MULTIPLE CHOICE

1. The nurse is preparing the anxious patient for major surgery and remarks, “Everyone feels some anxiety,
but you will be asleep during the whole thing.” This is an example of which communication style?
1. Empathy
2. Summarizing
3. False reassurance
4. Premature advice

ANS: 3
False reassurance shows lack of effort to understand and shuts off communication by imposing personal
opinion. It may sound empathetic, but it does not encourage further communication.
PTS: 1 DIF: Cognitive Level: Application REF: 54, Table 5-3
OBJ: 8 TOP: Communication Techniques
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity

2. The nurse explains that a document called the Patient’s Bill of Rights was created by the:
1. Joint Commission for Accreditation of Hospitals.
2. Medicare/Medicaid Act.
3. Social Security Act.
4. American Hospital Association.

ANS: 4
When displayed prominently in care areas, the Patient’s Bill of Rights gives the patient, family, and caregivers
written reminder of the rights of the competent patient for his or her own care decisions.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 50
OBJ: 6 TOP: Patient’s Bill of Rights
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment

3. As the nurse discusses the discharge plan with a recovering patient, the most effective communication
technique to use is:
1. assessing nonverbal clues.
2. allowing communication to focus on whatever topic the patient desires.
3. insisting on postrecovery activities as stated in the care plan.
4. reducing eye contact to convey nondirective attitudes.

ANS: 1
The assessment of the nonverbal clues will allow the nurse to determine whether the care plan is being
perceived as satisfactory and will indicate the level of compliance that can be expected. Allowing the patient
control the interview does not meet nursing care needs. Lack of eye contact and forcing the components of th
discharge plan on a patient are both counterproductive.
PTS: 1 DIF: Cognitive Level: Application REF: 52
OBJ: 8 TOP: Communication Techniques
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity

4. A 6-year-old who is brought to the Public Health Clinic Building to receive immunizations for the beginning
of school would be properly classified for service as a:
1. patient.
2. child.
3. customer.
4. client.

ANS: 4
The term “client,” in modern context, refers to one who is not ill and who is a partner in maintaining wellness.
PTS: 1 DIF: Cognitive Level: Knowledge REF: 50
OBJ: 4 TOP: Patient Image
KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

5. The patient says, “I am sick of being sick.” The most therapeutic response is:
1. “I can’t believe you really feel that way.”
2. “I don’t think that attitude is very helpful.”
3. “I think you sound pretty frustrated.”
4. “I want you to feel more positive.”

ANS: 3
“I” statements are used to confirm that the nurse understands the message from the patient.
PTS: 1 DIF: Cognitive Level: Application REF: 53
OBJ: 8 TOP: Therapeutic Communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity

6. On returning to the nurse’s station, the LPN discovers that the daughter of a frail but competent resident
reading her mother’s chart. The woman says, “I am entitled to see my mother’s medical record.” The nurse’s
best response would be:
1. “What is it that you believe you need to know? Give me the chart.”
2. “You must understand that only your mother has the right to read the contents of her medical record. Pleas
give me the chart.”
3. “Although the chart itself is not available to you to read, I would be glad to try and answer any questions yo
have. May I have the chart, please?”
4. “Reading that chart is a very serious violation of your mother’s privacy. I cannot allow you to see it. Please
put the chart down.”

ANS: 3
Unless the patient is legally declared incompetent and the person requesting to discuss the chart information
appointed legal surrogate, under the Patient’s Bill of Rights, he or she has the right to privacy and
confidentiality. All the other options are demanding or aggressive, invite a power struggle, and do not fulfill th
daughter’s need for information.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 50
OBJ: 6 TOP: Patient’s Right to Privacy and Confidentiality
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment

7. An LPN student is assigned to a patient who makes homosexual remarks and asks the student to meet af
discharge. The student’s best response would be:
1. “I am required to report inappropriate sexual behavior to my instructor.”
2. “I am uncomfortable dealing with homosexuals. Let’s just forget this conversation and get on with your car
as quickly as possible.”
3. “I am here as your nurse to meet your treatment needs. Such provocative conversation is not acceptable to
me as part of your care.”
4. “Your chosen lifestyle makes me uncomfortable. I will be back with your medication.”

ANS: 3
The patient has a right to have the nurses behave respectfully, regardless of sexual orientation. It is
professional to set limits without belittling the patient.
PTS: 1 DIF: Cognitive Level: Analysis REF: 52
OBJ: 8 TOP: Therapeutic Communication and Respectful Care
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity

8. The newly diagnosed cancer patient says, “I can’t stand to think about chemo.” The most therapeutic
response would be:
1. “What about chemo concerns you?”
2. “Chemo is so much better than it used to be.”
3. “Wow! I can sure understand that!”
4. “Have you had chemo before?”

ANS: 1
The open-ended query invites further discussion about the patient’s concerns. The other options reinforce the
patient’s concerns, give false reassurance, or offer a closed query.
PTS: 1 DIF: Cognitive Level: Analysis REF: 54, Table 5-2
OBJ: 8 TOP: Therapeutic Communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity

9. The families of patients expect their hospitalized member to receive holistic care. Although it may be
expressed in different terms, this concept means that the family expects care that is characterized by:
1. provision of safety with side rails up.
2. only foods and drinks that are to the patient’s liking.
3. bathing at a time and manner that is specified by the patient.
4. inclusion of families in the holistic approach.

ANS: 4
The practice of holistic care of patients includes the family as well as the patient in regard to physical,
emotional, social, economic, and spiritual needs.
PTS: 1 DIF: Cognitive Level: Analysis REF: 48
OBJ: 1 TOP: Family Expectations and Holistic Care
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment

10. The nurse, as a unique person, brings to each practice-patient relationship qualities such as knowledge,
past experiences, strengths, and weaknesses. The inclusive term used to describe this phenomenon is:
1. personhood experiences.
2. physiologic influence.
3. sociologic influence.
4. use of “self” in nursing.

ANS: 4
The nurse brings all parts of his or her personality into the care setting.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 48-49
OBJ: 2, 3 TOP: Use of Self in Nursing
KEY: Nursing Process Step: N/A MSC: NCLEX: Psychosocial Integrity

11. The 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.
This is an example of the violation of:
1. confidentiality.
2. privacy.
3. explanation of care.
4. continuity of care.

ANS: 3
All patients have the right to an explanation of all aspects of care and treatment.
PTS: 1 DIF: Cognitive Level: Application REF: 50
OBJ: 7 TOP: Explanation of Care
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity

12. When the dying patient says, “There is no God. There is no afterlife. When it’s over, it’s over.” The most
therapeutic response would be:
1. “You must feel very lonely.”
2. “Of course there is a God, and He loves you very much.”
3. “Why do you think there is no God?”
4. “You are absolutely right. I think that, too.”

ANS: 1
Verbalizing the implied helps the patient to talk about present concerns. Other options either reinforce or cut
communication by imposing the nurse’s beliefs.
PTS: 1 DIF: Cognitive Level: Analysis REF: 54, Table 5-2
OBJ: 7 TOP: Therapeutic Communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity

13. Which would be the most appropriate greeting to Mrs. Brown, a newly admitted 80-year-old hemiplegic
who is fully alert?
1. “Good morning, Mrs. Brown. My name is Ann, and I am your nurse today.”
2. “I am your nurse. Today is bath day. You will get yours right after breakfast.”
3. “Hello there, Sweetie. We need to get to work on getting your breakfast so we can get your shower.”
4. “My name is Ann. You are my patient today.”

ANS: 1
Older persons, new to a unit, need to be addressed by name. Introductions of caregivers should be made
without familiarity.
PTS: 1 DIF: Cognitive Level: Application REF: 50
OBJ: 4, 7 TOP: Therapeutic Communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity

14. Sometimes patients communicate by crying, moaning, or laughing. The term for this is:
1. verbal communication.
2. nonverbal communication.
3. acting out and seeking attention.
4. seeking holistic support.

ANS: 2
Expressions of emotion are frequently done through nonverbal methods.
PTS: 1 DIF: Cognitive Level: Knowledge REF: 52
OBJ: 8 TOP: Recognition of Nonverbal Clues
KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

15. If the nurse communicates in an open, honest, and nonjudgmental manner, this is characteristic of:
1. therapeutic communication.
2. democratic communication.
3. “I” statements.
4. autocratic communication.

ANS: 1
Therapeutic communication implies an open and honest verbal and nonverbal style of communication.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 52-53
OBJ: 8 TOP: Qualities of Therapeutic Communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment

16. The LPN 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.” To encourage further communication, the nurse’s best response would
be:
1. “You’ve lost a lot of work?”
2. “Would you like me to arrange an appointment for you to speak with the social worker?”
3. “How much pay have you lost?”
4. “You are to be discharged at the end of the week and you can return to work.”

ANS: 1
The reflective response encourages the patient to continue. Arranging for a social worker, pointing out his
return to work, and inquiry related to lost wages closes communication without responding to the patient’s
needs.
PTS: 1 DIF: Cognitive Level: Application REF: 54, Table 5-2
OBJ: 3, 8 TOP: Use of Self with Empathy
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity

17. The nurse is careful to do each procedure in the same step-by-step manner because such consistency in
care will:
1. make sure that no step is omitted.
2. guarantee complete safety.
3. build confidence in the nurse’s competence.
4. save time.

ANS: 3
One of the expectations of hospitalization is to receive competent care. Precise step-by-step procedures build
confidence in the client that the nurse is competent.
PTS: 1 DIF: Cognitive Level: Analysis REF: 51
OBJ: 5 TOP: Expectations for Hospitalization Care
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment

18. A nurse is assigned to a patient who has been a very close family friend for many years. To maintain a
therapeutic relationship under these circumstances, it would be appropriate for the nurse to tell the patient:
1. “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.”
2. “You may feel uncomfortable about my caring for you. Everything that happens here is considered to be
confidential, but would you prefer another caregiver?”
3. “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.”
4. “I’m so sorry that you are hospitalized; but I will tell all my friends to take special care of you for me.”

ANS: 2
Even friends as patients should retain decision-making options about their care.
PTS: 1 DIF: Cognitive Level: Application REF: 52, Table 5-1
OBJ: 7 TOP: Professional Caring for a Friend
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity

19. The nurse is changing an abdominal dressing on a disoriented 89-year-old man, when he grabs the nurse
breast with both hands and pulls it toward his mouth, muttering something about “Mary” (his wife). The best
therapeutic response is:
1. Stereotype him as a “dirty old man” and warn the rest of the staff to stay away from him.
2. Get a doctor’s order for wrist restraints when nurses go near the patient, such as for dressings, baths, and
feedings.
3. Maintain eye contact with the patient and then clearly tell him, and repeat, “I am your nurse, I am coming t
help you eat, bathe, and change your stomach bandage. I am not Mary.”
4. “That dressing needs changing. Don’t be a naughty boy with me again or I will slap your hands and call Mar
to come and do all your care herself!”

ANS: 3
Older, confused patients frequently confuse the nurse with close relations such as his or her spouse, whom th
are accustomed to touching.
PTS: 1 DIF: Cognitive Level: Analysis REF: 51
OBJ: 7 TOP: Therapeutic Communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment

20. A young woman comes to the Public Health Clinic for an M antibiotic for an STI. She is accompanied by h
live-in boyfriend. The most therapeutic remark the nurse should make to the young man is:
1. “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 given the means for a cure?”
2. “You probably have the same sexual infection too. You need to see about it before you give it back to her o
somebody else.”
3. “You may have the same infection. Have you been with any other females lately? The Health Department
needs to make a list.”
4. “This is the third time that your friend has been in here with the same infection! Why don’t you get some
shots yourself?”

ANS: 1
Therapeutic communication carefully chooses descriptive words that are nonjudgmental and are fitting to the
sociocultural background of the patient.
PTS: 1 DIF: Cognitive Level: Analysis REF: 52-53
OBJ: 7 TOP: Therapeutic Communication
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity

21. The nurse assessing a patient’s affect is trying to discern the patient’s:
1. problem.
2. mood.
3. orientation.
4. needs.

ANS: 2
A patient’s affect is the patient’s mood.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 53
OBJ: 7 TOP: Nurse-Patient relationship
KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity

MULTIPLE RESPONSE
1. The nurse clarifies that the Patient’s Bill of Rights ensures that patients will have (select all that apply):
1. provision of respectful care.
2. protection of privacy.
3. access to medical records.
4. reasonable fees for service.
5. information about current condition.

ANS: 1, 2, 3, 5
The bill provides for all the options except reasonable fees.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 50
OBJ: 6 TOP: Patient's Bill of Rights
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Safe, Effective Care Environment

2. The LPN explains to a client that in modern holistic nursing, the nurse includes in the plan of care the
aspects of the (select all that apply):
1. psychological.
2. financial.
3. physiologic.
4. spiritual.
5. sociologic.

ANS: 1, 3, 4, 5
Holism embraces the physiologic, psychological, sociologic, and spiritual. Financial concerns are included in
the sociologic aspect.
PTS: 1 DIF: Cognitive Level: Comprehension REF: 48
OBJ: 1 TOP: Holistic Nursing
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity

3. The nurse is diligent in keeping the patient informed about treatments, medication, and laboratory tests
because an informed patient will be (select all that apply):
1. less anxious.
2. more participative in the care.
3. less likely to complain.
4. more compliant with treatment goals.
5. more satisfied with treatment outcomes.

ANS: 1, 2, 4, 5
An informed patient will experience less anxiety and satisfaction with outcomes in which he or she had a part
Such participation and information does not ensure fewer complaints, however.
PTS: 1 DIF: Cognitive Level: Analysis REF: 50
OBJ: 8 TOP: Partners in Care
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance

COMPLETION
1. The first step that the nurse must take in developing a therapeutic nurse-patient relationship is to genera
____________________.
ANS: Trust
PTS: 1 DIF: Cognitive Level: Comprehension REF: 51
OBJ: 7 TOP: Nurse-Patient Relationship
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity