NUR 204 EXAM 1: CRAVEN CHAPTERS 17, 24, 25, 14,
33, 34, 35, 18, 19, 30 QUESTIONS WITH COMPLETE
SOLUTIONS
14. A patient's sister expresses her dissatisfaction to the nurse
regarding the discharge care coordination between the physician
and cardiology team. In order to practice patient advocacy, what
should the nurse do first?
a. Call the social worker to coordinate the discharge care.
b. Call the physician immediately to request a visit with the
patient's sister.
c. Assist the patient's sister in compiling a list of questions
related to discharge.
d. Admit to the patient's sister that there are problems with the
discharge system and resolve to correct these oversights. correct
answers ANSWER: C
RATIONALE: Assisting the patient's sister in compiling a list of
questions should be done first to clarify patient and family needs
and does not interfere with the physician-patient relationship.
While discussing the case and advocating for the family with the
physician and social work are important steps, these would not
be the first action. Admitting problems with the healthcare
system can undermine confidence in the system and is not the
best option in patient advocacy.
14. A previously healthy and active 31-year-old patient with a
radical mastectomy snaps at the nurse and asks her to leave her
alone. In analyzing this, the nurse is able to attribute the
behavior to:
,a. Empathy
b. Comfortable sense of self
c. Developmental stage of intimacy versus isolation
d. Vulnerability of illness correct answers ANSWER: D
RATIONALE: Active, achieving adults may find it difficult to
suddenly need assistance from nurses and may struggle with role
transition during hospitalization. Empathy relates to the ability
to perceive, reason, and communicate understanding of the other
person's feelings. A comfortable sense of self refers to the
nurse's ability to be self-aware of biases, communication styles,
and values: not relevant in the patient's behavior. Intimacy
versus isolation is part of Erikson theory of self-concept; though
appropriate for the age, it does not address this specific
behavior.
14. During assessment, a 27-year-old patient tells the nurse,
"Dying is better than constantly seeing the scar on my face."
Which statement made by the nurse conveys empathy?
a. "How long have you been feeling this way?"
b. "How would your mother feel if you died?"
c. "It is a relief that you would like to discuss how you feel."
d. "You may feel that way now, but you'll feel better in a few
months." correct answers ANSWER: A
RATIONALE: Engaging the patient to talk gives the patient a
feeling of being heard and shows the nurse identifying with the
patient's perspective and encourages reflection. Answer b is
judgmental, and answers c and d negate the patient's feelings.
,14. In communicating with a developmentally delayed adult
patient, which of the following would be the best techniques for
the nurse to use?
a. Silence
b. Providing reassurance at all times
c. Setting clear limits while allowing participation
d. Establishing a contract including values and rights correct
answers ANSWER: C
RATIONALE: Limit setting is a key factor in working
effectively with children and adolescents. Although considered a
therapeutic technique, silence may not be appropriate with this
patient. False reassurance should be avoided with all patients,
particularly pediatric patients and those who are developing
trust. An informal contract would not be appropriate based only
on the patient experiencing a developmental delay.
14. Nontherapeutic communication may interfere with
professional nursing care by hindering the patient-nurse
relationship. Which of the following are examples of
nontherapeutic communication? SATA
a. A nurse provides education on smoking cessation: "The same
thing happened to me and I was able to quit."
b. A nurse attempts to distract a patient at the end of their life:
"Let's focus on your walking for the day, not your worries about
death."
c. A nurse states during report that "the patient should not get an
abortion because it is wrong."
, d. A nurse is sending a pediatric patient for cardiac surgery. As
he leaves, she states "Don't worry, everything will be fine!"
e. A nurse is discussing care options with the family of a patient:
"What have your experiences been like with home healthcare in
the past?" correct answers ANSWER: A, B, C, D
RATIONALE: Giving advice, changing the subject, being
moralistic, and giving false reassurance are all components of
nontherapeutic communication. Open-ended questions are a
therapeutic technique.
14. The circle of confidentiality is essential in maintaining
sensitive information among appropriate professionals. A nurse
overhears a conversation about an unknown patient's care in the
elevator. The best immediate response would be:
a. "Clinically relevant information should be shared with the
healthcare team, thanks for your report"
b. "I'm concerned to hear discussions like this in nonprivate
areas; let's be mindful of patient privacy"
c. An incident report describing the event with the names of
those employees involved
d. Interjections with suggestions for the patient's care plan
considering his or her current situation correct answers
ANSWER: B
RATIONALE: Voicing concerns about discussions of patient
information in nonprivate areas states the nurse's ethical
concerns and violation of the Patient's Bill of Rights. Alternative
options do not address violation of the Patient's Bill of Rights
directly to the providers.
33, 34, 35, 18, 19, 30 QUESTIONS WITH COMPLETE
SOLUTIONS
14. A patient's sister expresses her dissatisfaction to the nurse
regarding the discharge care coordination between the physician
and cardiology team. In order to practice patient advocacy, what
should the nurse do first?
a. Call the social worker to coordinate the discharge care.
b. Call the physician immediately to request a visit with the
patient's sister.
c. Assist the patient's sister in compiling a list of questions
related to discharge.
d. Admit to the patient's sister that there are problems with the
discharge system and resolve to correct these oversights. correct
answers ANSWER: C
RATIONALE: Assisting the patient's sister in compiling a list of
questions should be done first to clarify patient and family needs
and does not interfere with the physician-patient relationship.
While discussing the case and advocating for the family with the
physician and social work are important steps, these would not
be the first action. Admitting problems with the healthcare
system can undermine confidence in the system and is not the
best option in patient advocacy.
14. A previously healthy and active 31-year-old patient with a
radical mastectomy snaps at the nurse and asks her to leave her
alone. In analyzing this, the nurse is able to attribute the
behavior to:
,a. Empathy
b. Comfortable sense of self
c. Developmental stage of intimacy versus isolation
d. Vulnerability of illness correct answers ANSWER: D
RATIONALE: Active, achieving adults may find it difficult to
suddenly need assistance from nurses and may struggle with role
transition during hospitalization. Empathy relates to the ability
to perceive, reason, and communicate understanding of the other
person's feelings. A comfortable sense of self refers to the
nurse's ability to be self-aware of biases, communication styles,
and values: not relevant in the patient's behavior. Intimacy
versus isolation is part of Erikson theory of self-concept; though
appropriate for the age, it does not address this specific
behavior.
14. During assessment, a 27-year-old patient tells the nurse,
"Dying is better than constantly seeing the scar on my face."
Which statement made by the nurse conveys empathy?
a. "How long have you been feeling this way?"
b. "How would your mother feel if you died?"
c. "It is a relief that you would like to discuss how you feel."
d. "You may feel that way now, but you'll feel better in a few
months." correct answers ANSWER: A
RATIONALE: Engaging the patient to talk gives the patient a
feeling of being heard and shows the nurse identifying with the
patient's perspective and encourages reflection. Answer b is
judgmental, and answers c and d negate the patient's feelings.
,14. In communicating with a developmentally delayed adult
patient, which of the following would be the best techniques for
the nurse to use?
a. Silence
b. Providing reassurance at all times
c. Setting clear limits while allowing participation
d. Establishing a contract including values and rights correct
answers ANSWER: C
RATIONALE: Limit setting is a key factor in working
effectively with children and adolescents. Although considered a
therapeutic technique, silence may not be appropriate with this
patient. False reassurance should be avoided with all patients,
particularly pediatric patients and those who are developing
trust. An informal contract would not be appropriate based only
on the patient experiencing a developmental delay.
14. Nontherapeutic communication may interfere with
professional nursing care by hindering the patient-nurse
relationship. Which of the following are examples of
nontherapeutic communication? SATA
a. A nurse provides education on smoking cessation: "The same
thing happened to me and I was able to quit."
b. A nurse attempts to distract a patient at the end of their life:
"Let's focus on your walking for the day, not your worries about
death."
c. A nurse states during report that "the patient should not get an
abortion because it is wrong."
, d. A nurse is sending a pediatric patient for cardiac surgery. As
he leaves, she states "Don't worry, everything will be fine!"
e. A nurse is discussing care options with the family of a patient:
"What have your experiences been like with home healthcare in
the past?" correct answers ANSWER: A, B, C, D
RATIONALE: Giving advice, changing the subject, being
moralistic, and giving false reassurance are all components of
nontherapeutic communication. Open-ended questions are a
therapeutic technique.
14. The circle of confidentiality is essential in maintaining
sensitive information among appropriate professionals. A nurse
overhears a conversation about an unknown patient's care in the
elevator. The best immediate response would be:
a. "Clinically relevant information should be shared with the
healthcare team, thanks for your report"
b. "I'm concerned to hear discussions like this in nonprivate
areas; let's be mindful of patient privacy"
c. An incident report describing the event with the names of
those employees involved
d. Interjections with suggestions for the patient's care plan
considering his or her current situation correct answers
ANSWER: B
RATIONALE: Voicing concerns about discussions of patient
information in nonprivate areas states the nurse's ethical
concerns and violation of the Patient's Bill of Rights. Alternative
options do not address violation of the Patient's Bill of Rights
directly to the providers.
