MIDTERM Flashcards
what are the 5 dynamics components of a therapeutic relationship?
TEACH
1. trust
2. empathy
3. autonomy
4. care
5. hope
how many dimensions does HOPE have and list them
6 dimensions
- affective
- affiliate
- behavioral
- cognitive
- temporal
- contextual
what is teach?
T: trust
E: empathy
A: autonomy
C: care
H: hope
what are the characteristics of a therapeutic relationship
- acceptance
- rapport
- genuineness
- use of self
To establish a therapeutic relationship, three qualities must be present. Which of the following is not one of the three
qualities?
a) Confidentiality
b) Acceptance
c) Rapport
d) Genuineness
a) confidentiality
how many stages are there in a therapeutic relationship and what are they?
4 stages
1.preparation stage; gather information on patient like previous or present chart’s
2. orientation stage; clarify roles and set goals, build a baseline
3. working stage; where most therapeutic process happens
4. termination stage; end relationship professionally
Culture is a significant part of caring. What do nurses who are culturally competent in their care display?
a) A complete understanding of their patient’s cultural preferences
b) An ability to provide patients with all cultural requirements
c) Caring behaviors based on patients’ cultural values and beliefs
d) An incorporation of touch in all aspects of nursing care
c) Caring behaviors based on patients’ cultural values and beliefs
nurses cant know about every culture out there so the next best thing is to provide care with their culture in mind
what family is this: has a father, mother, one or more children living together?
- no kin
- blended or reconstituted family
- nuclear family
Nuclear family
what family is this: second and third generation members who are related by blood or marriage but not living together?
- nuclear family
- step family
- extended family
extended family
what family is this: two individuals living together without children
- three-generational family
- dyad family
- common law family
Dyad family
what family is this: members from the first, second or third generation all living in one household
- same-sex family
- extended family
- three-generational family
three-generational family
what family is this: never married, separated, or widowed; has one or more child these families are usually headed by women
- step family
- no kin
- single-parent family
single parent family
what family is this: family in which one or both spouses are divorced or widowed, with one or more children from a previous marriage who may not live with the newly reconstituted family
- blended or reconstituted family
- step family
- common law family
step family
what family is this: two families living together, with children from one or both families and sometimes children of the newly married couple
- blended or reconstituted family
- extended family
- dyad family
blended or reconstituted family
what family is this: unmarried couple living together with or without children
- nuclear family
- common law family
- group marriage
common law family
what family is this: at least two people who have a nonsexual relationship, have no legal, blood or emotional ties with each other. Ex roommates
- commune
- no kin
- polygamous family
no kin
what family is this: one man or women with several spouses
- polygamous family
- same-sex family
- single-parent family
polygamous family
what family is this: same sex couple living together with or without children
- no kin
- extended family
- same-sex family
same sex family
what family is this: groups of individuals that may or may not be related but live together and share resources. Ex group home or orphanage
- commune
- no kin
-group marriage
commune
what family is this: individuals are all “married” to one another and are considered parents of all the children
- same sex family
- polygamous family
- group marriage
group marriage
Family-centered nursing involves which one of the following?
a. Supporting the coping abilities of the family
b. Determining who can be included in the family
c. Dealing with the whole family instead of the individuals in it.
d. Applying your own beliefs about family in each situation
A. because you need to be able to help the families emotional, social, and practical needs
in holistic care (mind, body and spirit) what care focuses on the patients care for their religious and spiritual needs
spiritual care
what are the 7 elements of the communication process
- referent; what causes the conversation to happen
- sender and receiver; person who encodes the message and person who decodes message
- message; what the conversation is
- channels; how this conversation takes place
- feedback; message reterined by reciever
- interpersonal variables; issues that may interfeer with the conversation
- environment; setting of the conversation
which communication process is this?
“motivates one person to communicate with another”
referent
which communication process is this?
“person who encodes the message and delivers it”
sender
which communication process is this?
“person who decodes the message and receives it”
receiver
which communication process is this?
“the content of communication”
message
which communication process is this?
“means of sending and receiving messages through visual, auditory, and tactile (touch) senses” Ex phone calls, text messages, or nonverbal communication
channels
which communication process is this?
“message returned by receiver”
feedback
which communication process is this?
“characteristics within sender and receiver that influence communication”
interpersonal variables
what are these?
- education
- gender
- values and beliefs
- pain
- anxiety
- medication effects
examples of interpersonal values last 3 are illness related that can effect nurse-patient communication
which communication process is this?
“setting where sender and receiver interact”
examples include
noise
distractions
lack of privacy
environment
what does SOLER stand for
S: sit facing patient
O: open posture
L: lean towards patient
E: establish and maintain intermittent eye contact
R: relax
what is non-therapeutic communication
communicating in a way that reduces trust of the patient, creates barriers, and makes patient feel unsupported (basically it effects patient rapport)
patient trying to say “I want a sandwich” but the words being produced or understood are “big food want”
aphasia
a motor aphasia, inability to name common objects or expresses ideas into words or writing
expressive aphasia
not being ale to understand written or verbal language
sensory or receptive aphasia
not being able to communicate or understand language orally
global aphasia
includes 4 aspects physical, cognitive, emotional, and spiritual; understanding on oneself
self-concept
knowing one self and connecting with others based on your own experiences and knowledge
self-awareness
related to Maslow’s hierarchy of needs; is relatively stable but can fluctuate depending on circumstances
self-esteem
what does CARE stand for in the caring process
C: connect with patient
A: appreciate your patient
R: respond to their needs
E: empower patient to problem solve with you (autonomy)
what does PCC mean
person-centered care
The nurse demonstrates an understanding of mutuality when
stating which of the following to the client?
a) “Mr. Jones, I think you should go to bed now”
b) ”Mr. Jones, I would like you to go to bed now”
c) “Mr. Jones, I don’t think you should sit in the chair”
d) “Mr. Jones, I thought we agreed that you would
return to bed at this time?
D mutuality is an understanding or agreement from both sides patient and nurse for the well being of patient
categorizing a group of people because you think all people from that group are like that or have the same characteristics
stereotyping
everyone has this, it can prevent positive client out comes
bias
In order to reduce clinical bias in nursing practice, the nurse
should:
a) Memorize beliefs held by different cultures
b) Generalize beliefs based on ethnic membership
c) Develop a nonjudgmental, natural attitude
d) Recognize that individuals of the same religion share
the same characteristics
C by knowing and acknowledging your biases
what are the 5 different styles of personal conflict management
- avoidance
- accommodation
- competition
- compromise
- collaboration
what style of personal conflict is this: ignoring the problem not wanting to talk about it
avoidance
what style of personal conflict is this: “giving in” approach letting the other person take the win
accommodation
what style of personal conflict is this: “win-lose” approach because one side want’s their own needs satisfied rather than both of their needs
competition
what style of personal conflict is this: “meet- in-the-middle” approach both parities give smt up to win
compromise
what style of personal conflict is this: “win-win” approach both parties win
collaboration
interpersonal vs intrapersonal
intRAPersonal; internal conflict
interpersonal; between you and another person
what are ethical principle?
internal conflicts
what is culture?
shared values, beliefs, and customs of a group of people
what is ethnicity?
group of people who share common ancestry, bloodline, cultural practices
what is cultural diversity?
bunch of different cultures
what is acculturation?
accepting new cultures and traditions like immigrants putting up charismas trees when we don’t celebrate it but still put it up
what is assimilation?
forced to accept a culture
When a physician writes an order for the nurse to withhold life-saving treatment from a terminally ill client, the nurse is faced with two different choices, each supported by a different ethical principle. This type of conflict is known as
_______ conflict.
a) Covert
b) Overt
c) Interpersonal
d) Intrapersonal
D
what is CARE in conflict resolution: nursing strategies
clarify the conflict
articulate your problems
request a change
evaluate the out come
what are the 5 steps for nursing behaviors when dealing with a violent person
- control self; knowing what angers you so you can step away from the situation
- nonthreatening body postures; always be near a exit so you can escape if needed
- verbal de-escalation; talk in a low calm gentle tone
- containment; be aware of your resources like security
- debrief immediately; reflect on the incident
Which of the following is a barrier to communication?
a. Intrusion into personal space
b. Unconditional acceptance
c. Self-awareness
d. Gender differences
A
Which personal conflict management style do females tend to use most often?
a. Avoidance and compromise
b. Collaboration and competition
c. Avoidance and collaboration
d. Competition and compromise
a
The most effective problem-solving style for genuine resolution that creates a win-win situation is:
a. Accommodation
b. Acceptance
c. Competition
d. Collaboration
d
A client on a psychiatric unit is found pacing the halls and angrily punching at the wall. The nurse’s primary goal should be to:
a. Assertively tell the client to stop the behavior
b. Suggest that the client write in a journal to help relieve anxiety
c. Speak in a loud voice in order to alert other staff members
d. Maintain safety while helping the client
d
The three phases of interviewing, when the client is present, are:
a. Confidentiality, trust, and empathy
b. Listening, hearing, and feeling
c. Orientation, working through problems, and termination
d. Getting details, thoughts, and answers
c
It is essential that nurses provide care based on transcultural principles. Which of the following examples best illustrates this principle?
a. Gender-congruent care includes caring touch by the nurse for all genders.
b. Part of caring is working with patients in the end-of-life stage. The caring aspect includes telling the patient directly that he or she is in the dying phase.
c. Assessment of the patient’s culture and family background by the nurse is important to determine if the nurse should provide or other individuals should be providing the caring and touch that communicates presence.
d. Caring touch by the nurse transcends all cultures and ethnic backgrounds.
c
what is culture sensitivity?
the attitude one has while caring for a patient with a different background
what is cultural competence?
responding respectfully and appropriately
what is cultural humility?
being open minded about others cultures and learning from them
what is cultural safety?
being able to practice your culture without being in danger
what is critical self-reflection
using the past, present and future to reflect
what is relational practice?
building therapeutic relationships with patient, families, and co workers
what is reflexivity?
ability to question and reflect on your own beliefs and values
The nurse is assigned to provide a bed bath to a client who cannot speak English. Which of the following communication strategies should the nurse use?
a. Nonverbal communication
b. Trained Interpreter
c. Family member as interpreter
d. Other staff member who speaks the same language
B always go to a professional as that’ll limit any miscommunications or prevent others from altering exactly what patient is saying
therapeutic communication includes…
trust
respect
empathy
empowerment
caring
mutuality
veracity
which of the following does this relate to or mean
“nurse and client both agree on clients health problems and resolves the issue involving the client in the decision making process”
- trust
- empathy
- mutuality
mutuality
what does ADPIE stand for
assessment
diagnosis (nursing diagnosis)
planning (SMART goals)
implementation
evaluation
which action could most harm the nurse-client relationship?
a) A nurse documents the patient’s care accurately and promptly.
b) A nurse involves the client in care decisions and respects their autonomy.
c) A nurse talks about a challenging patient situation on social media without naming the client.
d) A nurse provides education about patient rights to confidentiality.
c
what is the most important reason to maintain confidentiality in a therapeutic relationship?
a) To protect healthcare providers from legal repercussions.
b) To demonstrate the nurse’s control over information.
c) To establish the nurse as a trustworthy figure of authority.
d) To create a non-threatening interpersonal environment where clients feel comfortable revealing their needs.
d
learnt behaviors that healthcare works may have, that affect their judgment and decision-making in patient care is called what
- stereotyping
- clinical bias
- cultural barriers
clinical bias
In order to reduce clinical bias in nursing practice, the nurse
should:
a) Memorize beliefs held by different cultures
b) Generalize beliefs based on ethnic membership
c) Develop a nonjudgmental, natural attitude
d) Recognize that individuals of the same religion share
the same characteristics
C
ability to say no ask for what you want
able to express positive and negative feelings
is accountable for their own actions
are components of what?
- assertive behavior
- intrapersonal conflict
- ethical principles
assertive behavior
Why is assertiveness important in nursing?
a) It helps nurses avoid conflict with patients and colleagues.
b) It allows nurses to advocate for their patients’ needs and set professional boundaries.
c) It ensures that nurses always agree with their patients.
d) It encourages nurses to avoid challenging authority.
B nurses primary goal is to advocate for patient and have effective communication
“multiple people from multiple different backgrounds”
is called…
a. cultural assessment
b. cultural diversity
c. cultural competence
B
“gathering background information on client to give them culturally sensitive care”
a. cultural assessment
b. cultural sensitivity
c. cultural competence
A
“knowing how to respond respectfully and appropriately around the patient”
a. cultural awareness
b. cultural competence
c. acculturation
B
what group is this
“forms close personal relationships; don’t have a end date, considered your support system example could be family or friends”
a. secondary group
b. primary group
B
what group is this
“goal oriented groups with shot term relationships and an established beginning to end example coworkers or classmates”
a. secondary group
b. primary group
A
“how the group communicates and behaves with each other during the lifespan of the group”
a. therapeutic relationship
b. group think
c. group dynamics
C
“negative phenomena where the approval of other members becomes more important than your own” ex the whole group decides on pizza but you want burgers since its just you, you say u want pizza too because you that’s what everyone else said
a. group think
b. primary group
A
Which of the following is a characteristic of a secondary group?
a) There is no designated leader
b) The group has a planned, time-limited association
c) The group lacks a specific identified purpose
d) The group remains together even when goals are
achieved
B
what are the 2 different types of conflicts and describe them.
Interpersonal; conflict with others
Intrapersonal; conflict between your self
In intrapersonal conflict, a person may experience:
a) Tension between their professional and personal life.
b) Disagreements with family members over household rules.
c) A disagreement between two coworkers over job responsibilities.
d) A conflict with a friend over differing opinions.
A
team works separately and there is less communication
multidisciplinary or interdisciplinary
multidisciplinary
In a multidisciplinary team, the focus is on:
a) Shared decision-making and integrating diverse expertise.
b) Independent roles with limited communication between team members.
c) Equal participation in all aspects of patient care by all team members.
d) The team leader making all decisions without input from other members.
B
team works together and has shared decision making
multidisciplinary or interdisciplinary
interdisciplinary
Which of the following is a primary goal of a multidisciplinary team?
a) To create a unified approach where each member contributes equally to patient care.
b) To ensure each team member works independently without overlapping tasks.
c) To share knowledge and communicate frequently to make collective decisions.
d) To allow each member to make decisions within their own expertise and report to others.
B
Which of the following is a method of charting in which the nurse writes a progress note only when the standardized statement on the form is not met?
a) Narrative method
b) Source record
c) Problem-oriented medical record
d) Charting by exception
D
what does SOAP stand for
subjective
objective
assessment
plan
what does SOAPIE stand for
subjective
objective
assessment
planning
intervention
evaluation
what does PIE stand for
planning
intervention
evaluation
what does DAR a focus charting method stand for
data
action
response
The three phases of interviewing, when the client is present, are:
A. Confidentiality, trust, and empathy
B. Listening, hearing, and feeling
C. Orientation, working through problems, and termination
D. Getting details, thoughts, and answers
C
According to Watson’s transpersonal caring theory, the nurse should understand which of the following concepts about caring?
A. The act of caring is personal and cannot be shared.
B. Caring can increase healing and promote well-being.
C. Expressions of human caring are the same for all individuals.
D. Nurses must use caring behaviours specific to their own cultures.
B
what does Watsons transpersonal theory promote?
nurses must provide holistic care for better pt outcome
behaviour used when one feels threatened is what
A. Watsons transpersonal theory
B. clinical bias
C. barriers to communication
C barriers like projecting, denying, or avoiding
a digital copy of patients lifetime record of health information that can be accessed across Canada is called what
electronic health record (EHR)
which digital health record do you access for a single encounter or visit by a patient to the hospital
- EHR (electronic health record)
- EMR (electronic medical record)
EMR is only for a singe encounter while EHR is patients whole health history
what are the 3 Calgary family assessment models
structural; looks at who the family is and their relationship to each other like external or internal family
developmental; different stages and milestones
functional; assess the family’s functioning who makes the decisions, who is the problem starter
- Intervene early
- Consider the other’s viewpoint
- Avoid negative comments
- Assume responsibility
- Decide to implement the best solution
are all related to what
A. conflict resolution
B. characteristics of a interdisciplinary team
C. phases of interviewing
A
What is the primary purpose of a discharge summary flow sheet?
A. To provide a detailed list of all hospital staff interactions
B. To summarize the patient’s hospital stay and ensure continuity of care
C. To outline the hospital’s billing details
D. To document only medications given during the hospital stay
B, further doctors appointments, medication instructions, community recourses and pamphlets
how many elements are identified of a health workplace
- 12
- 8
- 6
- 9
8
In a healthy workplace, what is the approach to role expectations?
a) Roles are flexible and change frequently
b) Roles are undefined to promote creativity
c) Roles are clearly defined with accountability
d) Roles are assigned based on seniority
C
what is it called when a nurse builds trust, and understanding this can be shown by active listening, clarifying, and showing empathy
- therapeutic communication
- steps of communication
- cultural competence
therapeutic communication
acknowledges and encourages strengths and success of a person is know as what ex “good job on dealing with patient smith”
- positive feedback
- cultural competence
- self-awareness
positive feedback
communications barriers include (select all that apply) lack of..
- trust
- empathy
- empowerment
- mutuality
- respect
- personal space
All of these are examples of communication barriers where patient doesn’t feel valued or respected in the therapeutic relationship
important aspects of documentation include
- factual
- accurate
- complete
- current
- organized
- within standards
what does collaboration mean
working with others like other nurses or patients
what is the 5 stage model of the development of a small group
- forming
- storming
- norming
- performing
- adjournment
what does SBAR mean
S- situational
B- background
A- assessment
R- recommendation
what are the aspects of multidisciplinary communication
- records or chart; confidential legal documentation that’s valid for 10 years
- reports; can be oral, written, or taped
- consultations; a professional HCW giving advice to another HCW
- referrals; can be community refers for after hospital care
What are therapeutic actions nd give examples
Techniques to support clients’ emotional well-being
- using “I” statements
- avoid blaming
- touch
- active listening
- empathy
- empowerment
