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A patient reports to the nurse, "My doctor is not doing anything about my pain." Which response by the nurse is assertive and expresses warmth?
- A. "If I were you, I would see a different doctor."
- B. "What you really mean is you do not like your doctor."
- C. "It is wrong for you to blame your doctor."
- D. "You seem frustrated with your doctor."
Correct Answer: D
Rationale: The correct answer is D because it acknowledges the patient's feelings without judgment and expresses empathy. The nurse reflects the patient's emotions by stating, "You seem frustrated with your doctor," showing understanding. Option A is dismissive, suggesting the patient change doctors. Option B assumes the patient's feelings and could come off as confrontational. Option C is accusatory and could make the patient defensive. Overall, option D is assertive, warm, and empathetic, making it the best response in this situation.
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The nursing supervisor instructs a group of novice nurses about the appropriate use of self-disclosure with patients. The nursing supervisor determines that teaching was successful if the novice nurse makes which statement?
- A. "Self-disclosure provides an opportunity for the patient to understand the nurse."
- B. "It is better to disclose stories about others to maintain professional boundaries."
- C. "Self-disclosure may be used to build a trusting relationship with the patient."
- D. "A fabricated personal experience can be shared if the patient remains the main focus."
Correct Answer: C
Rationale: The correct answer is C. Self-disclosure can be used to build a trusting relationship with the patient. This is because sharing personal information appropriately can help create a connection and foster trust between the nurse and the patient. By being open and genuine, nurses can demonstrate empathy and understanding, leading to better communication and rapport.
Choice A is incorrect because while self-disclosure can help the patient understand the nurse, the primary goal is to build a therapeutic relationship. Choice B is incorrect because disclosing stories about others does not promote genuine connection and may not be relevant to the patient's care. Choice D is incorrect because fabricating personal experiences goes against the principles of honesty and authenticity in therapeutic communication.
Which assessment finding is the most critical and needs to be addressed first?
- A. Mr. U has tracheal deviation after a pulmonary resection.
- B. Mr. B, with bladder cancer, has decreased urinary output.
- C. Mr. N, with non-Hodgkin lymphoma, is having dysrhythmias.
- D. Ms. C has severe abdominal pain after a bowel resection.
Correct Answer: A
Rationale: The correct answer is A because tracheal deviation after a pulmonary resection indicates a life-threatening condition like tension pneumothorax. This condition requires immediate intervention to prevent respiratory distress and potential cardiovascular collapse. Tracheal deviation is a red flag sign that signals a medical emergency. Options B, C, and D are important but not as urgent as tracheal deviation. Decreased urinary output in a bladder cancer patient could indicate renal dysfunction, dysrhythmias in a patient with non-Hodgkin lymphoma may need further evaluation, and severe abdominal pain post-bowel resection could signal complications but are not as immediately life-threatening as tracheal deviation.
When communicating with a hearing impaired patient, the nurse appropriately:
- A. shouts repeatedly at the patient.
- B. speaks directly into the patient's ear.
- C. uses long, complex sentences.
- D. uses short, simple sentences.
Correct Answer: D
Rationale: The correct answer is D: uses short, simple sentences. This is the most appropriate approach because hearing-impaired patients may have difficulty processing complex information. Using short, simple sentences helps improve comprehension. Shouting repeatedly (choice A) can be distressing and ineffective. Speaking directly into the patient's ear (choice B) may be invasive and uncomfortable. Using long, complex sentences (choice C) can overwhelm the patient and lead to confusion. Therefore, option D is the best choice for effective communication with a hearing-impaired patient.
The nurse observes a nursing assistant interacting with an elderly patient. Which statement by the nursing assistant requires an immediate intervention by the nurse?
- A. "I will help you remember where your room is located."
- B. "Would you like me to read from your Bible today?"
- C. "Tell me a story about when you were young."
- D. "Sweetie, I will bring your coffee in a few minutes."
Correct Answer: D
Rationale: The correct answer is D because addressing an elderly patient as "Sweetie" is inappropriate and unprofessional. It can be perceived as demeaning and disrespectful. The nurse should intervene immediately to address this issue. Choices A, B, and C are all appropriate ways to interact with an elderly patient and promote their well-being. Choice A shows willingness to assist with orientation, choice B offers emotional support through spiritual means, and choice C encourages reminiscence therapy, which can be beneficial for cognitive function.
According to the ANA's Standards of Clinical Nursing Practice, there are several steps within the nursing process that surround patient care. However, one of the most important steps is the one in which the nurse partners with the patient, family, and other caregivers to create an acceptable path that meets the patient's needs and is specific to the disease process. This important step is identified as:
- A. Evaluation
- B. Planning
- C. Implementation
- D. Nursing diagnosis
Correct Answer: B
Rationale: The correct answer is B: Planning. In the nursing process, planning is a crucial step where the nurse collaborates with the patient, family, and caregivers to develop a comprehensive care plan tailored to the patient's needs and specific disease process. This step involves setting goals, determining interventions, and creating a roadmap for the patient's care. Planning ensures that the care provided is individualized, evidence-based, and addresses the patient's unique circumstances. Evaluation (A) comes after planning to assess the effectiveness of interventions. Implementation (C) involves carrying out the planned interventions. Nursing diagnosis (D) is an earlier step where the nurse identifies the patient's health problems and needs. Planning stands out as the most important step as it guides the entire care process.