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1. A nurse is caring for a patient in pain. Which nursing approach is priority?
a. Relationship-centered
b. Technology-centered
c. High tech-centered
d. Family-centered
Answer: A
It is important to preserve a relationship-centered approach to patient care for all aspects of nursing,
whether the care focuses on pain management, teaching self-care, or basic hygiene measures.
While technology, high tech, and family are important, they are not the priority.
4. The patient has a colostomy but has not yet been able to look at it. The nurse teaches the patient
how to care for the colostomy. The nurse sits with the patient, and together they form a plan on how
to approach dealing with colostomy care. Which caring process is the nurse performing?
a. Knowing
b. Doing for
c. Enabling
d. Maintaining belief
Answer: C
Enabling is facilitating another’s passage through a life transition and unfamiliar events. Working with
the patient to find alternate ways to perform the task is doing just that. Knowing is striving to
understand an event because it has meaning in the life of another. This must be done before
enabling can occur. Doing for is doing for the other as he or she would do for self if it were at all
possible. The nurse in this situation is not doing for the patient but is teaching/informing on how to
care for the colostomy. Maintaining belief is sustaining faith in the other’s capacity to get through an
event or transition and face a future with meaning. This may be an underlying theme to the process
but is not what the nurse is actually doing.
3. A nurse attends a seminar on nursing theories for caring. Which information from the nurse
indicates a correct understanding of these theories?
a. Benner identifies caring as highly connected involving patient and nurse.
b. Swanson develops four caring processes to convey caring in nursing.
c. Watson’s transcultural caring views inclusion of culture as caring.
d. Leininger’s theory places care before cure and is transformative.
Answer: A
Benner believes caring is highly connected involving each nurse-patient encounter. Swanson
developed five caring processes, not four. Watson’s theory places care before cure and is
transformative, whereas Leininger’s transcultural caring views inclusion of culture as caring.
5. A nurse is using Watson’s model to provide care to patients. Which carative factor will the nurse
use?
a. Maintaining belief
b. Instilling faith-hope
c. Maintaining ethics
d. Instilling values
Answer: B
Watson has 10 carative factors, one of which is instilling faith-hope. Maintaining belief is a caring
process of Swanson’s theory. Ethics and values are important in caring but they are not examples of
Watson’s carative factors.
6. A nurse provides care that is receptive to patients’ and families’ perceptions of caring. Which
action will the nurse take?
a. Provides clear, accurate information
b. Just performs nursing tasks competently
c. Does as much for the patient as possible
d. Focuses solely on the patient’s diagnosis
Answer: A
Research indicates caring behaviors of nurses from the patient’s/families’ perspective include the
following: (1) Providing honest, clear, and accurate information; (2) asking permission before doing
something to a patient; (3) helping patients do as much for themselves as possible; and (4) teaching
the family how to keep the relative physically comfortable. Patients continue to value nurses’
effectiveness in performing tasks, but clearly patients value the affective dimension of nursing care.
2. A nurse is providing pain medication to patients after surgery. Which component is key for the
nurse’s personal philosophy of nursing?
a. Caring
b. Technology
c. Informatics
d. Therapeutics
Answer: A
The American Organization of Nurse Executives describes caring and knowledge as the core of
nursing, with caring being a key component of what a nurse brings to a patient experience. While
technology, informatics, and therapeutics are important, they are not the key components of nursing.
7. A nurse follows the “ethics of care” when working with patients. Which action will the nurse take?
a. Becomes the patient’s advocate based on the patient’s wishes
b. Makes decisions for the patient solely using analytical principles
c. Uses only intellectual principles to determine what is best for the patient
d. Ignores unequal family relationships since that is a personal matter for the family
Answer: A
An ethic of care places the nurse as the patient’s advocate, solving ethical dilemmas by attending to
relationships and by giving priority to each patient’s unique personhood. An ethic of care is unique
so that professional nurses do not make professional decisions based solely on intellectual or
analytical principles. Instead, an ethic of care places “caring” at the center of decision making.
Nurses who function from an ethic of care are sensitive to unequal relationships that lead to abuse of
one person’s power over another—intentional or otherwise.
9. The patient is afraid to have a thoracentesis at the bedside. The nurse sits with the patient and
asks about the fears. During the procedure, the nurse stays with the patient, explaining each step
and providing encouragement. What is the nurse displaying?
a. Providing touch
b. Providing a presence
c. Providing family care
d. Providing a listening ear
Answer: B
The nurse’s presence helps to calm anxiety and fear related to stressful situations. Giving
reassurance and thorough explanations about a procedure, remaining at the patient’s side, and
coaching the patient through the experience all convey a presence that is invaluable to the patient’s
well-being. Listening and touch can be part of the “presence” but are not its entirety. No family was
involved in this scenario.
8. A nurse is providing presence to a patient and the family. Which nursing action does this involve?
a. Focusing on the task that needs to be done
b. Providing closeness and a sense of caring
c. Jumping in to provide patient comfort
d. Being there without an identified goal
Answer: B
Providing presence is a person-to-person encounter conveying closeness and a sense of caring.
“Being there” seems to depend on the fact that a nurse is attentive to the patient more than the task.
“Being with” means being available and at the patient’s disposal. If the patient accepts the nurse, the
nurse will be invited to see, share, and touch the patient’s vulnerability and suffering. Jumping in
may not be welcomed. Being there is something the nurse offers to the patient with the purpose of
achieving some patient care goal.
10. The patient is terminal and very near death. When the nurse checks the patient and finds no
pulse or blood pressure, the family begins sobbing and hugging each other. Some family members
hold the patient’s hand. The nurse is overwhelmed by the presence of grief and leaves the room.
What is the nurse demonstrating?
a. Caring touch
b. Protective touch
c. Therapeutic touch
d. Task-oriented touch
Protective touch is also a kind of touch that protects the nurse emotionally. A nurse withdraws or
distances herself or himself from a patient when he or she is unable to tolerate suffering or needs to
escape from a situation that is causing tension. Caring touch is a form of nonverbal communication
that influences a patient’s comfort and security, enhances self-esteem, and improves mental wellbeing. Therapeutic touch is a type of alternative therapy for healing. Task-oriented touch is done
when performing a task or procedure.
11. Which action indicates a nurse is using caring touch with a patient?
a. Inserts a catheter
b. Rubs a patient’s back
c. Prevents a patient from falling
d. Administers an injection
Answer: B
Caring touch is the way a nurse holds a patient’s hand, gives a back massage, or gently positions a
patient. Touch that occurs when tasks are being performed, such as insertion of a catheter or
administering an injection, is known as “task-oriented touch.” Touch used to protect the patient
(holding and bracing a patient to avoid a fall) or nurse (withdraws from tension-filled situations) is
known as “protective touch.”
5. A patient is fearful of upcoming surgery and a possible cancer diagnosis. He discusses his love for the Bible with his nurse, who recommends a favorite Bible verse. Another nurse tells the patient's nurse that there is no place in nursing for spiritual caring. The patient's nurse replies:
1. “You're correct; spiritual care should be left to a pastoral care professional.”
2. “You're correct; religion is a personal decision.”
3. “Nurses should explain their own religious beliefs to patients.”
4. “Spiritual, mind, and body connections can affect health.”
Answer: 4
12. The nurse is caring for a patient who has been sullen and quiet for the past three days.
Suddenly, the patient says, “I’m really nervous about surgery tomorrow, but I’m more worried about
how it will affect my family.” What should the nurse do first?
a. Assure the patient that everything will be all right.
b. Tell the patient that there is no need to worry.
c. Listen to the patient’s concerns and fears.
d. Inform the patient a social worker is available.
Answer: C
Listening to the meaning of what a patient says helps create a mutual relationship. Assuring and
telling a patient not to worry are not truly listening; these do not convey listening. Although contacting
a social worker could be an appropriate measure for this patient, the nurse should first listen to what
the patient is saying.
13. The patient is about to undergo a certain procedure and has voiced concern about outcomes
and prognosis. The nurse caring for the patient underwent a similar procedure and stops to listen.
Which response by the nurse may be most beneficial?
a. “I had a similar procedure and I can tell you what I went through.”
b. “I think you’ll be all right, but, of course, there are no sure guarantees.”
c. “I don’t think you have anything to worry about. They do lots of these.”
d. “I can call the doctor and cancel the procedure, if you are really concerned.”
Answer: A
When an ill person chooses to tell his story, it involves reaching out to another human being. Telling
the story implies a relationship that develops only if the clinician exchanges his or her stories as well.
Professionals do not routinely take seriously their own need to be known as part of a clinical
relationship. Yet, unless the professional acknowledges this need, there is no reciprocal relationship,
only an interaction. Offering false reassurances and cliches, telling not to worry, or offering to cancel
the procedure does not open up that relationship and dismisses the patient’s concerns.
14. In making rounds, the nurse meets a patient for the first time. The nurse asks the patient when
morning medications are taken, such as before breakfast, after breakfast, or during breakfast. What
does knowing the patient allow the nurse to do?
a. Choose the most appropriate time to give the medication.
b. Know what information to put on the medication error report form.
c. Explain to the patient that the medication will not be given at the usual time.
d. Evaluate whether or not the patient is taking the medication correctly at home.
Answer: A
“Knowing the patient” is at the core of the process nurses use to make clinical decisions. Knowing
when the patient normally takes the medication will allow the nurse to keep the patient on as near
normal a schedule as possible. Nothing in this question infers that the patient will not get the
medications on time or that a medication error report will need to be completed. Although the nurse
can evaluate whether or not the patient is taking the medication correctly at home, the main purpose,
within this scenario, is to determine the most appropriate time to administer the medication.
7. When a nurse helps a patient find the meaning of cancer by supporting beliefs about life, this is an example of:
1. Instilling hope and faith.
2. Forming a human-altruistic value system.
3. Cultural caring.
4. Being with
Answer: 1
4. Fill-in-the-Blank. Swanson's caring process of ______ is demonstrated by a nurse helping a new mother?
Answer: Enabling
2. Of the five caring processes described by Swanson, which describes “knowing the patient?”
1. Anticipating the patient's cultural preferences
2. Determining the patient's physician preference
3. Establishing an understanding of a specific patient
4. Gathering task-oriented information during assessment
Answer: 3
Match the examples to the areas the nurse will promote connectedness for patient’s spirituality
needs.
a. Connection with others
b. Connection with higher power
c. Connection with oneself
1. Intrapersonally
2. Interpersonally
3. Transpersonally
Answer:
A=Intrapersonally
B= Transpersonally
C= Interpersonally
1. A nurse cares for patients. Which areas does caring influence? (Select all that apply.)
a. The way in which patients feel
b. The way in which patients learn
c. The way in which patients think
d. The way in which patients study
e. The way in which patients behave
Answer: A, C, E
Caring is a universal phenomenon that influences the ways in which people think, feel, and behave
in relation to one another. How people learn and study involves other concepts such as
teaching/learning.
6. Which of the following is a strategy for creating work environments that enable nurses to demonstrate more caring behaviors? (Select all that apply.)
1. Decreasing the number of consecutive shifts of the nursing staff
2. Increasing salary and vacation benefits of the nursing staff
3. Increasing the number of nurses who work each shift to decrease the nurse-patient ratio
4. Encouraging increased input concerning nursing functions from health care providers
5. Providing nursing staff an opportunity to discuss practice changes they can implement to enhance opportunities for patient caring
Answer: 3, 5
3. A Muslim woman enters the clinic to have a woman's health examination for the first time. Which nursing behavior applies Swanson's caring process of “knowing the patient?”
1. Sharing feelings about the importance of having regular woman's health examinations
2. Gaining an understanding of what a woman's health examination means to the patient
3. Recognizing that the patient is modest; and obtaining gender-congruent caregiver
4. Explaining the risk factors for cervical cancer
Answer: 2
1. A nurse hears a colleague tell a nursing student that she never touches a patient unless she is performing a procedure or doing an assessment. The nurse tells the student that from a caring perspective:
1. She does not touch the patients either.
2. Touch is a type of verbal communication.
3. Touch is only used when a patient is in pain.
4. Touch forms a connection between nurse and patient.
Answer: 4
3. Which actions by the nurse indicate compassion and caring to patients? (Select all that apply.)
a. Saying “I’m here”
b. Including the family in care
c. Staying with the patient during a bedside test
d. Relying on monitors and technology
e. Refining work processes on the unit
Answer: A, B, C
Our patients tell us that a simple touch, a simple phrase, “I’m here,” or a promise to remain at the
bedside represent caring and compassion. Caring for an individual cannot occur in isolation from
that person’s family. As a nurse it is important to know the family almost as thoroughly as you know
a patient. A reliance on technology and cost-effective health care strategies and efforts to
standardize and refine work processes all undermine the nature of caring.
2. Which actions by the nurse should be done in order to get to know the patient? (Select all that
apply.)
a. Avoid assumptions
b. Focus on the patient
c. Engage in a caring relationship
d. Form the relationship very quickly
e. Not address spiritual or higher needs
Answer: A, B, C
To know a patient means that the nurse avoids assumptions, focuses on the patient, and engages in
a caring relationship with the patient that reveals information and cues that facilitate critical thinking
and clinical judgments. Knowing develops over time as a nurse learns the clinical conditions within a
specialty and the behaviors and physiological responses of patients.