. When Mrs. Gobell asks how they are healing, the nurse grimaces and says, “Oh, they’re doing just fine.” This is
a. Incongruence between verbal and nonverbal messages
b. A confirming statement
c. Objectivity in responding to the question
d. The therapeutic use of humor

 

 

ANS:   A

 

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

 

 

DIF:    Cognitive Level: Application             REF:    Page 201

 

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

 

 

ANS:   B

 

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

 

 

DIF:    Cognitive Level: Comprehension      REF:    Page 201

 

  1. A new mother says to the nurse, “It really hurts me to breast-feed. I think I should wean my baby.” The most appropriate response by the nurse is
a. “It is good to wean the baby early as it is easier on you.”
b. “If I understand you, it hurts when you breast-feed. Tell me how and when it hurts.”
c. “It is your decision to make whether you breast-feed or not.”
d. “You should continue to breast-feed as it is much better for the baby.”

 

 

ANS:   B

 

 

  Feedback
A Saying “It is good to wean the baby early as it is easier on you” gives a response before the situation is clarified and closes off continues communication.
B The nurse is gaining feedback that helps the nurse understand more about the situation from the patient’s perspective and keeps communication open.
C Saying “It is your decision to make whether you breast-feed or not” gives a response before the situation is clarified and closes off continued communication.
D Saying “You should continue to breast-feed as it is much better for the baby” gives a response before the situation is clarified and closes off continued communication.

 

 

DIF:    Cognitive Level: Application             REF:    Page 203

 

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

 

 

ANS:   C

 

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

 

 

DIF:    Cognitive Level: Application             REF:    Page 203

 

  1. When a patient tells the nurse, “I am not sure I will be able to give the right answers in the job interview,” the nurse replies, “I know what you mean. Interviews have always been a problem for me, too.” This response can be evaluated as lacking
a. Appropriateness
b. Efficiency
c. Feedback
d. Flexibility

 

 

ANS:   A

 

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

 

 

DIF:    Cognitive Level: Application             REF:    Page 203 – 204

 

  1. A new mother says, “My baby is being kept in the nursery. I’m really worried about him. I’m also worried that the separation will interfere with breast-feeding.” The most appropriate response by the nurse is
a. “Well, that’s not my territory. You’ll have to deal with the nursery staff about breast-feeding.”
b. “As a nurse on this unit, I can assure you that we will do all we can to help you.”
c. “I can see you’re upset about this, but to be honest with you, I’m a new nurse here and I’m not sure how I can help you.”
d. “I can see this is a problem for you. I will go to the nursery and see if I can get some answers for you.”

 

 

ANS:   D

 

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

 

 

DIF:    Cognitive Level: Application             REF:    Page 203 – 204

 

  1. Using simple, clear words to explain what a colonoscopy procedure involves shows sensitivity to which successful communication criterion?
a. Appropriateness
b. Efficiency
c. Feedback
d. Flexibility

 

 

ANS:   B

 

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

 

 

DIF:    Cognitive Level: Application             REF:    Page 203

 

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

 

 

ANS:   B

 

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

 

 

DIF:    Cognitive Level: Application             REF:    Page 204

 

  1. Which of the following examples illustrates the nurse’s failure to use flexibility effectively in professional communication?
a. Asking on the admission assessment, “You don’t smoke, do you?”
b. When updating a family member on a patient’s condition stating, “Your wife’s ABG report indicates significant barotraumas.”
c. Continuing to follow the agenda in a staff meeting when people are obviously upset by a recent death on the unit.
d. Requiring nurses to read back phone orders to physicians.

 

 

ANS:   C

 

 

  Feedback
A “You don’t smoke, do you?” is an example of value judgment.
B Telling a family member “Your wife’s ABG report indicates significant barotraumas” is an example of poor communication because the message is not geared to the receiver’s level of understanding.
C Continuing to follow an established agenda when the emotional state of the group needs to be addressed indicates inflexibility on the part of the leader.
D Requiring nurses to read back phone orders to physicians is an example of feedback.

 

 

DIF:    Cognitive Level: Analysis                  REF:    Page 204

 

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

 

 

ANS:   C

 

  Feedback
A Saying “Mrs. Dorst, it is time to discuss how to care for the surgical site” follows the established agenda and does not respond to the emotional state of the patient.
B Saying “You seem upset. You should start looking forward to going home and being a wife and mother again” follows the established agenda and does not respond to the emotional state of the patient.
C The nurse’s response demonstrates flexibility. The response identifies the emotional state of the patient and requires deviation from the established agenda.
D Saying “Dr. Abrams said you can go home tomorrow, and we need to talk about the care of your surgical site” follows the established agenda and does not respond to the emotional state of the patient.

 

 

DIF:    Cognitive Level: Application             REF:    Page 204

 

  1. The patient says to the nurse, “The staff treats me like I’m a child. Everyone tells me what to do. No one ever asks my opinion. After all, it is my body.” Which response by the nurse indicates she has been listening?
a. “Well, you’re sick. Don’t you think you should let us take care of you?”
b. “I don’t think I can help you with this. This is a personal matter between you and the rest of the staff.”
c. “It makes you angry not to be included in your health care decisions. Let’s talk about how you can vent your anger appropriately.”
d. “It bothers you not to be recognized for your abilities to handle your life. I can discuss this with the rest of the staff if you wish so that everyone is aware of the need to involve you in the planning of your care.”

 

 

ANS:   D

 

  Feedback
A Saying “Well, you’re sick. Don’t you think you should let us take care of you?” indicates a lack of interest in what the patient was saying.
B Saying “I don’t think I can help you with this. This is a personal matter between you and the rest of the staff”indicates a lack of interest in what the patient was saying.
C Saying “It makes you angry not to be included in your health care decisions. Let’s talk about how you can vent your anger appropriately” indicates a lack of interest in what the patient was saying.
D The nurse’s response recognizes the patient’s feelings and concerns. The nurse suggests an action, if the patient agrees, which gives the patient the control she is asking for.

 

 

DIF:    Cognitive Level: Application             REF:    Page 204

 

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

 

 

ANS:   C

 

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

 

 

DIF:    Cognitive Level: Application             REF:    Page 206

 

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

 

 

ANS:   A

 

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

 

 

DIF:    Cognitive Level: Application             REF:    Page 206 – 207

 

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

 

 

ANS:   D

 

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

 

 

DIF:    Cognitive Level: Comprehension      REF:    Page 207

 

  1. Within nurse-patient communication, the use of silence may
a. Block further therapeutic communication
b. Allow the patient to not feel pressured to provide information
c. Demonstrate trust
d. Provide the nurse with an opportunity to complete the patient’s care

 

 

ANS:   B

 

 

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

 

 

DIF:    Cognitive Level: Comprehension      REF:    Page 207

 

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

 

 

ANS:   A

 

 

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

 

 

DIF:    Cognitive Level: Application             REF:    Page 207 – 208

 

  1. When the patient states, “The thing that scares me the most about surgery is the spinal anesthesia. I’m afraid it’ll leave me paralyzed,” and the nurse responds, “Everything will be fine. The anesthesiologists are very skilled in administering spinal anesthesia,” the nurse’s response is an example of a communication breakdown known as
a. Failing to see the uniqueness of the individual
b. Failing to recognize levels of meaning
c. Using value statements
d. Using false assurance
e. Failing to clarify unclear messages

 

 

ANS:   D

 

 

  Feedback
A The nurse does not fail to respond to the patient as a unique individual.
B The nurse does not fail to take into account the meaning under the surface content.
C The nurse does not use value statements.
D The nurse offers false assurance.
E There is no clarification of an unclear message.

 

 

DIF:    Cognitive Level: Application             REF:    Page 209

 

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

 

 

ANS:   A

 

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

 

 

DIF:    Cognitive Level: Comprehension      REF:    Page 214 – 215

 

  1. Collaboration among health care professionals most importantly results in
a. The development of esprit de corps
b. Benefits to the organization alone
c. Positive patient outcomes
d. Maintenance of employee satisfaction

 

 

ANS:   C

 

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

 

 

DIF:    Cognitive Level: Comprehension      REF:    Page 216

 

MULTIPLE RESPONSE

 

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

 

 

ANS:   A, C, E

 

  Feedback
Correct Active listening is a method of communicating interest and attention.
Incorrect Limiting verbal expression is likely to decrease the sharing of information by the patient. A task may serve as a distraction for the nurse and patient and may limit active listening.

 

 

DIF:    Cognitive Level: Comprehension      REF:    Page 204

 

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

 

 

ANS:   B, C, D

 

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

 

 

DIF:    Analysis          REF:    Page 206

 

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