TEST BANK FOR INTERPERSONAL RELATIONSHIPS FOR
Chapter 1: Theory
PROFESSIONAL Based Perspectives and Contemporary
COMMUNICATION SKILLS FOR Dynamics
NURSING 8th
Arnold: Interpersonal Relationships, 8th Edition
EDITION BY ARNOLD
MULTIPLE CHOICE
1. When describing nursing to a group of nursing students, the nursing instructor lists all of the
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following characteristics of nursing except
T T T T
a. historically nursing is as old as mankind. T T T T T T
b. nursing was originally practiced informally by religious orders dedicated to care of
T T T T T T T T T T T T
the sick. T
c. nursing was later practiced in the home by female caregivers with no formal
T T T T T T T T T T T T T
education.
d. nursing has always been identifiable as a distinct occupation.
T T T T T T T T
ANS: A T
Historically, nursing is as old as mankind. Originally practiced informally by religious orders
T T T T T T T T T T T T T
dedicated to care of the sick and later in the home by female caregivers with no formal
T T T T T T T T T T T T T T T T T
education, nursing was not identifiable as a distinct occupation until the 1854 Crimean war.
T T T T T T T T T T T T T T
There, Florence Nightingale’s Notes on Nursing introduced the world to the functional roles
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of professional nursing and the need for formal education.
T T T T T T T T
DIF: Cognitive Level: Comprehension REF: p. T T T T
1 TOP: Step of the Nursing Process: All phases
T T T T T T T T
MSC: Client Needs: Psychosocial Integrity
T T T T
2. The nursing profession’s first nurse researcher, who served as an early advocate for
T T T T T T T T T T T T
high-quality care and used statistical data to document the need for handwashing in preventing
T T T T T T T T T T T T T T
infection, was T
a. Abraham Maslow. T
b. Martha Rogers. T
c. Hildegard Peplau. T
d. Florence Nightingale. T
ANS: D T
An early advocate for high-quality care, Florence Nightingale’s use of statistical data to
T T T T T T T T T T T T T
document the need for handwashing in preventing infection marks her as the profession’s first
T T T T T T T T T T T T T T
nurse researcher. T
DIF: Cognitive Level: Knowledge REF: p. T T T T
1 TOP: Step of the Nursing Process: All phases
T T T T T T T T
MSC: Client Needs: Management of Care
T T T T T
3. Today, professional nursing education begins at the
T T T T T T
a. undergraduate level. T
b. graduate level. T
c. advanced practice level. T T
d. administrative level. T
ANS: A T
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, Today, professional nursing education begins at the undergraduate level, with a growing
T T T T T T T T T T T T
number of nurses choosing graduate studies to support differentiated practice roles and/or
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research opportunities. Nurses are prepared to function as advanced practice nurse
T T T T T T T T T T T
practitioners, administrators, and educators. T T T
DIF: Cognitive Level: Comprehension REF: p. T T T T
2 TOP: Step of the Nursing Process: All phases
T T T T T T T T
MSC: Client Needs: Management of Care
T T T T T
4. Nursing’s metaparadigm, or worldview, distinguishes the nursing profession from other
T T T T T T T T T T
disciplines and emphasizes its unique functional characteristics. The four key concepts that
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form the foundation for all nursing theories are
T T T T T T T
a. caring, compassion, health promotion, and education.
T T T T T
b. respect, integrity, honesty, and advocacy. T T T T
c. person, environment, health, and nursing. T T T T
d. nursing, teaching, caring, and health promotion. T T T T T
ANS: C T
Individual nursing theories represent different interpretations of the phenomenon of nursing,
T T T T T T T T T T T
but central constructs—person, environment, health, and nursing—are found in all theories
T T T T T T T T T T T
and models. They are referred to as nursing’s metaparadigm.
T T T T T T T T
DIF: Cognitive Level: Knowledge REF: p. T T T T
2 TOP: Step of the Nursing Process: All phases
T T T T T T T T
MSC: Client Needs: Management of Care
T T T T T
5. When admitting a client to the medical-surgical unit, the nurse asks the client about cultural
T T T T T T T T T T T T T T
issues. The nurse is demonstrating use of the concept of
T T T T T T T T T
a. person.
b. environment.
c. health.
d. nursing.
ANS: B T
The concept of environment includes all cultural, developmental, and social determinants that
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influence a client’s health perceptions and behavior. A person is defined as the recipient of
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nursing care, having unique bio-psycho-social and spiritual dimensions. The word health
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derives from the word whole. Health is a multidimensional concept, having physical,
T T T T T T T T T T T T
psychological, sociocultural, developmental, and spiritual characteristics. The World Health
T T T T T T T T T
Organization (WHO, 1946) defines health as “a state of complete physical, mental, social well-
T T T T T T T T T T T T T
being, not merely the absence of disease or infirmity.” Nursing includes the promotion of
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health, prevention of illness, and the care of ill, disabled, and dying people.
T T T T T T T T T T T T
DIF: Cognitive Level: Application REF: p. T T T T
3 TOP: Step of the Nursing Process: Assessment
T T T T T T T
MSC: Client Needs: Psychosocial Integrity
T T T T
6. A young mother tells the nurse, “I’m worried because my son needs a blood transfusion. I
T T T T T T T T T T T T T T T T
don’t know what to do, because blood transfusions cause AIDS.” Which central nursing
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construct is represented in this situation? T T T T T
a. Environment
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, b. Caring
c. Health
d. Person
ANS: D T
The concept of environment includes all cultural, developmental, and social determinants that
T T T T T T T T T T T T
influence a client’s health perceptions and behavior. Caring is not one of the four central
T T T T T T T T T T T T T T T
nursing constructs. The word health derives from the word whole. Health is a
T T T T T T T T T T T T T
multidimensional concept, having physical, psychological, sociocultural, developmental, and T T T T T T T T
spiritual characteristics. The World Health Organization (WHO, 1946) defines health as “a
T T T T T T T T T T T T
state of complete physical, mental, social well-being, not merely the absence of disease or
T T T T T T T T T T T T T T
infirmity.” Nursing includes the promotion of health, prevention of illness, and the care of ill,
T T T T T T T T T T T T T T T
disabled, and dying people. Person is defined as the recipient of nursing care, having unique
T T T T T T T T T T T T T T T
bio-psycho-social and spiritual dimensions. T T T
DIF: Cognitive Level: Application REF: p. T T T T
2 TOP: Step of the Nursing Process: Implementation
T T T T T T T T
MSC: Client Needs: Psychosocial Integrity
T T T T
7. The nurse performs a dressing change using sterile technique. This is an example of which
T T T T T T T T T T T T T T T
pattern of knowledge? T T
a. Empirical
b. Personal
c. Aesthetic
d. Ethical
ANS: A T
Empirical knowledge is the scientific rationale for skilled nursing interventions. Personal
T T T T T T T T T T T
ways of knowing allow the nurse to understand and treat each individual as a unique person.
T T T T T T T T T T T T T T T T
Aesthetic ways of knowing allow the nurse to connect in different and more meaningful ways.
T T T T T T T T T T T T T T T
Ethical ways of knowing refer to the moral aspects of nursing.
T T T T T T T T T T
DIF: Cognitive Level: Comprehension REF: p. T T T T
5 TOP: Step of the Nursing Process: Implementation
T T T T T T T T
MSC: Client Needs: Management of Care
T T T T T
8. The nurse-client relationship as described by Hildegard Peplau
T T T T T T T
a. would not be useful in a short-stay unit. T T T T T T T
b. allows personal and social growth to occur only for the client.
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c. facilitates the identification and accomplishment of therapeutic goals.
T T T T T T T
d. focuses on maintaining a personal relationship between the nurse and client.
T T T T T T T T T T
ANS: C T
Hildegard Peplau offers the best-known nursing model for the study of interpersonal
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relationships in health care. Her model describes how the nurse-client relationship can
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facilitate the identification and accomplishment of therapeutic goals to enhance client and
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family well-being. In contemporary practice, Peplau’s framework is more applicable today in
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longer term relationships, and in settings such as rehabilitation centers, long-term care, and
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nursing homes. Despite the brevity of the alliances in acute care settings, basic principles of
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being a participant observer in the relationship, building rapport, developing a working
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partnership, and terminating a relationship remain relevant.
T T T T T T
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, DIF: Cognitive Level: Knowledge REF: p. T T T T
10 TOP: Step of the Nursing Process: All phases
T T T T T T T T
MSC: Client Needs: Psychosocial Integrity
T T T T
9. The identification phase of the nurse-client relationship
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a. sets the stage for the rest of the relationship.
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b. correlates with the assessment phase of the nursing process. T T T T T T T T
c. focuses on therapeutic goals to enhance client and family well-being.
T T T T T T T T T
d. uses community resources to help resolve health care issues.
T T T T T T T T
ANS: C T
Hildegard Peplau offers the best-known nursing model for the study of interpersonal
T T T T T T T T T T T T
relationships in health care. Her model describes how the nurse-client relationship can
T T T T T T T T T T T T
facilitate the identification and accomplishment of therapeutic goals to enhance client and
T T T T T T T T T T T T
family well-being. T
DIF: Cognitive Level: Knowledge REF: p. T T T T
10 TOP: Step of the Nursing Process: Implementation
T T T T T T T T
MSC: Client Needs: Management of Care
T T T T T
10. Abraham Maslow's needs theory is a framework that
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a. begins with meeting basic psychosocial needs first.
T T T T T T
b. ensures essential needs are satisfied, then people move into higher physiological
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areas of development. T T
c. proposes that people are motivated to meet their needs in a descending order.
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d. nurses use to prioritize client needs and develop relevant nursing approaches.
T T T T T T T T T T
ANS: D T
Abraham Maslow's needs theory is a framework that nurses use to prioritize client needs and
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develop relevant nursing approaches. Maslow's model proposes that people are motivated to
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meet their needs in an ascending order beginning with meeting basic survival needs. As
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essential needs are satisfied, people move into higher psychosocial areas of development.
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DIF: Cognitive Level: Application REF: p. T T T T
10 TOP: Step of the Nursing Process: All phases
T T T T T T T T
MSC: Client Needs: Psychosocial Integrity
T T T T
11. Which of the following statements about communication theory is true?
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a. Primates are able to learn new languages to share ideas and feelings. T T T T T T T T T T T
b. Concepts include only verbal communication. T T T T
c. Perceptions are clarified through feedback. T T T T
d. Past experience does not influence communication.
T T T T T
ANS: C T
Feedback is the only way to know that one’s perceptions about meanings are valid. Human
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communication is unique. Only human beings have large vocabularies and are capable ofT T T T T T T T T T T T T
learning new languages as a means of sharing their ideas and feelings. Communication
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includes language, gestures, and symbols to convey intended meaning, exchange ideas and
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feelings, and to share significant life experience. To encode a message appropriately requires
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a clear understanding of the receiver’s mental frame of reference (e.g., feelings, personal
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agendas, past experiences) and knowledge of its purpose or intent of the communication.
T T T T T T T T T T T T
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, DIF: Cognitive Level: Knowledge REF: p. T T T T
7 TOP: Step of the Nursing Process: Assessment
T T T T T T T
MSC: Client Needs: Psychosocial Integrity
T T T T
12. In the circular transactional model of communication,
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a. questions are framed in order to recognize the context of the message.
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b. people take only complementary roles in the communication.
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c. the context of the communication is unimportant.
T T T T T T
d. the purpose of communication is to influence the receiver.
T T T T T T T T
ANS: A T
A circular model expands linear models to include the context of the communication,
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feedback loops, and validation. With this model, the sender and receiver construct a mental
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picture of the other, which influences the message and includes perceptions of the other
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person’s attitude and potential reaction to the message.
T T T T T T T
DIF: Cognitive Level: Comprehension REF: p. T T T T
8 TOP: Step of the Nursing Process: All phases
T T T T T T T T
MSC: Client Needs: Psychosocial Integrity
T T T T
13. The nurse recognizes that feedback loops
T T T T T
a. do not allow for correction of original information.
T T T T T T T
b. are solely based on the General Systems Theory.
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c. do not allow for validation of information.
T T T T T T
d. allow the human system to correct its original information.
T T T T T T T T
ANS: D T
Feedback (from the receiver or the environment) allows the system to correct or maintain its
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original information. Feedback loops (from the receiver, or the environment) validate the
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information, or allow the human system to correct its original information. General Systems
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Theory, initially described by Ludwig von Bertalanffy (1968), focuses on process and
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interconnected relationships comprising the “whole.” T T T T
DIF: Cognitive Level: Knowledge REF: p. T T T T
8 TOP: Step of the Nursing Process: All phases
T T T T T T T T
MSC: Client Needs: Psychosocial Integrity
T T T T
14. Which of the following statements best represents therapeutic communication when a student
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discovers a client crying in bed? T T T T T
a. “I am the nurse who will be doing your treatments today.”
T T T T T T T T T T
b. “Will you listen to me so I can help you get better?”
T T T T T T T T T T T
c. “This is what is going to happen during surgery.”
T T T T T T T T
d. “Can we talk about what seems to be bothering you?”
T T T T T T T T T
ANS: D T
Asking about what is bothering the client is goal directed. Its purpose is to promote client
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well-being. “I am the nurse who will be doing your treatments today” is a statement of fact,
T T T T T T T T T T T T T T T T T
and it ignores the client’s emotional needs. “Will you listen to me so I can help you get
T T T T T T T T T T T T T T T T T T
better?” is not goal directed and does not involve mutuality. “This is what is going to happen
T T T T T T T T T T T T T T T T T
during surgery” is simply one way. It does not engage the client in a therapeutic manner.
T T T T T T T T T T T T T T T
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, DIF: Cognitive Level: Application REF: p. T T T T
10 TOP: Step of the Nursing Process: Assessment
T T T T T T T
MSC: Client Needs: Psychosocial Integrity
T T T T
15. The central constructs of person, environment, health, and nursing are found in all nursing
T T T T T T T T T T T T T T
theories and models and are referred to as
T T T T T T T
a. telehealth.
b. the medical model. T T
c. nursing’s metaparadigm. T
d. five core areas of competency. T T T T
ANS: C T
Individual nursing theories represent different interpretations of the phenomenon of nursing,
T T T T T T T T T T T
but central constructs—person, environment, health, and nursing—are found in all theories
T T T T T T T T T T T
and models. They are referred to as nursing’s metaparadigm. These constructs are the
T T T T T T T T T T T T T
“metalanguage” of nursing, and together they act as basic building blocks for the discipline of
T T T T T T T T T T T T T T T
professional nursing. Telehealth is fast becoming an integral part of the health care system,
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used both as a live interactive mechanism (particularly in remote areas, where there is a
T T T T T T T T T T T T T T T
scarcity of health care providers) and as a way to track clinical data. Two important outcomes
T T T T T T T T T T T T T T T T
are reduced health costs and increased access to care. During the last century, the bulk of
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professional care was delivered in acute care settings, based on the disease-focused medical
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model. Switching to today’s community focus recognizes the fact that chronic medical
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conditions account for most of today’s care, with most being treated in the community. The
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IOM report Health professions education: A bridge to quality (2003) calls for the
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restructuring of clinical education responsive to the 21st century health system transformation
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goals of providing the highest quality and safest medical care possible. This report identified
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five core areas of competency required to cross the bridge to quality.
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DIF: Cognitive Level: Comprehension REF: p. T T T T
4 TOP: Step of the Nursing Process: All phases
T T T T T T T T
MSC: Client Needs: Health Promotion and Maintenance
T T T T T T
MULTIPLE RESPONSE T
1. The discipline of nursing has “a unique perspective, a distinct way of viewing all phenomena,
T T T T T T T T T T T T T T T
which ultimately defines and limits the nature of its inquiry,” related to (Select all that apply.)
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a. principles and laws that govern the life processes, well-being, and optimum
T T T T T T T T T T T
functioning of human beings, sick or well. T T T T T T
b. patterning of human behavior in interaction with the environment in critical life
T T T T T T T T T T T T
situations.
c. processes by which positive changes in health status are affected. T T T T T T T T T
d. processes by which negative changes in health status are affected. T T T T T T T T T
e. patterning of human behavior in interaction with the environment in every life
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situation.
f. principles and laws that govern the life processes, well-being, and optimum
T T T T T T T T T T T
functioning of human beings, in relation to wellness only. T T T T T T T T
ANS: A, B, C T T T
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,Donaldson and Crowley characterize the discipline of nursing as having "a unique
T T T T T T T T T T T T
perspective, a distinct way of viewing all phenomena, which ultimately defines and limits the
T T T T T T T T T T T T T T
nature of its inquiry," related to "Principles and laws that govern the life processes,
T T T T T T T T T T T T T
well-being, and optimum functioning of human beings, sick or well; patterning of human
T T T T T T T T T T T T T
behavior in interaction with the environment in critical life situations; and processes by which
T T T T T T T T T T T T T T
positive changes in health status are affected."
T T T T T T
DIF: Cognitive Level: Application REF: p. 2T T T T T
TOP: Step of the Nursing Process: Implementation
T T T T T T T
MSC: Client Needs: Health Promotion and Maintenance
T T T T T T
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,Chapter 2: Professional Guides for Nursing Communication
T T T T T T T
Arnold: Interpersonal Relationships, 8th Edition
T T T T
MULTIPLE CHOICE T
1. The nurse demonstrates effective communication by ensuring all of the following except
T T T T T T T T T T T
a. two-way exchange of information among clients and health providers.T T T T T T T T
b. making sure that unilateral information is exchanged between clients and nurses.
T T T T T T T T T T
c. making sure that the expectations and responsibilities of all are clearly understood.
T T T T T T T T T T T
d. recognizing that effective communication is an active process for all involved. T T T T T T T T T T
ANS: B T
Effective communication is defined as a two-way exchange of information among clients and
T T T T T T T T T T T T T
health providers ensuring that the expectations and responsibilities of all are clearly
T T T T T T T T T T T T
understood. It is an active process for all involved. T T T T T T T T
DIF: Cognitive Level: Knowledge REF: p. T T T T
23 TOP: Step of the Nursing Process: All phases
T T T T T T T T
MSC: Client Needs: Management of Care
T T T T T
2. A preoperative assessment shows that a client’s hemoglobin level is dropping. The anesthetist
T T T T T T T T T T T T T
orders 3 units of blood to be administered. The nurse administers the first unit before
T T T T T T T T T T T T T T T
discovering that the client is a Jehovah’s Witness, as documented in the record. This is an
T T T T T T T T T T T T T T T T
example of T
a. professional conduct. T
b. a negligent act.
T T
c. physical abuse. T
d. breaching client confidentiality. T T
ANS: B T
The nurse was negligent by not checking the record and by failure to obtain written consent
T T T T T T T T T T T T T T T T
from the client for the procedure. This is an example of misconduct, not professional conduct.
T T T T T T T T T T T T T T T
The nurse did not intend to physically harm the patient. The nurse did not breach client
T T T T T T T T T T T T T T T T
confidentiality.
DIF: Cognitive Level: Application REF: pp. 28- T T T T
29 TOP: Step of the Nursing Process: All phases
T T T T T T T T
MSC: Client Needs: Management of Care
T T T T T
3. Which of the following is a violation of client confidentiality? Reporting
T T T T T T T T T T
a. certain communicable diseases. T T
b. child abuse. T
c. gunshot wounds. T
d. client data to a colleague in a nonprofessional setting.
T T T T T T T T
ANS: D T
Releasing information to people not directly involved in the client’s care is a breach of
T T T T T T T T T T T T T T T
confidentiality. Certain communicable or sexually transmitted diseases, child and elder abuse,
T T T T T T T T T T T
and the potential for serious harm to another individual are considered exceptions to sharing
T T T T T T T T T T T T T T
of confidential information.
T T
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, DIF: Cognitive Level: Knowledge REF: p. T T T T
37 TOP: Step of the Nursing Process: All phases
T T T T T T T T
MSC: Client Needs: Management of Care
T T T T T
4. A 16-year-old trauma victim arrives in the emergency department with a life-threatening
T T T T T T T T T T T T
condition and requires emergency surgery. The nurse knows that
T T T T T T T T
a. a parent/guardian must give consent.
T T T T
b. the client can give consent if she provides proof of emancipation.
T T T T T T T T T T
c. the client must first be evaluated for competency before obtaining consent.
T T T T T T T T T T
d. surgery can be performed without consent. T T T T T
ANS: D T
Surgery can be performed without consent because it is a life-threatening emergency.
T T T T T T T T T T T T
Normally parents or a guardian must give consent, but in a life-threatening emergency
T T T T T T T T T T T T T
medical care can be administered without consent. Providing proof of emancipation is not
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necessary in a life-threatening situation. The client does not need to first be evaluated for
T T T T T T T T T T T T T T T
competency in a life-threatening situation. T T T T
DIF: Cognitive Level: Application REF: p. T T T T
38 TOP: Step of the Nursing Process: All phases
T T T T T T T T
MSC: Client Needs: Management of Care
T T T T T
5. In regard to informed consent, which of the following statements is true?
T T T T T T T T T T T
a. Only legally incompetent adults can give consent.
T T T T T T
b. Only parents can give consent for minor children.
T T T T T T T
c. It is not required that the client be told about costs and alternatives to treatment.
T T T T T T T T T T T T T T
d. Consent must be voluntary. T T T
ANS: D T
For legal consent to be valid, it must be voluntary. Only legally competent adults can give
T T T T T T T T T T T T T T T T
consent. Parents or legal guardians can give consent for minor children. Clients must have full
T T T T T T T T T T T T T T T
disclosure about risks/benefits, including costs and alternatives.
T T T T T T
DIF: Cognitive Level: Knowledge REF: p. T T T T
37 TOP: Step of the Nursing Process: All phases
T T T T T T T T
MSC: Client Needs: Management of Care
T T T T T
6. The client has a living will in which he states he does not want to be kept alive by artificial
T T T T T T T T T T T T T T T T T T T T
means. The client’s family wants to disregard the client’s wishes and have him maintained on
T T T T T T T T T T T T T T T
artificial life support. The most appropriate initial course of action for the nurse would be to
T T T T T T T T T T T T T T T
a. tell the family that they have no legal rights.
T T T T T T T T
b. tell the family that they have the right to override the living will because the
T T T T T T T T T T T T T T T
patient cannot speak. T T
c. report the situation to the hospital ethics committee.
T T T T T T T
d. allow the family to verbalize their feelings and concerns, while maintaining the
T T T T T T T T T T T T
role of client advocate. T T T
ANS: D T
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, Allowing the family to verbalize their feelings and concerns is the most appropriate action at
T T T T T T T T T T T T T T T
the time to help the family deal with their loss and come to terms with their family member’s
T T T T T T T T T T T T T T T T T T
wishes. Telling the family that they have no legal rights would not be supportive and might
T T T T T T T T T T T T T T T T
create hostility. The family does not have the right to override a living will. It is not the most
T T T T T T T T T T T T T T T T T T T
appropriate initial course of action to report the situation to the hospital ethics committee.
T T T T T T T T T T T T T
According to the American Nurses Association Code of Ethics for Nurses, the nurse
T T T T T T T T T T T T T
promotes, advocates for, and strives to protect the health, safety, and rights of the patient.
T T T T T T T T T T T T T T
DIF: Cognitive Level: Analysis REF: p. T T T T
27 TOP: Step of the Nursing Process: Implementation
T T T T T T T T
MSC: Client Needs: Management of Care
T T T T T
7. The nurse collects both objective and subjective data. An example of subjective data is
T T T T T T T T T T T T T
a. BP 140/80. T
b. skin color jaundiced. T T
c. “I have a headache.”
T T T
d. history of seizures. T T
ANS: C T
Subjective data refers to the client’s perception of data and what the client or family says
T T T T T T T T T T T T T T T T
about the data. Objective data refers to data that are directly observable or verifiable through
T T T T T T T T T T T T T T T
physical examination or tests. Blood pressure recording is objective. Jaundiced skin color
T T T T T T T T T T T T
observation by the nurse is objective data. A history of seizures is objective data.
T T T T T T T T T T T T T
DIF: Cognitive Level: Knowledge REF: p. T T T T
33 TOP: Step of the Nursing Process: Assessment
T T T T T T T
MSC: Client Needs: Physiological Integrity
T T T T
8. The nurse observes a client pacing the floor. The nurse validates an inference when speaking
T T T T T T T T T T T T T T T
to the client by stating,
T T T T
a. “You are anxious, so let’s talk about it.”
T T T T T T T
b. “Let’s try some deep breathing to help you relax.”
T T T T T T T T
c. “You seem anxious. Will you tell me what is going on?”
T T T T T T T T T T
d. “Clients who pace usually need to talk to a physician. Should I call yours?”
T T T T T T T T T T T T T
ANS: C T
The nurse has inferred that the client is anxious but needs to ask further questions to validate
T T T T T T T T T T T T T T T T T
the information. A nurse should not make assumptions without first confirming that the
T T T T T T T T T T T T T
inference is correct. Deep breathing exercise is an intervention; it is not validating an
T T T T T T T T T T T T T T
inference.
DIF: Cognitive Level: Application REF: p. T T T T
33 TOP: Step of the Nursing Process: Assessment
T T T T T T T
MSC: Client Needs: Psychosocial Integrity
T T T T
9. A client who is scheduled for a bilateral inguinal hernia repair the next day is observed pacing
T T T T T T T T T T T T T T T T T
the unit. After validating that the client is anxious about his upcoming surgery because he is
T T T T T T T T T T T T T T T T
afraid of pain, a relevant nursing diagnosis would be
T T T T T T T T
a. anxiety related to surgery. T T T
b. pain related to anxiety about surgery as evidenced by pacing.
T T T T T T T T T
c. anxiety related to fear of postoperative pain as evidenced by pacing.
T T T T T T T T T T
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Chapter 1: Theory
PROFESSIONAL Based Perspectives and Contemporary
COMMUNICATION SKILLS FOR Dynamics
NURSING 8th
Arnold: Interpersonal Relationships, 8th Edition
EDITION BY ARNOLD
MULTIPLE CHOICE
1. When describing nursing to a group of nursing students, the nursing instructor lists all of the
T T T T T T T T T T T T T T T
following characteristics of nursing except
T T T T
a. historically nursing is as old as mankind. T T T T T T
b. nursing was originally practiced informally by religious orders dedicated to care of
T T T T T T T T T T T T
the sick. T
c. nursing was later practiced in the home by female caregivers with no formal
T T T T T T T T T T T T T
education.
d. nursing has always been identifiable as a distinct occupation.
T T T T T T T T
ANS: A T
Historically, nursing is as old as mankind. Originally practiced informally by religious orders
T T T T T T T T T T T T T
dedicated to care of the sick and later in the home by female caregivers with no formal
T T T T T T T T T T T T T T T T T
education, nursing was not identifiable as a distinct occupation until the 1854 Crimean war.
T T T T T T T T T T T T T T
There, Florence Nightingale’s Notes on Nursing introduced the world to the functional roles
T T T T T T T T T T T T T
of professional nursing and the need for formal education.
T T T T T T T T
DIF: Cognitive Level: Comprehension REF: p. T T T T
1 TOP: Step of the Nursing Process: All phases
T T T T T T T T
MSC: Client Needs: Psychosocial Integrity
T T T T
2. The nursing profession’s first nurse researcher, who served as an early advocate for
T T T T T T T T T T T T
high-quality care and used statistical data to document the need for handwashing in preventing
T T T T T T T T T T T T T T
infection, was T
a. Abraham Maslow. T
b. Martha Rogers. T
c. Hildegard Peplau. T
d. Florence Nightingale. T
ANS: D T
An early advocate for high-quality care, Florence Nightingale’s use of statistical data to
T T T T T T T T T T T T T
document the need for handwashing in preventing infection marks her as the profession’s first
T T T T T T T T T T T T T T
nurse researcher. T
DIF: Cognitive Level: Knowledge REF: p. T T T T
1 TOP: Step of the Nursing Process: All phases
T T T T T T T T
MSC: Client Needs: Management of Care
T T T T T
3. Today, professional nursing education begins at the
T T T T T T
a. undergraduate level. T
b. graduate level. T
c. advanced practice level. T T
d. administrative level. T
ANS: A T
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, Today, professional nursing education begins at the undergraduate level, with a growing
T T T T T T T T T T T T
number of nurses choosing graduate studies to support differentiated practice roles and/or
T T T T T T T T T T T T
research opportunities. Nurses are prepared to function as advanced practice nurse
T T T T T T T T T T T
practitioners, administrators, and educators. T T T
DIF: Cognitive Level: Comprehension REF: p. T T T T
2 TOP: Step of the Nursing Process: All phases
T T T T T T T T
MSC: Client Needs: Management of Care
T T T T T
4. Nursing’s metaparadigm, or worldview, distinguishes the nursing profession from other
T T T T T T T T T T
disciplines and emphasizes its unique functional characteristics. The four key concepts that
T T T T T T T T T T T T
form the foundation for all nursing theories are
T T T T T T T
a. caring, compassion, health promotion, and education.
T T T T T
b. respect, integrity, honesty, and advocacy. T T T T
c. person, environment, health, and nursing. T T T T
d. nursing, teaching, caring, and health promotion. T T T T T
ANS: C T
Individual nursing theories represent different interpretations of the phenomenon of nursing,
T T T T T T T T T T T
but central constructs—person, environment, health, and nursing—are found in all theories
T T T T T T T T T T T
and models. They are referred to as nursing’s metaparadigm.
T T T T T T T T
DIF: Cognitive Level: Knowledge REF: p. T T T T
2 TOP: Step of the Nursing Process: All phases
T T T T T T T T
MSC: Client Needs: Management of Care
T T T T T
5. When admitting a client to the medical-surgical unit, the nurse asks the client about cultural
T T T T T T T T T T T T T T
issues. The nurse is demonstrating use of the concept of
T T T T T T T T T
a. person.
b. environment.
c. health.
d. nursing.
ANS: B T
The concept of environment includes all cultural, developmental, and social determinants that
T T T T T T T T T T T T
influence a client’s health perceptions and behavior. A person is defined as the recipient of
T T T T T T T T T T T T T T T
nursing care, having unique bio-psycho-social and spiritual dimensions. The word health
T T T T T T T T T T T
derives from the word whole. Health is a multidimensional concept, having physical,
T T T T T T T T T T T T
psychological, sociocultural, developmental, and spiritual characteristics. The World Health
T T T T T T T T T
Organization (WHO, 1946) defines health as “a state of complete physical, mental, social well-
T T T T T T T T T T T T T
being, not merely the absence of disease or infirmity.” Nursing includes the promotion of
T T T T T T T T T T T T T T
health, prevention of illness, and the care of ill, disabled, and dying people.
T T T T T T T T T T T T
DIF: Cognitive Level: Application REF: p. T T T T
3 TOP: Step of the Nursing Process: Assessment
T T T T T T T
MSC: Client Needs: Psychosocial Integrity
T T T T
6. A young mother tells the nurse, “I’m worried because my son needs a blood transfusion. I
T T T T T T T T T T T T T T T T
don’t know what to do, because blood transfusions cause AIDS.” Which central nursing
T T T T T T T T T T T T T
construct is represented in this situation? T T T T T
a. Environment
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, b. Caring
c. Health
d. Person
ANS: D T
The concept of environment includes all cultural, developmental, and social determinants that
T T T T T T T T T T T T
influence a client’s health perceptions and behavior. Caring is not one of the four central
T T T T T T T T T T T T T T T
nursing constructs. The word health derives from the word whole. Health is a
T T T T T T T T T T T T T
multidimensional concept, having physical, psychological, sociocultural, developmental, and T T T T T T T T
spiritual characteristics. The World Health Organization (WHO, 1946) defines health as “a
T T T T T T T T T T T T
state of complete physical, mental, social well-being, not merely the absence of disease or
T T T T T T T T T T T T T T
infirmity.” Nursing includes the promotion of health, prevention of illness, and the care of ill,
T T T T T T T T T T T T T T T
disabled, and dying people. Person is defined as the recipient of nursing care, having unique
T T T T T T T T T T T T T T T
bio-psycho-social and spiritual dimensions. T T T
DIF: Cognitive Level: Application REF: p. T T T T
2 TOP: Step of the Nursing Process: Implementation
T T T T T T T T
MSC: Client Needs: Psychosocial Integrity
T T T T
7. The nurse performs a dressing change using sterile technique. This is an example of which
T T T T T T T T T T T T T T T
pattern of knowledge? T T
a. Empirical
b. Personal
c. Aesthetic
d. Ethical
ANS: A T
Empirical knowledge is the scientific rationale for skilled nursing interventions. Personal
T T T T T T T T T T T
ways of knowing allow the nurse to understand and treat each individual as a unique person.
T T T T T T T T T T T T T T T T
Aesthetic ways of knowing allow the nurse to connect in different and more meaningful ways.
T T T T T T T T T T T T T T T
Ethical ways of knowing refer to the moral aspects of nursing.
T T T T T T T T T T
DIF: Cognitive Level: Comprehension REF: p. T T T T
5 TOP: Step of the Nursing Process: Implementation
T T T T T T T T
MSC: Client Needs: Management of Care
T T T T T
8. The nurse-client relationship as described by Hildegard Peplau
T T T T T T T
a. would not be useful in a short-stay unit. T T T T T T T
b. allows personal and social growth to occur only for the client.
T T T T T T T T T T
c. facilitates the identification and accomplishment of therapeutic goals.
T T T T T T T
d. focuses on maintaining a personal relationship between the nurse and client.
T T T T T T T T T T
ANS: C T
Hildegard Peplau offers the best-known nursing model for the study of interpersonal
T T T T T T T T T T T T
relationships in health care. Her model describes how the nurse-client relationship can
T T T T T T T T T T T T
facilitate the identification and accomplishment of therapeutic goals to enhance client and
T T T T T T T T T T T T
family well-being. In contemporary practice, Peplau’s framework is more applicable today in
T T T T T T T T T T T T
longer term relationships, and in settings such as rehabilitation centers, long-term care, and
T T T T T T T T T T T T T
nursing homes. Despite the brevity of the alliances in acute care settings, basic principles of
T T T T T T T T T T T T T T T
being a participant observer in the relationship, building rapport, developing a working
T T T T T T T T T T T T
partnership, and terminating a relationship remain relevant.
T T T T T T
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, DIF: Cognitive Level: Knowledge REF: p. T T T T
10 TOP: Step of the Nursing Process: All phases
T T T T T T T T
MSC: Client Needs: Psychosocial Integrity
T T T T
9. The identification phase of the nurse-client relationship
T T T T T T
a. sets the stage for the rest of the relationship.
T T T T T T T T
b. correlates with the assessment phase of the nursing process. T T T T T T T T
c. focuses on therapeutic goals to enhance client and family well-being.
T T T T T T T T T
d. uses community resources to help resolve health care issues.
T T T T T T T T
ANS: C T
Hildegard Peplau offers the best-known nursing model for the study of interpersonal
T T T T T T T T T T T T
relationships in health care. Her model describes how the nurse-client relationship can
T T T T T T T T T T T T
facilitate the identification and accomplishment of therapeutic goals to enhance client and
T T T T T T T T T T T T
family well-being. T
DIF: Cognitive Level: Knowledge REF: p. T T T T
10 TOP: Step of the Nursing Process: Implementation
T T T T T T T T
MSC: Client Needs: Management of Care
T T T T T
10. Abraham Maslow's needs theory is a framework that
T T T T T T T
a. begins with meeting basic psychosocial needs first.
T T T T T T
b. ensures essential needs are satisfied, then people move into higher physiological
T T T T T T T T T T T
areas of development. T T
c. proposes that people are motivated to meet their needs in a descending order.
T T T T T T T T T T T T
d. nurses use to prioritize client needs and develop relevant nursing approaches.
T T T T T T T T T T
ANS: D T
Abraham Maslow's needs theory is a framework that nurses use to prioritize client needs and
T T T T T T T T T T T T T T T
develop relevant nursing approaches. Maslow's model proposes that people are motivated to
T T T T T T T T T T T T
meet their needs in an ascending order beginning with meeting basic survival needs. As
T T T T T T T T T T T T T T
essential needs are satisfied, people move into higher psychosocial areas of development.
T T T T T T T T T T T
DIF: Cognitive Level: Application REF: p. T T T T
10 TOP: Step of the Nursing Process: All phases
T T T T T T T T
MSC: Client Needs: Psychosocial Integrity
T T T T
11. Which of the following statements about communication theory is true?
T T T T T T T T T
a. Primates are able to learn new languages to share ideas and feelings. T T T T T T T T T T T
b. Concepts include only verbal communication. T T T T
c. Perceptions are clarified through feedback. T T T T
d. Past experience does not influence communication.
T T T T T
ANS: C T
Feedback is the only way to know that one’s perceptions about meanings are valid. Human
T T T T T T T T T T T T T T T
communication is unique. Only human beings have large vocabularies and are capable ofT T T T T T T T T T T T T
learning new languages as a means of sharing their ideas and feelings. Communication
T T T T T T T T T T T T T
includes language, gestures, and symbols to convey intended meaning, exchange ideas and
T T T T T T T T T T T T
feelings, and to share significant life experience. To encode a message appropriately requires
T T T T T T T T T T T T T
a clear understanding of the receiver’s mental frame of reference (e.g., feelings, personal
T T T T T T T T T T T T T
agendas, past experiences) and knowledge of its purpose or intent of the communication.
T T T T T T T T T T T T
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, DIF: Cognitive Level: Knowledge REF: p. T T T T
7 TOP: Step of the Nursing Process: Assessment
T T T T T T T
MSC: Client Needs: Psychosocial Integrity
T T T T
12. In the circular transactional model of communication,
T T T T T T
a. questions are framed in order to recognize the context of the message.
T T T T T T T T T T T
b. people take only complementary roles in the communication.
T T T T T T T
c. the context of the communication is unimportant.
T T T T T T
d. the purpose of communication is to influence the receiver.
T T T T T T T T
ANS: A T
A circular model expands linear models to include the context of the communication,
T T T T T T T T T T T T T
feedback loops, and validation. With this model, the sender and receiver construct a mental
T T T T T T T T T T T T T T
picture of the other, which influences the message and includes perceptions of the other
T T T T T T T T T T T T T T
person’s attitude and potential reaction to the message.
T T T T T T T
DIF: Cognitive Level: Comprehension REF: p. T T T T
8 TOP: Step of the Nursing Process: All phases
T T T T T T T T
MSC: Client Needs: Psychosocial Integrity
T T T T
13. The nurse recognizes that feedback loops
T T T T T
a. do not allow for correction of original information.
T T T T T T T
b. are solely based on the General Systems Theory.
T T T T T T T
c. do not allow for validation of information.
T T T T T T
d. allow the human system to correct its original information.
T T T T T T T T
ANS: D T
Feedback (from the receiver or the environment) allows the system to correct or maintain its
T T T T T T T T T T T T T T T
original information. Feedback loops (from the receiver, or the environment) validate the
T T T T T T T T T T T T
information, or allow the human system to correct its original information. General Systems
T T T T T T T T T T T T T
Theory, initially described by Ludwig von Bertalanffy (1968), focuses on process and
T T T T T T T T T T T T
interconnected relationships comprising the “whole.” T T T T
DIF: Cognitive Level: Knowledge REF: p. T T T T
8 TOP: Step of the Nursing Process: All phases
T T T T T T T T
MSC: Client Needs: Psychosocial Integrity
T T T T
14. Which of the following statements best represents therapeutic communication when a student
T T T T T T T T T T T T
discovers a client crying in bed? T T T T T
a. “I am the nurse who will be doing your treatments today.”
T T T T T T T T T T
b. “Will you listen to me so I can help you get better?”
T T T T T T T T T T T
c. “This is what is going to happen during surgery.”
T T T T T T T T
d. “Can we talk about what seems to be bothering you?”
T T T T T T T T T
ANS: D T
Asking about what is bothering the client is goal directed. Its purpose is to promote client
T T T T T T T T T T T T T T T T
well-being. “I am the nurse who will be doing your treatments today” is a statement of fact,
T T T T T T T T T T T T T T T T T
and it ignores the client’s emotional needs. “Will you listen to me so I can help you get
T T T T T T T T T T T T T T T T T T
better?” is not goal directed and does not involve mutuality. “This is what is going to happen
T T T T T T T T T T T T T T T T T
during surgery” is simply one way. It does not engage the client in a therapeutic manner.
T T T T T T T T T T T T T T T
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, DIF: Cognitive Level: Application REF: p. T T T T
10 TOP: Step of the Nursing Process: Assessment
T T T T T T T
MSC: Client Needs: Psychosocial Integrity
T T T T
15. The central constructs of person, environment, health, and nursing are found in all nursing
T T T T T T T T T T T T T T
theories and models and are referred to as
T T T T T T T
a. telehealth.
b. the medical model. T T
c. nursing’s metaparadigm. T
d. five core areas of competency. T T T T
ANS: C T
Individual nursing theories represent different interpretations of the phenomenon of nursing,
T T T T T T T T T T T
but central constructs—person, environment, health, and nursing—are found in all theories
T T T T T T T T T T T
and models. They are referred to as nursing’s metaparadigm. These constructs are the
T T T T T T T T T T T T T
“metalanguage” of nursing, and together they act as basic building blocks for the discipline of
T T T T T T T T T T T T T T T
professional nursing. Telehealth is fast becoming an integral part of the health care system,
T T T T T T T T T T T T T T
used both as a live interactive mechanism (particularly in remote areas, where there is a
T T T T T T T T T T T T T T T
scarcity of health care providers) and as a way to track clinical data. Two important outcomes
T T T T T T T T T T T T T T T T
are reduced health costs and increased access to care. During the last century, the bulk of
T T T T T T T T T T T T T T T T
professional care was delivered in acute care settings, based on the disease-focused medical
T T T T T T T T T T T T T
model. Switching to today’s community focus recognizes the fact that chronic medical
T T T T T T T T T T T T
conditions account for most of today’s care, with most being treated in the community. The
T T T T T T T T T T T T T T T
IOM report Health professions education: A bridge to quality (2003) calls for the
T T T T T T T T T T T T T
restructuring of clinical education responsive to the 21st century health system transformation
T T T T T T T T T T T T
goals of providing the highest quality and safest medical care possible. This report identified
T T T T T T T T T T T T T T
five core areas of competency required to cross the bridge to quality.
T T T T T T T T T T T
DIF: Cognitive Level: Comprehension REF: p. T T T T
4 TOP: Step of the Nursing Process: All phases
T T T T T T T T
MSC: Client Needs: Health Promotion and Maintenance
T T T T T T
MULTIPLE RESPONSE T
1. The discipline of nursing has “a unique perspective, a distinct way of viewing all phenomena,
T T T T T T T T T T T T T T T
which ultimately defines and limits the nature of its inquiry,” related to (Select all that apply.)
T T T T T T T T T T T T T T T
a. principles and laws that govern the life processes, well-being, and optimum
T T T T T T T T T T T
functioning of human beings, sick or well. T T T T T T
b. patterning of human behavior in interaction with the environment in critical life
T T T T T T T T T T T T
situations.
c. processes by which positive changes in health status are affected. T T T T T T T T T
d. processes by which negative changes in health status are affected. T T T T T T T T T
e. patterning of human behavior in interaction with the environment in every life
T T T T T T T T T T T T
situation.
f. principles and laws that govern the life processes, well-being, and optimum
T T T T T T T T T T T
functioning of human beings, in relation to wellness only. T T T T T T T T
ANS: A, B, C T T T
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,Donaldson and Crowley characterize the discipline of nursing as having "a unique
T T T T T T T T T T T T
perspective, a distinct way of viewing all phenomena, which ultimately defines and limits the
T T T T T T T T T T T T T T
nature of its inquiry," related to "Principles and laws that govern the life processes,
T T T T T T T T T T T T T
well-being, and optimum functioning of human beings, sick or well; patterning of human
T T T T T T T T T T T T T
behavior in interaction with the environment in critical life situations; and processes by which
T T T T T T T T T T T T T T
positive changes in health status are affected."
T T T T T T
DIF: Cognitive Level: Application REF: p. 2T T T T T
TOP: Step of the Nursing Process: Implementation
T T T T T T T
MSC: Client Needs: Health Promotion and Maintenance
T T T T T T
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,Chapter 2: Professional Guides for Nursing Communication
T T T T T T T
Arnold: Interpersonal Relationships, 8th Edition
T T T T
MULTIPLE CHOICE T
1. The nurse demonstrates effective communication by ensuring all of the following except
T T T T T T T T T T T
a. two-way exchange of information among clients and health providers.T T T T T T T T
b. making sure that unilateral information is exchanged between clients and nurses.
T T T T T T T T T T
c. making sure that the expectations and responsibilities of all are clearly understood.
T T T T T T T T T T T
d. recognizing that effective communication is an active process for all involved. T T T T T T T T T T
ANS: B T
Effective communication is defined as a two-way exchange of information among clients and
T T T T T T T T T T T T T
health providers ensuring that the expectations and responsibilities of all are clearly
T T T T T T T T T T T T
understood. It is an active process for all involved. T T T T T T T T
DIF: Cognitive Level: Knowledge REF: p. T T T T
23 TOP: Step of the Nursing Process: All phases
T T T T T T T T
MSC: Client Needs: Management of Care
T T T T T
2. A preoperative assessment shows that a client’s hemoglobin level is dropping. The anesthetist
T T T T T T T T T T T T T
orders 3 units of blood to be administered. The nurse administers the first unit before
T T T T T T T T T T T T T T T
discovering that the client is a Jehovah’s Witness, as documented in the record. This is an
T T T T T T T T T T T T T T T T
example of T
a. professional conduct. T
b. a negligent act.
T T
c. physical abuse. T
d. breaching client confidentiality. T T
ANS: B T
The nurse was negligent by not checking the record and by failure to obtain written consent
T T T T T T T T T T T T T T T T
from the client for the procedure. This is an example of misconduct, not professional conduct.
T T T T T T T T T T T T T T T
The nurse did not intend to physically harm the patient. The nurse did not breach client
T T T T T T T T T T T T T T T T
confidentiality.
DIF: Cognitive Level: Application REF: pp. 28- T T T T
29 TOP: Step of the Nursing Process: All phases
T T T T T T T T
MSC: Client Needs: Management of Care
T T T T T
3. Which of the following is a violation of client confidentiality? Reporting
T T T T T T T T T T
a. certain communicable diseases. T T
b. child abuse. T
c. gunshot wounds. T
d. client data to a colleague in a nonprofessional setting.
T T T T T T T T
ANS: D T
Releasing information to people not directly involved in the client’s care is a breach of
T T T T T T T T T T T T T T T
confidentiality. Certain communicable or sexually transmitted diseases, child and elder abuse,
T T T T T T T T T T T
and the potential for serious harm to another individual are considered exceptions to sharing
T T T T T T T T T T T T T T
of confidential information.
T T
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, DIF: Cognitive Level: Knowledge REF: p. T T T T
37 TOP: Step of the Nursing Process: All phases
T T T T T T T T
MSC: Client Needs: Management of Care
T T T T T
4. A 16-year-old trauma victim arrives in the emergency department with a life-threatening
T T T T T T T T T T T T
condition and requires emergency surgery. The nurse knows that
T T T T T T T T
a. a parent/guardian must give consent.
T T T T
b. the client can give consent if she provides proof of emancipation.
T T T T T T T T T T
c. the client must first be evaluated for competency before obtaining consent.
T T T T T T T T T T
d. surgery can be performed without consent. T T T T T
ANS: D T
Surgery can be performed without consent because it is a life-threatening emergency.
T T T T T T T T T T T T
Normally parents or a guardian must give consent, but in a life-threatening emergency
T T T T T T T T T T T T T
medical care can be administered without consent. Providing proof of emancipation is not
T T T T T T T T T T T T T
necessary in a life-threatening situation. The client does not need to first be evaluated for
T T T T T T T T T T T T T T T
competency in a life-threatening situation. T T T T
DIF: Cognitive Level: Application REF: p. T T T T
38 TOP: Step of the Nursing Process: All phases
T T T T T T T T
MSC: Client Needs: Management of Care
T T T T T
5. In regard to informed consent, which of the following statements is true?
T T T T T T T T T T T
a. Only legally incompetent adults can give consent.
T T T T T T
b. Only parents can give consent for minor children.
T T T T T T T
c. It is not required that the client be told about costs and alternatives to treatment.
T T T T T T T T T T T T T T
d. Consent must be voluntary. T T T
ANS: D T
For legal consent to be valid, it must be voluntary. Only legally competent adults can give
T T T T T T T T T T T T T T T T
consent. Parents or legal guardians can give consent for minor children. Clients must have full
T T T T T T T T T T T T T T T
disclosure about risks/benefits, including costs and alternatives.
T T T T T T
DIF: Cognitive Level: Knowledge REF: p. T T T T
37 TOP: Step of the Nursing Process: All phases
T T T T T T T T
MSC: Client Needs: Management of Care
T T T T T
6. The client has a living will in which he states he does not want to be kept alive by artificial
T T T T T T T T T T T T T T T T T T T T
means. The client’s family wants to disregard the client’s wishes and have him maintained on
T T T T T T T T T T T T T T T
artificial life support. The most appropriate initial course of action for the nurse would be to
T T T T T T T T T T T T T T T
a. tell the family that they have no legal rights.
T T T T T T T T
b. tell the family that they have the right to override the living will because the
T T T T T T T T T T T T T T T
patient cannot speak. T T
c. report the situation to the hospital ethics committee.
T T T T T T T
d. allow the family to verbalize their feelings and concerns, while maintaining the
T T T T T T T T T T T T
role of client advocate. T T T
ANS: D T
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, Allowing the family to verbalize their feelings and concerns is the most appropriate action at
T T T T T T T T T T T T T T T
the time to help the family deal with their loss and come to terms with their family member’s
T T T T T T T T T T T T T T T T T T
wishes. Telling the family that they have no legal rights would not be supportive and might
T T T T T T T T T T T T T T T T
create hostility. The family does not have the right to override a living will. It is not the most
T T T T T T T T T T T T T T T T T T T
appropriate initial course of action to report the situation to the hospital ethics committee.
T T T T T T T T T T T T T
According to the American Nurses Association Code of Ethics for Nurses, the nurse
T T T T T T T T T T T T T
promotes, advocates for, and strives to protect the health, safety, and rights of the patient.
T T T T T T T T T T T T T T
DIF: Cognitive Level: Analysis REF: p. T T T T
27 TOP: Step of the Nursing Process: Implementation
T T T T T T T T
MSC: Client Needs: Management of Care
T T T T T
7. The nurse collects both objective and subjective data. An example of subjective data is
T T T T T T T T T T T T T
a. BP 140/80. T
b. skin color jaundiced. T T
c. “I have a headache.”
T T T
d. history of seizures. T T
ANS: C T
Subjective data refers to the client’s perception of data and what the client or family says
T T T T T T T T T T T T T T T T
about the data. Objective data refers to data that are directly observable or verifiable through
T T T T T T T T T T T T T T T
physical examination or tests. Blood pressure recording is objective. Jaundiced skin color
T T T T T T T T T T T T
observation by the nurse is objective data. A history of seizures is objective data.
T T T T T T T T T T T T T
DIF: Cognitive Level: Knowledge REF: p. T T T T
33 TOP: Step of the Nursing Process: Assessment
T T T T T T T
MSC: Client Needs: Physiological Integrity
T T T T
8. The nurse observes a client pacing the floor. The nurse validates an inference when speaking
T T T T T T T T T T T T T T T
to the client by stating,
T T T T
a. “You are anxious, so let’s talk about it.”
T T T T T T T
b. “Let’s try some deep breathing to help you relax.”
T T T T T T T T
c. “You seem anxious. Will you tell me what is going on?”
T T T T T T T T T T
d. “Clients who pace usually need to talk to a physician. Should I call yours?”
T T T T T T T T T T T T T
ANS: C T
The nurse has inferred that the client is anxious but needs to ask further questions to validate
T T T T T T T T T T T T T T T T T
the information. A nurse should not make assumptions without first confirming that the
T T T T T T T T T T T T T
inference is correct. Deep breathing exercise is an intervention; it is not validating an
T T T T T T T T T T T T T T
inference.
DIF: Cognitive Level: Application REF: p. T T T T
33 TOP: Step of the Nursing Process: Assessment
T T T T T T T
MSC: Client Needs: Psychosocial Integrity
T T T T
9. A client who is scheduled for a bilateral inguinal hernia repair the next day is observed pacing
T T T T T T T T T T T T T T T T T
the unit. After validating that the client is anxious about his upcoming surgery because he is
T T T T T T T T T T T T T T T T
afraid of pain, a relevant nursing diagnosis would be
T T T T T T T T
a. anxiety related to surgery. T T T
b. pain related to anxiety about surgery as evidenced by pacing.
T T T T T T T T T
c. anxiety related to fear of postoperative pain as evidenced by pacing.
T T T T T T T T T T
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