Chapter 1: Holistic Caring

Multiple Choice
Identify the choice that best completes the statement or answers the question.

1. The nurse incorporates the concepts of the Science of Human Caring when providing patient care. Which action should the nurse avoid?
1. Implementing transpersonal approaches
2. Making eye contact while speaking softly
3. Listening to the patient during communication
4. Adhering to a strict schedule to complete morning care

Answer: _____

2. The nurse is planning care for a patient. Which action should the nurse implement that demonstrates holistic care?
1. Eliminating an order prescribed by the physician
2. Asking the family to leave the room during medication teaching
3. Listening to ways the patient has overcome a health problem in the past
4. Performing an action that may not necessarily be appropriate for the patient’s needs

Answer: _____

3. An older patient with a terminal illness and heart problems is angry and pushes away the breakfast meal tray. Which response should the nurse make? 
1. Call the supervisor.
2. Loudly tell the patient to stop screaming. 
3. Take the meal tray away and silently leave the room. 
4. Ask the patient to explain the reason for the outburst and listen to the response. 

Answer: _____

4. The nurse overhears a conversation between unlicensed assistive personnel (UAP) and an older patient. For which statement should the nurse counsel UAP?
1. “Good morning, honey!”
2. “Can I help you with your breakfast?”
3. “Mr. Jones, can I bring you your dentures?”
4. “Please tell me when you want to have your shower.”

Answer: _____ 

5. The nurse is asked to explain the word gerontology. Which response should the nurse make? 
1. It means the use of older medications to treat illnesses.
2. It comes from a Greek word that means “related to old age.”
3. It focuses on the housing needs of people who are underserved. 
4. It is a way of explaining health problems of people over age 50. 

Answer: _____

6. The nurse is preparing a program on the health needs of older community members. For which reason should physical activity and exercise be encouraged? 
1. They want to prevent boredom. 
2. They have more time to exercise. 
3. They initiated the fitness movement.
4. They want to spend more time with grandchildren.

Answer: _____

7. During an employment interview, the nurse is asked to describe the purpose of a nursing philosophy. Which response should the nurse make?
1. It is a personal concept.
2. It defines personal goals and aspirations.
3. It recognizes the importance of education. 
4. It outlines the steps to take for a successful career.

Answer: _____

8. The nurse is providing patient care. Which behavior demonstrates that the nurse wants to develop a healing relationship with this patient? 
1. Answering the call light using the intercom system
2. Telling the patient that there is no time to try something new
3. Sitting down in the patient’s room to discuss the plan of care
4. Reminding the patient that other patients need attention at this time

Answer: _____

9. The nurse desires to improve the ability to provide holistic care. On which skill should the nurse focus to be successful? 
1. Active listening
2. Critical thinking
3. Care coordination
4. Time management

Answer: _____

10. The nurse schedules an interdisciplinary team meeting to address an older patient’s care needs. Who should the nurse include to ensure that the team provides holistic care? 
1. The nurse, doctor, and pharmacist
2. The nurse, dietician, and discharge planner
3. Those who will help meet the patient’s needs
4. The social worker, physical therapist, and nurse

Answer: _____

11. The nurse attends an educational program on caring. Which action should the nurse take to become a more caring nurse?
1. Become a caring person.
2. Ensure adequate daily rest.
3. Set aside time for personal activities.
4. Consume nutritious meals and exercise.

Answer: _____

12. During a home visit, an older patient reports planning to have dinner with a close friend and then see a movie. What does this behavior indicate to the nurse?
1. Industry
2. Self-absorption
3. Identity diffusion
4. Gerotranscendence

Answer: _____

Multiple Response
Identify one or more choices that best complete the statement or answer the question.

13. The home health nurse is completing an admission assessment of an older patient. Which health problems should the nurse identify as being leading chronic diseases of older adults? Select all that apply.
1. Cancer
2. Diabetes
3. Heart disease
4. Hypertension
5. Multiple sclerosis

Answer: _____

14. The nurse is preparing a teaching tool for a community recreation center. Which should the nurse include that explains the reason for the increased number of older adults in today’s society? Select all that apply. 
1. Better nutrition
2. Earlier retirement
3. Increased exercise
4. Improved health care
5. Consistent sanitation

Answer: _____

15. The nurse is identifying characteristics to include in a personal philosophy of nursing. Which should the nurse include as essential elements of this philosophy? Select all that apply. 
1. Make it simple.
2. Keep it inexpensive. 
3. Identify specific actions.
4. Ensure that it is meaningful.
5. Incorporate popular approaches. 

Answer: _____

Questions, Answers, and Rationales

MULTIPLE CHOICE
Identify the choice that best completes the statement or answers the question.

1. The nurse incorporates the concepts of the Science of Human Caring when providing patient care. Which action should the nurse avoid?
1. Implementing transpersonal approaches
2. Making eye contact while speaking softly
3. Listening to the patient during communication
4. Adhering to a strict schedule to complete morning care

ANS: 4
Page: 8
	Feedback	
1	Transpersonal caring is the human-to-human relationship, which is a part of the Science of Human Caring. 	
2	The person is the focus in the Science of Human Caring.	
3	Personal contact, eye contact, and speaking softly are parts of the Science of Human Caring. 	
4	The nurse needs to treat the whole person, not view care as completing a checklist of routine tasks. 	

2. The nurse is planning care for a patient. Which action should the nurse implement that demonstrates holistic care?
1. Eliminating an order prescribed by the physician
2. Asking the family to leave the room during medication teaching
3. Listening to ways the patient has overcome a health problem in the past
4. Performing an action that may not necessarily be appropriate for the patient’s needs

ANS: 3
Page: 6
	Feedback	
1	A basic concept of holistic nursing practice is to always follow the physician’s orders. Eliminating an order is not a part of holistic care. 	
2	A close relationship is developed with family members and significant others in holistic nursing. 	
3	Holistic nursing draws on the intuition and creativity that patients have to resolve their own health problems. 	
4	The practice of holistic nursing includes developing and using clinical expertise. Performing an action that may not meet the patient’s needs is not a concept of holistic nursing. 	

3. An older patient with a terminal illness and heart problems is angry and pushes away the breakfast meal tray. Which response should the nurse make? 
1. Call the supervisor.
2. Loudly tell the patient to stop screaming. 
3. Take the meal tray away and silently leave the room. 
4. Ask the patient to explain the reason for the outburst and listen to the response.

ANS: 4
Page: 10
	Feedback	
1	There is no reason to contact the supervisor. The reason for the patient’s outburst needs to be determined and comfort provided. 	
2	Telling the patient to stop screaming in a loud voice is responding with anger and does not determine the cause of the outburst.	
3	Removing the meal try and leaving the room is uncaring and insulting to the patient.	
4	The nurse should try to find out what is bothering the patient and ask specific questions. Remember that the patient has a very serious and probably terminal diagnosis, and anger is understandable. There is a reason for every behavior, and the nurse has the responsibility to learn the reason before reacting. 	

4. The nurse overhears a conversation between unlicensed assistive personnel (UAP) and an older patient. For which statement should the nurse counsel UAP?
1. “Good morning, honey!”
2. “Can I help you with your breakfast?”
3. “Mr. Jones, can I bring you your dentures?”
4. “Please tell me when you want to have your shower.”

ANS: 1
Page: 10

	Feedback	
1	Speaking to patients as if they are children is a form of paternalism. Older people should be addressed with respect, usually by Mr. or Mrs., unless they specifically say to use their first name. 	
2	Offering help to an older patient is appropriate communication. 	
3	Using the older patient’s formal name is an appropriate way to address the patient. 	
4	Being polite by saying please and asking the patient to decide when care will be provided is appropriate. 	

5. The nurse is asked to explain the word gerontology. Which response should the nurse make? 
1. It means the use of older medications to treat illnesses.
2. It comes from a Greek word that means “related to old age.”
3. It focuses on the housing needs of people who are underserved. 
4. It is a way of explaining health problems of people over age 50.

ANS: 2
Page: 2

	Feedback	
1	Gerontology is not the use of older medications to treat illnesses.	
2	Gerontology comes from a Greek word that means “related to old age.”	
3	Gerontology does not focus on the housing needs of people who are underserved.	
4	Gerontology is not a way of explaining health problems of people over age 50. 	

6. The nurse is preparing a program on the health needs of older community members. For which reason should physical activity and exercise be encouraged? 
1. They want to prevent boredom. 
2. They have more time to exercise. 
3. They initiated the fitness movement.
4. They want to spend more time with grandchildren.

ANS: 3
Page: 5

	Feedback	
1	Older people are not more likely to participate in exercise programs because they are trying to avoid boredom.	
2	Older people are not more likely to participate in exercise programs because they have more time to exercise. 	
3	Older people are more likely to participate in exercise programs because they initiated the fitness movement. 	
4	Older people are not more likely to participate in exercise programs because they want to spend more time with their grandchildren. 	

7. During an employment interview, the nurse is asked to describe the purpose of a nursing philosophy. Which response should the nurse make?
1. It is a personal concept.
2. It defines personal goals and aspirations.
3. It recognizes the importance of education. 
4. It outlines the steps to take for a successful career.

ANS: 1
Page: 5

	Feedback	
1	A nursing philosophy is a personal concept that has to come from within. 	
2	A nursing philosophy does not define goals and aspirations. 	
3	A nursing philosophy is not used to recognize the importance of education.	
4	A nursing philosophy does not outline steps to a successful career. 	

8. The nurse is providing patient care. Which behavior demonstrates that the nurse wants to develop a healing relationship with this patient? 
1. Answering the call light using the intercom system
2. Telling the patient that there is no time to try something new
3. Sitting down in the patient’s room to discuss the plan of care
4. Reminding the patient that other patients need attention at this time

ANS: 3
Page: 7

	Feedback	
1	Answering a call light using the intercom system does not demonstrate a nurse who is unrushed and truly wants to develop a relationship with the patient. 	
2	Telling the patient that there is no time to try something new does not demonstrate a healing relationship with the patient. 	
3	Sitting down with the patient to discuss the plan of care indicates an interest in developing a healing relationship with the patient. 	
4	Reminding the patient that other patients need attention at this time does not indicate an interest in developing a healing relationship with the patient. 	

9. The nurse desires to improve the ability to provide holistic care. On which skill should the nurse focus to be successful? 
1. Active listening
2. Critical thinking
3. Care coordination
4. Time management	

ANS: 1
Page: 6

	Feedback	
1	The critical activity to promote holistic care is active listening. 	
2	Critical thinking is not essential in holistic care.	
3	Care coordination is not essential in holistic care.	
4	Time management is not essential in holistic care. 	

10. The nurse schedules an interdisciplinary team meeting to address an older patient’s care needs. Who should the nurse include to ensure that the team provides holistic care? 
1. The nurse, doctor, and pharmacist
2. The nurse, dietician, and discharge planner
3. Those who will help meet the patient’s needs
4. The social worker, physical therapist, and nurse

ANS: 3
Page: 7

	Feedback	
1	Members of the holistic health-care team may or may not include the doctor and pharmacist. 	
2	Members of the holistic health-care team may or may not include the dietician and discharge planner. 	
3	Members of the holistic health-care team include those who will help meet the patient’s needs.	
4	Members of the holistic health-care team may or may not include the social worker and physical therapist. 	

11. The nurse attends an educational program on caring. Which action should the nurse take to become a more caring nurse?
1. Become a caring person.
2. Ensure adequate daily rest.
3. Set aside time for personal activities.
4. Consume nutritious meals and exercise.

ANS: 1
Page: 11

	Feedback	
1	To become a more caring nurse, the nurse should become a caring person. 	
2	Adequate rest is not identified as an action to become a more caring nurse. 	
3	Setting aside time for personal activities is not identified as an action to become a more caring nurse. 	
4	Consuming nutritious meals and exercising are not identified as actions to become a more caring nurse. 	

12. During a home visit, an older patient reports planning to have dinner with a close friend and then see a movie. What does this behavior indicate to the nurse?
1. Industry
2. Self-absorption
3. Identity diffusion
4. Gerotranscendence

ANS: 4
Page: 11
 
	Feedback	
1	Industry is a developmental task of middle childhood. 	
2	Self-absorption is a part of the adult middle age developmental task. 	
3	Identity diffusion is a part of the adolescent developmental task. 	
4	Gerotranscendence means that the older person is satisfied with life and looks forward to living a full life for the rest of his or her days.	

MULTIPLE RESPONSE
Identify one or more choices that best complete the statement or answer the question.

13. The home health nurse is completing an admission assessment of an older patient. Which health problems should the nurse identify as being leading chronic diseases of older adults? Select all that apply.
1. Cancer
2. Diabetes
3. Heart disease
4. Hypertension
5. Multiple sclerosis

ANS:	 2, 3, 4
Page: 5

	Feedback	
1. 	Cancer is not identified as being a leading chronic disease of older adults.	
2. 	Diabetes is identified as being a leading chronic disease of older adults. 	
3. 	Heart disease is identified as being a leading chronic disease of older adults.	
4. 	Hypertension is identified as being a leading chronic disease of older adults.	
5. 	Multiple sclerosis is not identified as being a leading chronic disease of older adults. 	

14. The nurse is preparing a teaching tool for a community recreation center. Which should the nurse include that explains the reason for the increased number of older adults in today’s society? Select all that apply. 
1. Better nutrition
2. Earlier retirement
3. Increased exercise
4. Improved health care
5. Consistent sanitation

ANS:	 1, 4, 5
Page: 4
	Feedback	
1. 	Reasons for the increased number of older persons in our society include better nutrition. 	
2. 	Reasons for the increased number of older persons in our society do not include early retirement. 	
3. 	Reasons for the increased number of older persons in our society do not include increased exercise. 	
4. 	Reasons for the increased number of older persons in our society include improved health care. 	
5. 	Reasons for the increased number of older persons in our society include consistent sanitation. 	

15. The nurse is identifying characteristics to include in a personal philosophy of nursing. Which should the nurse include as essential elements of this philosophy? Select all that apply. 
1. Make it simple.
2. Keep it inexpensive. 
3. Identify specific actions.
4. Ensure that it is meaningful.
5. Incorporate popular approaches. 

ANS:	 1, 3, 4
Page: 5
	Feedback	
1. 	A characteristic of a valuable nursing philosophy is that it is simple. 	
2. 	Cost is not a characteristic of a meaningful nursing philosophy.	
3. 	A characteristic of a valuable nursing philosophy is that it is specific. 	
4. 	A characteristic of a valuable nursing philosophy is that it is meaningful. 	
5. 	Popularity is not a characteristic of a valuable nursing philosophy.