Medical Surgical Nursing An Integrated Approach 3rd Edition by Lois White -Test Bank
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Sample Test
Chapter 3—Communicating with Clients with Personal and Family
Issues
MULTIPLE CHOICE
1. One
vital skill in coping with health and other life crises is:
|
a. |
passive listening |
c. |
good communication |
|
b. |
conflict avoidance |
d. |
suppressing emotion |
ANS: C
One vital skill in coping with health and other life crises is
good communication.
PTS:
1
DIF: Comprehension
REF: White (2013)
2. A
client presented for a pre-op appointment. At the appointment, the wife states
that the husband has been giving her the cold shoulder ever since the surgery
was scheduled. The nurse knows this behavior to be:
|
a. |
denial |
c. |
passive-aggressive |
|
b. |
defensive |
d. |
hidden agenda |
ANS: C
Passive-aggressive tendencies are negative or aggressive
feelings expressed indirectly or displayed by an unwillingness to cooperate.
Some behaviors seen in passive aggressive individuals are pouting, giving the
cold shoulder, giving the silent treatment, stubbornness, intentional
forgetfulness, or tardiness.
PTS:
1
DIF: Application REF: White
(2013)
3. A
nurse has entered a client’s room and overhears a mother and daughter arguing
about the mother’s discharge plan. The mother really wants to go to a rehab
center and the daughter really wants the mother to go to a nursing home. Their
argument is an example of:
|
a. |
defensiveness |
c. |
conflict avoidance |
|
b. |
a power struggle |
d. |
a lack of trust |
ANS: B
Power struggles involves individuals with different points of
view. One individual is attempting to override the other individual’s feeling
or opinion.
PTS: 1
DIF: Application REF: White
(2013)
4. Therapeutic
communication involves which of the following?
|
a. |
passive listening |
c. |
disregard of body language |
|
b. |
active listening |
d. |
conflict avoidance |
ANS: B
Active listening is really listening to what the client is
saying and attempting to understand the situation from the client’s
perspective. It is important to take in the voice tone, pitch, and inflection
as well as watching to see if the body language corresponds to what the client
is saying.
PTS:
1
DIF:
Comprehension
REF: White (2013)
5. When
communicating with a client, the nurse finds that she is not able to offer a
solution or answer to the client who has concerns. The nurse should:
|
a. |
ignore the client’s
concerns |
c. |
tell the client of worse
experience |
|
b. |
generate a very specific
solution |
d. |
validate the client’s
concerns |
ANS: D
When it is not possible to offer an answer or solution to a
client communicating a concern, validation may help. Assure the client
that it is normal for the client to be both experiencing stress and desiring to
talk about whatever personal or family issues are occurring. The nurse should
validate the client’s unique experience.
PTS:
1
DIF:
Comprehension
REF: White (2013)
6. A
nurse who is able to imagine one’s self in circumstances similar to what the
client is experiencing is able to convey which feeling?
|
a. |
empathy |
c. |
trust |
|
b. |
sympathy |
d. |
discernment |
ANS: A
Empathy is the ability to imagine one’s self in a similar
circumstance or situation.
PTS:
1
DIF: Comprehension
REF: White (2013)
7. Which
of the following statements made to a client conveys empathy?
|
a. |
“I wouldn’t worry; I once
had a patient who had a worse condition.” |
|
b. |
“You’ll get over it in no
time!” |
|
c. |
“I am sorry for your loss.” |
|
d. |
“What you’ve experienced is
horrible and I can’t even imagine suffering through that!” |
ANS: C
Often, offering sympathy may hinder therapeutic communication.
This can also make a client feel isolated and alone. Careful expressions of
sympathy can result in therapeutic communication.
PTS:
1
DIF: Application REF: White
(2013)
8. What
must occur in order for significant meaningful communication to occur between a
client and a nurse?
|
a. |
Be the same approximate
age. |
|
b. |
Share a similar diagnosis. |
|
c. |
Client and nurse should be
friends. |
|
d. |
The client must feel that a
genuine relationship exists. |
ANS: D
Generally, in order for a significant meaningful communication
to occur between the client and a nurse, the client must feel that a warm and
genuine relationship between the two parties exists.
PTS:
1
DIF:
Comprehension
REF: White (2013)
9. A
client has just shared some serious concerns about performing colostomy care
independently upon discharge. The nurse responds to the client saying
“Everything will be alright.” This has made the client feel unheard. This is an
example of:
|
a. |
empathy |
c. |
sympathy |
|
b. |
a cliché |
d. |
caring |
ANS: B
The use of a trite or frequently used phrase, like a cliché,
results in the client feeling unheard. Clichés are often perceived as a
signal that no further discussion is warranted.
PTS:
1
DIF: Application REF: White
(2013)
10. Hospitalized
clients, or clients under stress, have which type of response?
|
a. |
They have similar reactions
and emotions. |
|
b. |
They move through two
phases: anger and fear. |
|
c. |
They mimic the behavior of
their fellow clients. |
|
d. |
They have unique and varied
as the clients themselves. |
ANS: D
It is important to remember that the responses to the stressors
associated with health related issues can be as unique and varied as the
individuals themselves.
PTS:
1
DIF:
Comprehension
REF: White (2013)
11. In
which order should the nurse focus on a client’s concerns?
|
a. |
all at the same time |
c. |
focus on most pressing
worry first |
|
b. |
only one concern per conversation |
d. |
focus on minor concerns
then major |
ANS: C
It is important for the nurse to remember to focus on the
client’s most pressing worries before moving on to other topics that need to be
addressed. As long as a client is worried about his problem, the client may not
hear the suggestions or other topics discussed.
PTS:
1
DIF:
Comprehension
REF: White (2013)
12. In
communicating with a family who has experienced divorce, what is an important
concept to remember?
|
a. |
Information should be
shared with all family members. |
|
b. |
Determine first how the
family interacts and communicates. |
|
c. |
Speak only with the females
in the family. |
|
d. |
Exclude children from all
healthcare information and communication. |
ANS: B
Divorce is a major life crisis that brings challenges to
families, especially in the area of communication. Determining an understanding
of how those in the family interact with each other is an important first step
in communicating with the family.
PTS:
1
DIF:
Comprehension
REF: White (2013)
13. While
working at a wound care clinic, the nurse noticed that a client is not changing
his lower extremity dressings per the physician’s orders. The nurse approaches
the client in a respectful, tactful and non-threatening manner regarding the
dressing change schedule. This is an example of:
|
a. |
gentle confrontation |
c. |
productive confrontation |
|
b. |
soft inquiry |
d. |
compliance confrontation |
ANS: C
Productive confrontation can be an important part of the
communication process between the nurse and the client if this technique is
used in a respectful, tactful and non-threatening manner. Doing this can help
to facilitate the client’s move toward self-examination and opportunities for
growth.
PTS:
1
DIF: Application REF: White
(2013)
14. When
meeting with a client to make a health related decision, the nurse should:
|
a. |
assemble the whole family
to assist the client |
|
b. |
allow only one other
individual to assist the client |
|
c. |
meet with the client alone |
|
d. |
determine with the client
who they wish to be involved in the discussion |
ANS: D
In many families, the entire family is involved in making health
related decisions. It is important to determine with the client who they wish
to be involved when discussing health matters. While the nurse may be used to
interacting with only a client’s spouse, some families choose several members
to be involved.
PTS:
1
DIF:
Comprehension
REF: White (2013)
15. When
a person quickly assumes that others are blaming or confronting them, this is
called:
|
a. |
denial |
c. |
passive-aggressive behavior |
|
b. |
defensiveness |
d. |
lack of trust |
ANS: B
Defensiveness is a behavior when an individual quickly assumes
others are blaming or confronting them.
PTS:
1
DIF: Comprehension
REF: White (2013)
16. The
intentional evasion of potentially uncomfortable confrontations or
disagreements is called:
|
a. |
therapeutic avoidance |
c. |
suppression of emotion |
|
b. |
conflict avoidance |
d. |
passive confrontation |
ANS: B
Conflict avoidance is the intentional evasion of potentially
uncomfortable confrontations or disagreements.
PTS:
1
DIF:
Comprehension
REF: White (2013)
17. A
client has presented at the Emergency Department reporting that she has been a
victim of domestic abuse. After a physical exam, the next step the nurse should
take is to:
|
a. |
do nothing |
|
b. |
share her personal
experience of domestic violence |
|
c. |
counsel the victim on next
steps |
|
d. |
ask the ED social worker to
meet with the client to offer support and resources |
ANS: D
When presented with the harsh reality of domestic abuse, nurses
may inadvertently pull back from the client with domestic abuse. While at first
the nurse may be unsure how to best help a client in an abusive relationship,
doing nothing is not an option. In such complex situations, a team of
healthcare providers may need to explore how best to help the client.
PTS:
1
DIF: Comprehension
REF: White (2013)
18. A
negative family dynamic where feelings are not allowed to be shared is called:
|
a. |
lack of trust |
c. |
negativity |
|
b. |
suppression of emotions |
d. |
hidden agenda |
ANS: B
Suppression of emotions is a family and/or individual dynamic
where feelings and emotions are not shared. This communication pattern does not
lead to therapeutic communication.
PTS:
1
DIF:
Comprehension
REF: White (2013)
MULTIPLE RESPONSE
1. In
healthy families, members can use communication to help meet the individual
needs of all members. In addition, communication can provide support to others.
Which of the following are traits and tendencies common to health functioning
families?
|
a. |
passive listening |
e. |
openness |
|
b. |
honest, forthright
communication |
f. |
respect for elders only |
|
c. |
flexibility |
g. |
sense of fairness |
|
d. |
active listening |
h. |
sense of trust |
ANS: B, C, D, E, G, H
The following are traits and tendencies common to health
functioning families: use of active listening, honest, forthright
communication, members feel sense of security and acceptance, flexibility,
openness, encourages other family members, sense of fairness ( a give and take
approach), sense of trust, feelings of love and kindness are easily displayed
and respect is given for all members.
PTS:
1
DIF: Application REF: White
(2013)
2. Verbal
communication is extremely important in caring for clients. Listening to
clients is just as important. Which of the following are keys to effective
listening?
|
a. |
giving full attention |
d. |
summarizing what client has
said |
|
b. |
avoiding interruptions |
e. |
validating client’s
concerns |
|
c. |
providing premature
interpretations |
|
|
ANS: A, B, D, E
Keys to effective listening include: provide full attention
avoiding interruptions and premature interpretations. Give evidence of
understanding through restating or summarize what you heard. Just as important
is recognizing when your client is not ready to have you communicate
information to them. Bad news may need to be delivered in small chunks to allow
the client to process the information. If multiple stressors are present some
may need to be resolved before more bad news can be processed
PTS:
1
DIF: Application REF: White
(2013)
Chapter 4—Complementary and Alternative Therapies
MULTIPLE CHOICE
1. The
nurse is caring for a client using therapies instead of conventional or
mainstream medical treatments. This nurse is aware that this client’s caring
includes:
|
a. |
alternative therapies |
c. |
energetic touch |
|
b. |
complementary therapies |
d. |
inventive therapies |
ANS: A
Alternative therapies are treatments other than traditional or
mainstream medical modalities. Complementary therapies, on the other hand, are
used in conjunction with conventional medical modalities.
PTS:
1
DIF:
Comprehension
REF: White (2013)
2. The
nurse is caring for a client using therapies along with conventional medical
therapies. This client’s plan of care includes the use of:
|
a. |
alternative therapies |
c. |
congruent therapies |
|
b. |
complementary therapies |
d. |
nonconventional therapies |
ANS: B
Alternative therapies are treatments other than traditional or
mainstream medical modalities. Complementary therapies, on the other hand, are
used in conjunction with conventional medical modalities. These practices, rediscovered
by modern healers, are based on traditions traced to the cultures of ancient
Greece, the Far East, China, India, and to shamanism.
PTS:
1
DIF:
Comprehension
REF: White (2013)
3. Which
of the following statements is TRUE regarding the performance of alternative or
complementary therapies by nurses?
|
a. |
Experimental alternative
therapies cannot be performed on a client without meeting study requirements. |
|
b. |
Nurses can perform any type
of alternative therapy upon receipt of initial licensure. |
|
c. |
Some types of alternative
therapies are not within the scope of practice for nurses. |
|
d. |
State law requires nurses
to meet certain educational standards before performing any alternative therapy. |
ANS: C
It is important for nurses to know about these traditions and
practices for several reasons. The nurse must show respect to clients who
believe in these practices, even if he or she does not share such beliefs. In
some states, use of alternative therapies may be restricted by law, and the
nurse who performs any of the legally restricted therapies may be subject to
legal action. These practices may also be beyond the scope of nursing practice
designated by individual health care facilities. Some clients may hear or read
about some of these complementary or alternative therapies and ask nurses about
them; nurses should understand the consequences of making any endorsement or
recommendation of any of these therapies.
PTS:
1
DIF:
Comprehension
REF: White (2013)
4. The
nurse is caring for a Chinese American client and understands that an essential
component of traditional Chinese healing practice includes:
|
a. |
Ayurveda |
c. |
meridianism |
|
b. |
herbalism |
d. |
shamanism |
ANS: B
In China, the belief in the oneness of all things in nature
formed the traditional Chinese healing system. According to this system, life
energy (chi) flows through the universe and the individual, creating a wholeness
among things and people. This life energy, which connects a person’s organs
together and to the universe, is disrupted in illness or injury but can be
influenced by stimulating various points along the energy pathways (meridians).
Healers in the Chinese tradition use herbs or techniques such as acupuncture to
promote balance.
PTS:
1
DIF:
Comprehension
REF: White (2013)
5. A
Chinese client may believe that disease results when the energy flow is blocked
and that a healing technique releases blocked energy by pressing or massaging
certain points along the meridians. This technique is known as:
|
a. |
acupressure |
c. |
Ayurveda |
|
b. |
acupuncture |
d. |
body-mind centering |
ANS: B
Shiatsu and acupressure are based on the theory that the body is
divided into meridian channels through which energy flows; disease results when
the energy flow is blocked. Acupressure is used to release blocked energy by
pressing or massaging certain points along the meridians; the disease subsides
when the blocked energy is dispersed. Acupressure is used to treat muscle and
joint pain, depression, digestive disturbances, and respiratory disorders.
Shiatsu focuses on clients’ health maintenance.
PTS:
1
DIF:
Comprehension
REF: White (2013)
6. The
nurse is caring for a client from India and is aware that the client’s culture
may include the belief that prevention of illness and restoration of health
through inner search and spiritual growth is the primary goal of which
spiritually based system?
|
a. |
Ayurveda |
c. |
meridianism |
|
b. |
herbalism |
d. |
shamanism |
ANS: A
In India, Ayurvedic medicine emphasizes prevention and a
holistic approach to life; its underlying basis is spiritual. According to this
approach, each person is born with a unique balance of three metabolic
principles (doshas), determining body type, temperament, and susceptibility to
certain illnesses. Areas of energy concentration in the body (chakras) can
become blocked, resulting in illness. Prevention of illness and restoration of
health through inner search and spiritual growth are the primary goals of the
Ayurvedic system.
PTS:
1
DIF:
Comprehension
REF: White (2013)
7. The
practice of entering altered states of consciousness with the intent of helping
others is known as:
|
a. |
Ayurveda |
c. |
mental imagery |
|
b. |
meditation |
d. |
shamanism |
ANS: D
Shamanism is the practice of entering altered states of
consciousness to help others. The shaman or folk healer-priest acts as guardian
of the spirits, using natural or supernatural forces or herbs to help others.
Illness is considered to be the result of spirit loss, so the shaman acts as
both priest and healer to encourage the spirits to return to the individual.
The shaman may also use totems, ritual songs, foods, and clothing to connect to
the spirit world.
PTS:
1
DIF: Knowledge REF: White
(2013)
8. Folk
healer-priests who have the power to heal by working with spirits to encourage
their full return to an individual. These guardian of the spirits are known as:
|
a. |
Ayurvedic healers |
c. |
root doctors |
|
b. |
medicine men |
d. |
shamans |
ANS: D
Shamanism is the practice of entering altered states of
consciousness to help others. The shaman or folk healer-priest acts as guardian
of the spirits, using natural or supernatural forces or herbs to help others.
Illness is considered to be the result of spirit loss, so the shaman acts as
both priest and healer to encourage the spirits to return to the individual.
The shaman may also use totems, ritual songs, foods, and clothing to connect to
the spirit world.
PTS:
1
DIF:
Comprehension
REF: White (2013)
9. Research
into which new field of science supports the idea that the human mind can alter
the physiology of the body?
|
a. |
macrobiotic reflexology |
c. |
mental imagery |
|
b. |
meditation |
d. |
psychoneuroimmunology |
ANS: D
The field of psychoneuroimmunology (PNI) studies the complex
relationship among the cognitive, affective, and physical facets of human
beings, including how the brain transmits signals along the nerve pathways to
enhance normal immune functioning. This research supports the concept that the
human mind can alter physiology and that cells can be directly affected by
emotions.
PTS:
1
DIF:
Comprehension
REF: White (2013)
10. Amino
acids that are produced in the brain and other body sites and act as chemical
communicators are called:
|
a. |
antioxidants |
c. |
neurotransmitters |
|
b. |
neuropeptides |
d. |
phytochemicals |
ANS: B
All body cells have receptors for neuropeptides, which are amino
acids that are produced in the brain and other body sites and act as chemical
communicators. Neuropeptides are released when neurotransmitters signal
emotions to the brain.
PTS:
1
DIF: Knowledge REF: White
(2013)
11. Chemical
substances that are produced by the body and facilitate nerve-impulse
transmission are called:
|
a. |
antioxidants |
c. |
neurotransmitters |
|
b. |
neuropeptides |
d. |
phytochemicals |
ANS: C
All body cells have receptors for neuropeptides, which are amino
acids that are produced in the brain and other body sites and act as chemical
communicators. Neuropeptides are released when neurotransmitters, which are
chemical substances that are produced by the body and facilitate nerve-impulse
transmission, signal emotions to the brain.
PTS:
1
DIF: Knowledge REF: White
(2013)
12. The
inseparable connection and operation of thoughts, feelings, and physiologic
functions is known as:
|
a. |
biofeedback |
c. |
phytochemical pathways |
|
b. |
bodymind |
d. |
psychoneural mediations |
ANS: B
The complex interrelationship between psyche and body chemistry
is called bodymind, denoting the unified connection and operation of thoughts,
feelings, and physiologic functions. Because of the interconnection of body systems,
mental images can become neurotransmitters in the autonomic nervous system,
hormones in the endocrine system, and white blood cells in the immune system.
The interaction between the nervous, endocrine, and immune systems modulates
the activity of each system.
PTS:
1
DIF: Knowledge REF: White
(2013)
13. The
client has undergone surgery to remove a ruptured appendix. The purpose of the
surgery was to bring about a state of:
|
a. |
curing |
c. |
health |
|
b. |
healing |
d. |
wellness |
ANS: A
The removal of disease from an individual is called curing.
PTS:
1
DIF:
Comprehension
REF: White (2013)
14. A
process that activates the individual’s forces from within is called:
|
a. |
curing |
c. |
healing |
|
b. |
health |
d. |
wellness |
ANS: C
The healing process activates the individual’s internal forces,
and the nurse can act as a healing facilitator or instrument of healing to the
client.
PTS: 1
DIF: Knowledge REF: White
(2013)
15. When
acting as a healing facilitator, the nurse enters into a relationship with a
client for what purpose?
|
a. |
to act as a change agent |
|
b. |
to perform health care
activities |
|
c. |
to be a guide |
|
d. |
to use various
complementary or alternative therapies |
ANS: C
Nurses may use complementary or alternative therapies to promote
client well-being, focusing on healing (making whole) rather than curing
(treating disease processes). The healing process activates the individual’s
internal forces, and the nurse can act as a healing facilitator or instrument
of healing to the client. The nurse as a healing facilitator enters into a
relationship with the client to assist the client by being a guide. The
objective is to assist the client in releasing inner resources for healing.
PTS:
1
DIF:
Comprehension
REF: White (2013)
16. A
client is experiencing acute pain for which pain medication is not indicated.
The nurse can teach the client which of the following complementary interventions
to assist with pain control?
|
a. |
relaxation |
c. |
tai chi |
|
b. |
reflexology |
d. |
meditation |
ANS: A
Relaxation builds on the elements of meditation. The relaxation
response requires a quiet environment, a comfortable position, focused attention,
a passive attitude, and practice. Progressive muscle relaxation, which is the
alternate tensing and relaxing of muscles, is one way to achieve relaxation.
Relaxation techniques are useful for clients experiencing pain or stress and
for clients undergoing cognitive behavioral therapy for phobias, fears, and
depression.
PTS:
1
DIF:
Comprehension
REF: White (2013)
17. The
nurse can encourage a client to visualize a soothing mental picture in combination
with traditional medical intervention. The client is practicing which
self-regulatory technique?
|
a. |
biofeedback |
c. |
meditation |
|
b. |
imagery |
d. |
relaxation |
ANS: B
Imagery is the imagination to visualize a pleasant, comforting
picture by drawing upon one or more senses (visual, auditory, kinesthetic,
gustatory, olfactory) to form images. Clients can use imagery to promote a
sense of well-being and to change their perceptions about their disease,
treatment, or healing ability; imagery can be combined with medication to
decrease physical tension and anxiety and can distract clients from pain or
discomfort. Imagery is also useful in making decisions and in altering
behaviors by allowing clients to “try out” a decision or behavior before actually
implementing it.
PTS:
1
DIF:
Comprehension
REF: White (2013)
18. The
client is using a measurement of physiologic responses to learn to manipulate
the autonomic nervous system through mental activity. This is an example of:
|
a. |
biofeedback |
c. |
meditation |
|
b. |
imagery |
d. |
relaxation |
ANS: A
Biofeedback is self-training to control one’s autonomic nervous
system. It allows a client to see the effect of the mind on the body by viewing
sensitive instruments that record physiologic data. Biofeedback is useful in
rehabilitation settings and can enhance muscle relaxation, relieve tension
headaches and backaches, reduce bruxism, lower blood pressure, and prevent or
relieve migraine headaches.
PTS:
1
DIF:
Comprehension
REF: White (2013)
19. Which
of the following statements about hypnosis is TRUE?
|
a. |
Advanced training in
hypnosis is advised for nurses but not required. |
|
b. |
Hypnosis induces an altered
state of consciousness that results in cure. |
|
c. |
Hypnosis should be used
only after other self-regulatory techniques have failed. |
|
d. |
Nurses should be aware of
state nursing guidelines before practicing hypnosis. |
ANS: D
Hypnosis induces an altered state of consciousness or awareness
similar to sleep, during which a person is more receptive to suggestion.
Hypnosis can help clients to form images. Use of hypnosis by nurses may be
defined by state boards of nursing and generally requires advanced training.
PTS:
1
DIF: Application REF: White
(2013)
20. Which
of the following clients would be the BEST candidate for touch therapy?
|
a. |
a client experiencing pain
that may be related to stress or musculoskeletal stiffness |
|
b. |
a client with burns or very
sensitive skin |
|
c. |
a client who is angry or
distrustful |
|
d. |
a client who has been
neglected, abused, or injured |
ANS: A
Touch, the means of perceiving or experiencing through tactile
sensation, is one of the universal complementary and alternative modalities. In
certain cultures, there are taboos associated with touch; in others, touch can
be used in certain situations and within specific parameters. For these
reasons, a nurse should not touch a client until effective communication has
been established. Touch is used by nurses in the assessment process and is an
important means of communication, particularly when other senses are impaired.
Touch promotes nurse-client bonding and helps soothe, comfort, and orient
clients.
PTS:
1
DIF:
Comprehension
REF: White (2013)
21. Which
of the following statements about therapeutic massage is TRUE?
|
a. |
A back rub administered by
a nurse in the hospital is not considered to be therapeutic massage. |
|
b. |
Localized massage should be
considered for clients with varicose veins, phlebitis, or thrombus. |
|
c. |
Many states do not have licensing
requirements for massage practitioners. |
|
d. |
Massage should be used with
caution in clients with certain illnesses and disease processes in which
increased circulation may be harmful. |
ANS: D
Therapeutic massage is the application of pressure and motion by
hands and involves kneading, rubbing, and the use of friction to improve client
well-being. Nurses use massage techniques such as back rubs to provide comfort,
to improve circulation, and to provide relief from pain or musculoskeletal
stiffness. Massage therapists may require licensure in some states.
PTS:
1
DIF:
Comprehension
REF: White (2013)
22. Which
of these statements about healing touch is TRUE?
|
a. |
It is identical to therapeutic
touch. |
|
b. |
It is an energy therapy
using hands to clear, energize, and balance the client’s energy field. |
|
c. |
It requires lifelong,
ongoing sessions to be effective. |
|
d. |
It requires a team of
specially prepared nurses to conduct sessions. |
ANS: B
Healing touch alters the person’s energy field through touch and
affects physical, mental, emotional, and spiritual health. After a healing
touch session, the client needs follow-up or additional treatments.
Practitioners who use either therapeutic or healing touch also use a centering
process of bringing the self to an inner focus of serenity before initiating
treatment.
PTS:
1
DIF:
Comprehension
REF: White (2013)
23. The
client uses a technique of releasing blocked energy within an individual when
specific points along the meridians are pressed or massaged by the
practitioner’s fingers, thumbs, and heels of the hands. This is an example of:
|
a. |
acupressure |
c. |
therapeutic massage |
|
b. |
acupuncture |
d. |
therapeutic touch |
ANS: A
Shiatsu and acupressure are based on the theory that the body is
divided into meridian channels through which energy flows; disease results when
the energy flow is blocked. Acupressure is used to release blocked energy by
pressing or massaging certain points along the meridians; the disease subsides
when the blocked energy is dispersed. Acupressure is used to treat muscle and
joint pain, depression, digestive disturbances, and respiratory disorders. Shiatsu
focuses on clients’ health maintenance.
PTS:
1
DIF:
Comprehension
REF: White (2013)
24. What
is the fundamental concept of reflexology?
|
a. |
The foot is the microcosm
of the entire body. |
|
b. |
Various body zones control
a person’s health status. |
|
c. |
Foot massage can cure many
acute health problems. |
|
d. |
Taking good care of the
feet prolongs life. |
ANS: A
According to reflexology, the body is divided into longitudinal
zones running the length of the body, each correlated with the fingers and
toes, with the foot serving as the microcosm of the entire body. Illness
results in calcium deposits and acids in the corresponding part of the person’s
foot. Pressure on specific points of the foot stimulates energy movement,
resulting in relaxation, stress reduction, and release of accumulated toxins.
Reflexology is used as a complementary therapy for managing chronic conditions
such as asthma, sinus infections, constipation, and kidney stones.
PTS:
1
DIF:
Comprehension
REF: White (2013)
25. Substances
such as vitamins C and E, beta-carotene, and selenium are examples of:
|
a. |
antioxidants |
c. |
herbs |
|
b. |
free radicals |
d. |
phytochemicals |
ANS: A
Antioxidants are substances such as vitamins C and E,
beta-carotene, and selenium, which prevent or inhibit oxidation; they prevent
tissue damage related to free radicals, which are unstable molecules that alter
genetic codes and can trigger cancer cell growth. Free radicals are also
associated with cardiovascular disease.
PTS:
1
DIF:
Comprehension
REF: White (2013)
26. Nonnutritive,
physiologically active compounds that are present in fruits such as cantaloupe,
oranges and other citruses, grapes, strawberries, raspberries, and cherries,
and in vegetables such as onions, garlic, carrots, sweet potatoes, squash, and
pumpkin are known as:
|
a. |
antioxidants |
c. |
herbs |
|
b. |
free radicals |
d. |
phytochemicals |
ANS: D
Phytochemicals are nonnutritive, physiologically active
compounds present in small amounts in plants. They store nutrients and provide
structure, aroma, flavor, and color. Phytochemicals are found in fruits such as
cantaloupe, oranges and other citruses, grapes, strawberries, raspberries, and
cherries, and in vegetables such as onions, garlic, carrots, sweet potatoes,
squash, and pumpkin; they can protect people from cancer and prevent heart
disease, stroke, and cataracts. Because no single fruit or vegetable contains
all phytochemicals, it is important for nurses to encourage clients to eat a
wide variety of fruits and vegetables daily.
PTS:
1
DIF:
Comprehension
REF: White (2013)
27. Unstable
molecules that alter genetic codes and trigger the growth of cancer in cells
are called:
|
a. |
antioxidants |
c. |
herbs |
|
b. |
free radicals |
d. |
phytochemicals |
ANS: B
Antioxidants are substances such as vitamins C and E, beta-carotene,
and selenium, which prevent or inhibit oxidation; they prevent tissue damage
related to free radicals, which are unstable molecules that alter genetic codes
and can trigger cancer cell growth. Free radicals are also associated with
cardiovascular disease.
PTS:
1
DIF: Knowledge REF: White
(2013)
28. Therapeutic
use of concentrated essences or essential oils that have been extracted from
plants and flowers is known as:
|
a. |
aromatherapy |
c. |
phytochemical therapy |
|
b. |
imagery |
d. |
odorology |
ANS: A
Aromatherapy is the therapeutic use of concentrated essences or
essential oils extracted from plants and flowers to produce different effects.
PTS:
1
DIF: Knowledge REF: White
(2013)
29. When
nurses assess clients, it is essential that they include questions about:
|
a. |
life goals |
|
b. |
the use of herbal and
vitamin supplements |
|
c. |
experiences with
therapeutic touch |
|
d. |
visits to reflexologists |
ANS: B
Herbal therapy uses plant extracts to achieve therapeutic
outcomes because of their chemical composition. Different herbs contain
different compounds that have certain medicinal values. It is vital that the
nurse assess clients for the use of these.
PTS:
1
DIF:
Comprehension
REF: White (2013)
30. The
client uses a macrobiotic diet. The nurse is aware that this includes the main
use of which types of food?
|
a. |
meat and eggs |
c. |
tropical sweet foods |
|
b. |
brown rice and whole grains |
d. |
fruits and vegetables |
ANS: B
A macrobiotic diet is based on the concept of balance between
opposites achieved through food intake; some foods are considered yin
(associated with death, cold, and darkness, such as tropical sweet foods) or yang
(associated with immortality, heat, and light, such as meat and eggs).
Overindulgence in either type of food can cause problems, and the idea is to
balance consumption of yin and yang foods. Brown rice and whole grains are
considered to be balanced foods and are staples in the macrobiotic diet.
PTS:
1
DIF:
Comprehension
REF: White (2013)
MULTIPLE RESPONSE
1. The
nurse is aware that phytochemicals are present in which of the following foods?
(Select all that apply.)
|
a. |
cantaloupe |
d. |
onions |
|
b. |
potatoes |
e. |
meats |
|
c. |
celery |
f. |
oranges |
ANS: A, D, F
Phytochemicals are nonnutritive, physiologically active
compounds present in small amounts in plants. They store nutrients and provide structure,
aroma, flavor, and color. Phytochemicals are found in fruits such as
cantaloupe, oranges and other citruses, grapes, strawberries, raspberries, and
cherries, and in vegetables such as onions, garlic, carrots, sweet potatoes,
squash, and pumpkin; they can protect people from cancer and prevent heart
disease, stroke, and cataracts. Because no single fruit or vegetable contains
all phytochemicals, it is important for nurses to encourage clients to eat a
wide variety of fruits and vegetables daily.
PTS:
1
DIF:
Comprehension
REF: White (2013)
2. The
nurse is caring for a client on a hospice unit who has been diagnosed with
terminal cancer. The plan of care might include the use of which complementary
therapies to help reduce the client’s cancer pain? (Select all that apply.)
|
a. |
relaxation |
d. |
yoga |
|
b. |
imagery |
e. |
healing touch |
|
c. |
movement and exercise |
f. |
biofeedback |
ANS: A, B, E, F
Progressive muscle relaxation, which is the alternate tensing
and relaxing of muscles, is one way to achieve relaxation. Relaxation
techniques are useful for clients experiencing pain or stress and for clients
undergoing cognitive behavioral therapy for phobias, fears, and depression.
Imagery uses the imagination to visualize a pleasant, comforting picture and
draws upon one or more senses (visual, auditory, kinesthetic, gustatory,
olfactory) to form images. Clients can use imagery to promote a sense of
well-being and to change their perceptions about their disease, treatment, or
healing ability; imagery can be combined with medication to decrease physical
tension and anxiety and can distract clients from pain or discomfort. Movement
and exercise promote fitness by improving muscle strength, flexibility,
endurance, and cardiovascular and respiratory health. Yoga can rejuvenate,
promote longevity and self-realization, and aid in self-enlightenment. Healing
touch alters the person’s energy field through touch and affects physical,
mental, emotional, and spiritual health. Biofeedback is useful in
rehabilitation settings and can enhance muscle relaxation, relieve tension
headaches and backaches, reduce bruxism, lower blood pressure, and prevent or
relieve migraine headaches.
PTS: 1
DIF: Application REF: White
(2013)
3. The
nurse can act as a healing facilitator or instrument of healing to the client
in which of the following ways? (Select all that apply.)
|
a. |
help a client to attempt to
remain healthy and balanced |
|
b. |
help a client to have a
conscious goal or direction |
|
c. |
help a client use inner
resources for healing |
|
d. |
help a client to care for
oneself |
|
e. |
help a client to prepare
for their death |
|
f. |
help a client to honor
culturally based health beliefs |
ANS: A, B, C, D, F
The healing process activates the individual’s internal forces,
and the nurse can act as a healing facilitator or instrument of healing to the
client. As an instrument of healing (a means by which healing can be achieved,
performed, or enhanced), a nurse helps a client use inner resources for healing
by the attributes of a knowledge base (initiated in nursing school and expanded
through lifelong learning); intentionality (having a conscious goal or
direction); respect for differences (honoring a client’s culturally based
health beliefs); and ability to model wellness (caring for oneself and
attempting to remain healthy and balanced).
PTS:
1
DIF:
Comprehension
REF: White (2013)
Chapter 6—Caring for Clients in Shock
MULTIPLE CHOICE
1. A
client has sustained a gunshot wound to the left femoral artery. Which type of
shock should the nurse watch for?
|
a. |
cardiogenic |
c. |
hypovolemic |
|
b. |
neurogenic |
d. |
septic |
ANS: C
Hypovolemic shock is characterized by a decreased circulating
blood volume resulting in inadequate tissue perfusion and oxygenation for
normal cell function. Hypovolemic shock is caused by an acute blood loss from
trauma, fluid shifts, and/or loss from surgery, fluid loss from burns,
vomiting, diarrhea, and severe electrolyte imbalances.
PTS:
1
DIF: Application REF: White
(2013)
2. Hypovolemic
shock is a decrease in the client’s circulating blood volume that leads to inadequate
tissue perfusion and then which of the following?
|
a. |
bradycardia |
c. |
hypotension |
|
b. |
vasodilation |
d. |
hypoxia |
ANS: D
Hypovolemic shock is a decrease in the client’s circulating
blood volume that leads to inadequate tissue perfusion (the passage of blood
through tissues or vasculature). Inadequate tissue perfusion deprives the cells
from oxygen resulting in hypoxia, the inability of the cell to maintain normal
metabolic activities including energy production and waste removal from a lack
of oxygen. As a result, the body cells become injured and die, leading to organ
damage and failure, and potentially the client’s death.
PTS:
1
DIF:
Comprehension
REF: White (2013)
3. Severe
shock results when the client has lost more than what percentage of the
circulating blood volume?
|
a. |
less than 20% |
c. |
5% |
|
b. |
between 20 and 40% |
d. |
more than 40% |
ANS: D
The term mild hypovolemic shock is used when less than 20% of
the circulating blood volume is lost. Moderate shock occurs when blood loss
volume is between 20 to 40%, and severe shock results when the client has lost
more than 40% of the circulating blood volume.
PTS:
1
DIF:
Comprehension
REF: White (2013)
4. What
type of product would a physician most likely order for a client to treat
hypovolemic shock?
|
a. |
0.9% normal saline |
c. |
nasoenteric feeding |
|
b. |
oral rehydration fluid |
d. |
hypotonic IV fluid |
ANS: A
Commonly prescribed fluids for hypovolemic shock include
Lactated Ringers (LR) or normal saline (0.9% sodium chloride), which not only
help correct the volume loss, but also help with electrolyte replacement.
PTS:
1
DIF: Comprehension
REF: White (2013)
5. In
the Emergency Department, a client has been given large amount of IV fluid to
treat hypovolemic shock. Which electrolyte imbalance is MOST common after large
amounts have been infused?
|
a. |
hyponatremia |
c. |
hypernatremia |
|
b. |
hypokalemia |
d. |
hypocalcemia |
ANS: B
Electrolyte replacement may be necessary, especially if large
amount of fluids are needed to correct the client’s hypovolemia. Hypokalemia is
common in this client population after large amounts of fluids have been
infused. Also, either hyponatremia or hypernatremia may also occur, depending
on the type of intravenous solution used. Less commonly, calcium imbalance may
be present. The nurse should take care to remember that cardiac arrhythmias can
occur as a result of electrolyte imbalance.
PTS:
1
DIF:
Comprehension
REF: White (2013)
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