NSC 242 EXAM 2 QUESTIONS WITH
100% CORRECT ANSWERS
What are some things nurses can do for communicating with families - Answer- Asses
level of readiness to accept the finality of the situation
It is normal for impending death to affect different family members in different ways
Unfinished business
Memory making
Providing information: give hope. Give accurate information. Ask questions. Reassure.
Inform and document for the benefit of other members of the team.
Family conferences
What are some things information needs? - Answer- Honest complete answers,
repetition and further explanation
Updated as they occur
Clear, understandable explanations delivered with empathy and respect
Frequent opportunities to express concerns
Information about what to expect
Legal issues: funeral planning
Appreciation of the complexity of their experience
Permission to leave the dying client with the knowledge that the nurse will contact the
family member with any changes
What are some cross cultural considerations - Answer- Autonomy vs collectivism
Attitudes towards advance directives
Code status
Disclosure of information: passwords
Choice of words during conferences: "passing away" "home going" "dying" "dead"
"gone" and clinical jargon
Reliance on physician as ultimate authority
Views on suffering
Role of religion/ spirituality
How does the nurse incorporate cultural and spiritual needs - Answer- ASSESS: do you
have any cultural or spiritual beliefs they need to be part of your care, how do you feel
about visitors, who can receive information, how much does the client know, what have
you been told, would you life to soak to s physician
CONSPIRACY OF SILENCE: protecting the client and avoiding hopelessness
,What do you need to know for the process of transitioning - Answer- Death and the
dying process often heralds a spiritual/ existential crisis
Faith, hope, meaning are all called into question
Respect and support the client and family's spiritual beliefs ( or lack thereof)- spirituality
vs religiosity
Be with the client and family as their needs arise
Allow for silence and for privacy
Provide information as client declines
Always be available
therapeutic relationship - Answer- Professional interpersonal alliance based on
mutuality.Each Interaction is unique because disease, response and context differ
therapeutic relationships are facilitated by what? - Answer- Facilitated by empathy,
Requires an integration of the nurse's focus and the client's focus creating a common
ground. w/o this effective decision making is limited.
what are the 7 goals of therapeutic relationships? - Answer- 1. Support clients and
families to understand the client's experience of an illness.
2. Provide support to help clients and families make health care decisions
3. Assist clients to cope and find meaning in their illness
4. Connect clients and families with other members of the team
5. Empower clients with knowledge and tools they need to navigate and negotiate their
care
6. Helping clients and their families learn practical strategies o effectively self manage
chronic health conditions
7. helping clients discover new directions in line with their interests and capabilities.
Client Centered Care (CCC) - Answer- An approach to practice established through the
formation and fostering of therapeutic relationships between all care providers.
what is the focus of client centered care? - Answer- Focuses on individual preferences,
values, beliefs and needs as fundamental considerations. core value in health care
delivery.
what are the guiding principles of client centered care? - Answer- Presence, Purpose,
Positive Regard, Mutuality, Authenticity, Empathy, Respect for the dignity of the person
& Confidentiality (these strengthen the healing influence of a therapeutic relationship)
Review 4 ways of knowing (empirical, personal, aesthetic & ethical) helps nurse guide
patient in client centered care - Answer-
authenticity - Answer- therapeutic use of self in nurse/ Pt. relationship. genuineness,
requires self awareness; it means recognizing and acknowledging your personal
vulnerabilities, strengths, and limitations; ex: nurse realized that the respiratory therapist
, would be better equipped to explain the process of weaning the client from a ventilator;
she arranged for the therapist to explain it and she provided her support by staying w/
client during the explanation; requires admitting mistakes like forgetting a med.
empathy - Answer- the ability to be sensitive to and communicate understanding of the
client's feelings. putting yourself in their position (don't have to remember this def., just
know in case he ask a situation about client centered care)
mutuality - Answer- Experience of real or symbolic commonalities of visions, goals,
sentiments, or characteristics, including shared acceptance of difference that validates
the person's worldview. Sharing of collective knowledge
what is another definition for mutuality? - Answer- An on-going sharing of knowledge
between healthcare professionals and shared decision making helps ensure patient
satisfaction. basically means that the nurse and the Pt. agree on the client's health
problems and the means for resolving them and that both parties are committed to
enhancing the client's well-being.
veracity - Answer- when clients know they can expect the truth, the development of trust
is promoted and helps build the relationship
presence - Answer- to expose themselves to the client's and their own experiences,
being there and being with; examples- active listening, sharing of skills, full attention of
the nurse for the Pt.
self- awareness - Answer- not the same as authenticity; nurse needs to know that parts
of the relationship with the Pt. may be painful, distasteful or uncomfortable. nurses need
to be clear about their personal beliefs, values, stereotypes and personal perspectives
bc of their potential influence on client;
Validation - Answer- Consciously seeking out our clients' opinions and feelings at each
phase of the nursing process.
Unearthing any questions or concerns our clients have about plans for their healthcare
and securing their understanding and willingness to proceed to the next step
what 4 things does validation do for the nurse/client relationship? - Answer- 1. Makes
the difference between problem solving for clients and mutual problem solving with
clients
2. Keeps us focused on the rights and obligations of clients to make their own decisions
about their health
3. Must be incorporated at each step of the problem-solving process in nursing
4. Stops us from moving too quickly and "doing" to our clients
what are the four phases of therapeutic relationships? - Answer- Preinteraction Phase,
Orientation Phase- Identification Phase (under the orientation phase), Exploitation
Phase(working phase) & resolution phase
100% CORRECT ANSWERS
What are some things nurses can do for communicating with families - Answer- Asses
level of readiness to accept the finality of the situation
It is normal for impending death to affect different family members in different ways
Unfinished business
Memory making
Providing information: give hope. Give accurate information. Ask questions. Reassure.
Inform and document for the benefit of other members of the team.
Family conferences
What are some things information needs? - Answer- Honest complete answers,
repetition and further explanation
Updated as they occur
Clear, understandable explanations delivered with empathy and respect
Frequent opportunities to express concerns
Information about what to expect
Legal issues: funeral planning
Appreciation of the complexity of their experience
Permission to leave the dying client with the knowledge that the nurse will contact the
family member with any changes
What are some cross cultural considerations - Answer- Autonomy vs collectivism
Attitudes towards advance directives
Code status
Disclosure of information: passwords
Choice of words during conferences: "passing away" "home going" "dying" "dead"
"gone" and clinical jargon
Reliance on physician as ultimate authority
Views on suffering
Role of religion/ spirituality
How does the nurse incorporate cultural and spiritual needs - Answer- ASSESS: do you
have any cultural or spiritual beliefs they need to be part of your care, how do you feel
about visitors, who can receive information, how much does the client know, what have
you been told, would you life to soak to s physician
CONSPIRACY OF SILENCE: protecting the client and avoiding hopelessness
,What do you need to know for the process of transitioning - Answer- Death and the
dying process often heralds a spiritual/ existential crisis
Faith, hope, meaning are all called into question
Respect and support the client and family's spiritual beliefs ( or lack thereof)- spirituality
vs religiosity
Be with the client and family as their needs arise
Allow for silence and for privacy
Provide information as client declines
Always be available
therapeutic relationship - Answer- Professional interpersonal alliance based on
mutuality.Each Interaction is unique because disease, response and context differ
therapeutic relationships are facilitated by what? - Answer- Facilitated by empathy,
Requires an integration of the nurse's focus and the client's focus creating a common
ground. w/o this effective decision making is limited.
what are the 7 goals of therapeutic relationships? - Answer- 1. Support clients and
families to understand the client's experience of an illness.
2. Provide support to help clients and families make health care decisions
3. Assist clients to cope and find meaning in their illness
4. Connect clients and families with other members of the team
5. Empower clients with knowledge and tools they need to navigate and negotiate their
care
6. Helping clients and their families learn practical strategies o effectively self manage
chronic health conditions
7. helping clients discover new directions in line with their interests and capabilities.
Client Centered Care (CCC) - Answer- An approach to practice established through the
formation and fostering of therapeutic relationships between all care providers.
what is the focus of client centered care? - Answer- Focuses on individual preferences,
values, beliefs and needs as fundamental considerations. core value in health care
delivery.
what are the guiding principles of client centered care? - Answer- Presence, Purpose,
Positive Regard, Mutuality, Authenticity, Empathy, Respect for the dignity of the person
& Confidentiality (these strengthen the healing influence of a therapeutic relationship)
Review 4 ways of knowing (empirical, personal, aesthetic & ethical) helps nurse guide
patient in client centered care - Answer-
authenticity - Answer- therapeutic use of self in nurse/ Pt. relationship. genuineness,
requires self awareness; it means recognizing and acknowledging your personal
vulnerabilities, strengths, and limitations; ex: nurse realized that the respiratory therapist
, would be better equipped to explain the process of weaning the client from a ventilator;
she arranged for the therapist to explain it and she provided her support by staying w/
client during the explanation; requires admitting mistakes like forgetting a med.
empathy - Answer- the ability to be sensitive to and communicate understanding of the
client's feelings. putting yourself in their position (don't have to remember this def., just
know in case he ask a situation about client centered care)
mutuality - Answer- Experience of real or symbolic commonalities of visions, goals,
sentiments, or characteristics, including shared acceptance of difference that validates
the person's worldview. Sharing of collective knowledge
what is another definition for mutuality? - Answer- An on-going sharing of knowledge
between healthcare professionals and shared decision making helps ensure patient
satisfaction. basically means that the nurse and the Pt. agree on the client's health
problems and the means for resolving them and that both parties are committed to
enhancing the client's well-being.
veracity - Answer- when clients know they can expect the truth, the development of trust
is promoted and helps build the relationship
presence - Answer- to expose themselves to the client's and their own experiences,
being there and being with; examples- active listening, sharing of skills, full attention of
the nurse for the Pt.
self- awareness - Answer- not the same as authenticity; nurse needs to know that parts
of the relationship with the Pt. may be painful, distasteful or uncomfortable. nurses need
to be clear about their personal beliefs, values, stereotypes and personal perspectives
bc of their potential influence on client;
Validation - Answer- Consciously seeking out our clients' opinions and feelings at each
phase of the nursing process.
Unearthing any questions or concerns our clients have about plans for their healthcare
and securing their understanding and willingness to proceed to the next step
what 4 things does validation do for the nurse/client relationship? - Answer- 1. Makes
the difference between problem solving for clients and mutual problem solving with
clients
2. Keeps us focused on the rights and obligations of clients to make their own decisions
about their health
3. Must be incorporated at each step of the problem-solving process in nursing
4. Stops us from moving too quickly and "doing" to our clients
what are the four phases of therapeutic relationships? - Answer- Preinteraction Phase,
Orientation Phase- Identification Phase (under the orientation phase), Exploitation
Phase(working phase) & resolution phase
