Chapter 02: Nursing Practice in the Clinical Setting

Chapter 02: Nursing Practice in the Clinical Setting

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

 

1. Which nursing action is a reflection of Hildegard Peplau’s theoretic framework regarding psychiatric mental health nursing?

a.	Basing patient outcomes on expected instinctual responses
b.	Discussing a patient’s feelings regarding parents and siblings
c.	Providing the patient with clean clothes and wholesome food
d.	Centering professional practice in a state run psychiatric facility

 

ANS: B

Peplau’s pioneering endeavors and contributions were largely influenced by interpersonal psychotherapy. She believed that disorders evolved in the social context of interpersonal interactions. (i.e., what went on between people). Instinctual responses are more related to intrapersonal interactions. Florence Nightingale was instrumental in the holistic approach to nursing care, whereas Linda Richards’ practice was centered on institutional care of the mental ill.

 

DIF:   Cognitive Level: Application        REF:  Page 18

TOP:  Nursing Process: Implementation

MSC: NCLEX: Safe, Effective Care Environment, Psychosocial Integrity

 

2. The nurse is attempting to provide a safe environment for a patient at great risk for self-harm. Which intervention shows an understanding of evidence-based practice (EBP)?

a.	Using physical restraints only after all other options have been proven ineffective
b.	Referring to the facility’s policies manual for guidelines for applying physical restraints
c.	Collecting data regarding the short-term effects of using physical restraints on an aggressive patient
d.	Requiring constant monitoring of a patient whose inability to self-regulate anger has required the use of physical restraints

 

ANS: B

Health care systems are participating in the shift in nursing practice by encouraging research in their facilities and by implementing interventions that increase nurses’ knowledge about EBP. Nurses are participating to make evidence-based nursing practices available for their use, and they are helping to determine the outcomes that will benefit patients. The remaining options are examples of long-standing practice related to the use of physical restraints.

 

DIF:   Cognitive Level: Application        REF:  Page 19

TOP:  Nursing Process: Implementation

MSC: NCLEX: Safe, Effective Care Environment, Psychosocial Integrity

 

3. Which statement by the patient reflects patient education that was based on the concept of integrated patient care?

a.	“I know I’m anxious when I get a tension headache.”
b.	“My anxiety is a result of stressors I don’t cope well with.”
c.	“Medication has helped me tremendously with anxiety control.”
d.	“Anxiety runs in my family; my entire family is trying to deal with it.”

 

ANS: A

Integrated patient care is the recognition of the interplay between physical and mental health. In integrated care, these disorders are not treated as separate illnesses; rather, they are treated together. The remaining options make no mention of a relationship between mental and physical illness.

 

DIF:   Cognitive Level: Application        REF:  Page 19          TOP:  Nursing Process: Evaluation

MSC: NCLEX: Psychosocial Integrity

 

4. The nurse demonstrates objective patient care when:

a.	Being sympathetic to the patient’s recent loss of a spouse
b.	Protecting the anxious patient by eliminating stressors in the milieu
c.	Responding to the patient by stating, “I know exactly how you feel.”
d.	Facilitating the patient’s exploration of various stress reduction techniques

 

ANS: D

The nurse demonstrates objectivity by helping the patient to process and organize thoughts that are directed toward the solving of his or her own problems. With sympathy, the nurse loses objectivity and moves into his or her own personal feelings. Removing all stress does not allow the patient to develop necessary coping skills.

 

DIF:   Cognitive Level: Application        REF:  Pages 21- 22

TOP:  Nursing Process: Implementation

MSC: NCLEX: Safe, Effective Care Environment: Management of Care, Psychosocial Integrity

 

5. Which nursing intervention would be appropriately addressed during the orientation phase of the nurse–patient relationship?

a.	Self reflection by the nurse regarding personal biases and prejudices regarding the patient
b.	Patient works at prioritizing personal needs and develops realistic expected outcomes
c.	Establishing the contract between the nurse and the patient regarding mutual needs and expectations
d.	Patient commits to the reinforcement of positive personal characteristics while working on problems and concerns

 

ANS: C

A contract or agreement is established during the orientation phase of the relationship. The contract defines limits and expectations of both the patient and the nurse. Self Reflection occurs during the pre-orientation phase while the remaining options are addressed during the working phase of the relationship.

 

DIF:   Cognitive Level: Analysis             REF:  Page 22          TOP:  Nursing Process: Planning

MSC: NCLEX: Safe, Effective Care Environment: Management of Care, Psychosocial Integrity