Deck 2: Holistic Care of the Patient and Family

Question 1

The spouse of a patient recently diagnosed with terminal cancer has voiced concerns about her husband's continual denial of his disease.What should the nurse consider when planning a response to this concern?

A)It may be helpful for the patient's emotional state at this time to be in a state of denial.
B)Denial is abnormal and the patient needs to have a consultation with a therapist.
C)It will be helpful to plan an intervention to force the patient to acknowledge his disease.
D)There is a limited amount of time left in the patient's life so the denial must be rapidly worked through.

Answer 1

It may be helpful for the patient's emotional state at this time to be in a state of denial.

Question 2

The nurse is attempting to provide discharge teaching to a patient recently diagnosed with a terminal illness.The patient says,"I would rather talk to my usual nurse about my discharge." What action by the nurse is indicated?

A)Ask the patient to sign a refusal of information form.
B)Continue to provide the information to the patient.
C)Ask the patient what efforts could be taken to make her feel more comfortable.
D)Contact the healthcare provider.

Answer 2

Ask the patient what efforts could be taken to make her feel more comfortable.

Question 3

Which interventions would the nurse use to help the patient get at least 2 hours of uninterrupted REM sleep?

A)Work with ancillary services such as physical therapy to establish a predictable routine.
B)Keep the lights in the unit dim at all times.
C)Turn alarms down or off during sleep periods.
D)Restrict visitation to a short time in the morning,the afternoon,and evening.

Answer 3

Work with ancillary services such as physical therapy to establish a predictable routine.

Question 4

The nurse is conducting assessment on a patient who appears to be of Asian ancestry.Which questions are indicated? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)"How long have you been in the United States?"
B)"How do you describe your ethnicity?"
C)"How does your culture influence your healthcare choices?"
D)"Do you speak English or do I need to try to find an interpreter?"
E)"Would you like for someone from your family to be in the room during your assessment?"

Question 5

A patient who has been seriously ill has recovered sufficiently to be transferred to a monitored medical unit.Which intervention will best reduce transfer anxiety for this patient?

A)Transfer the patient immediately before bedtime so that the first few hours on the new unit will be sleeping hours.
B)Promise to frequently visit the patient on the new unit.
C)Explain some of the routines used on the new unit.
D)Offer reassurance by telling the patient you once worked on the new unit.

Question 6

A nurse elects to assist the patient with guided imagery during dressing changes.Which question best helps the nurse design this experience?

A)"Have you ever been to the beach?"
B)"What was your favorite vacation?"
C)"How bad is your pain during your dressing changes?"
D)"How good is your imagination?"

Question 7

A patient is being treated for a massive myocardial infarction.His wife has just arrived in the emergency department and grabs the nurse's arm demanding to know what is happening.Which initial nursing response is indicated?

A)"Your husband needs my full attention right now."
B)"Someone call security."
C)"Take your hands off me."
D)"Please go back to the waiting area."

Question 8

A patient says,"I've been hearing about aromatherapy as part of treatment for serious illness.What do you think about me trying it?" Which nursing responses are indicated? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)"Some studies have shown that using lavender oil can reduce anxiety."
B)"I would focus my energy on more traditional forms of healing."
C)"Other than jasmine oil,you are probably safe using aromatherapy."
D)"You should discuss this plan with your physician before purchasing anything."
E)"I know that some massage therapists use essential oils."

Question 9

The nurse manager is planning an educational program to address noise levels on the unit.What information should be given about the recommended noise levels? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)It is recommended that noise levels in patient rooms should be no greater than 35 dBA.
B)Many of the sounds in the high-acuity unit are foreign and frightening.
C)Excessive noise levels also have an impact on the staff.
D)The recommended noise levels in high-acuity areas are higher due to increased noise from alarms and machines.
E)The biggest patient complaint about noise is about staff conversation.

Question 10

A patient is being kept on bedrest during treatment for deep vein thrombosis.The patient is uncomfortable because being in bed is stressful and has made her arthritis worse.Which complementary and alternative therapies might the nurse suggest to help treat this discomfort? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Aromatherapy
B)Therapeutic humor
C)Massage
D)Guided imagery
E)Music therapy

Question 11

Which assessment finding would most alert the nurse that the patient might have low health literacy skills?

A)The patient reports not completing high school.
B)The patient is 65 years old.
C)The patient says,"I stopped taking the last medication because I read on the internet that it could make me have rashes."
D)The patient says,"I called the doctor's office to reschedule my appointment for later in the morning."

Question 12

A newly licensed nurse says,"Every time I go into my trauma patient's room his wife asks the same questions about his medication." How should the preceptor evaluate this statement?

A)Anxiety about the husband's condition has affected the wife's ability to retain information.
B)The preceptor should present the information so that it is more understandable.
C)When serious injuries have occurred,new nurses often make the mistake of talking to the patient instead of the family.
D)The nurse and wife are not communicating well with one another.

Question 13

Which nursing teaching statement would likely be of most immediate need to a patient on the high-acuity unit?

A)"People with your condition typically stay in the hospital a week to ten days."
B)"The beeping noise you hear is your heart monitor."
C)"Your condition is often caused by a blockage in your intestine."
D)"If you feel like eating in the morning,your physician will order a regular diet for you."

Question 14

A newly licensed nurse has overheard a nurse telling a patient a joke.The nurse tells the preceptor,"I don't think that nurse is being respectful of the patient's diagnosis by telling jokes." What response by the preceptor is indicated?

A)"When you have more experience you will understand the value of a good joke."
B)"We try not to eavesdrop on other nurses' conversations with patients."
C)"Sometimes that nurse's jokes do get old."
D)"Sometimes laughing and joking can help us connect better with the patient."

Question 15

A family of a critically injured patient is about to make their first bedside visit.Which statement,made by the nurse,is the most helpful in this situation?

A)"If you have any questions while you are at the bedside,just ask."
B)"You will need to speak slower and in a softer voice while at the bedside."
C)"Do not touch anything in the room."
D)"His face is swollen and he has a lot of equipment around him."

Question 16

The charge nurse on a busy high-acuity care unit is reviewing the plan of care for four patients.The nurse would evaluate that which patient is at highest risk for sensory perceptual alterations (SPAs)?

A)52-year-old male patient who has been hospitalized for complications related to diabetes
B)41-year-old female patient admitted with severe abdominal pain
C)65-year-old male patient diagnosed with pulmonary embolism
D)79-year-old female patient who is unresponsive after a stroke

Question 17

A nurse questions why socioeconomic status has been included in the admission assessment form.What response by the nurse manager is most appropriate?

A)Socioeconomic status helps the business office determine the likelihood of receiving payment.
B)Socioeconomic status will provide helpful information in choosing a room and roommate for the patient.
C)Socioeconomic status may provide information about previous access to care.
D)Socioeconomic status will reveal the patient's healthcare priorities.

Question 18

The family of a critically ill patient reports to the nurse concerns that none of the healthcare team members seem to be listening to their wishes.Which nursing response is indicated?

A)"You have to stand up for yourself and for your loved one."
B)"It is time for us to meet in a patient care conference."
C)"I will talk to the hospital administrator about your complaint."
D)"I know this whole thing has been very hard on your family."

Question 19

A patient in the anger stage of illness has become argumentative and demanding.The nursing staff is becoming frustrated with the behaviors.What actions by the nurse are indicated?

A)The nurse should accept the behaviors and attempt to open the lines of communication.
B)Rotate the nursing assignments frequently to limit each nurse's exposure to the behaviors.
C)Confront the patient about his demeanor.
D)Consolidate care so the nurse is in the room for shorter periods.

Question 20

The nurse manager is holding educational sessions to improve staff nurse competency in providing culturally sensitive care.Which myths will the manager identify in these sessions? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Cultural competence increases the cost of the nursing care provided.
B)Cultural competence is difficult to achieve when working with patients who are victims of trauma or violence.
C)Cultural competence is focused on providing sensitive care to minorities.
D)The first step of cultural competence is self-awareness.
E)The nurse who provides the same level of care to every patient is providing culturally competent care.