Nokea
A 36-year-old woman who is in traction for a fractured femur that she received in an auto accident is found crying quietly. The nurse can best address this situation by saying:
- A. "What's the matter? Why are you crying? Are you in pain?"
- B. "Stop crying and tell me what your problem is."
- C. "This could have been much worse. You're lucky no one was killed."
- D. "You are upset. Can you tell me what's wrong?"
Correct Answer: D
Rationale: The correct answer is D because it acknowledges the patient's emotions, shows empathy, and encourages open communication. By stating "You are upset. Can you tell me what's wrong?" the nurse validates the patient's feelings and invites her to express her concerns. This approach fosters trust and allows the nurse to address the underlying issues causing the patient's distress.
Choice A is incorrect as it assumes the patient is in pain without confirmation and may come off as dismissive. Choice B is inappropriate as it lacks empathy and demands the patient to stop crying, which can further escalate the situation. Choice C is insensitive as it diminishes the patient's feelings by comparing her situation to a potential worse outcome, which is not helpful in addressing her emotional distress.
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The nurse has selected an outcome for the patient to eat all of the food on the breakfast tray each day. Assessing that the patient has eaten all of the breakfast, the nurse would give positive feedback by saying:
- A. "Wow! That breakfast must have been pretty good."
- B. "I like pancakes too. Everyone on the hall seemed to enjoy them."
- C. "I hope you can keep all that breakfast down."
- D. "Hurray! You finished your whole meal! What would you like for tomorrow?" Giving positive feedback increases the likelihood of the desired behavior to be repeated. Commenting on the tastiness of the food or the fact that others liked it is not responding directly to the patient's having eaten the whole meal.
Correct Answer: D
Rationale: The correct answer is D because it acknowledges the patient's achievement of finishing the whole meal, provides positive reinforcement, and invites the patient to make choices for the next meal, encouraging continued compliance with the desired outcome. This response directly reinforces the behavior that was targeted, making it more likely for the patient to repeat the behavior in the future. Choices A, B, and C do not specifically address the patient's accomplishment of eating all the food, therefore they do not provide effective positive feedback for reinforcing the desired behavior.
A nurse manager asks a colleague for advice on strategies to improve communication with staff nurses. Which response by the nurse manager's colleague is best?
- A. "Be sensitive, show respect, and be genuine."
- B. "You need to be consistently nice to the staff nurses."
- C. "Work as a staff nurse every month to develop empathy."
- D. "Staff nurses need a leader who is not emotional."
Correct Answer: A
Rationale: The correct answer is A because it emphasizes essential components of effective communication: sensitivity, respect, and genuineness. Sensitivity helps in understanding others' emotions, respect fosters a positive relationship, and genuineness promotes trust. Choice B is too simplistic and lacks depth. Choice C is impractical as working as a staff nurse monthly may not be feasible for a manager. Choice D is incorrect as emotional intelligence and empathy are crucial for effective leadership, not being emotionless. Thus, choice A is the best response due to its focus on key communication principles.
The charge nurse informs a staff nurse that it is her turn to float to another unit. Which response by the staff nurse is aggressive?
- A. "I had such a bad experience last time. Please send another nurse instead of me."
- B. "I will miss working with you today, but I understand that it is my turn to float."
- C. "I will not survive on the other unit. The staff are always too busy to help me."
- D. "I will float, but you'll be sorry. You cannot handle emergencies without me."
Correct Answer: C
Rationale: The correct answer is C because the response is aggressive and defensive. The staff nurse is making a negative and exaggerated statement about not surviving on the other unit, implying that others are incompetent and not willing to help. This response lacks professionalism and teamwork, showing an unwillingness to adapt and collaborate.
Choice A is not aggressive as it expresses a personal negative experience and suggests sending another nurse. Choice B is not aggressive as it acknowledges the situation and shows understanding. Choice D is assertive but not necessarily aggressive; it implies importance but does not attack or undermine others.
The nurse instructs the nursing assistant to obtain temperatures on four patients and report abnormal findings immediately. Two hours later the nurse discovers that one of the patients had a fever that was not reported. The nurse is upset with the nursing assistant. Which statement, if made by the nurse, is concrete and specifically explains the nurse's feelings?
- A. "I am not dissatisfied with your performance, because we all make mistakes."
- B. "You must have misunderstood. I wanted to know about any elevated temperatures."
- C. "I am disappointed because you did not follow my directions."
- D. "You have made me so angry. Why did you not report the fever to me?"
Correct Answer: C
Rationale: The correct answer is C: "I am disappointed because you did not follow my directions." This statement is the most concrete and specifically explains the nurse's feelings of disappointment towards the nursing assistant for not reporting the fever as instructed. It directly addresses the issue at hand, which is the failure to follow directions, and conveys the nurse's emotions in a clear and concise manner.
Choice A: "I am not dissatisfied with your performance, because we all make mistakes." This choice does not address the specific issue of the nursing assistant not following instructions, and it seems to downplay the importance of the mistake.
Choice B: "You must have misunderstood. I wanted to know about any elevated temperatures." This choice shifts the blame to the nursing assistant for misunderstanding, rather than holding them accountable for not following instructions.
Choice D: "You have made me so angry. Why did you not report the fever to me?" This choice focuses on the nurse's anger rather than disappointment, and it does not
After the BCG treatment, the team leader delegates disposal of the fluid contents in Mr. B's (bladder cancer) urinary drainage bag to the UAP. What instructions should be given to the UAP?
- A. "No special handling of the bag or its contents is required."
- B. "Wear a lead apron when you are emptying the drainage container."
- C. "Discard the fluid in the toilet and disinfect the toilet with bleach for 6 hours."
- D. "Wear sterile gloves when you are handling the bag and its contents."
Correct Answer: C
Rationale: The correct answer is C because after BCG treatment, the fluid in the urinary drainage bag is considered hazardous due to the live bacteria used in the treatment. Therefore, instructing the UAP to discard the fluid in the toilet and disinfect it with bleach is crucial to prevent the spread of infection. This step helps to ensure proper disposal and minimize the risk of exposure to others.
Choice A is incorrect because special handling is indeed required due to the nature of the contents. Choice B is incorrect as wearing a lead apron is not necessary for handling the fluid in the urinary drainage bag. Choice D is also incorrect as sterile gloves are not specifically required for this task; instead, proper disinfection of the toilet is essential.