Chapter 05: The Nurse–Patient Relationship
Linton: Introduction to Medical–Surgical Nursing, 6th Edition
MULTIPLE CHOICE
1. A nurse is preparing an anxious patient for major surgery and remarks, “Everyone feels some
anxiety, but you will be asleep during the whole thing.” Which communication style does this
exemplify?
a.
Empathy
b.
Summarizing
c.
False reassurance
d.
Premature advice
2. A nurse is explaining a pamphlet called the “Patient Care Partnership” to a patient and family.
Who should the nurse indicate created this pamphlet?
a.
The Joint Commission
b.
Medicare/Medicaid Act
c.
Social Security Act
d.
American Hospital Association
3. A nurse is discussing the discharge plan with a recovering patient. What is the most effective
communication technique for this nurse to implement?
a.
Assess nonverbal clues.
b.
Allow communication to focus on whatever topic the patient desires.
c.
Insist on postrecovery activities as stated in the care plan.
d.
Reduce eye contact to convey nondirective attitudes.
4. A 6-year-old child is brought to the Public Health Clinic Building to receive immunizations
for the beginning of school. What is the proper classification for the recipient of this service?
a.
Patient
b.
Child
c.
Customer
d.
Client
5. A patient says, “I am sick of being sick.” What is the most therapeutic response?
a.
“I can’t believe you really feel that way.”
b.
“I don’t think that attitude is very helpful.”
c.
“I think you sound pretty frustrated.”
d.
“I want you to feel more positive.”
6. On returning to the nurse’s station, a licensed practical/vocational nurse (LPN/LVN)
discovers that the daughter of a frail but competent resident is reading her mother’s chart. The
woman says, “I am entitled to see my mother’s medical record.” What is the nurse’s best
response?
a.
“What is it that you believe you need to know? Give me the chart.”
b.
“You must understand that only your mother has the right to read the contents of
her medical record. Please give me the chart.”
c.
“Although the chart itself is not available to you to read, I would be glad to try to
answer any questions you have. May I have the chart, please?”
d.
“Reading that chart is a very serious violation of your mother’s privacy. I cannot
allow you to see it. Please put down the chart.”
7. A PN/VN student is assigned to a patient who makes homosexual remarks and asks the
student to meet after discharge. What is the student’s best response?
a.
“I am required to report inappropriate sexual behavior to my instructor.”
b.
“I am uncomfortable dealing with homosexuals. Let’s just forget this conversation
and get on with your care as quickly as possible.”
c.
“I am here as your nurse to meet your treatment needs. Such provocative
conversation is not acceptable to me as part of your care.”
d.
“Your chosen lifestyle makes me uncomfortable. I will be back with your
medication.”
8. A patient with newly diagnosed cancer states, “I can’t stand to think about chemo.” What is
the most therapeutic response?
a.
“What about chemo concerns you?”
b.
“Chemo is so much better than it used to be.”
c.
“Wow! I can sure understand that!”
d.
“Have you had chemo before?”
9. The families of patients expect their hospitalized member to receive holistic care. What
characteristic is an example of provision of holistic care?
a.
Providing safety with the side rails up
b.
Providing only foods and drinks that are to the patient’s liking
c.
Bathing at a time and manner that is specified by the patient
d.
Including the family in the holistic approach
10. A nurse, as a unique person, brings to each practice-patient relationship qualities such as
knowledge, experiences, strengths, and weaknesses. What is the inclusive term used to
describe this phenomenon?
a.
Personhood experiences
b.
Physiologic influence
c.
Sociologic influence
d.
Use of self in nursing
11. A patient asks the nurse who is picking up the breakfast trays, “What will happen during the
radiology test this morning?” The nurse replies, “All the necessary explanations are on that
sheet of paper on the table.” What does this response violate?
a.
Confidentiality
b.
Privacy
c.
Explanation of care
d.
Continuity of care
12. A dying patient says, “There is no God. There is no afterlife. When it’s over, it’s over.” What
is the most therapeutic response?
a.
“You must feel very lonely.”
b.
“Of course there is a God, and He loves you very much.”
c.
“Why do you think there is no God?”
d.
“You are absolutely right. I think that, too.”
13. A newly admitted 80-year-old patient with hemiplegia is fully alert. Which is the most
appropriate greeting by the nurse?
a.
“Good morning, Mrs. Brown. My name is Ann, and I am your nurse today.”
b.
“I am your nurse. Today is bath day. You will get yours right after breakfast.”
c.
“Hello there, sweetie. We need to get to work on getting your breakfast so we can
get your shower.”
d.
“My name is Ann. You are my patient today.”
14. Sometimes patients communicate by crying, moaning, or laughing. What should this behavior
be considered?
a.
Verbal communication
b.
Nonverbal communication
c.
Acting out and seeking attention
d.
Seeking holistic support
15. A nurse communicates in an open, honest, and nonjudgmental manner. How should this
approach be characterized?
a.
Therapeutic communication
b.
Democratic communication
c.
“I” statements
d.
Autocratic communication
16. An LPN/LVN finds a young man tearfully staring out the window. He says, “I’ve been in this
hospital 23 days out of the last 50. I’ve lost a lot of pay.” What response by the nurse should
be used to encourage further communication?
a.
“You’ve lost a lot of work?”
b.
“Would you like me to arrange an appointment for you to speak with the social
worker?”
c.
“How much pay have you lost?”
d.
“You are to be discharged at the end of the week, and you can return to work.”
17. A nurse is careful to perform each procedure in the same step-by-step manner. What will this
consistency of care accomplish?
a.
That no step is omitted
b.
Complete safety
c.
Confidence in the nurse’s competence
d.
Save time
18. A nurse is assigned to a patient who has been a very close family friend for many years. What
statement would be most appropriate for the nurse to maintain a therapeutic relationship under
these circumstances?
a.
“Don’t worry about a thing. I will see that extra care is given to you on the other
shifts, because you are my friend.”
b.
“You may feel uncomfortable about my caring for you. Although everything that
happens here is considered to be confidential, would you prefer another
caregiver?”
c.
“This is a very busy unit, but I will make sure that you get lots of attention, and I
will come back after my shift to help you.”
d.
“I’m so sorry that you are hospitalized, but I will tell all my friends to take special
care of you for me.”
19. A nurse is changing an abdominal dressing on a disoriented 89-year-old man when he grabs
the nurse’s breast muttering something about “Mary” (his wife). What is the most therapeutic
response by the nurse?
a.
Stereotype him as a “dirty old man” and warn the rest of the staff to stay away
from him.
b.
Get a physician’s order for wrist restraints when nurses go near the patient for
activities such as dressings, baths, and feedings.
c.
Maintain eye contact with the patient and then clearly tell him and repeat, “I am
your nurse. I am coming to help you eat, bathe, and change your stomach bandage.
I am not Mary.”
d.
“That dressing needs changing. Don’t be a naughty boy with me again or I will
slap your hands and call Mary to come and do all your care herself!”
20. A young woman comes to the public health clinic for an antibiotic to treat a sexually
transmitted infection (STI). She is accompanied by her live-in boyfriend. What is the most
therapeutic remark by the nurse?
a.
“Her infection is very contagious. Would you like me to give you the name of a
place where you can be screened for the infection and be given the means for a
cure?”
b.
“You probably have the same sexual infection. You need to see about it before you
give it back to her or somebody else.”
c.
“You may have the same infection. Have you been with any other women lately?
The health department needs to make a list.”
d.
“This is the third time that your friend has been in here with the same infection!
Why don’t you get some shots yourself?”
21. What is a nurse trying to discern when assessing a patient’s affect?
a.
Problem
b.
Mood
c.
Orientation
d.
Needs
22. A newly admitted resident to a long-term care facility tells the nurse that he misses his dog.
What is the most therapeutic response by the nurse?
a.
“You need to get a stuffed dog to keep you company.”
b.
“Have you made friends with Buddy, our facility’s mascot?”
c.
“Yes, dogs are a great deal of company.”
d.
“What do you miss about your dog?”
MULTIPLE RESPONSE
23. What does the pamphlet “Patient Care Partnership” clarify that patients will have? (Select all
that apply.)
a.
Provision of respectful care
b.
Protection of privacy
c.
Access to medical records
d.
Reasonable fees for service
e.
Information concerning current condition
24. What aspects should be included in a plan of care in modern holistic nursing? (Select all that
apply.)
a.
Psychologic
b.
Financial
c.
Physiologic
d.
Spiritual
e.
Sociologic
25. A nurse is diligent in keeping a patient informed about treatments, medication, and laboratory
tests. What should the provision of this information accomplish for the patient? (Select all that
apply.)
a.
Less anxiety
b.
More participation in care
c.
Less likelihood of complaints
d.
More compliance with treatment goals
e.
More satisfaction with treatment outcomes
26. How does a therapeutic relationship differ from a social relationship? (Select all that apply.)
a.
Has no limits
b.
Is always acceptable to the patient
c.
Is goal directed
d.
Is nonjudgmental
e.
Focuses only on the patient