NURS 302 - Final

Question 1

Why is a basic understanding of ethnopharmacology part of being a culturally competent nurse?

a. Nurses should know how medications may affect individual patients to properly administer the medication.
b. Significant differences among ethnic groups have been found in relation to the effects of medications.
c. Pharmacology is a significant aspect of nursing practice.
d. Ethnopharmacology is a new area of study important to all nurses.

Answer 1

b. Significant differences among ethnic groups have been found in relation to the effects of medications.

Question 2

Which of the following could be considered congruent communication?

a. The nurse manager states, “Come by my office anytime.” Then she keeps her door closed and does not answer phone calls.
b. The nurse manager sits with you in the nurse’s lounge and asks, “Is there anything you would like to talk about?”
c. As she drops a stack of charts loudly on the desk, a co-worker states, “This is going to be a wonderful day.”
d. As a co-worker hurries down the hall, he asks, “Is there anything you need help with?”

Answer 2

b. The nurse manager sits with you in the nurse’s lounge and asks, “Is there anything you would like to talk about?”

Question 3

During report, a nurse complains about a 3-year-old boy, saying “He sure knows when to pour on the tears. There’s nothing wrong until he sees you; then the tears start, but they stop as soon as you leave or his mother comes. He’s just spoiled because they have a nanny at home who waits on him hand and foot.” This is an example of

a. stereotyping because the child has a nanny.
b. lack of understanding of child development.
c. frustration that the mother is not present.
d. assessment of the child’s behavior.

Answer 3

a. stereotyping because the child has a nanny.

Question 4

Collaboration among health care professionals most importantly results in

a. the development of esprit de corps.
b. benefits to the organization alone.
c. positive patient outcomes.
d. maintenance of employee satisfaction.

Answer 4

c. positive patient outcomes.

Question 5

A new mother says, “My baby is being kept in the nursery. I’m really worried about him. I’m also worried that the separation will interfere with breastfeeding.” The most appropriate response by the nurse is,

a. “I can see you’re upset about this, but to be honest with you, I’m a new nurse here, and I’m not sure how I can help you.”
b. “Well, that’s not my territory. You’ll have to deal with the nursery staff about breastfeeding.”
c. “I can see this is a problem for you. I will go to the nursery and see if I can get some answers for you.”
d. “As a nurse on this unit, I can assure you that we will do all we can to help you.”

Answer 5

c. “I can see this is a problem for you. I will go to the nursery and see if I can get some answers for you.”

Question 6

Which behaviors help patients develop trust in the nurse?

a. Answering questions with authority
b. Sharing personal information to indicate openness
c. Conveying acceptance of the patient and a nonjudgmental attitude
d. Meeting with the patient spontaneously because that indicates caring

Answer 6

c. Conveying acceptance of the patient and a nonjudgmental attitude

Question 7

The current emphasis on eliminating racially based health disparities is based on which of the following ethical principles?

a. Veracity
b. Fidelity
c. Justice
d. Double effect

Answer 7

c. Justice

Question 8

A nurse comments in private about a patient: “That lady with six kids is pregnant again! It makes me sick to see these people on welfare taking away from our tax dollars. I don’t know how she can continue to do this.” The best response by a nurse peer is to

a. convey acceptance of the patient.
b. accept the comments as self-disclosure.
c. offer neutral responses.
d. ignore the biased statements.

Answer 8

a. convey acceptance of the patient.

Question 9

A patient is in the intensive care unit after a myocardial infarction and refuses to stay in bed, saying, “I have to be up and walking around. When I stayed in bed after having my babies 40 years ago, I got so weak I could hardly move.” This patient’s illness behavior is being influenced by

a. role expectations.
b. hardiness.
c. culture.
d. past experiences.

Answer 9

d. past experiences.

Question 10

A nurse who advocates for a longer stay when a medically indigent patient is being prematurely discharged to reduce hospital cost is relying on which ethical principle?

a. Beneficence
b. Justice
c. Fidelity
d. Autonomy

Answer 10

b. Justice

Question 11

A contemporary view of the sick role includes

a. patient as submissive to the health care provider.
b. patient noncompliant with the health care provider.
c. moving away from cultural values when making health care decisions.
d. patient as partner with the health care provider.

Answer 11

d. patient as partner with the health care provider.

Question 12

Which of the following best illustrates nonjudgmental acceptance by the nurse?

a. Using professional influence to change a patient’s morality to be more in keeping with societal norms
b. Avoiding all negative feelings about the patient
c. Demonstrating caring behavior in spite of negative feelings
d. Changing your assignment if you discover that you have negative feelings toward your patient’s lifestyle

Answer 12

c. Demonstrating caring behavior in spite of negative feelings

Question 13

Context is one of the five major elements of communication identified by Ruesch. Which of the following is part of the context of communication?

a. Content of the message
b. Response of the receiver
c. Attitude of the receiver
d. Information about the sender

Answer 13

c. Attitude of the receiver

Question 14

How would a nurse’s use of the technique of reflection help a person?

a. Showing knowledge the person is not expected to know
b. Showing an awareness of the person’s feelings
c. Encouraging the person to think through problems for himself or herself
d. Causing the person to answer more fully than yes or no

Answer 14

c. Encouraging the person to think through problems for himself or herself

Question 15

When nurses receive a patient assignment and accept reports on these patients, they are committed to providing care to those assigned to them. This is based on the ethical principle of

a. veracity.
b. justice.
c. fidelity.
d. beneficence.

Answer 15

c. fidelity.

Question 16

A young girl from a Middle Eastern country is in the process of dying. Her parents ask the nurses to allow her to be prepared for death by being dressed in a specific garment and headdress every day. The parents cannot be there every day to do this and ask the nurses to apply the attire. Which actions by the nurses demonstrate culturally competent care?

a. Informing the parents that hospital policy requires all patients to wear hospital garments
b. Consulting the chaplain as to the meaning of the ritual in the Middle East
c. Learning how to apply the garment and headdress properly
d. Allowing the parents to dress the patient in the garment and headdress when they are by her side

Answer 16

c. Learning how to apply the garment and headdress properly

Question 17

What is the most important information the nurse should share with the patient during the orientation phase?

a. Name, credentials, extent of responsibility
b. Nurse’s name, physician’s name, possible discharge date
c. Plan for discharge, teaching needs, goals for the day
d. Plan for the day, times the nurse will be unavailable, how to contact the nurse

Answer 17

a. Name, credentials, extent of responsibility

Question 18

A patient states, “I do not understand why I keep getting these headaches. I have seen a nurse practitioner and two specialists. I have taken several medications, but the headaches keep coming back.” In which stage of illness is the patient?

a. Disbelief and denial
b. Acceptance and participation
c. Irritability and anger
d. Attempting to gain control

Answer 18

d. Attempting to gain control

Question 19

The patient says to the nurse, “The staff treats me like I’m a child. Everyone tells me what to do. No one ever asks my opinion. After all, it is my body.” Which response by the nurse indicates active listening?

a. “It makes you angry not to be included in your health care decisions. Let’s talk about how you can vent your anger appropriately.”
b. “Let me see if I understand. It bothers you not to be recognized for your abilities to handle your life. I can discuss this with the staff if you wish so that everyone involves you in planning your care.”
c. “I don’t think I can help you with this. This is a personal matter between you and the rest of the staff.”
d. “Well, you’re sick. Don’t you think you should let us take care of you?”

Answer 19

b. “Let me see if I understand. It bothers you not to be recognized for your abilities to handle your life. I can discuss this with the staff if you wish so that everyone involves you in planning your care.”

Question 20

The nurse and patient may experience sadness during the termination phase. How can the nurse help the patient be successful in the termination phase of the nurse-patient relationship?

a. Visiting the patient at home during off-duty time to help the transition to self-care
b. Providing personal contact information so the patient can contact the nurse if needed
c. Emphasizing the achievements the patient has made, including the ability for self-care
d. Exchanging goodbye gifts as a sign that the relationship is terminated

Answer 20

c. Emphasizing the achievements the patient has made, including the ability for self-care

Question 21

In which of the following examples is the nurse demonstrating empathy for the postoperative mastectomy patient?

a. “You’ll be back to your busy routine sooner than you think.”
b. “This must be a very difficult time for you.”
c. “With today’s advanced reconstruction techniques, you’ll quickly forget you ever had surgery.”
d. “I know how you feel; I also had breast cancer.”

Answer 21

b. “This must be a very difficult time for you.”

Question 22

A patient is being discharged from the hospital. Which statement by the nurse is appropriate for the termination phase of the nurse-patient relationship?

Answer 22

a. “During the past 3 days, you have learned how to inject insulin and how to make appropriate food choices. Remember that you have the unit telephone number if you have any questions.”

Question 23

A patient has been diagnosed with angina. As he talks with the nurse, he asks several good questions about angina and seems able to concentrate on the explanations. He seems eager to learn how to manage his condition. What assessment can be made by the nurse?

a. Severe anxiety is present.
b. Moderate anxiety is present.
c. Mild anxiety is present.
d. The level of anxiety cannot be determined.

Answer 23

c. Mild anxiety is present.

Question 24

A patient demonstrates obvious regression in ability to perform self-care during the working phase. Which response by the nurse is most appropriate?

a. Frustration because the patient does not appear to be motivated to achieve goals
b. Ignoring it because the nurse realizes the patient is exhibiting childlike behavior
c. Persistence in demonstrating the importance of achieving goals
d. Patience and understanding because regression is a defense mechanism

Answer 24

d. Patience and understanding because regression is a defense mechanism

Question 25

Which illness has the characteristics of an acute illness?

a. Type 2 diabetes
b. Cleft palate
c. Influenza
d. Exercise-induced asthma

Answer 25

c. Influenza

Question 26

Which of the following is among the fastest growing health problems among U.S. citizens? (Select all that apply.)

a. Being diagnosed with an acute illness
b. Being diagnosed with a chronic illness
c. Being diagnosed with an infectious disease
d. Being diagnosed with a congenital disability

Answer 26

a and b. Being diagnosed with either an acute or a chronic illness:

Being diagnosed with an acute or chronic illness can be a major life crisis. The emotional reactions of the patient and family sometimes present a greater challenge than dealing with the physical aspects of the disease.

Question 27

Which is an aspect of coping that can be defined as a pattern of successful adaptation despite challenging or threatening circumstances?

a. Physical activity
b. Learned resourcefulness
c. Resilience
d. Spirituality

Answer 27

c. Resilience:

Resilience is an aspect of coping that can be defined as “a pattern of successful adaptation despite challenging or threatening circumstances.” (Humphreys, 2001) Resilient responses are thought to be a result of three factors:

1. Disposition (i.e., temperament, personality, overall health and appearance, and cognitive style)
2. Family factors such as warmth, support, and organization
3. Outside support factors, such as a supportive network and success in school or workResilience can be thought of as both a process and an outcome. It can develop over a person’s lifetime and can be taught, modeled, and learned.

Question 28

Which of the following factors can impact a patient’s capacity to learn to cope better with stress due to illness? (Select all that apply.)

a. Physiology
b. Culture
c. Motivation
d. Environment

Answer 28

All answers are correct:

Factors that affect patients’ capacity to learn and cope with stress include physiologic factors (visual or hearing deficits); cultural factors (cultural meaning of illness, language differences); lack of motivation and readiness (still in shock from diagnosis, cannot focus, does not believe in what is being taught); environmental factors (patient needs comfortable setting, private, and free of distractions). (Chapter 10, “Coping with Stress through Education)

Question 29

In a clinical setting, professional ethics should override personal morals and values.

a. True
b. False

Answer 29

a. True:

In a professional setting, professional ethics override personal morals and values.

Question 30

Which approach to moral reasoning stated that women’s and girls’ relational orientation to the world shaped their moral reasoning to be different from that of men and boys?

a. Gilligan’s stages of moral reasoning
b. Kohlberg’s stages of moral reasoning

Answer 30

a. Gilligan’s Stages of Moral Reasoning:

Gilligan (1982) was concerned that Kohlberg did not adequately recognize women’s experiences in the development of moral reasoning. She noted that Kohlberg’s theories had largely been generated from research with men and boys, and when women were tested using Kohlberg’s stages of moral reasoning, they scored lower than men. Gilligan believed that women’s and girls’ relational orientation to the world shaped their moral reasoning to be different from that of men and boys. Women do not have inadequate moral development but different development because of their gender. Kohlberg’s inattention to gender differences meant that his theory was inadequate in explaining women’s moral development.

Question 31

What is the nursing profession’s expression of its ethical values and duties to the public?

a. ANA’s Nursing: Scope and Standards of Practice
b. Code of Ethics for Nurses with Interpretive Statements
c. Gilligan’s stages of moral reasoning
d. International Council of Nurses

Answer 31

b. The Code of Ethics for Nurses with Interpretive Statements:

The Code of Ethics for Nurses with Interpretive Statements is the nursing profession’s expression of its ethical values and duties to the public (ANA, 2001). The Code has undergone no fewer than seven revisions, each clarifying meanings, defining terms, and making the Code more relevant to nursing practice at the time. Codes through the years have also reflected trends in social awareness issues, such as women’s and patients’ rights. The consequences of breaking the Code have become more specific with later versions.

Question 32

Excellent clinical skills are the basis for the concept of “therapeutic use of self.”

a. True
b. False

Answer 32

b. False:

All the clinical skills in the world cannot compensate for poor interpersonal skills.

Question 33

During the termination phase of the nurse-patient relationship, patients should be encouraged to express which one of the following?

a. Positive feelings that encourage healing
b. Negative feelings that allow for constructive venting
c. Positive and negative feelings that occur together

Answer 33

c. Positive and negative feelings that occur together:

The termination phase includes those activities that enable a patient and the nurse to end the relationship in a therapeutic manner. As in any relationship, positive and negative feelings often accompany termination.

Question 34

Nurses should be sensitive in focusing on differences between patients in order to what? (Select all that apply.)

a. Develop skills in communication
b. Discriminate between ability levels of patients
c. Pay attention to gender orientation for planning care
d. Make use of nonverbal communication over verbal for patients who speak a different language

Answer 34

a, b, and c are correct:

Diversity creates opportunities for nurses to develop skill in transcultural communication.Sensitivity to differences entails attention to age and generational differences; cultural, racial, and ethnic distinctions; differing levels of abilities; gender and sexual orientation; and patients from different countries of origin.

Question 35

What are the three phases of the traditional nurse-patient relationship?

Answer 35

Orientation: introductory phase
Working: address tasks
Termination: therapeutic end to relationship

Question 36

Who is the pioneer in nursing theory development that originated the term “therapeutic use of self”?

Answer 36

Hildegard Peplau

Question 37

President Obama signed the ACA to ensure that a systematic and comprehensive reform of the entire health care system will take place for citizens of the United States.

a. True
b. False

Answer 37

b. FALSE:

President Obama signed ACA, which includes comprehensive reforms to improve access and protect consumers from abusive insurance company practices. It is unlikely that a systematic and comprehensive reform of the entire health care system is possible. Instead, we can expect state-by-state efforts to address issues.

Question 38

Disease management services are provided primarily to help patients manage acute illnesses in their own homes, eliminating the need for costly hospitalization.

a. True
b. False

Answer 38

b. False:

Disease management services are provided primarily to patients with chronic diseases through calls with nurses and other health professionals, with interactive voice responses, educational videos/books and Internet-based tools such as e-mail and video conferencing.

Question 39

Which of the following statements about shared governance is false? (Select all that apply.)

a. It is the philosophy that employees have the right and the responsibility to govern their own work and time.
b. It promotes centralization and a top-down approach to nursing.
c. It promotes improved patient outcomes.
d. It makes the clinical nursing staff responsible for adhering to standards and benchmarks of quality care.

Answer 39

b, c, and d are FALSE:

Shared governance is the term used to indicate that employees have both the right and the responsibility to govern their own work and time within a system.

Question 40

Who has the power to license RNs?

a. The National League for Nursing Accrediting Commission
b. The NCLEX examination
c. The school of nursing
d. The state board of nursing

Answer 40

d. The State Board of Nursing:

Who gets a nursing license is determined by the state, which also determines the limits on the license. NCLEX provides the nursing licensure examination. The NLN Accrediting Commission nationally accredits the school of nursing. The school of nursing provides the education allowing a person to take the nursing licensure examination.

Question 41

What is the primary purpose of licensure for nurses?

a. To certify a level of practice beyond nursing school graduation
b. To protect the health, safety, and welfare of the public
c. To distinguish between nurses and other health care professionals

Answer 41

b. To protect the health, safety, and welfare of the public.

Nursing is a regulated practice at the state level. Each state grants nursing licensure to professional nurses for the primary purpose of protecting the public’s health, safety, and welfare.

Question 42

What is the most common reason nurses are disciplined by state boards of nursing?

a. Malpractice
b. Negligence
c. Practicing while impaired
d. Practicing without a license

Answer 42

c. Practicing while impaired:

The most common reason nurses are disciplined by state boards of nursing is for practicing while impaired (under the influence of a substance).

Question 43

Recently, an increase in the number of nursing organizations nationwide has prompted an increase in membership for nurses, with approximately 30% of nurses belonging to at least one organization.

a. True
b. False

Answer 43

b. False:

Fewer then 10% of U.S. RNs belong to one of the 100 or more specialty nursing organizations. Nurses cite many issues for not joining, including: high cost, lack of time, and lack of interest. Other issues include complex relationships between state and national organizations and different expectations among generations of nurses.

Question 44

Each nursing organization has a mission, defined by its mission statement. A mission statement specifies what? (Select all that apply.)

a. The purpose of the organization
b. Who is served by the organization
c. An operations plan for the organization
d. The philosophical basis for the organization

Answer 44

a and b (the purpose of the organization, and who is served by the organization):

An organization has a mission, defined by its mission statement. A mission statement specifies the purpose of the organization and who is served by the organization.

Question 45

Because regulations developed from legislation can change from time to time to affect nursing practice, nurses need to do what? (Select all that apply.)

a. Keep license valid to maintain a large population of nurses
b. Be active in politics to help prevent regulations from negatively impacting nursing
c. Monitor own state’s nurse practice act to keep track of regulations that impact personal practice
d. Be knowledgeable about the specific contents of own state’s scope of practice for nursing

Answer 45

b, c, d:

The regulations governing nursing practice in each state flow from that state’s nurse practice act. Regulations are changed from time to time and can negatively affect nursing practice, so nurses need to be knowledgeable about the contents of their nurse practice act. Nurses must monitor policies that affect their practice, and they should become active in policymaking initiatives to enhance nursing authority and prevent restrictions on practice and other negative impacts of regulation changes.

Question 46

The upward spiraling of incidents of incivility in nursing is readily explained by pressure on nurses to increase their workload.

a. True
b. False

Answer 46

b. False:

There are many causes of incivility in nursing. Uncivil behaviors range along a continuum, from talking on your cell phone while someone is talking to you to the extreme of bullying or aggression. Incivility occurs when people are stressed or feel powerless or out of control in any aspect of their lives. Among nurses and in health care settings, implications include negatively affected patient outcomes and safety.

Question 47

Transformations in our health care system have led to restricted roles for nurses.

a. True
b. False

Answer 47

b. False:

Nurses have an opportunity at this transformation time in health care to assume their role as leaders in primary care and other forms of practice. This leads to an increased variety of roles for nurses.

Question 48

Since the ANA is the official voice of nursing, it is expected to be responsible for which of the following? (Select all that apply.)

a. Code of ethics
b. Articulation of nursing’s social policy
c. Position papers
d. Contributions to political candidates

Answer 48

a, b, c, d:

The ANA is responsible for a nursing code of ethics, the scope and standards of nursing care, articulation of nursing’s social policy, position papers pertinent to nursing practice, and contributions to political candidates