(Test Bank) Interpersonal Relationships - Professional Communication Skills for Nurses

Arnold,Boggs, 8

Medicine

Test Bank

8th Edition

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Author(s): Arnold, Boggs

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TEST BANK INTERPERSONAL RELATIONSHIPS 8TH EDITION Professional Communication Skills for Nurses By: Elizabeth Arnold & Kathleen Boggs Interpersonal Relationships 8th Edition : Professional Communication Skills for Nurses by Arnold Test Bank Chapters Contents: Chapter 1. Historical Perspectives and Contemporary Dynamics Chapter 2. Clarity and Safety in Communication Chapter 3. Professional Guides for Nursing Communication Chapter 4. Critical Judgment: Critical Thinking and Ethical Decision Making Chapter 5. Developing Patient Centered Communication Skills Chapter 6. Variation in Communication Styles Chapter 7. Intercultural Communication Chapter 8. Communicating in Groups Chapter 9. Self-Concept in Professional Interpersonal Relationships Chapter 10. Developing Patient Centered Therapeutic Relationships Chapter 11. Bridges and Barriers in Therapeutic Relationships Chapter 12. Communicating with Families Chapter 13. Resolving Conflicts Between Nurse and Patient Chapter 14. Communication Strategies for Health Promotion and Disease Prevention Chapter 15. Communication in Health Teaching and Coaching Chapter 16. Communication in Stressful Situations Chapter 17. Communicating with Patients Experiencing Communication Deficits Chapter 18. Communicating with Children Chapter 19. Communicating with Older Adults Chapter 20. Communicating with Patients in Crisis Chapter 21. Communication in Palliative Care Chapter 22. Role Relationship Communication within Nursing Chapter 23. Interprofessional Communication Chapter 24. Communicating for Continuity of Care Chapter 25. Documentation in Health Information Technology Systems Chapter 26. Health and Communication Technology Interpersonal Relationships 8th Edition : Professional Communication Skills for Nurses by Arnold Test Bank Chapter 01: Historical Perspectives and Contemporary Dynamics Arnold: Interpersonal Relationships, 8th Edition MULTIPLE CHOICE 1. When describing nursing to a group of nursing students, the nursing instructor lists all of the following characteristics of nursing except a. Historically nursing is as old as mankind. b. Nursing was originally practiced informally by religious orders dedicated to care ofthe sick. c. Nursing was later practiced in the home by female caregivers with no formaleducation. d. Nursing has always been identifiable as a distinct occupation. ANS: A Historically, nursing is as old as humankind. Originally practiced informally by religious orders dedicated to care of the sick and later in the home by female caregivers with no formal education, nursing was not identifiable as a distinct occupation until the 1854 Crimean War. There, Florence Nightingale’s Notes on Nursing introduced the world to the functional roles of professional nursing and the need for formal education. DIF: Cognitive Level: Comprehension TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Psychosocial Integrity 2. The nursing profession’s first nurse researcher, who served as an early advocate forhigh -quality care and used statistical data to document the nOeed for hand washing in preventing infection was? a. Abraham Maslow. b. Martha Rogers. c. Hildegard Peplau. d. Florence Nightingale. ANS: D An early advocate for high -quality care, Florence Nightingale’s use of statistical data to document the need for hand washing in preventing infection marks her as the profession’s first nurse researcher. DIF: Cognitive Level: Knowledge TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 3. Today, professional nursing education begins at the a. Undergraduate level. b. Graduate level. c. Advanced practice level. d. Administrative level. ANS: A Interpersonal Relationships 8th Edition : Professional Communication Skills for Nurses by Arnold Test Bank Today, professional nursing education begins at the undergraduate level, with a growing number of nurses choosing graduate studies to support differentiated practice roles and/or research opportunities. Nurses are prepared to function as advanced practice nurse practitioners, administrators, and educators. DIF: Cognitive Level: Comprehension TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 4. Nursing’s metaparadigm, or worldview, distinguishes the nursing profession from other disciplines and emphasizes its unique functional characteristics. The four key concepts that form the foundation for all nursing theories are a. Caring, compassion, health promotion, and education. b. Respect, integrity, honesty, and advocacy. c. Person, environment, health, and nursing. d. Nursing, teaching, caring, and health promotion. ANS: C Individual nursing theories represent different interpretations of the phenomenon of nursing, but central constructs —person, environment, health, and nursing —are found in all theories and models. They are referred to as nursing’s metaparadigm . DIF: Cognitive Level: Knowledge TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 5. When admitting a patient to the medical -surgical unit, the nurse asks the patient about cultural Issues. The nurse is demonstrating use of the concept of a. Person. b. Environment . c. Health. d. Nursing. ANS: B The concept of environment includes all cultural, developmental, and social determinants that influence a patient’s health perceptions and behavior. A person is defined as the recipient of nursing care, having unique bio -psycho -social and spiritual dimensions. The word health derives from the word whole. Health is a multidimensional concept, having physical, psychological, sociocultural, developmental, and spiritual characteristics. The Worl d Health Organization (WHO, 1946) defines health as “a state of complete physical, mental, social well-being, not merely the absence of disease or infirmity.” Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled, and dying people. DIF: Cognitive Level: Application TOP: Step of the Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 6. A young mother tells the nurse, “I’m worried because my son needs a blood transfusion. I don’t know what to do, because blood transfusions cause AIDS.” Which central nursing construct is represented in this situation? a. Environment b. Caring c. Health d. Person Interpersonal Relationships 8th Edition : Professional Communication Skills for Nurses by Arnold Test Bank ANS: D The concept of environment includes all cultural, developmental, and social determinants that influence a patient’s health perceptions and behavior. Caring is not one of the four central nursing constructs. The word health derives from the word whole. Health is a multidimensional concept, having physical, psychological, sociocultural, developmental, and spiritual characteristics. The World Health Organization (WHO, 1946) defines health as “a state of complete physical, mental, social well -being, not merely the abse nce of disease or Infirmity.” Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled, and dying people. Person is defined as the recipient of nursing care, having unique bio-psycho -social and spiritual dimensions. DIF: Cognitive Level: Application TOP: Step of the Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity 7. The nurse performs a dressing change using sterile technique. This is an example of which pattern of knowledge? a. Empirical b. Personal c. Aesthetic d. Ethical ANS: A Empirical knowledge is the scientific rationale for skilled nursing interventions. Personal ways of knowing allow the nurse to understand and treat each individual as a unique person. Aesthetic ways of knowing allow the nurse to connect in different and more meaningful ways. Ethical ways of knowing refer to the moral aspects of nursing. DIF: Cognitive Level: Comprehension TOP: Step of the Nursing Process: Implementation MSC: Client Needs: Management of Care 8. The nurse -patient relationship as described by Hildegard Peplau a. Would not be useful in a short -stay unit. b. Allows personal and social growth to occur only for the patient. c. Facilitates the identification and accomplishment of therapeutic goals. d. Focuses on maintaining a personal relationship between the nurse and the patient. ANS: C Hildegard Peplau offers the best -known nursing model for the study of interpersonal relationships in health care. Her model describes how the nurse -patient relationship can facilitate the identification and accomplishment of therapeutic goals to enhance patient and family well-being. In contemporary practice, Peplau’s framework is more applicable today in longer term relationships, and in settings such as rehabilitation cente rs, long -term care, and nursing homes. Despite the brevity of the alliances in acute care settings, basic principles of being a participant observer in the relationship, building rapport, developing a working partnership, and terminating a relationship rem ain relevant. DIF: Cognitive Level: Knowledge TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Psychosocial Integrity 9. The identification phase of the nurse -patient relationship a. Sets the stage for the rest of the relationship. Interpersonal Relationships 8th Edition : Professional Communication Skills for Nurses by Arnold Test Bank b. Correlates with the assessment phase of the nursing process. c. Focuses on therapeutic goals to enhance patient and family well-being. d. Uses community resources to help resolve health care issues. ANS: C Hildegard Peplau offers the best -known nursing model for the study of interpersonal relationships in health care. Her model describes how the nurse -patient relationship can facilitate the identification and accomplishment of therapeutic goals to enhance patient and family well-being. DIF: Cognitive Level: Knowledge TOP: Step of the Nursing Process: Implementation MSC: Client Needs: Management of Care 10. Which of the following is NOT a specific way interpersonal health communication impacts health care service quality? a. More effective diagnosis and earlier recognition of health changes. b. Better understanding of the patient’s condition. c. Development of a workable treatment partnership. d. Each communicator constructs a mental picture of the other during the conversation. ANS: D Communication between health care providers and patients impacts the way care is delivered; it is as important as the care itself. Outcomes of effective interpersonal communication in health care relate to higher patient satisfaction and productive health changes. DIF: Cognitive Level: Applying TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 11. Which of the following statements about communication theory is true? a. Primates are able to learn new languages to share ideas and feelings. b. Concepts include only verbal communication. c. Perceptions are clarified through feedback. d. Past experience does not influence communication. ANS: C Feedback is the only way to know that one’s perceptions about meanings are valid. Human communication is unique. Only human beings have large vocabularies and are capable of learning new languages as a means of sharing their ideas and feelings. Communicati on includes language, gestures, and symbols to convey intended meaning, exchange ideas and feelings, and to share significant life experience. To encode a message appropriately requires a clear understanding of the receiver’s mental frame of reference (e.g ., feelings, personal agendas, past experiences) and knowledge of its purpose or intent of the communication. DIF: Cognitive Level: Knowledge TOP: Step of the Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 12. In the circular transactional model of communication, a. Questions are framed in order to recognize the context of the message. b. People take only complementary roles in the communication. c. The context of the communication is unimportant. d. The purpose of communication is to influence the receiver. Interpersonal Relationships 8th Edition : Professional Communication Skills for Nurses by Arnold Test Bank ANS: A A circular model expands linear models to include the context of the communication, feedback loops, and validation. With this model, the sender and receiver construct a mental picture of the other, which influences the message and includes perceptions of the other person’s attitude and potential reaction to the message. DIF: Cognitive Level: Comprehension TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Psychosocial Integrity 13. The nurse recognizes that feedback loops a. Do not allow for correction of original information. b. Are solely based on the General Systems Theory. c. Do not allow for validation of information. d. Allow the human system to correct its original information. ANS: D Feedback (from the receiver or the environment) allows the system to correct or maintain its original information. Feedback loops (from the receiver, or the environment) validate the information, or allow the human system to correct its original information. General Systems Theory, initially described by Ludwig von Bertalanffy (1968), focuses on process and Interconnected relationships comprising the “whole.” DIF: Cognitive Level: Knowledge TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Psychosocial Integrity 14. Which of the following statements best represents therapeutic communication when a student disco vers a patient crying in nbedr? a. “I am the nurse who will be doing your treatments today.” b. “Will you listen to me so I can help you get better?” c. “This is what is going to happen during surgery.” d. “Can we talk about what seems to be bothering you?” ANS: D Asking about what is bothering the patient is goal directed. Its purpose is to promote patient well-being. “I am the nurse who will be doing your treatments today” is a statement of fact, and it ignores the patient’s emotional needs. “Will you listen to me so I can help you get Better?” Is not goal directed and does not involve mutuality. “This is what is going to happen during surgery” is simply one way. It does not engage the patient in a therapeutic manner. DIF: Cognitive Level: Application TOP: Step of the Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 15. The central constructs of person, environment, health, and nursing are found in all nursing theories and models and are referred to as a. Telehealth. b. The medical model. c. Nursing’s metaparadigm. d. Five core areas of competency. ANS: C Interpersonal Relationships 8th Edition : Professional Communication Skills for Nurses by Arnold Test Bank Individual nursing theories represent different interpretations of the phenomenon of nursing, but central constructs —person, environment, health, and nursing —are found in all theories and models. They are referred to as nursing’s metaparadigm . These constructs are the “metalanguage” of nursing, and together they act as basic building blocks for the discipline of professional nursing. Telehealth is fast becoming an integral part of the health care system, used both as a live interactive mechanism (particularly in remote areas, where there is a scarcity of health care providers) and as a way to track clinical data. Two important outcomes are reduced health costs and increased access to care. During the last century, the bulk of professional care was delivered in acute care settings, based on the disease -focused medical model . Switching to today’s commu nity focus recognizes the fact that chronic medical conditions account for most of today’s care, with most being treated in the community. The IOM report Health professions education: A bridge to quality (2003) calls for the restructuring of clinical educa tion responsive to the 21st century health system transformation goals of providing the highest quality and safest medical care possible. This report identified five core areas of competency required to cross the bridge to quality. DIF: Cognitive Level: Comprehension TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Health Promotion and Maintenance MULTIPLE RESPONSE 1. The discipline of nursing has “a unique perspective, a distinct way of viewing all phenomena, which ultimately defines and limits the nature of its inquiry,” related to (Select all that apply.) a. Principles and laws that govern the life processes, well -being, and optimumfunctioning of human beings, sick or well. b. Patterning of human b ehanviorr iniintegractbio.ncwithmthe environm ent in critical life Situations. c. Processes by which positive changes in health status are affected. d. Processes by which negative changes in health status are affected. e. Patterning of human behavior in interaction with the environment in every life situation. f. Principles and laws that govern the life processes, well -being, and optimumfunctioning of human beings, in relation to wellness only. ANS: A, B, C Donaldson and Crowley characterize the discipline of nursing as having “a unique perspective, a distinct way of viewing all phenomena, which ultimately defines and limits the nature of its inquiry,” related to “Principles and laws that govern the life processes, Well -being, and optimum functioning of human beings, sick or well; patterning of human behavior in interaction with the environment in critical life situations; and processes by which positive changes in health status are affected.” DIF: Cognitive Level: Application TOP: Step of the Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance Interpersonal Relationships 8th Edition Arnold Test Bank Chapter 02: Clarity and Safety in Communication Arnold: Interpersonal Relationships, 8th Edition MULTIPLE CHOICE 1. A nurse manager is teaching a group of nurses about patient safety. The nurse manager teaches the nurses that safety is defined as “avoidance, prevention, and amelioration of Adverse outcomes or injurie s stemming from the process of health care itself.” What is the source of this definition? a. Hippocratic oath b. National Patient Safety Foundation c. American Association of Colleges of Nursing d. American Nurses Association’s Code of Ethics ANS: B The National Patient Safety Foundation defines safety as “avoidance, prevention, and Amelioration of adverse outcomes or injuries stemming from the process of healthcare itself.” DIF: Cognitive Level: Knowledge TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 2. When conducting an in-service on serious medical errors, the nurse teaches that nearly 70% of sentinel events are related to a. Lack of education. b. Inadequate resources. c. Minimal rest periods. d. Miscommunication. ANS: D Multiple studies have pinpointed miscommunication as a major causative agent in sentinel events, that is, errors resulting in unnecessary death and serious injury. Miscommunication is the root cause in nearly 70% of sentinel events. DIF: Cognitive Level: Understanding TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 3. When working on a nursing unit, the nurse recognizes that incomplete communication errors most often occur during a. Staff meetings. b. The night shift. c. A handoff procedure. d. Medication administration. ANS: C It is estimated that 70% of reported errors are preventable. “Preventable” means the error occurs through a medical intervention, not because of the patient’s illness. Fatigue is repeatedly cited as a factor con tributing to errors. The most common cause of error is Incomplete communication during the very many “handoffs” transferring responsibility for client care to another care provider, another unit, or agency. It is estimated that in one day a client may expe rience up to eight handoffs. Interpersonal Relationships 8th Edition Arnold Test Bank DIF: Cognitive Level: Understanding TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 4. A student nurse is learning about how to reduce errors and increase safety. The nursing instructor recognizes that further teaching is warranted when the student nurse states which of the following? a. “When communicating with patients, I will be clear.” b. “I will be timely in my communication with patients.” c. “I will promote communication with patients that is ambiguous.” d. “When communicating with patients, I will ensure the patient understood.” ANS: C Standardization of communication is an effective tool to avoid incomplete or misleading messages. Standardization needs to be institutionalized at the system level and implemented consistently at the staff level. Safe communication about patient care matte rs needs to be clear, unambiguous, timely, accurate, complete, open, and understood by the recipient to reduce errors. DIF: Cognitive Level: Analyzing TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 5. The nurse manager se ts a goal to establish a new safety culture on a hospital unit. The nurse manager recognizes that basic components in establishing a new safety culture include a. Support of effective health care teamwork. b. Encouragement of individualism. c. Discouragement of new concepts. d. Promotion of a hierarchiacal system 6. ANS: A A major international effort is underway to prioritize safety goals by improving communication about patients among his or her various providers. The aim is to reduce patient mortality, decrease medical errors, and promote effective health care teamwork. DIF: Cognitive Level: Application TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 7. A nurse attends an in-service aimed to educate staff about reporting hospital errors. The nurse demonstrates understanding when listing which of the following as being NOT consistent with creating a culture of safety? a. Creating a way to advise and compensate harmed patients b. Supporting care providers after adverse events c. Ensuring the negative consequences of disclosing errors serve as a guide d. Installing a nonpunative reporting system ANS: C Many health care providers express concern about reporting errors or near miss incidents. The system needs to be redesigned to be nonpunitive if we are to create a culture of safety. A culture of safety is characterized by installing a strong, nonpunative reporting system; supporting care providers after adverse events; and developing a method to i nform and compensate patients who were harmed. Interpersonal Relationships 8th Edition Arnold Test Bank DIF: Cognitive Level: Analyzing TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 8. When educating a newly diagnosed patient about management of diabetes mellitus, the nurse recognizes that health care –related communication a. Does not lead to errors within the hospital. b. Is generally well understood by most patients. c. Is not an important component of patient care. d. Can cause patients to misunderstand information. ANS: D It is important to make verbal and written information as simple as possible. Nurses need to assess the health literacy level of each patient. Nurses should provide privacy to avoid Embarrassment and obtain feedback or “teach -backs” to determine the patien t’s understandingof teaching: Simplify, Clarify, Verify! DIF: Cognitive Level: Understanding TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 9. A nurse manager reminds staff that if an adverse event occurs, everyone’s focus needs to be on a. How the aviation industry would handle things. b. Correcting system flaws to avoid future events. c. The fact that only a tiny fraction of unsafe care incidents are reported. d. Determining what staff member(s) made the error. ANS: B Create a new climate of safetyin which agencies, policies and employees maintain a vigilant, proactive attitude toward adverse events. Recognizing that human error occurs, everyone’s Focus needs to be on correcting system flaws to avoid future adverse events, rather thanfinding the one to blame. DIF: Cognitive Level: Application TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 10. When educating a student nurse about safety communication improvement solutions, the nursing instruc tor recognizes that additional teaching is warranted when the student nurse lists which of the following as a safety communication improvement solution? a. Adopting technology -oriented tools b. Using standardized verbal and electronic communication tools c. Disempowering patients to be partners in safer care d. Participating in team training communication seminars ANS: C While a nurse’s clinical judgment remains a valid, essential aspect of communication, other safety communication improvement solutions include using standardized verbal and electronic communications tools, participating in team -training communication seminars, adopting technology -oriented tools, and empowering patients to be partners in safer care. Communication that promotes patient safety needs to include both communication of concise critical information and active listening. DIF: Cognitive Level: Application TOP: Step of the Nursing Process: All Phases Interpersonal Relationships 8th Edition Arnold Test Bank MSC: Client Needs: Management of Care 11. The nurse is teaching the student nurse about how to use SBAR when calling a physician. The student nurse verbalizes understanding of SBAR when stating that SBAR is a. Used as a situational briefing. b. Utilized strictly within the hospital setting. c. Not used in e-mails due to HIPAA rules. d. Never recorded within the patient’s chart. ANS: A SBAR is used as a situational briefing, so the team is “on the same page.” It is used across all types of agencies, groups, and even in e -mails. SBAR simplifies verbal communication between nurses and physicians because content is presented in an expected format. Some hospitals use laminated SBAR guidelines at the telephones for nurses to use when calling physicians about changes in patient status and requests for new orders. Document ing the new order is the only part of SBAR that gets recorded. DIF: Cognitive Level: Application TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 12. A nurse recognizes that strategies for clear, accurate communication to promote patient safety include which of the following? a. Establishing a safe environment b. Maintaining a climate of closed communication c. Using unique interdisciplinary communication tools d. Using communication tools that promote vague communication ANS: A Clear, accurate communication is the bedrock of safe care. Accurate, clear communication and best practice are indicators of quality of care and serve to maintain a safe environment. DIF: Cognitive Level: Understanding TOP: Step of the Nursing Process: Al l Phases MSC: Client Needs: Management of Care 13. What tool for safer care is designed to increase cognitive decision -making skills, increase technical proficiency, and enhance teamwork, including communication skills? a. Clinical situation simulations b. SBAR c. Checklists d. Team training models ANS: A The development and refinement of communication and practice skills are provided with clinical situation simulations. Students learn in a safe low stakes simulation lab. The simulations can be low fidelity with model patients or high fidelity with computerized human patient simulators. The students can practice their communication, critical thinking and clinical judgment skills. Since the instructor is present with several students in the lab, there is a more dynamic experience than the one -on-one in clinical settings. Students should feel free to attempt assessments, get feedback and improve over time. DIF: Cognitive Level: Understanding TOP: Step of the Nursing Process: A ll Phases MSC: Client Needs: Management of Care Interpersonal Relationships 8th Edition Arnold Test Bank 14. When calling a healthcare provider, the nurse provides name, what unit and what hospital the call is being made from, the patient’s name, and that the patient is having trouble breathing. The nurse is demonstrating which step in the SBAR format for communicating with a patient’s physician? a. Situation b. Assessment c. Background d. Recommendation ANS: A An example of the situation component of SBAR reporting is: “Dr. Preston, this is Wendy Obi, evening nurse on 4G at St. Simeon Hospital, calling about Mr. Lakewood, who’s having trouble breathing.” An example of the assessment component of SBAR reporting is: “I don’t hear any breath sounds in his right chest. I think he has a pneumothorax.” An example of the background component of SBAR reporting is: “Kyle Lakewood, DOB 7/1/60, a 53 -year-old man with chronic lung disease, admitted 12/25, who has been sliding downhill  2 hours. Now he’s acutely worse: VS heart rate 92, respiratory rate 40 with gasping, B/P 138/94, oxygenation down to 72%.” An example of the recommendation component of SBAR reporting is: “I need you to see him right now. I think he needs a chest tube.” DIF: Cognitive Level: Understanding TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 15. The nurse is caring for a patient who is becoming increasingly short of breath. The nurse decides to call the physician. Which of the following should the nurse initially do when speaking with the physician? a. State the problem b. Tell what is needed c. State the patient’s allergies d. Relate the patient’s background ANS: A During the situation component of SBAR, the nurse identifies herself, the patient, and the problem. During the recommendation component of SBAR, the nurse tells what is needed. During the background component of SBAR, the nurse relates the patient’s backgr ound. DIF: Cognitive Level: Analyzing TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 16. When communicating with a patient’s physician, the nurse suggests ordering a STAT chest X-ray for a patient who is experiencing dyspnea. This is an example of which component of the SBAR format for communicating with the patient’s physician? a. Situation b. Assessment c. Background d. Recommendation ANS: D Interpersonal Relationships 8th Edition Arnold Test Bank During the recommendation component of S BAR, the nurse states an informed suggestion for the continued care of the patient by proposing an action and stating what is needed and in what time frame it needs to be completed. During the situation component of SBAR, the nurse identifies herself, the patient, and the problem. During the assessment component of SBAR, the nurse states a conclusion that is based on what she thinks is wrong. During the background component of SBAR, the nurse relates the patient’s background. DIF: Cognitive Level: Application TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 17. When a night shift nurse completes a shift, she gives a report about her patients to the oncoming day shift nurse. When beginning the report, the night shift nurse introduces herself and states her role, states the patient’s name, identifiers, age, sex, and location. Which of the following should the nurse do next? a. State critical lab reports, allergies, and alerts b. List current medications and patient’s family history c. Talk about any anticipated changes in the plan of care d. Relate patient’s chief complaint, vital signs, symptoms, and diagnosis ANS: D When using the acronym “I PASS the BATON,” the nurse should first introduce herself and state her role; then state the patient’s name, identifiers, age, sex, and location; and then go over the patient’s assessment, including the chief complaint, vital signs, symptoms, and diagnosis. The fifth step in “I PASS the BATON” is safety concerns, whi ch include critical lab reports, allergies, and alerts. The sixth step in “I PASS the BATON” is background, which includes comorbidities, previous episodes, current medications, and family history. The final step in “I PASS the BATON” is next, which the pl an is stated, including what will happen next, and includes any anticipated changes. DIF: Cognitive Level: Analyzing TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 18. When using the acronym “I PASS the BATON,” the nurse demonstrates understanding by beginning with an introduction; then stating the patient’s name, identifiers, age, sex, and location; then discussing the assessment of the patient; and then talking about a. Safety concerns related to the patient. b. The situation, including current status. c. A summary of the patient’s medications. d. A synopsis of the patient’s psychosocial needs. ANS: B After assessment, the next step using the acronym “I PASS the BATON” is situatio n, which includes current status, level of certainty, recent changes, and response to treatment. When using the acronym “I PASS the BATON,” safety concerns comes immediately after situation. A summary of the patient’s current medications occurs during the background step when using the acronym “I PASS the BATON.” A synopsis of the patient’s psychosocial needs is not part of the acronym “I PASS the BATON.” DIF: Cognitive Level: Application TOP : Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care Interpersonal Relationships 8th Edition Arnold Test Bank 19. When educating staff about how to reduce errors and increase safety, the nurse manager emphasizes the importance of communication that is (Select all that apply.) a. Clear. b. Vague. c. Timely. d. Accurate. e. Unambiguous. ANS: A, C, D, E Changes in communication to reduce errors and increase safety need to be institutionalized at the system level and implemented consistently at the staff level. Safe commu nication about patient care matters needs to be clear, unambiguous, timely, accurate, complete, open, and understood by the recipient to reduce errors. Safe communication about patient matters should be clear, not vague. DIF: Cognitive Level: Understanding TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 20. The nurse manager is educating the unit staff about ways to promote safer clinical practice. The nurse manager emphasizes that this can be done through the incorporation of which of the following? (Select all that apply.) f. Correlation g. Cooperation h. Collaboration i. Cultural sensitivity j. Communication clarity ANS: B, C Beyond individual changes to create safer climates for our patients, we need to advocate for organizational system changes. Leadership is needed to incorporate the “3 Cs,” which promote safer clinical practice:  Communication clarity  Collaboration  Cooperation DIF: Cognitive Level: Understanding TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care Interpersonal Relationships 8th Edition Arnold Test Bank Chapter 03: Professional Guides for Nursing Communication Arnold: Interpersonal Relationships, 8th Edition MULTIPLE CHOICE 1. The nurse fails to demonstrate effective communication by engaging in what activity? a. Implementing a two-way exchange of information among patients and health providers. b. Making sure that unilateral information is exchanged between patients and nurses. c. Baking sure that the expectations and responsibilities of all are clearly understood. d. Recognizing that effective communication is an active process for all involved. ANS: B Effective communication is defined as a two -way exchange of information among patients and health providers ensuring that the expectations and responsibilities of all are clearly understood. It is an active process for all involved. DIF: Cognitive Level: Applying TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 2. A preoperative assessment shows that a patient’s hemoglobin level is dropping. The anesthetist orders 3 units of blood to be administered. The nurse administers the first unit before discovering that the patient is a Jehovah’s Witness, as documented in the record. This scenario is referred to using what phrase? a. Professional conduct. b. A negligent act. c. Physical abuse. d. Breaching patient confidentiality. ANS: B The nurse was negligent by not checking the record and by failure to obtain written consent from the patient for the procedure. This is an example of misconduct, not professional conduct. The nurse did not intend to physically harm the patient. The nurse did not breach patient confidentiality. DIF: Cognitive Level: Application TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 3. Reporting what information is a violation of patient confidentiality? a. Certain communicable diseases. b. Child abuse. c. Gunshot wounds. d. Patient data in a nonprofessional setting. ANS: D Releasing information to people not directly involved in the patient’s care is a breach of confidentiality. Certain communicable or sexually transmitted diseases, child and elder abuse, and the potential for serious harm to another individual are considere d exceptions to sharing of confidential information. Interpersonal Relationships 8th Edition Arnold Test Bank U S N T DIF: Cognitive Level: Knowledge TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 4. A 16 -year-old trauma victim arrives in the emergency department with a life -threatening condition and requires emergency surgery. The nurse knows that a. A parent/guardian must give consent. b. The patient can give consent if she provides proof of emancipation. c. The patient must first be evaluated for competency before obtaining consent. d. Surgery can be performed without consent. ANS: D Surgery can be performed without consent because it is a life -threatening emergency. Normally parents or a guardian must give consent, but in a life -threatening emergency medical care can be administered without consent. Providing proof of emancipation is not necessary in a life -threatening situation. The patient does not need to first be evaluated for competency in a life -threatening situation. DIF: Cognitive Level: Application TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 5. In regard to informed consent, which of the following statements is true? a. Only legally incompetent adults can give consent. b. Only parents can give consent for minor children. c. It is not required that the patient be told about costs and alternatives to treatment. d. Consent must be voluntary. ANS: D For legal consent to be valid,Nit mrustibe gvolubn.tacry. Omnly legally competent adults can give consent. Parents or legal guardians can give consent for minor children. Patients must have Full disclosure about risks/benefits, including costs and alternatives. DIF: Cognitive Level: Knowledge TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 6. Which of the following statements does NOT adequately describe evidence -based practice? a. A conscious choice to use the most current research to provide “best care.” b. Guidelines to clinical behaviors compiled from the best current research evidence available and the expertise of clinicians. c. Translating knowledge into practice using findings from multiple empirical studies to help solve clinical problems. d. Applicat ion of standards of professional communication necessitates use of critical thinking and problem -solving skills in all aspects of care. ANS: D Each nurse is expected to be able to integrate “best current evidence” with clinical expertise and patient/family preferences and values to deliver optimum care. In developing this skill, nurses learn to determine which data are scientifically valid and useful in guiding their practice. By consulting EBP guidelines, the ability to make specific clin ical decisions about patient care is enhanced. While applying communication standards indeed requires critical thinking and problem -solving skills, it has little to do with EBP in all aspects of care. DIF: Cognitive Level: Applying TOP: Step of the Nursing Process: All Phases Interpersonal Relationships 8th Edition Arnold Test Bank N R I MSC: Client Needs: Management of Care 7. Which of the following shows the correct progression of the nursing process’ phases? a. Evaluation, implementation, outcome identification/planning, problem identification/diagnosis, assessment b. Assessment, problem identification/diagnosis, outcome identification/planning, implementation, evaluation c. Assessment, problem identification/diagnosis, outcome identification/planning, implementation, evaluation d. Problem identification/diagnosis, evaluation, assessment, implementation, outcome identification/planning ANS: C The nursing process consists of five progressive phases: assessment, problem identification and diagnosis, outcome identification and planning, implementation, and evaluation. As a dynamic, systematic clinical management tool, it functions as a primary means of directing the sequence, planning, implementation, and evaluation of nursing care to ac hieve specific health goals. Continual and timely communication is a component of each step in the nursing process. DIF: Cognitive Level: Applying TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 8. What can be defined as “a patient safety issue", , but primarily a legal right protected by common law and “case law” and “giving care acquiescence knowing the purpose, the extents of the risks and benefits, and possible alternatives of treatment”? a. Evidence -based practice (EDP) b. Mandatory reporting c. Informed consent d. Privacy cautions ANS: C Informed consent is defined as giving care acquiescence knowing the purpose, the extents of the risks and benefits, and possible alternatives of treatment. Client rights ethical principles, such as autonomy and (self -determination) and as well as ethical principles, such as beneficence, are the basis for informed consent. In today’s health care m arket, legal decision making requires that you educate clients about their care. Informed consent is a patient safety issue, a patient -centered care issue, but primarily is a legal right protected by common law and case law. DIF: Cognitive Level: Applying TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 9. Under what circumstances would result in a nurse not securing a signed informed consent from a client scheduled for a bilateral inguinal hernia repair? a. The client voluntarily came to the surgery center and suggested the need for a hernia repair. b. The client completely understands the necessity of the procedure, but is nervous and unhappy about going through with the surgery. c. The client has been diagnosed with early -onset dementia. d. The client is a month away from his 18th birthday. Interpersonal Relationships 8th Edition Arnold Test Bank ANS: C Nurses are accountable for verifying the competency of a patient to give consent. Only legally competent adults can give legal consent; adults who are mentally retarded, developmentally disabled, or cognitively impaired cannot give legal consent. Evaluation of competency is made on an individual basis (e.g., in the case of emancipated adolescents no longer under their parent’s control, brain -injured patients, or those with early dementia) to determine the extent to which they understand what they are signing. In most cases, legal guardians or parents must give legal consent for minor children, define d as those younger than 18, unless the youth is legally considered an emancipated minor. DIF: Cognitive Level: Analyzing TOP: Step of the Nursing Process: Assessment MSC: Client Needs: Management of Care 10. A nurse is required to provide all information specific to a prescribed treatment, and offer the chance to ask questions or share concerns before requesting a signature on a consent form to which client? a. A physically disabled 30-year-old. b. A 17 year old child a sudden life-threatening injury. c. An emancipated minor. d. An adult who fell and fractured a femur whose blood alcohol level is 0.13% ANS: A Informed consent is a focused communication process in which you provide all relevant information related to a procedure or treatment, offering full opportunity for discussion, questions, and expressions of concern, before asking the patient or health care agent to sign a legal consent form. Unless there is a life -threatening emergency, all patients have the right to Decide about whether to consneUnt.roSnilyNleggTalbly.ccomOpmetent adults can give legal con sent; adults who are mentally retarded, developmentally disabled, or cognitively impaired cannot give legal consent. Evaluation of competency is made on an individual basis (e.g., an individual Under the influence of alcohol (0.10% or above is considered illegally drunk, in the case ofemancipated adolescents no longer under their parent’s control, brain -injured patients, or those with early dementia) to determine the extent to which they understand what they aresigning. DIF: Cognitive Level: Analyzing TOP: Step of the Nursing Process: Assessment MSC: Client Needs: Management of Care 11. The nurse is teaching a patient who is alert and oriented about the medication, warfarin. When teaching the patient about this drug, the nurse emphasizes the need to be consistent with Vitamin K intake, which is found primarily in green leafy vegetables. When the patient’s spouse comes to vi sit, the patient states, “I can no longer consume green leafy vegetables.” This is an example of what type of failure caused by a communication problem? a. System failure b. Reception failure c. Transmission failure d. Global aphasia ANS: B Interpersonal Relationships 8th Edition Arnold Test Bank Communication problems occur when there are failures in one or more categories: the system, the transmission, or in the reception. Reception failures occur when channels exist and necessary information is sent, but the recipient misinterprets the message. System failures occur when the necessary channels of communication are absent or not functioning. Transmission failures occur when the channels exist but the message is never sent or is not clearly sent. DIF: Cognitive Level: Analysis TOP: Step of the Nursing Process: Implementation MSC: Client Needs: Teaching and Learning 12. How is social media transforming traditional nurse -patient interactions? a. By transforming the way people interact. b. By communicating health care information and support with many at once. c. Governmental agency privacy regulations make decision making related to confidentiality easier. d. Nursing students are expected to engage clients in a more social manner. ANS: B Social media is transforming traditional nurse -patient interactions. By allowing us to communicate with hundreds of people simultaneously we potentially have the power to provide health care information and support. Social media should not affect the nurse - client relationship by altering communication or expectations of the nursing professional. DIF: Cognitive Level: Analyzing TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Communication and Documentation 13. A student nurse working in an ER takes a picture of a visiting friend in the middle of the crowded waiting room whilenpuosrinsgiwnitgh teibgh.t cpaotiments. Everyone in the photo us smiling and waving at the camera. The student nurse posts the photo on Facebook later to show how much Fun working in an ER can be. Which statement best applies to this described scenario? a. Nurses breach patient privacy when they post enough information to allow recognition of a patient. b. Postings on social media platforms are an everyday happening that is innocent and harmless. c. Social media is transforming traditional nurse -patient interactions and how they are demonstrated. d. Extreme caution is required when discussing or demonstrating any patient -related experience. ANS: A Governmental agency privacy regulations apply to student nurses in off-duty time as well as during clinical experiences. Students cannot at any time reveal private health information. This includes posting of any pictures taken in a clinical facility or during a home health care visit. The actions described may be considered innocent but they are not harmless. While it is true social media is changing aspects of social relationships, it should not be allowed to alter the privacy demanded of the nurse -client relationship. DIF: Cognitive Level: Analyzing TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 14. Which of these statements is NOT true regarding nurses’ use of social media? Interpersonal Relationships 8th Edition Arnold Test Bank u s n t o a. Confidentiality and privacy laws, such as HIPAA, apply to online postings. b. Clicking “restricted access” does not quality as a private site. c. A state board may act on complaints of privacy violations. d. Privacy laws apply to photos, but not to videos if you avoid showing a face. ANS: D Posts are bound by confidentiality and privacy laws, such as HIPAA. Clicking on “restricted access” does not qualify as a private site. Regulatory agencies, such as state boards, act on complaints. Posting identifiable patient information absolutely applies to photos or videos — even if you do not show faces. DIF: Cognitive Level: Applying TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 15. Whose code of ethics for nurses establishes principled guidelines designed to protect the integrity of patients related to their care, health, safety, and rights? a. American Nurses Association b. American Health Insurance Portability and Accountability Act c. National Academy of Medicine Division of the National Academies of Science, Engineering and Medicine d. Evidence -Based Practice ANS: A Professional nurses, regardless of setting, are expected to follow ethical guidelines in their practice. The American Nurses Association Code of Ethics for Nurses establishes principled guidelines designed to protect the integrity of patients related to th eir care, health, safety, and rights. It provides ethical guidelines for ethical practice and decision making to protect patient Rights, provide a mechanism nfor rprofiessigonabl a.cccountabili ty, and educate about sound ethical conduct. DIF: Cognitive Level: Applying TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 16. During a routine visit, the nurse notes that a child has several bruises at various stages of healing. The child reports, " Mommy doesn't like me when I don't do my chores". Failure to report these findings is an example of what form of nursing malpractice? a. Negligence b. Slander c. Liable d. Defamation ANS: A Failing to report suspected physical or sexual child abuse is an example of a negligent act. Defamation is an area of law that provides a civil remedy when someone's words end up causing harm to your reputation or your livelihood. Libel is a written or published defamatory statement, while slander is defamation that is spoken by the defendant. DIF: Cognitive Level: Application TOP: Step of the Nursing Process: Implementation MSC: Client Needs: Management of Care MULTIPLE RESPONSE Interpersonal Relationships 8th Edition Arnold Test Bank U S N T 1. When practicing effective and correct communication, the nurse should demonstrate what actions? (Select all that apply.) a. Speaking in a clear voice. b. Being concise when providing patient education. c. Being concrete when communicating with patients. d. Focusing entirely on abstract communication techniques with patients. e. Ensuring that communication with patients is complete. f. Providing courteous communication when interacting with patients. ANS: A, B, C, E, F Effective and correct communication is: clear, concise, concrete, complete, and courteous. Abstract communication is not effective when interacting with all patients. DIF: Cognitive Level: Analysis TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Psychosocial Integrity 2. What may be the consequences for a simple patient privacy violation through social media? Select all that apply. a. Dismissal from nursing school b. Jail time c. Revocation of nursing license d. Monetary fine e. State Board of Nursing censure ANS: A, C, D, E Consequences for violations can be severe. Student nurses have been dismissed from their schools, State Boards have cennsurredi, finged, Bor.ecvenmrevoked license to practice. Violations of privacy laws also carry a risk of civil law suits and sanctions such as fines for the individual. DIF: Cognitive Level: Applying TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care Interpersonal Relationships 8th Edition Arnold Test Bank Chapter 04: Clinical Judgment: Critical Thinking and Ethical Decision Making Arnold: Interpersonal Relationships, 8th Edition MULTIPLE CHOICE 1. Which of the following types of thinking reflects the nursing process? a. Habits b. Inquiry c. Mnemonic d. Practice ANS: B More structured methods of thinking, such as inquiry, have been developed in disciplines related to nursing. Repetitive practice does not reflect the nursing process. Memorizing does not reflect the nursing process. DIF: Cognitive Level: Knowledge TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 2. Which of the following personality characteristics is a barrier to critical thinking? a. Accepting change b. Being open minded c. Stereotyping d. Going with the flow ANS: C Stereotyping is a cognitive banrUrierrStoicNritgicTalbth.icnkinmg because it interfere s with the ability to treat a patient as an individual. Critical thinkers recognize that priorities change continually. Being open minded is the ability to consider alternatives. Being flexible is a bridge to critical Thinking, not a barrier. DIF: Cognitive Level: Comprehension TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 3. The ethical decision -making model where good is defined as maximum welfare or happiness is known as the a. Utilitarian model. b. Human rights based model. c. Duty -based model. d. Kant’s model. ANS: A The utilitarian model is also known as the goal-based model, where the duties of the nurse are determined by what will achieve maximum welfare. In the human rights model, the patient has basic rights, including the right to refuse care. In the duty -based m odel, rightness is determined by moral worth. The duty-based model is based on Kant’s philosophy. DIF: Cognitive Level: Knowledge TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 4. Which of the following case examples represents the ethical concept of distributive justice? Interpersonal Relationships 8th Edition Arnold Test Bank a. A famous baseball player receives a heart transplant. b. An older adult who has government insurance is denied standard cancer treatment. c. During a visit to his physician’s office, a patient demands antibiotics for his cold and is given a prescription. d. A patient suffering from cirrhosis of the liver is placed on a transplant list. ANS: B The decision to deny expensive treatments or to deny acute care to clients older than a certain age because of scarce treatment resources is an example of the concept of distributive justice. A famous baseball player who receives a heart transplant could be an example of the concept of social worth. A patient demanding antibiotics for his cold during a physician’s office visit is an example of the concept of unnecessary treatment. A client who suffers from cirrhosis and who is placed on a transplant list is an example of justice, being fair or impartial. DIF: Cognitive Level: Analysis TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 5. Personal values are defined as a. Values shaped by family, religious beliefs, and years of experience. b. Altruism. c. Two values that are in conflict. d. Values determined by commitment. ANS: A We all have a personal value system developed over a lifetime that has been extensively shaped by our family, our religious beliefs, and our years of life experiences. Altruism is a core value of professional nursing. Cognitive dissonance refers to two conflicting values. Value intensi ty refers to the anmuorunst iofnagntinbdi.vicdouaml’s commitment to v alues. DIF: Cognitive Level: Knowledge TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 6. A nurse values autonomy and self-determination as well as the preservation of life. This is an example of a. Conceptions of the ideal. b. Cognitive dissonance. c. Operative values. d. Commitment. ANS: B Cognitive dissonance refers to the mental discomfort felt when there is a discrepancy between what an individual already believes and some new information that does not go along with that view. It refers to the holding of two or more conflicting values at the same time. Concep tions of the ideal are conceived values. Operative values do not refer to conflicting values. Commitment refers to value intensity. DIF: Cognitive Level: Application TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 7. Which of the following statements is true about the critical thinking process? a. It is a linear process. b. The skills are inborn. Interpersonal Relationships 8th Edition Arnold Test Bank c. It is goal directed. d. It assists nurses to criticize the health care system. ANS: C The process of critical thinking is systematic, organized, and goal directed. As critical thinkers, nurses are able to explore all aspects of a complex clinical situation. Critical thinking is a circular process. Critical thinking is a learned skill that teaches you how to “think about your thinking.” Critical thinking is clinical judgment, not criticism. DIF: Cognitive Level: Comprehension TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 8. Which of the following best describes the critical thinking skills of a novice nurse and an expert nurse? a. The expert nurse is able to diagnose faster than the novice nurse. b. The expert nurse does not need to question and reassess like the novice nurse. c. The novice nurse uses past knowledge, whereas the expert nurse stays in the here and now. d. The expert nurse organizes data more efficiently than the novice nurse. ANS: D The novice nurse collects lots of facts but does not logically organize them. Novice nurses tend to jump too quickly to a diagnosis without recognizing the need to obtain more facts. The expert nurse constantly questions and reassesses. The expert nurse co mpares new information with prior knowledge, while the novice nurse makes fewer connections to past knowledge. DIF: Cognitive Level: Comprehension TOP: Step of the Nursing Process: All Phases MSC: Client Needs: managemnenut orfsciarne 9. A patient with schizophrenia has been stabilized on long -acting haloperidol, an antipsychotic medication that is administered by injection every 3 weeks. The physician switches the medication to Seroquel, a new antipsychotic oral medication that is adminis tered twice a day. The patient complains that he cannot afford the new medication and will not be able to remember to take it. The physician replies, “I can’t help that; I have to treat you the way I think is best.” The patient’s nurse may experience a. Paternalism. b. Cognitive dissonance. c. Nonmaleficence. d. Moral distress. ANS: D Moral distress results when the nurse knows what is right but is bound to do otherwise because of legal or institutional constraints. Paternalism is making decisions for patients based on what is thought best for them. Cognitive dissonance occurs when there are two conflicting values. Nonmaleficence is avoiding actions that bring harm to another person. DIF: Cognitive Level: Application TOP: Step of the Nursing Process: All Phases MSC: Client Needs: Management of Care 10. Characteristics of a critical thinker include all but which of the following? a. Haphazardly seeking solutions b. Anticipating consequences