NURSING TEST TAKING STRATEGY VI: Client Needs

A. Safe, Effective Care Environment

1. These questions address the nurse’s role in providing and directing care that will ensure an environment that promotes protecting the client, family or significant others and other health care personnel.

2. Content addressed in these questions relates to the nursing role of coordinating and integrating cost-effective care, supervising and/or collaborating with members of the multidisciplinary health care team, and environmental safety.

3. Be alert to safety needs addressed in a question, and remember the importance of hand washing, call bells, bed positioning, the appropriate use of side rails, and standard precautions.

B. Physiological Integrity

1. These questions address the nurse’s role in promoting physical health and well-being in the client by providing care and comfort, reducing client risk potential, and managing the client’s health alterations.

2. Content addressed in these questions relates to basic care and comfort, pharmacological and parenteral therapies, reducing the risk of the development of complications, and managing and providing care to clients with acute, chronic, or life-threatening conditions.

3. Remember that physiological needs are a priority and are addressed first.

4. Use the ABC’s airway, breathing, and circulation; Maslow’s hierarchy of needs theory; and the steps of the nursing process when selecting an option addressing physiological integrity.

C. Psychosocial Integrity

1. These questions address the nurse’s role in providing nursing care that supports and promotes the emotional, mental, and social well-being of the client and significant others.

2. Content addressed in these questions relates to promoting the client’s or significant other’s ability to cope, adapt or problem solve in situations such as illness or stressful events and to providing care to clients with maladaptive behavior or acute or chronic mental illness.

3. In this Client Needs category you may be asked communication-type questions that relate to how you would respond to a client, a client’s family member or significant other, or to other health care team members.

4. Use therapeutic communication techniques to answer communication questions because of their effectiveness in the communication process.

5. Remember to select the answer that focuses on the client’s, client’s family members or significant other’s feelings, concerns, anxieties, or fears.

PRACTICE QUESTION: Communication

A mother says to the nurse. “I am afraid that my child might have another seizure.” Which response by the nurse is most therapeutic?

1. “Why worry about something that you cannot control?”
2. “Most children will never experience a second seizure.”
3. “Tell me what frightens you the most about seizures.”
4. “Acetaminophen (Tylenol) can prevent another seizure from occurring.”

Answer: 3

Test-taking Strategy: Option 3 is the only option that addresses the client’s fears. Option 1 blocks communication because it states that the mother should not worry. Options 2 and 4 are incorrect because the nurse is giving false assurance that a seizure will not reoccur or can be prevented in this child. Remember focus on feelings, concerns, anxieties or fears.

D. Health Promotion and Maintenance

1. These questions address the nurse’s role in providing and directing nursing care that prevents health problems, provides early detection of health problems, and provides and directs care that incorporates knowledge of expected growth and development principles.

2. Content addressed in these questions relates to assisting the client and significant others through the normal stages of growth and development and assisting the client and significant others to develop health practices that promote wellness and to recognize alterations in health care status.

3. Use the teaching/learning theory if the question addresses client education, remembering that client motivation and client readiness to learn is the first priority.

4. Be alert to false response questions that address health promotion and maintenance and client education.