P RACTICE
Potter: Fundamentals of Nursing, 11th Edition
MULTIPLE CHOICE
1. 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 famil y care
d. Providing a listening ear
ANS: B
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 th at is invaluable to the
patient’s well -being. Listening and touch can be part of the —presence‖
but are not its entirety. No famil y was involved in this scenario.
DIF: Understand (comprehension) OBJ: Describe ways to
express caring through presence and touch. TOP: Caring
MSC: Psychosocial Integrit y
, 2. The patient has a terminal diagnosis an d is very near death. When the
nurse assesses the patient and finds no pulse or blood pressure, the famil y
begins sobbing and hugging each other. Some famil y 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
ANS: B
Protective touch is also a kind of touch that protects the nurse
emotionall y. 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
securit y, enhances self -esteem, and improves mental wel l-being.
Therapeutic touch is a t ype of alternative therapy for healing.
Task-oriented touch is done when performing a task or procedure.
DIF: Appl y (application) OBJ: Describe ways to express
caring through presence and touch. TOP: Implementation
MSC: Psychosocial Integrit y
3. 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.