Chapter 25 My Nursing Test Banks

Kozier & Erbs Fundamentals of Nursing, 10/E
Chapter 25

Question 1

Type: MCSA

The student nurse is following a preceptor on the assigned clinical shift. Which behavior of the nurse should the student interpret as caring?

1. Making sure that all medications and treatments are done on time

2. Using aseptic technique when performing a dressing change

3. Advising the physician that the client wants to speak to him or her prior to a procedure

4. Explaining an invasive procedure to the client, then asking if it is all right to begin the procedure

Correct Answer: 4

Rationale 1: Caring is more than just performing skills adequately or even efficiently.

Rationale 2: Caring is more than just performing skills adequately or even efficiently.

Rationale 3: Caring is more than just performing skills adequately or even efficiently.

Rationale 4: Caring practice involves connection, mutual recognition, and involvement. Its a sense that the nurse has made a difference to someone else. Caring means that people, relationships, and things matter. Explaining a procedure, then seeking permission to begin, lets the client know that the nurse respects the client as an individual.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care:

AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship

NLN Competencies: Personal and Professional Development; Ethical Comportment; Demonstrate caring and compassion

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 4. Describe how nurses demonstrate caring in practice.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 398

Question 2

Type: MCSA

The nurse is reviewing Mayeroffs philosophy of caring prior to providing care to a client. What should the nurse include to demonstrate caring to the client?

1. Honesty

2. Trust

3. Humility

4. Professionalism

5. Courtesy

Correct Answer: 1, 2, 3

Rationale 1: Mayeroff defines major ingredients of caring that provide structure and further description of this process. Honesty includes awareness and openness to ones own feelings and a genuineness in caring for the other person.

Rationale 2: Mayeroff defines major ingredients of caring that provide structure and further description of this process. Trust involves letting go, to allow the other to grow in his or her own way and own time.

Rationale 3: Mayeroff defines major ingredients of caring that provide structure and further description of this process. Humility means acknowledging that there is always more to learn, and that learning may come from any source.

Rationale 4: Professionalism and courtesy are not ingredients described by Mayeroff.

Rationale 5: Professionalism and courtesy are not ingredients described by Mayeroff.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care:

AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship

NLN Competencies: Personal and Professional Development; Ethical Comportment; Demonstrate caring and compassion

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 2. Identify nursing theories that focus on caring.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 398

Question 3

Type: MCSA

The nurse is emulating the characteristics of caring, as described by Mayeroff. Which action demonstrates knowing, in relationship to caring?

1. Seeing that a client is withdrawn and sullen, and spending extra time when providing cares or treatments

2. Understanding the reason a clients lab values are elevated

3. Seeing the connection between the pathophysiology of the cardiac condition and treatment and giving the rationale for certain medications when the client asks

4. Getting an extra blanket when the client says he is cold

Correct Answer: 1

Rationale 1: Knowing means understanding the others needs and how to respond to those needs. Sensing that a client is withdrawn and sullen, the nurse knows that spending extra time can sometimes allow the client to feel comfortable in talking about what might be bothering him.

Rationale 2: Understanding the reason for elevated lab values is an example of knowing in the didactic sense.

Rationale 3: Seeing the connection between the pathophysiology and treatment of a condition is an example of knowing in the didactic sense.

Rationale 4: Getting an extra blanket is responding to client needs after being told what those needs are, not sensing or understanding them.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care:

AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship

NLN Competencies: Personal and Professional Development; Ethical Comportment; Demonstrate caring and compassion

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 2. Identify nursing theories that focus on caring.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 398

Question 4

Type: MCSA

A nurse manager has been dealing with staffing problems and high patient acuity on the unit. The director of nursing unit has been sensitive to other issues in the past, so the nurse manager decides to approach her with these new concerns. Which aspect of caring is the nurse manager demonstrating?

1. Knowing

2. Trust

3. Humility

4. Courage

Correct Answer: 4

Rationale 1: Knowing means understanding the others needs and how to respond to these needs.

Rationale 2: Trust involves letting go, to allow the other to grow in his or her own way and own time.

Rationale 3: Humility means acknowledging that there is always more to learn, and that learning may come from any source.

Rationale 4: Courage is the sense of going into the unknown, informed by insight from past experiences. Because the manager had prior experience that was positive from the director of nursing, the manager will use this information to address a problem that has not been introduced before.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care:

AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship

NLN Competencies: Personal and Professional Development; Ethical Comportment; Demonstrate caring and compassion

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 2. Identify nursing theories that focus on caring.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 398

Question 5

Type: MCSA

A new nurse has just started work on an oncology unit. One of the clients has decided to discontinue treatment, even though he understands that his life will be shortened extensively if he does. The nurse is having difficulty with this situation and decides to approach a seasoned nurse for insight and a way to help support this particular client. The nurse is exemplifying which aspect of caring?

1. Hope

2. Humility

3. Honesty

4. Patience

Correct Answer: 3

Rationale 1: Hope is belief in the possibilities of the others growth.

Rationale 2: Humility means acknowledging that there is always more to learn, and that learning may come from any source.

Rationale 3: Honesty includes awareness of and openness to ones own feelings and genuineness in caring for the other. In this situation, the nurse has her own feelings about what the client should do, but truly wants to provide good care, so she seeks out assistance from someone who may be able to enlighten her.

Rationale 4: Patience enables the other to grow in his or her own way and time.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care:

AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship

NLN Competencies: Personal and Professional Development; Ethical Comportment; Demonstrate caring and compassion

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 2. Identify nursing theories that focus on caring.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 398

Question 6

Type: MCSA

The nurse is researching the concept of caring as it relates to specific situations in the clinical area. More specifically, the nurse is interested in caring as it relates to cultural differences. Of the following theorists, which would be of the most help to this nurse researcher?

1. Florence Nightingale

2. Jean Watson

3. Dorothea Orem

4. Madeline Leininger

Correct Answer: 4

Rationale 1: Nightingales theory focuses on the environment.

Rationale 2: Watsons theory focuses on caring in itself.

Rationale 3: Orems theory is about self-care and deficit.

Rationale 4: Leiningers theory of culture care diversity and universality is based on the assumption that nurses must understand different cultures in order to function effectively.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care:

AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship

NLN Competencies: Personal and Professional Development; Ethical Comportment; Demonstrate caring and compassion

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 2. Identify nursing theories that focus on caring.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 399

Question 7

Type: MCMA

The nurse is planning to provide care according to Leiningers theory of culturally congruent care. What should the nurse include when providing care to the client?

1. Care should be influenced by the organizational structure.

2. The clients familiar lifeways are preserved.

3. Accommodations should be satisfying to clients.

4. Nursing care must be repatterned to help the client move toward wellness.

5. Care should be structured to fit the nurses needs

Correct Answer: 2, 3, 4

Rationale 1: Care influenced by organizational structure is in line with Rays theory of bureaucratic caring.

Rationale 2: Culturally congruent care involves three action-decision care approaches, one of which is preservation of the clients familiar lifeways.

Rationale 3: Culturally congruent care involves three action-decision care approaches, one of which is ensuring accommodations that help clients adapt to or negotiate for satisfying care.

Rationale 4: Culturally congruent care involves three action-decision care approaches, one of which is repatterning nursing care to help the client move toward wellness.

Rationale 5: Structuring care to meet the nurses needs is not an aspect of culturally congruent care.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care:

AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship

NLN Competencies: Personal and Professional Development; Ethical Comportment; Demonstrate caring and compassion

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 2. Identify nursing theories that focus on caring.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 399

Question 8

Type: MCSA

While evaluating how care is delivered at various hospitals, the nurse identifies a facility where caring in the emergency department is perceived differently than caring in the rehabilitation unit. Whose theory of caring is the nurse observing in action?

1. Leininger

2. Ray

3. Roach

4. Boykin and Schoenhofer

Correct Answer: 2

Rationale 1: Leiningers theory is focused on cultural congruency.

Rationale 2: Rays theory of bureaucratic caring suggests that caring in nursing is contextual and is influenced by the organizational structure. Each unit had its own specific meaning of caring and how it was influenced.

Rationale 3: Roach focuses on the philosophical concept of caring and proposes that caring is the human mode of being.

Rationale 4: Boykin and Schoenhofers theory suggests that caring is a lifelong process, lived moment to moment by the nurse and

constantly unfolding.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care:

AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship

NLN Competencies: Personal and Professional Development; Ethical Comportment; Demonstrate caring and compassion

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 2. Identify nursing theories that focus on caring.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 399

Question 9

Type: MCSA

The nurse is working in a busy intensive care unit. A client is admitted with extensive medical problems and requires a ventilator. Because the nurse already has two other clients assigned to his care, he requests that the nurse manager change assignments so that appropriate attention can be given to this new admission. According to Roachs six Cs of caring, which one is the nurse emulating?

1. Compassion

2. Confidence

3. Commitment

4. Conscience

Correct Answer: 4

Rationale 1: Compassion is about being aware of ones relationship to others; sharing joys, sorrows, pain, and accomplishments; and participating in the experience of another.

Rationale 2: Confidence is the quality that fosters trust. It means the nurse has comfort with himself, his clients, and his family.

Rationale 3: Commitment is a convergence between ones desires and obligations and the deliberate choice to act in accordance with them.

Rationale 4: Conscience deals with morals, ethics, and an informed sense of right and wrong as well as an awareness of personal responsibility. This nurse understands the situation of taking on a critically ill client when he is already busy enough and makes an appropriate request for a change in assignment.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Safe and Effective Care Environment

Client Need Sub: Safety and Infection Control

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care:

AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship

NLN Competencies: Personal and Professional Development; Ethical Comportment; Demonstrate caring and compassion

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 2. Identify nursing theories that focus on caring.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 399

Question 10

Type: MCSA

A nurse has been working a 12-hour shift in a labor and delivery unit. A client was admitted early in the shift and is now ready to deliver. The client had a difficult labor experience, was worried and anxious throughout, and had physiological problems with blood pressure as well as pain management. The nurse decides to stay until the delivery is over, after having it approved by her manager. What is this nurse demonstrating?

1. Compassion

2. Competence

3. Confidence

4. Conscience

Correct Answer: 1

Rationale 1: Compassion is being aware of ones relationship to others; sharing their joys, sorrows, pain, and accomplishments; and participating in the experience of another. The nurse exemplifies this by staying until the delivery is over and the birth is accomplished.

Rationale 2: Competence is having the knowledge, skills, energy, experience, and motivation to respond adequately to others, within the demands of the professional responsibilities.

Rationale 3: Confidence is the quality that fosters trusting relationships. It is comfort with self, patient, and family.

Rationale 4: Conscience is focused on morals, ethics, and an informed sense of right and wrong. Awareness of personal responsibility is part of conscience.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care:

AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship

NLN Competencies: Personal and Professional Development; Ethical Comportment; Demonstrate caring and compassion

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 4. Describe how nurses demonstrate caring in practice.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 399

Question 11

Type: MCSA

A nurse educator is teaching students about the philosophy of caring in nursing and states that nurses can only be truly caring if they are true to themselves first. This action then emphasizes the importance of nurses knowing themselves, which brings about a process that allows the nurse to be with another person. Whose theory is the educator using to teach the concept of caring?

1. Roach

2. Ray

3. Boykin and Schoenhofer

4. Watson

Correct Answer: 3

Rationale 1: Roachs theory focuses on caring as a philosophical concept and proposes that caring is the human mode of being, or the most common, authentic criterion of humanness.

Rationale 2: Rays theory of caring focuses on caring in organizations and is influenced by the organizational structure.

Rationale 3: Boykin and Schoenhofer emphasize the importance of the nurse knowing oneself as caring. Through knowing oneself as a caring person, the nurse can be authentic to self, freeing oneself to truly be with others.

Rationale 4: Watson views caring as the essence and the moral ideal of nursing.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care:

AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship

NLN Competencies: Personal and Professional Development; Ethical Comportment; Demonstrate caring and compassion

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 2. Identify nursing theories that focus on caring.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 400

Question 12

Type: MCSA

A labor and delivery nurse wants to conduct research focused on the response of new parents toward their babies. The approach the nurse would like to use suggests that caring is a nurturing process. The nurse should review the ideas of which theorist because they are best in line with this research?

1. Swanson

2. Watson

3. Roach

4. Benner

Correct Answer: 1

Rationale 1: Swanson defines caring as a nurturing way of relating to a valued other toward whom one feels a personal sense of commitment and responsibility.

Rationale 2: Watson views caring as the essence and moral ideal of nursing.

Rationale 3: Roach identifies caring as a philosophical concept and proposes that caring is the human mode of being.

Rationale 4: Benner describes caring as the essence of excellence in nursing.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care:

AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship

NLN Competencies: Personal and Professional Development; Ethical Comportment; Demonstrate caring and compassion

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 2. Identify nursing theories that focus on caring.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 401

Question 13

Type: MCSA

The nurse working with students on a medical unit describes the pathophysiology of a client with a respiratory acidosis condition as well as specific assessment findings. Which type of knowledge is the nurse demonstrating?

1. Aesthetic

2. Empirical

3. Personal

4. Creative

Correct Answer: 2

Rationale 1: Aesthetic knowledge is the art of nursing and is expressed by nurses in their creativity and style in meeting the needs of clients.

Rationale 2: Empirical knowing ranges from factual, observable phenomena to theoretical analysis. Empirical knowledge is systematic and helps to describe, explain, and predict phenomena.

Rationale 3: Personal knowledge is concerned with the knowing, encountering, and actualizing of the concrete, individual self.

Rationale 4: Creativity is part of aesthetic knowledge.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care:

AACN Essentials Competencies: IV. 4. Contribute the unique nursing perspective to interprofessional teams to optimize patient outcomes

NLN Competencies: Personal and Professional Development; Ethical Comportment; Demonstrate caring and compassion

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 3. Analyze the importance of different types of knowledge in nursing.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 401

Question 14

Type: MCSA

During a midterm evaluation, the nurse educator tells the students they need to work on improving their aesthetic knowledge. How should the students plan to accomplish this recommendation?

1. Study harder.

2. Take better notes.

3. Read about the same topic from a variety of sources.

4. Spend time in the clinical area with seasoned nurses.

Correct Answer: 4

Rationale 1: Studying harder improves empirical knowledge.

Rationale 2: Taking better notes improves empirical knowledge.

Rationale 3: Reading about the same topic from a variety of sources improves empirical knowledge.

Rationale 4: Aesthetic knowing is the art of nursing and is expressed by the individual nurse through his or her creativity and style in meeting the needs of clients. Understanding how other nurses meet the needs of their clients and seeing a variety of methods to provide the same care will help improve this type of knowledge for the students.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care:

AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship

NLN Competencies: Personal and Professional Development; Ethical Comportment; Demonstrate caring and compassion

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 3. Analyze the importance of different types of knowledge in nursing.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 401

Question 15

Type: MCSA

A nurse has been asked to be a member of a hospitals internal review board and evaluate research studies. Which characteristic does this nurse most likely possess?

1. Sound empirical knowledge

2. Sound personal knowledge

3. Sound aesthetic knowledge

4. Sound ethical knowledge

Correct Answer: 4

Rationale 1: Empirical knowledge is systematically organized into laws and theories for the purpose of describing, explaining, and predicting phenomena.

Rationale 2: Personal knowledge promotes wholeness and integrity in the personal encounter.

Rationale 3: Aesthetic knowledge is the art of nursing and is expressed by the individual nurse through his or her creativity and style in meeting the needs of clients.

Rationale 4: Ethical knowing focuses on matters of obligation or what ought to be done and goes beyond simply following the ethical codes of the discipline. Internal review boards review research projects and determine whether they meet sound, ethical standards. The more sensitive and knowledgeable the nurse is to these issues, the more ethical the nurse will be.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: I.A. 7. Explore ethical and legal implications of patient-centered care

AACN Essentials Competencies: VIII. 11. Access interprofessional and intraprofessional resources to resolve ethical and other practice dilemmas

NLN Competencies: Personal and Professional Development; Ethical Comportment; Demonstrate caring and compassion

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 3. Analyze the importance of different types of knowledge in nursing.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 401

Question 16

Type: MCSA

A student asks the nursing instructor which types of knowledge are important in the clinical area. How should the instructor respond to the student?

1. Empirical knowledgeyou have to know the physiology of the problem before you decide which interventions to use.

2. A good nurse will have a mix of all four types of knowledge.

3. Ethical knowledgenurses must be able to identify principles and norms, handle conflicts, and be sensitive to sensitive issues.

4. Aesthetic knowledgea nurse must appreciate the special qualities of each client and the individual situation.

Correct Answer: 2

Rationale 1: All options are true, but a nurse must possess all four types of knowledge.

Rationale 2: The nurse who practices effectively is able to integrate all types of knowledge to understand situations more holistically.

Rationale 3: All options are true, but a nurse must possess all four types of knowledge.

Rationale 4: All options are true, but a nurse must possess all four types of knowledge.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care:

AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship

NLN Competencies: Personal and Professional Development; Ethical Comportment; Demonstrate caring and compassion

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 3. Analyze the importance of different types of knowledge in nursing.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 401

Question 17

Type: MCSA

The nurse working on an acute psychiatric unit learns that a client with bipolar disorder is being admitted and says to a coworker, We better be ready for a busy night. This nurse is exemplifying which process of Swansons theory of caring?

1. Knowing

2. Being with

3. Doing for

4. Enabling

Correct Answer: 1

Rationale 1: Knowing, according to Swanson, is striving to understand an event as it has meaning in the life of the other. A subdimension of this process is avoiding assumptions. The nurse in this situation made an assumption about clients with bipolar disorder.

Rationale 2: Being with is being emotionally present to another person.

Rationale 3: Doing for is providing for others as they would do for themselves if it were possible.

Rationale 4: Enabling is facilitating the others passage through life transitions and unfamiliar events.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care:

AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship

NLN Competencies: Personal and Professional Development; Ethical Comportment; Demonstrate caring and compassion

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 2. Identify nursing theories that focus on caring.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 401

Question 18

Type: MCSA

The nurse is working in the school system with a group of students who are struggling with the death of a classmate. The nurse encourages the students to talk about their friend, bring pictures, and share memories with each other. The nurse also invites the deceaseds family members to come to the school and visit with their childs classmates. This nurse is working in which of Swansons processes?

1. Knowing

2. Being with

3. Doing for

4. Enabling

Correct Answer: 4

Rationale 1: Knowing is striving to understand an event as it has meaning in the life of the other. If this were the case in this situation, the nurse would be asking the students to explain what they are going through, or what it feels like to lose a friend.

Rationale 2: Being with is being emotionally present to the other.

Rationale 3: Doing for is providing for others as they would do for themselves if it were possible.

Rationale 4: Enabling is facilitating the others passage through life transitions and unfamiliar events. Being supportive of the students and encouraging them to share and talk about their friend is allowing them to move through the grief process. Enabling also includes supporting, assisting, guiding, and validating.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care:

AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship

NLN Competencies: Personal and Professional Development; Ethical Comportment; Demonstrate caring and compassion

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 2. Identify nursing theories that focus on caring.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 401

Question 19

Type: MCSA

The nurse manager determines that a staff nurse demonstrates compassion when providing client care. What did the manager observe to come to this conclusion?

1. A nurse who has expert technical skills and has the most experience with critical care

2. A nurse who routinely gives back rubs to clients before they go to sleep

3. A nurse who has written procedures and policies in language that is both professional and realistic

4. A nurse who takes time to understand the spiritual needs of clients

Correct Answer: 4

Rationale 1: Technical skills focus on the competency of the nurse.

Rationale 2: Giving routine back rubs focuses on comfort.

Rationale 3: Writing abilities focus on the competency of the nurse.

Rationale 4: Attention to spiritual needs is part of compassionate care, particularly in the face of death and bereavement.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care:

AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship

NLN Competencies: Personal and Professional Development; Ethical Comportment; Demonstrate caring and compassion

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 1. Discuss the meaning of caring.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 403

Question 20

Type: MCSA

The nurse educator teaches students about caring nursing practice. Which situation demonstrates a nurse implementing the whole idea of caring?

1. The nurse who takes time for a favorite hobby, at least once a week

2. The nurse who volunteers at church and school events

3. The nurse who makes lists every morning so the day stays organized and planned

4. The nurse who takes care of his elderly parents as well as providing care to his immediate family

Correct Answer: 1

Rationale 1: It is imperative that nurses attend to their own needs, because caring for self is central to caring for others.

Rationale 2: As nurses take on multiple commitments to family, work, school, and community, they risk exhaustion, burnout, and stress.

Rationale 3: This nurse is trying to stay on top of the many tasks involved in a daily routine.

Rationale 4: This nurse is caring for other people.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care:

AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship

NLN Competencies: Personal and Professional Development; Ethical Comportment; Demonstrate caring and compassion

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 5. Evaluate the importance of self-care for the professional nurse.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 404

Question 21

Type: MCSA

The nurse has adopted a healthy lifestyle. What action demonstrates that the nurse is being successful in this endeavor?

1. Exercising every day, at least for an hour and a half

2. Buying only fat-free foods and allowing absolutely no deviation from this

3. Balancing good nutrition and exercise in moderation

4. Exercising more on days when feeling guilty about a snack

Correct Answer: 3

Rationale 1: Nutrition and exercise are necessary for a healthy lifestyle, but key words to remember are balance and moderation. Exercising every day for at least an hour an half does not demonstrate balance.

Rationale 2: Completely avoiding a certain nutrient or keeping the nutritional aspects of ones life so strict that there can be no variance is difficult and indicates more of a compulsive nature than a healthy one.

Rationale 3: Nutrition and exercise are necessary for a healthy lifestyle, but key words to remember are balance and moderation.

Rationale 4: Exercising more on days when feeling guilty about a snack is not permitting variation or balance.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care:

AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship

NLN Competencies: Personal and Professional Development; Ethical Comportment; Demonstrate caring and compassion

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 5. Evaluate the importance of self-care for the professional nurse.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 404

Question 22

Type: MCSA

A nurse practitioner emphasizes the importance of the staff engaging in activities that help restore peace and balance between the mind and body. Which might be an appropriate therapy for this?

1. Bike riding

2. Cake decorating

3. Reading

4. Storytelling

Correct Answer: 4

Rationale 1: Bike riding is an exercise.

Rationale 2: Cake decorating would be recreation.

Rationale 3: Reading would be recreation.

Rationale 4: Mindbody therapies include storytelling, which is a complementary therapy that brings balance to thoughts and emotions.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care:

AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship

NLN Competencies: Personal and Professional Development; Ethical Comportment; Demonstrate caring and compassion

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 5. Evaluate the importance of self-care for the professional nurse.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 405

Question 23

Type: MCSA

A nursing student was involved in a very difficult situation with a client, the clients family, and a physician. The student felt like she was caught in the middle and wasnt sure how to respond to some of the questions that were being asked about care, treatment, and scheduling. Instead of getting her instructor, the student fielded these questions as best she could. In order to help the student work through this situation, the nursing instructor might advise the student to try which action?

1. Meditation

2. Guided imagery

3. Reflection

4. Music therapy

Correct Answer: 3

Rationale 1: Meditation is quieting the mind and focusing it on the present. It helps the individual release fears, worries, and doubts.

Rationale 2: Guided imagery is a mindbody intervention that uses the power of imagination as a therapeutic tool.

Rationale 3: Reflection is thinking from a critical point of view, analyzing why one acted in a certain way and assessing the results of ones actions. Reflection must be personal and meaningful. In this example, it will help the student understand how the situation could have been handled better.

Rationale 4: Music therapy includes listening, singing, rhythm, and body movement. It is often used to induce relaxation.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care:

AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship

NLN Competencies: Personal and Professional Development; Ethical Comportment; Demonstrate caring and compassion

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6. Identify the value of reflective practice in nursing.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 406

Question 24

Type: MCSA

A nurse is providing bathing assistance to a young client who was seriously injured and is unable to care entirely for herself. Which action demonstrates the nurse implementing the doing for process in Swansons theory of caring?

1. Allowing the client to wash her perineal area

2. Drying the client completely

3. Seeing the client is uncomfortable with the whole bathing process

4. Touching the clients shoulder when she starts to cry

Correct Answer: 1

Rationale 1: Doing for is providing for the client as she would do for herself if it were possible. Subdimensions of this process include preserving dignity.

Rationale 2: Drying the client completely, if she is able to do some herself, would not be part of doing for.

Rationale 3: Sensing that the client is uncomfortable fits in the subdimension of knowing (sensing cues).

Rationale 4: Touching the clients shoulder is comforting, a subdimension of being with.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care:

AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship

NLN Competencies: Personal and Professional Development; Ethical Comportment; Demonstrate caring and compassion

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 2. Identify nursing theories that focus on caring.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 401

Question 25

Type: MCMA

The nurse is identifying strategies to support a clients empowerment. What strategies should the nurse use?

Standard Text: Select all that apply.

1. Making it possible for the client diagnosed with mild Alzheimers disease to continue to dance regularly, as it has always been a passion of hers

2. Being sure to polish the clients nails now that she is not able to do it herself, as it has always been important to her that she have pretty hands

3. Suggesting to a clients family members that they should insist that the client move into an assisted living facility so as to ensure her safety

4. Helping the clients family identify community support services that will make it possible for the client to remain in her own home

5. Encouraging the client to use a walker and stay indoors, just in case she might fall

Correct Answer: 1, 2, 4

Rationale 1: This nursing intervention supports and thus empowers the client to continue expressing herself and experiencing life in spite of a chronic disease.

Rationale 2: This nursing intervention supports and thus empowers the client by helping her to maintain her self-esteem and pride in her appearance.

Rationale 3: This nursing intervention might be premature, and so might deny the client the independence and autonomy she is due.

Rationale 4: This nursing intervention supports and thus empowers the client by helping her to maintain her autonomy and independence longer.

Rationale 5: This nursing intervention might be premature, and so might deny the client the independence and autonomy she is due.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care:

AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship

NLN Competencies: Personal and Professional Development; Ethical Comportment; Demonstrate caring and compassion

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 4. Describe how nurses demonstrate caring in practice.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 403

Question 26

Type: MCMA

The new graduate nurse has committed to improving self-care activities. Which behaviors exemplify that the nurse is following through on this personal commitment?

Standard Text: Select all that apply.

1. Using meditation to de-stress at the end of a long day at work

2. Eating a low fat-diet, as there is a family history of heart disease

3. Attending workshops designed to enhance professional skills at least twice yearly

4. Volunteering to cover a friends weekend shifts so the friend can fully recover from a sprained ankle

5. Making sure to reserve the time to read a favorite book between 12 hours of shift work

Correct Answer: 1, 2, 5

Rationale 1: Self-care is described as helping oneself grow and actualize ones possibilities. Managing stress in a healthy manner is certainly a positive behavior directed at self-care.

Rationale 2: Self-care is described as helping oneself grow and actualize ones possibilities. Eating a low-fat diet, especially when one has an increased risk for heart disease, is certainly a positive behavior directed at self-care.

Rationale 3: Although self-care is described as helping oneself grow and actualize ones possibilities, this action is more related to ones professional, not personal, life.

Rationale 4: Although this action reflects caring, it is directed at another rather than toward the self.

Rationale 5: Self-care is described as helping oneself grow and actualize ones possibilities. Engaging in enjoyable activities in a healthy manner is certainly a positive behavior directed at self-care.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care:

AACN Essentials Competencies: IX. 21. Engage in caring and healing techniques that promote a therapeutic nurse-patient relationship

NLN Competencies: Personal and Professional Development; Ethical Comportment; Demonstrate caring and compassion

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5. Evaluate the importance of self-care for the professional nurse.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Page Number: 404

Question 27

Type: MCMA

The graduate nurse learns of failing the NCLEX-RN examination but realizes that passing the examination is a challenge worth achieving. To improve her outlook, the graduate nurse writes positive affirmations that are reviewed daily before studying for the examination. Which affirmations would be the most beneficial for the graduate nurse to use?

Standard Text: Select all that apply.

1. I will focus on a new career.

2. I should have studied harder .

3. I am doing what brings me joy.

4. This is an opportunity to grow.

5. I cannot remember everything.

Correct Answer: 3, 4

Rationale 1: Positive affirmations can lead to greater self-esteem and control self-doubt. Focusing on a new career is not a positive affirmation.

Rationale 2: Positive affirmations can lead to greater self-esteem and control self-doubt. Focusing on study habits in school is not a positive affirmation.

Rationale 3: Positive affirmations can lead to greater self-esteem and control self-doubt. Stating what brings joy is a positive affirmation.

Rationale 4: Positive affirmations can lead to greater self-esteem and control self-doubt. Realizing the situation is an opportunity to grow is a positive affirmation.

Rationale 5: Positive affirmations can lead to greater self-esteem and control self-doubt. Focusing on the inability to remember everything is not a positive affirmation.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Client Need Sub:

QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care:

AACN Essentials Competencies: VIII. 7. Identify personal, professional and environmental risks that impact personal and professional choices and behaviors

NLN Competencies: Personal and Professional Development; Ethical Comportment; Demonstrate caring and compassion

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 5. Evaluate the importance of self-care for the professional nurse.

MNL Learning Outcome: 1.2.1. Explore the various roles in nursing practice.

Leave a Reply