Introduction to Nursing Practice
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Course Introduction
Introduction to Nursing Practice provides students with a foundational understanding of the nursing profession, exploring the roles, responsibilities, and ethical principles that guide nursing care. This course covers the basic concepts and skills essential for safe and effective practice, including patient assessment, communication, infection control, and documentation. Through a combination of theoretical instruction and hands-on laboratory experiences, students are introduced to the clinical decision-making process, interdisciplinary collaboration, and the importance of culturally competent and patient-centered care. The course prepares learners for further study and practice within the diverse and evolving field of nursing.
Recommended Textbook
Interpersonal Relationships Professional Communication Skills for Nurses 7th Edition by Arnold
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Chapter 1: Theory Based Perspectives and Contemporary Dynamics
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Q1) The discipline of nursing has "a unique perspective,a distinct way of viewing all phenomena,which ultimately defines and limits the nature of its inquiry," related to
A) principles and laws that govern the life processes, well-being, and optimum functioning of human beings, sick or well.
B) patterning of human behavior in interaction with the environment in critical life situations.
C) processes by which positive changes in health status are affected.
D) processes by which negative changes in health status are affected.
E) patterning of human behavior in interaction with the environment in every life situation.
F) principles and laws that govern the life processes, well-being, and optimum functioning of human beings, in relation to wellness only.
Answer: A,B,C
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Chapter 2: Professional Guides for Nursing Communication
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Q1) When the nurse identifies a health problem or alteration in a client's health status that requires a nursing intervention,the nurse is performing which step of the nursing process?
A) Diagnosis
B) Planning
C) Intervention
D) Evaluation
Answer: A
Q2) When practicing effective and correct communication,the nurse should
A) speak in a clear voice.
B) be concise when providing client education.
C) be concrete when communicating with clients.
D) focus entirely on abstract communication techniques with clients.
E) ensure that communication with clients is complete.
F) provide courteous communication when interacting with clients.
Answer: A,B,C,E,F
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Chapter 3: Clinical Judgment and Ethical Decision Making
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Q1) The student nurse can best learn the steps in critical thinking through
A) reading journals.
B) classroom instruction.
C) repeated practice.
D) developing a mnemonic.
Answer: C
Q2) Characteristics of a critical thinker include all but which of the following?
A) Haphazardly seeking solutions
B) Anticipating consequences
C) Considering alternative solutions
D) Revising actions based on new input
Answer: A
Q3) Which of the following statements is true about the critical thinking process?
A) It is a linear process.
B) The skills are inborn.
C) It is goal directed.
D) It assists nurses to criticize the health care system.
Answer: C
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Chapter 4: Clarity and Safety in Communication
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Q1) A nurse attends an in-service aimed to educate staff about reporting hospital errors.The nurse demonstrates understanding when listing which of the following as consistent with error reporting within the United States?
A) Error reporting is transparent
B) Errors are overreported
C) Errors are underreported
D) Providers are not concerned about consequences of reporting errors
Q2) When educating a newly diagnosed client about management of diabetes mellitus,the nurse recognizes that health care-related communication
A) does not lead to errors within the hospital.
B) is generally well understood by most clients.
C) is not an important component of client care.
D) can cause clients to misunderstand information.
Q3) A nurse recognizes that strategies for clear,accurate communication to promote client safety include which of the following?
A) Establishing a safe environment
B) Maintaining a climate of closed communication
C) Using unique interdisciplinary communication tools
D) Using communication tools that promote vague communication
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Chapter 5: Developing Therapeutic Communication Skills
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Q1) The nurse demonstrates understanding of the concept of metacommunication through
A) recognizing the impact of communication on others.
B) actively listening with good eye contact.
C) implementing barriers to effective communication.
D) ensuring that verbal and nonverbal messages are incongruent.
Q2) The nurse asks a newly admitted client,"Can you tell me what brought you to the hospital today?" The purpose of an open-ended question is to
A) influence the direction of an acceptable response.
B) encourage the client to answer the question with a one-word response.
C) allow clients latitude in telling their story.
D) allow the client to engage in a passive relationship with the nurse.
Q3) When teaching a client how to administer insulin,the nurse recognizes that the best method of communicating therapeutically with the client is to
A) talk to the client in the visitors' lounge.
B) talk to the client within his personal space.
C) communicate with the client using touch.
D) face the client while leaning slightly forward.
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Chapter 6: Variation in Communication Styles
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Q1) Social cognitive competency refers to
A) the ability to use verbal and nonverbal interventions.
B) understanding the relationships between the roles of the sender and receiver.
C) the ability to interpret message content within interactions from the point of view of each participant.
D) interpreting emotional content by observing body language.
Q2) The majority of person-to-person communication is
A) verbal.
B) process.
C) nonverbal.
D) content.
Q3) A description of denotation is
A) a personalized meaning of a word or phrase.
B) a generalized meaning assigned to a word.
C) a meaning shared by families.
D) a meaning generally shared within a specific culture.
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Chapter 7: Intercultural Communication
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Q1) The nurse is assigned to provide a bed bath to a client who cannot speak English.Which of the following communication tools or 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
Q2) Which of the following statements is true?
A) A Muslim client may refuse to take insulin if it contains beef.
B) African American males have a lower chance of developing cancer.
C) Hispanic clients make small talk before discussing their health problems.
D) Asian clients frequently challenge health care workers.
Q3) When practicing cultural awareness,the nurse recognizes that cultural patterns
A) are socially transmitted through ethnic groups.
B) are nonessential parts of personal identity.
C) are minor determinants of health-related attitudes.
D) are important determinants of health-related beliefs.
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Chapter 8: Therapeutic Communication in Groups
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Q1) During the first session of an Alzheimer disease support group for family members,the nurse recognizes the need to
A) encourage member contributions and emphasize cooperation in recognizing each person's talents related to group goals.
B) accept differences in member perceptions as being normal and growth producing.
C) encourage group members to introduce themselves and share a little of their background or their reason for coming to the group.
D) link constructive themes while stating the nature of the disagreement.
Q2) The nurse is caring for a client who has a large extended family.The nurse recognizes the client is part of a group known as a
A) focus group.
B) educational group.
C) primary group.
D) secondary group.
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Chapter 9: Self Concept in Professional Interpersonal Relationships
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Q1) The nurse is caring for an adolescent client who has had an amputation of his right leg.The client states,"I'm really worried my girlfriend might not want to be with me anymore.I don't look the same." Which of the following concepts is represented in this situation?
A) Role performance
B) Body image
C) Self-esteem
D) Personal identity
Q2) Which of the following statements is true about self-esteem?
A) It is an objective emotional process.
B) Achievements lead to high self-esteem.
C) It is the emotional value a person places on his or her self-concept.
D) It is a concept that becomes fixed.
Q3) After receiving her morning assignment,the nurse realizes that she will be caring for a client with Alzheimer disease.The nurse understands that when communicating with this client,it will be important to
A) avoid touch because this may be misinterpreted by the client.
B) shorten processing time before the client becomes distracted.
C) break instructions down into small, sequential steps.
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D) present ideas all at once before the client's attention wanders.
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Chapter 10: Developing Therapeutic Relationships
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Q1) Which of the following examples indicates adherence to client confidentiality?
A) Talking about the client's symptoms in front of family members
B) Using the client's name in a social conversation
C) Sharing client information with other members of the health care team as needed
D) Reading a friend's chart on another hospital unit
Q2) Which of the following personality characteristics can affect the nurse's ability to function in a therapeutic manner,if disclosed to the client?
A) The nurse is shy.
B) The nurse becomes angry when criticized.
C) The nurse has difficulty handling conflict.
D) The nurse struggles with getting up in the morning.
Q3) The nurse practices "here and now" focus on problem identification,with an emphasis on quickly understanding the context in which the problem is embedded during which of the following phases of the nurse-client relationship?
A) Orientation
B) Preinteraction
C) Termination
D) Working
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Chapter 11: Bridges and Barriers in Therapeutic Relationships
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Q1) Which of the following is a barrier to communication?
A) Intrusion into personal space
B) Unconditional acceptance
C) Self-awareness
D) Gender differences
Q2) Which of the following nursing behaviors are included in the levels of nursing actions within Level 1?
A) Confronts conflict
B) Uses client's correct name
C) Maintains eye contact
D) Adopts open posture
E) Responds to cues
Q3) The nurse knocks on the client's door and waits for the client to answer before entering the room.The nurse is demonstrating
A) nonverbal communication skills.
B) respect for the client's personal space.
C) respect for the client's confidentiality.
D) respect for the client's gender difference.
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Chapter 12: Communicating With Families
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Q1) When the nurse cares for a client with a terminal illness,a question that the nurse can ask the client's family to elicit information about family strengths is
A) "Who best understands what the doctors have told you?"
B) "What has the family been doing so far that is helpful?"
C) "Who is most uncomfortable at the bedside?"
D) "Who is now taking care of the house?"
Q2) When caring for clients,it is important for the nurse to understand that A) treatment plans should be tailored around personal family goals.
B) meaningful involvement in the client's care will be consistent among family members.
C) the nurse should listen to only immediate family members when considering implications for family involvement.
D) individual family members have different perspectives.
Q3) Which of the following is a true statement when comparing biological and blended families?
A) In biological families, rules are varied and complicated.
B) A blended family is born of loss.
C) In biological families, there are multiple sets of rules.
D) In blended families, traditions are shared.
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Chapter 13: Resolving Conflicts Between Nurse and Client
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Q1) The most effective problem-solving style for genuine resolution that creates a win-win situation is
A) accommodation.
B) avoidance.
C) competition.
D) collaboration.
Q2) A client yells at the nurse frequently and uses profane language.Which of the following is the most appropriate response by the nurse?
A) Remain silent and do not respond
B) Use an "I" statement when speaking to the client
C) Tell the client, "You make me angry."
D) Ignore the behavior and walk away
Q3) A client yells,"Take this mess away from here.How could anyone eat this food? What kind of place are you running here?" The nurse uses skills of assertiveness to promote change that is focused on
A) feelings.
B) attitudes.
C) behaviors.
D) motivations.
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Chapter 14: Communicating to Encourage Health Literacy,
health Promotion, and Prevention of
Disease
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Q1) A client has just completed an alcohol detoxification program.The client has recently experienced the loss of his wife and has been having difficulties at work.The client has some serious health effects from long-term alcohol abuse,including elevated serum liver enzymes.The client states,"Alcohol is ruining my life; I will do anything to quit drinking." The nurse should
A) ask the client what kinds of changes will be needed in order to stop drinking.
B) discuss the client's elevated serum liver enzymes and the predictive consequences of serious health problems, including premature death.
C) ask the client what life would be like without alcohol.
D) remind the client that he or she has been abstinent from drinking, allowing liver tests to significantly improve.
Q2) The personal values and beliefs in one's ability to achieve health behavior changes is known as
A) social incentive.
B) self-efficacy.
C) cognitive motivator.
D) physical motivator.
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Page 16
Chapter 15: Health Teaching and Coaching
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Q1) A theoretical foundation for the use of teaching methodologies in which a learner-centered approach engages clients as active partners in the learning process and helps them to take responsibility for their own learning to whatever extent possible is known as
A) Skinner's behavioral approach.
B) Premack's principle.
C) modeling.
D) client-centered health teaching.
Q2) When the nurse formulates a goal that "the client will be able to accurately draw up the correct dose of insulin," the nurse recognizes this goal as referring primarily to health teaching in which domain?
A) Changing attitudes
B) Psychomotor
C) Understanding content
D) Promoting acceptance
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Chapter 16: Empowerment-Oriented Communication
Strategies to Reduce Stress
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Q1) A client tells the nurse,"I think I'm losing my mind." The best response by the nurse is
A) "Tell me what you are experiencing right now."
B) "You should take a nap now; it will help you to feel better."
C) "If you say that you're losing mind, you really will lose your mind."
D) "I don't think you really feel that you are losing your mind."
Q2) A client who has been diagnosed with cancer asks the nurse,"If I take the chemotherapy,will I be cured,or am I going to die anyway?" The nurse's best response is
A) "Tell me what prompted your question."
B) "I don't think you should have chemotherapy; it will harm you more than help you."
C) "Let's not talk about dying; I'm sure you will be cured."
D) "I really don't think you should worry about such things; it isn't something you can control."
Q3) Which of the following is true in relation to stress?
A) Men and women respond to stress in the same fashion.
B) Culture does not affect the stress experience.
C) Stress is always a negative experience.
D) Stress can have protective and adaptive functions.
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Chapter 17: Communicating With Clients Experiencing
Communication Deficits
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Q1) The nurse is caring for an older adult client who has recently withdrawn from relationships,appears depressed,and appears reluctant to seek information from the nurse.The nurse suspects the client is experiencing hearing loss.The nurse recognizes that
A) the client will readily acknowledge that this is the problem if asked.
B) the client may try to hide deficits and withdraw from relationships.
C) decreased hearing ability is not related to conversational style.
D) older adults, as a group, have better consonant discrimination.
Q2) The nurse is caring for a client who is hearing-impaired and legally blind in his right eye.The client has just returned from cataract surgery on his left eye.The nurse recognizes that
A) the client's arm should be held when walking.
B) verbal speech is useless in this situation.
C) signals should be developed to indicate changes in pace or direction while walking. D) the client should be discouraged from reading lips.
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Chapter 18: Communicating With Children
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Q1) The nurse is caring for a 2-year-old child on a pediatric unit.The child's parents have just left the unit for the night.The child is standing at the edge of the crib and crying.Which of the following interventions is most appropriate for the nurse to use?
A) Limit the use of kinesthetic approaches when caring for the child.
B) Talk to the child about Mommy and Daddy and how much the child cares for them.
C) Maintain a flat affect when interacting with the child.
D) At first maintain a distance of 8 feet from the child.
Q2) The nurse is caring for a postoperative preschooler who is crying and has been refusing to eat.The best communication strategy for the nurse to use is to
A) avoid providing the child with simple explanations.
B) assign the child to a different nurse in order to optimize socialization.
C) give the child some clay, crayons, and paper.
D) encourage the child to express complex thoughts and feelings.
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Chapter 19: Communicating With Older Adults
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Q1) A client diagnosed with dementia is becoming increasingly unable to express complete thoughts and is having difficulty engaging in simple conversations.When communicating with this client,the nurse should
A) use words directly applicable to the client's daily routine.
B) restate ideas using different words in a different sequence.
C) refrain from validating the meaning of the client's responses.
D) ask the client questions that require more than a yes or no answer.
Q2) When assessing an older adult client,the nurse recognizes the client has a significant hearing loss.The most appropriate intervention by the nurse is to A) introduce herself first.
B) shout into the client's good ear.
C) repeat words the client doesn't understand.
D) check the hearing aid batteries.
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Chapter 20: Communicating With Clients in Crisis
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Q1) When educating a student nurse about the definition of a crisis state,the nurse recognizes that additional instruction is needed when the student nurse states,
A) "A crisis state is an acute normal human response."
B) "A crisis state is a mental illness."
C) "A crisis state represents a personal response."
D) "A crisis state creates a temporary disconnect from attachment to others."
Q2) A model of psychosocial development in which each stage is associated with a psychosocial crisis to be resolved was developed by which theorist?
A) Caplan
B) Erikson
C) Aguilera
D) Roberts
Q3) A client experiences an unusually stressful life event that exceeds their resources and coping skills.The nurse recognizes the client is experiencing which type of crisis?
A) Developmental
B) Private
C) Adventitious
D) Situational
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22
Chapter 21: Communicating With Clients and Families at the End of Life
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Q1) Which of the following individuals is most likely experiencing a delayed grief reaction?
A) A 22-year-old army pilot on leave from the Iraq war who talks about the death of his crew member
B) A 93-year-old women, whose husband of 73 years died 1 year ago, who reminisces about their life together
C) A 54-year-old man suffering from alcoholism who just completed a 28-day inpatient rehabilitation talking about the death of his wife 3 years ago
D) A child whose parents were divorced 3 months ago and is acting out at school
Q2) The nurse is caring for a client who has been given 6 months to live after being diagnosed with stage 4 cancer of the lung.Evidence that the client is in the bargaining stage of death and dying is demonstrated by which of the following statements?
A) "Not me."
B) "Why me?"
C) "Yes, me."
D) "Let me."
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Chapter 22: Role Relationships and Interprofessional Communication
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Q1) A novice nurse decides to attend a diabetes workshop after a client was admitted to the unit with an insulin pump that the nurse was not familiar with.This is an example of A) role performance.
B) client advocacy.
C) collaboration.
D) professional self-awareness.
Q2) A nurse,who has been practicing for 4 years,demonstrates competence,speed,and flexibility when performing clinical skills.According to Benner,the nurse is practicing at which developmental stage?
A) Advanced beginner
B) Competency
C) Proficiency
D) Expert
Q3) Essential components of interprofessional professionalism are clear communication,caring,professional ethics,and
A) aesthetics.
B) altruism.
C) justice.
D) truth.
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Chapter 23: Communicating With Other Health Professionals
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Q1) The nurse manager is working on strategies to turn conflict into collaboration by creating a climate in which participants view negotiation as a collaborative effort.In order to accomplish this goal,the nurse manager works to promote
A) offering of feedback on an infrequent basis.
B) clarification of role expectations.
C) minimal participation in organizational interdisciplinary groups.
D) absence of role-modeling behaviors related to communication.
Q2) The charge nurse is working on a unit where a nurse is frequently late for work.The charge nurse addresses the behavior by telling the nurse,"It is necessary for you to be here on time from now on." This is an example of what type of constructive criticism?
A) Expressing sympathy
B) Describing the behavior
C) Stating expectations
D) Listing consequences
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Chapter 24: Communicating for Continuity of Care
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Q1) Which of the following best describes continuity of care?
A) It involves only clients with acute physical conditions.
B) It involves client-centered high-quality care across clinical settings.
C) It should focus on episodic hospital care of seriously ill clients.
D) Relational, informational, and functional are its key components.
Q2) A nurse has been employed as a staff nurse for 20 years.When comparing her current clients to those she cared for at the beginning of her career,the nurse finds that clients today are
A) being discharged later.
B) coping with being discharged earlier.
C) dealing with simpler medication and treatment regimens.
D) significantly healthier at the time of discharge.
Q3) The nurse recognizes that a potential barrier to effective team communication includes which of the following?
A) Team role clarity
B) Lack of territoriality
C) Professional rivalries
D) Transparent job responsibilities
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Chapter 25: Documentation in an Electronic Era
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Q1) One major advantage of an electronic health information technology system is A) lack of integration.
B) accessibility of health records.
C) it is not easily transferable.
D) it consists of imaging files that allow for delayed access.
Q2) A client is 3 days postoperative from gallbladder surgery secondary to gallstones.Domain: Physiological.Class: Fluid and electrolyte balance.Activity: Check intravenous fluid rate intake every hour.Which of the following nursing coding systems is represented in this situation?
A) North American Nursing Diagnosis (NANDA)
B) Nursing intervention classification
C) Nursing outcome classification
D) Omaha system of client problems
Q3) Which classification system is a comprehensive practice,documentation,and information management tool?
A) NANDA
B) NIC
C) NOC
D) Omaha system
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Chapter 26: Communicating at the Point of Care:
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Q1) Which of the following is true about electronic mail communication?
A) Most physicians use e-mail to schedule appointments.
B) E-mail is a means of ensuring confidentiality.
C) Physicians expressed concerns about lack of income generation.
D) Paper copies can be eliminated.
Q2) When working on a hospital unit,the nurse uses a cellular telephone as an aid to giving client care.When using a cellular telephone,the nurse recognizes that a barrier to this type of technology is
A) cellular telephones lead to less productivity.
B) cellular telephones can lead to a higher rate of hospital errors.
C) some hospitals prohibit using cellular telephones.
D) cellular telephones complicate information retrieval at the point of care.
Q3) A nursing instructor educates a student nurse about standards of effective communication.The nursing instructor recognizes that additional teaching is warranted when the student nurse lists which of the following as a standard of effective communication?
A) Clear
B) Timely
C) Lengthy
D) Complete
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