| Never | Rarely | Sometimes | Almost Always | Always | |
| a. The nursing care plan | ➀ | ➁ | ➂ | ➃ | ➄ |
| b. The therapies he/she gave him | ➀ | ➁ | ➂ | ➃ | ➄ |
| c. An invasive nursing maneuver (e.g., insertion of a venous catheter), before performing it | ➀ | ➁ | ➂ | ➃ | ➄ |
| d. The disease they were suffering from | ➀ | ➁ | ➂ | ➃ | ➄ |
| e. A diagnostic test they had to do | ➀ | ➁ | ➂ | ➃ | ➄ |
| f. A surgery they had to undergo | ➀ | ➁ | ➂ | ➃ | ➄ |
| g. What to do after discharge | ➀ | ➁ | ➂ | ➃ | ➄ |