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Terms in this set (17)
1. A nurse is caring for a patient in pain. Which nursing approach is priority?
a. Relationship-centered
b. Technology-centered
c. High tech-centered
d. Family-centered
a. Relationship-centered
It is important to preserve a relationship-centered approach to patient care for all aspects
of nursing, whether the care focuses on pain management, teaching self-care, or basic hygiene measures. While technology, high tech, and family are important, they are not the priority.
2. A nurse is providing pain medication to patients after surgery. Which component is key for the nurse's personal philosophy of nursing?
a. Caring
b. Technology
c. Informatics
d. Therapeutics
a. Caring
The
American Organization of Nurse Executives describes caring and knowledge as the core of nursing, with caring being a key component of what a nurse brings to a patient experience. While technology, informatics, and therapeutics are important, they are not the key components of nursing.
3. A nurse attends a seminar on nursing theories for caring. Which information from the nurse indicates a correct understanding of these theories?
a. Benner
identifies caring as highly connected involving patient and nurse.
b. Swanson develops four caring processes to convey caring in nursing.
c. Watson's transcultural caring views inclusion of culture as caring.
d. Leininger's theory places care before cure and is transformative.
a. Benner identifies caring as highly connected involving patient and nurse.
Benner believes caring is highly connected involving each nurse-patient encounter. Swanson
developed five caring processes, not four. Watson's theory places care before cure and is transformative, whereas Leininger's transcultural caring views inclusion of culture as caring.
4. The patient has a colostomy but has not yet been able to look at it. The nurse teaches the patient how to care for the colostomy. The nurse sits with the patient, and together they form a plan on how to approach dealing with colostomy care. Which caring process is
the nurse performing?
a. Knowing
b. Doing for
c. Enabling
d. Maintaining belief
c. Enabling
Enabling is facilitating another's passage through a life transition and unfamiliar events. Working with the patient to find alternate ways to perform the task is doing just that. Knowing is striving to understand an event because it has meaning in the life of another. This must be done before enabling can occur. Doing for is doing for the other as he or she would do for self if it were at all possible. The nurse in this situation is not doing for the patient but is teaching/informing on how to care for the colostomy. Maintaining belief is sustaining faith in the other's capacity to get through an event or transition and face a future with meaning. This may be an underlying theme to the process but is not what the nurse is actually doing.
5. A nurse is using Watson's model to provide care to
patients. Which carative factor will the nurse use?
a. Maintaining belief
b. Instilling faith-hope
c. Maintaining ethics
d. Instilling values
b. Instilling faith-hope
Watson has 10 carative factors, one of which is instilling faith-hope. Maintaining belief is a caring process of Swanson's theory. Ethics and values are important in caring but they are not examples of Watson's carative factors.
6. A
nurse provides care that is receptive to patients' and families' perceptions of caring. Which action will the nurse take?
a. Provides clear, accurate information
b. Just performs nursing tasks competently
c. Does as much for the patient as possible
d. Focuses solely on the patient's diagnosis
a. Provides clear, accurate information
Research indicates caring behaviors of nurses from the patient's/families' perspective include the following: (1)
Providing honest, clear, and accurate information; (2) asking permission before doing something to a patient; (3) helping patients do as much for themselves as possible; and (4) teaching the family how to keep the relative physically comfortable. Patients continue to value nurses' effectiveness in performing tasks, but clearly patients
7. A nurse follows the "ethics of care" when working with patients. Which action will the nurse take?
a.
Becomes the patient's advocate based on the patient's wishes
b. Makes decisions for the patient solely using analytical principles
c. Uses only intellectual principles to determine what is best for the patient
d. Ignores unequal family relationships since that is a personal matter for the family
a. Becomes the patient's advocate based on the patient's wishes
An ethic of care places the nurse as the patient's advocate, solving ethical dilemmas by
attending to relationships and by giving priority to each patient's unique personhood. An ethic of care is unique so that professional nurses do not make professional decisions based solely on intellectual or analytical principles. Instead, an ethic of care places "caring" at the center of decision making. Nurses who function from an ethic of care are sensitive to unequal relationships that lead to abuse of one person's power over another—intentional or otherwise.
8. A nurse is providing presence to a patient and the family. Which nursing action does this involve?
a. Focusing on the task that needs to be done
b. Providing closeness and a sense of caring
c. Jumping in to provide patient comfort
d. Being there without an identified goal
b. Providing closeness and a sense of caring
Providing presence is a person-to-person encounter conveying closeness and a sense of caring. "Being there" seems to depend on the fact that a nurse is attentive to the patient more than the task. "Being with" means being available and at the patient's disposal. If the patient accepts the nurse, the nurse will be invited to see, share, and touch the patient's vulnerability and suffering. Jumping in may not be welcomed. Being there is something the nurse offers to the patient with the purpose of achieving some patient care goal.
9. The patient is
afraid to have a thoracentesis at the bedside. The nurse sits with the patient and asks about the fears. During the procedure, the nurse stays with the patient, explaining each step and providing encouragement. What is the nurse displaying?
a. Providing touch
b. Providing a presence
c. Providing family care
d. Providing a listening ear
b. Providing a presence
The nurse's presence helps to calm anxiety and fear related to stressful situations.
Giving reassurance and thorough explanations about a procedure, remaining at the patient's side, and coaching the patient through the experience all convey a presence that is invaluable to the patient's well-being. Listening and touch can be part of the "presence" but are not its entirety. No family was involved in this scenario.
10. The patient is terminal and very near death. When the nurse checks the patient and finds no pulse or blood pressure,
the family begins sobbing and hugging each other. Some family members hold the patient's hand. The nurse is overwhelmed by the presence of grief and leaves the room. What is the nurse demonstrating?
a. Caring touch
b. Protective touch
c. Therapeutic touch
d. Task-oriented touch
b. Protective touch
Protective touch is also a kind of touch that protects the nurse emotionally. A nurse withdraws or distances herself or himself from a patient when
he or she is unable to tolerate suffering or needs to escape from a situation that is causing tension. Caring touch is a form of nonverbal communication that influences a patient's comfort and security, enhances self-esteem, and improves mental well-being. Therapeutic touch is a type of alternative therapy for healing. Task-oriented touch is done when performing a task or procedure.
11. Which action indicates a nurse is using caring touch with a
patient?
a. Inserts a catheter
b. Rubs a patient's back
c. Prevents a patient from falling
d. Administers an injection
b. Rubs a patient's back
Caring touch is the way a nurse holds a patient's hand, gives a back massage, or gently positions a patient. Touch that occurs when tasks are being performed, such as insertion of a catheter or administering an injection, is known as "task-oriented touch." Touch used to protect the patient (holding and
bracing a patient to avoid a fall) or nurse (withdraws from tension-filled situations) is known as "protective touch."
12. The nurse is caring for a patient who has been sullen and quiet for the past three days. Suddenly, the patient says, "I'm really nervous about surgery tomorrow, but I'm more worried about how it will affect my family." What should the nurse do first?
a. Assure the patient that everything will be all right.
b. Tell the
patient that there is no need to worry.
c. Listen to the patient's concerns and fears.
d. Inform the patient a social worker is available.
c. Listen to the patient's concerns and fears.
Listening to the meaning of what a patient says helps create a mutual relationship. Assuring and telling a patient not to worry are not truly listening; these do not convey listening. Although contacting a social worker could be an appropriate measure for this
patient, the nurse should first listen to what the patient is saying.
13. The patient is about to undergo a certain procedure and has voiced concern about outcomes and prognosis. The nurse caring for the patient underwent a similar procedure and stops to listen. Which response by the nurse may be most beneficial?
a. "I had a similar procedure and I can tell you what I went through."
b. "I think you'll be all right, but, of course, there are
no sure guarantees."
c. "I don't think you have anything to worry about. They do lots of these."
d. "I can call the doctor and cancel the procedure, if you are really concerned."
a. "I had a similar procedure and I can tell you what I went through."
When an ill person chooses to tell his story, it involves reaching out to another human being. Telling the story implies a relationship that develops only if the clinician exchanges his or her stories as
well. Professionals do not routinely take seriously their own need to be known as part of a clinical relationship. Yet, unless the professional acknowledges this need, there is no reciprocal relationship, only an interaction. Offering false reassurances and cliches, telling not to worry, or offering to cancel the procedure does not open up that relationship and dismisses the patient's concerns.
14. In making rounds, the nurse meets a patient for
the first time. The nurse asks the patient when morning medications are taken, such as before breakfast, after breakfast, or during breakfast. What does knowing the patient allow the nurse to do?
a. Choose the most appropriate time to give the medication.
b. Know what information to put on the medication error report form.
c. Explain to the patient that the medication will not be given at the usual time.
d. Evaluate whether or not the patient is taking the medication correctly at
home.
a. Choose the most appropriate time to give the medication.
"Knowing the patient" is at the core of the process nurses use to make clinical decisions. Knowing when the patient normally takes the medication will allow the nurse to keep the patient on as near normal a schedule as possible. Nothing in this question infers that the patient will not get the medications on time or that a medication error report will need to be completed. Although the nurse
can evaluate whether or not the patient is taking the medication correctly at home, the main purpose, within this scenario, is to determine the most appropriate time to administer the medication.
1. A nurse cares for patients. Which areas does caring influence? (Select all that apply.)
a. The way in which patients feel
b. The way in which patients learn
c. The way in which patients think
d. The way in which patients study
e. The way
in which patients behave
a. The way in which patients feel
c. The way in which patients think
e. The way in which patients behave
2. Which actions by the nurse should be done in order to get to know the patient? (Select all that apply.)
a. Avoid assumptions
b. Focus on the patient
c. Engage in a caring relationship
d. Form the relationship very quickly
e. Not address spiritual or higher
needs
a. Avoid assumptions
b. Focus on the patient
c. Engage in a caring relationship
To know a patient means that the nurse avoids assumptions, focuses on the patient, and engages in a caring relationship with the patient that reveals information and cues that facilitate critical thinking and clinical judgments. Knowing develops over time as a nurse learns the clinical conditions within a specialty and the behaviors and physiological responses of patients.
3. Which actions by the nurse indicate compassion and caring to patients? (Select all that apply.)
a. Saying "I'm here"
b. Including the family in care
c. Staying with the patient during a bedside test
d. Relying on monitors and technology
e. Refining work processes on the unit
a. Saying "I'm here"
b. Including the family in care
c. Staying with the patient during a bedside
Our patients tell us that a simple touch, a simple phrase, "I'm here," or a promise to remain at the bedside represent caring and compassion. Caring for an individual cannot occur in isolation from that person's family. As a nurse it is important to know the family almost as thoroughly as you know a patient. A reliance on technology and cost-effective health care strategies and efforts to standardize and refine work processes all undermine the nature of caring.
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