Chapter 19: Caring in Nursing Practice My Nursing Test Banks

Chapter 19: Caring in Nursing Practice

Potter: Essentials for Nursing Practice, 8th Edition

MULTIPLE CHOICE

1.A nurse is working in a health care clinic. She loves her work because of all the different people she meets. She professes to care for all of them and states that she understands them because she realizes which of the following is true?

a.

Basically all patients are the same.

b.

Each person has a unique background.

c.

Caring for people requires very little experience.

d.

There are standard solutions to most health care problems.

ANS: B

Patients are not all the same. Each person brings a unique background of experiences, values, and cultural perspectives to a health care encounter. Caring is always specific and relational for each nurse-patient encounter. As nurses acquire more experience, they learn that caring helps them to focus on the patients for whom they care. Caring facilitates a nurses ability to know a patient, allowing the nurse to recognize a patients problems and to find and implement individualized solutions.

PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)

REF:51BJescribe ways to express caring in practice.

TOP: Nursing Process: Planning MSC: NCLEX: Psychosocial Integrity

2.Madeleine Leininger identifies the concept of care as the essence and unifying domain that sets nursing apart from other health care disciplines. Which of the following is true in her view?

a.

Care and cure are synonymous.

b.

Care is designed to focus only on individuals.

c.

Caring acts are independent of patient values.

d.

Caring depends on communication.

ANS: D

Caring is very personal. One challenge is to find ways to communicate with patients so as to learn the culturally specific behaviors and words that reflect human caring. Care is an essential human need, necessary for the health and survival of all individuals. Care, unlike cure, assists an individual or group in improving a human condition. A caring act depends on the needs, problems, and values of a patient.

PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)

REF: 519 OBJ: Describe the commonalities among theories of caring.

TOP: Nursing Process: Planning MSC: NCLEX: Psychosocial Integrity

3.Nurses care for a variety of patients. What is an activity that best demonstrates the caring role of a nurse?

a.

Staying with a patient and developing a plan of care before surgery

b.

Performing IV insertion with confidence

c.

Assessing the patients entire health history

d.

Inserting a urinary catheter using aseptic technique

ANS: A

Caring is highly relational. A nurse and a patient enter into a relationship that is much more than one person simply doing tasks for another. There is a mutual give-and-take that develops as nurse and patient begin to know and care for one another. As a nurse-patient relationship forms, a nurse becomes a coach and partner rather than a detached provider of care. Performing an IV insertion, assessing a health history, and inserting a catheter are all tasks that can be accomplished with or without a caring nurse-patient relationship being developed.

PTS:1DIF:Cognitive Level: Applying (Application)

REF:520 | 521OBJescribe ways to express caring in practice.

TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

4.Which of the following would indicate that the nurse has established a level of mutual problem solving?

a.

The nurse helps the patient develop questions to ask the health care provider.

b.

The nurse tells the patient what needs to be done to resolve health problems.

c.

The nurse is seen as the authority when it comes to health care issues.

d.

The nurse excludes the family from health discussions to protect privacy.

ANS: A

A caring nurse helps hospitalized patients understand how to think about their health and illness and to figure out questions to ask of their health care providers. In addition, a caring nurse helps patients explore options for resolving health problems and provides information and instruction. Using evidence in practice is an aspect of mutual problem solving, with a nurse continuously learning and engaging patients and families in discussions about their health issues. Basic to nursing practice is the inclusion of family members in a patients care.

PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)

REF:521 | 522

OBJ: Discuss the role that caring plays in building nurse-patient relationships.

TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

5.The patient was hospitalized with pneumonia. He had always been very healthy and was concerned that now his family would have to take care of him. During one conversation the nurse said to him, This gives the ones who love you a chance to show you how much they care for you. The comment that the nurse made best demonstrated which behavior?

a.

Human respect

b.

Encouraging manner

c.

Healing environment

d.

Affiliation needs

ANS: B

When a nurse remains poised and cheerful and points out the good in a difficult situation, patients perceive these behaviors as caring. Having an encouraging manner also involves helping a patient deal with negative feelings. Having an encouraging manner also involves helping patients deal with bad feelings. Human respect refers to nurses being able to appreciate the value of human beings and displaying behaviors that demonstrate value, such as accepting or paying attention to a patient. By showing respect, a nurse honors the worth of individuals. Although the nurse in this case is not disrespectful, the primary concept being demonstrated is an encouraging manner. It is important to note that concepts are not necessarily exclusive. A healing environment, for example, is one in which nurses check patients frequently, respect patient privacy, reduce noise, and treat the body carefully. Affiliation needs refer to the inclusion of family members in a patients care. It is a key element in discharge planning. Hospitalized patients perceive nurses as caring when they are responsive to patients families and allow them to be involved in the patients health care situation. In this scenario, the patients family is not involved.

PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)

REF:522 | 523

OBJ: Discuss the evidence that exists about patients perceptions of caring.

TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

6.A registered nurse who works for an orthopedic unit of an acute care hospital makes hourly rounds on his patients. He also closes the door and pulls the curtains around the beds of patients in semiprivate rooms before exposing them for treatments. This is an example of which of the following behaviors?

a.

Human respect

b.

Encouraging manner

c.

Healing environment

d.

Affiliation needs

ANS: C

A healing environment, for example, is one in which nurses check patients frequently, respect patient privacy, and treat the body carefully. Such an environment leads patients to a sense of security and protection from harm. Human respect refers to nurses being able to appreciate the value of human beings and displaying behaviors that demonstrate value, such as accepting or paying attention to a patient. By showing respect, a nurse honors the worth of individuals. Having an encouraging manner also involves helping patients deal with bad feelings. Affiliation needs refers to inclusion of family members in a patients care. It is a key element in discharge planning. Hospitalized patients perceive nurses as caring when they are responsive to patients families and allow them to be involved in the patients health care situation.

PTS:1DIF:Cognitive Level: Applying (Application)

REF:522 | 523OBJescribe ways to express caring in practice.

TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

7.A registered nurse who worked in an extended care facility could see that a patient was in the process of dying. The lab technician came to draw his blood. The nurse requested that the blood draw be postponed for a while so that the patients wife, who was at his bedside, could spend some quiet time with her husband. This is an example of which caring behavior?

a.

Providing presence

b.

Encouraging manner

c.

Healing environment

d.

Affiliation needs

ANS: A

Providing presence is a person-to-person encounter conveying closeness and a sense of caring. Presence occurs within an atmosphere of intimacy and sensitivity and is characterized by open and honest interactions. An encouraging manner occurs when a nurse is poised and cheerful and points out the good in a difficult situation, patients perceive these behaviors as caring. Having an encouraging manner also involves helping patients deal with bad feelings. A healing environment, for example, is one in which nurses check patients frequently, respect patient privacy, reduce noise, and treat the body carefully. Attending to affiliation needs occurs in nursing practice with the inclusion of family members in a patients care. It is a key element in discharge planning. Hospitalized patients perceive nurses as caring when they are responsive to patients families and allow them to be involved in the patients health care situation. Often these behaviors overlap.

PTS:1DIF:Cognitive Level: Applying (Application)

REF:522 | 523

OBJ: Explain the relationship between knowing a patient and clinical decision making.

TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

8.A female patient has just found a large lump in her breast. The health care provider needs to perform a breast biopsy. The nurse assists the patient into the proper position and offers support during the biopsy. What is the nurse doing?

a.

Creating a healing environment

b.

Fulfilling affiliation needs

c.

Providing a sense of presence

d.

Demonstrating an encouraging manner

ANS: C

A sense of presence is something a nurse offers to patients with the purpose of achieving some goal, such as support, comfort, or encouragement; to diminish the intensity of unwanted feelings; or for reassurance. Establishing presence when patients are experiencing stressful events or situations is very important. A nurses presence calms anxiety and fear related to stressful situations. Giving reassurance and thorough explanations about a procedure, remaining at a patients side, and coaching a patient through the experience all convey a presence that is invaluable to a patients well-being. A healing environment, for example, is one in which nurses check patients frequently, respect patient privacy, reduce noise, and treat the body carefully. Affiliation need in nursing practice occurs with the inclusion of family members in a patients care. It is a key element in discharge planning. Having an encouraging manner occurs when a nurse is poised and cheerful and points out the good in a difficult situation. Patients perceive these behaviors as caring.

PTS:1DIF:Cognitive Level: Applying (Application)

REF:522 | 523OBJescribe ways to express caring in practice.

TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

9.A nurse enters a patients room and is very methodical in her assessment skills and in providing a safe environment, but only speaks with the patient when necessary to gather data. This nurse is:

a.

uncaring and probably always will be.

b.

most likely a product of a less caring environment.

c.

probably more caring with other patients.

d.

a product of a caring environment.

ANS: B

There are no known ways that will ensure you will become a caring professional. For those who find caring a normal part of their life, caring is a product of their culture, values, experiences, and relationships with others. Persons who do not experience care in their lives often find it difficult to act in caring ways. As nurses deal with health and illness in their practice, most grow in the ability to care. Caring nurses use a caring approach in each patient encounter.

PTS:1DIF:Cognitive Level: Analyzing (Analysis)

REF:523

OBJ: Discuss the evidence that exists about patients perceptions of caring.

TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

10.The patient was admitted to the hospital with advanced-stage cancer. As the nurse was admitting her, the patient told her about how her little dog learned a new trick, and could play dead when she said bang-bang. Why did the nurse listen attentively to the patients story?

a.

She knew it was easy to do and she had nothing else to do at that time.

b.

It was little more than two people talking back and forth.

c.

She knew it was probably not going to affect the patient-nurse relationship.

d.

She knew it was a way to know and respond to what matters to the patient.

ANS: D

True listening leads to knowing and responding to what really matters to a patient and family. Learning to listen to a patient is sometimes difficult. It is easy to become distracted by tasks at hand, colleagues shouting instructions, or other patients waiting to have their needs met. Caring is an interpersonal interaction that is much more than two persons simply talking back and forth. In a caring relationship a nurse establishes trust, opens lines of communication, and listens to what a patient has to say. Listening to the meaning of what a patient says creates a mutual relationship.

PTS:1DIF:Cognitive Level: Applying (Application)

REF: 524 | 525 OBJ: Describe the therapeutic benefit of listening to patients.

TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

11.When individuals become ill, there may be a story about the meaning of the illness. When a nurse listens, the patient is:

a.

able to break the distress of illness.

b.

unable to express what he actually needed when he was ill.

c.

usually not able to determine what is at stake because of his illness.

d.

able keep the nurse from prying into his more personal life.

ANS: A

When an individual becomes ill, he or she usually has a story to tell about the meaning of the illness. Being able to tell that story helps a patient break the distress of illness. He needs to be able to express what he needs when ill. The personal concerns that are part of a patients illness story determine what is at stake for the patient. Caring through listening enables you to participate in a patients life.

PTS: 1 DIF: Cognitive Level: Understanding (Comprehension)

REF: 524 | 525 OBJ: Describe the therapeutic benefit of listening to patients.

TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

12.One of the five caring processes described by Swanson (1991) is knowing the patient. The concept comprises both a nurses understanding of a specific patient and subsequent selection of interventions. To become adept at knowing patients early, what should the nurse do?

a.

Check on patients at irregular times so they do not get used to a routine.

b.

Depend on other nurses assessments to evaluate your own.

c.

Assume that your interventions are effective because they have been ordered.

d.

Reflect about your patient interactions and evaluations.

ANS: D

Reflect about what you have learned, each time you either assess or evaluate a patient. Routinely round on patients at the beginning of a work shift and ongoing as appropriate. Do not depend on others observationsbe thorough and make your own assessment. Always go back and observe how a patient responded to your interventions.

PTS:1DIF:Cognitive Level: Applying (Application)

REF:525

OBJ: Explain the relationship between knowing a patient and clinical decision making.

TOP: Nursing Process: Evaluation MSC: NCLEX: Psychosocial Integrity

13.The relief of pain and suffering give a patient comfort, dignity, respect, and peace. To enhance the therapeutic environment, what should the nurse do?

a.

Make the environment as noise free as possible.

b.

Remove personal items so that the environment is as clinical as possible.

c.

Focus on removing negative physical stimuli.

d.

Make the environment a place to soothe mind, body, and spirit.

ANS: D

The relief of pain and suffering are caring nursing actions that give a patient comfort, dignity, respect, and peace. By ensuring that the patient care environment is clean, reasonably quiet, and pleasant and inclusive of personal items, you make the physical environment a place that soothes and heals the mind, body, and spirit.

PTS:1DIF:Cognitive Level: Applying (Application)

REF:525OBJescribe ways to express caring in practice.

TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

14.The ANA, National League for Nursing, AONE, and American Association of Colleges of Nursing recommend strategies to reverse the current nursing shortage. A number of the strategies have potential for creating work environments that enable nurses to demonstrate more caring behaviors. Which of the following provisions is advocated to create a more desirable work environment?

a.

Provide nurses with autonomy over their practice.

b.

Increase the rigor in the work environment structure.

c.

Increase the availability of technology.

d.

Stress the cost-effectiveness of health care.

ANS: A

To create environments conducive to caring, health care organizations must introduce greater flexibility into the work environment structure, reward experienced nurse mentors, offer programs for compassion fatigue, improve nurse staffing, and provide nurses with autonomy over their practice. A reliance on technology and cost-effective health care strategies and efforts to standardize and refine work processes all undermine the nature of caring.

PTS: 1 DIF: Cognitive Level: Understanding (Comprehension)

REF:526

OBJ: Describe how health care institutions stress the importance of caring practices in achieving patient satisfaction. TOP: Nursing Process: Implementation

MSC: NCLEX: Psychosocial Integrity

MULTIPLE RESPONSE

1.Nurses demonstrate caring behaviors when they do which of the following? (Select all that apply.)

a.

Give clear explanations.

b.

Make the patient do everything for himself or herself.

c.

Tell the patient that getting pain medication depends on his or her cooperation.

d.

Share information about the patients responses with other staff members.

e.

Ask permission before doing something to the patient.

ANS: A, E

Caring behaviors include being honest, advocating for the patients care preferences, giving clear explanations, keeping family members informed, asking permission before doing something to a patient, and providing comfort: Offering a warm blanket, finding food a patient can swallow, rubbing a patients back, reading patients passages from religious texts, a favorite book, cards or mail, providing for and maintaining patient privacy, assuring patients that nursing services will be available, helping patients to do as much for themselves as possible, and teaching families how to keep patients physically comfortable.

PTS:1DIF:Cognitive Level: Applying (Application)

REF:526OBJescribe ways to express caring in practice.

TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

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