Nokea
A client asks a nurse, 'Do you think I should move back home after this procedure?' and the nurse responds by saying, 'Do you think you should move back home?' What type of therapeutic communication is the nurse representing?
- A. Observation
- B. Reflection
- C. Summarizing
- D. Validating
Correct Answer: B
Rationale: The correct answer is B: Reflection. Reflection involves paraphrasing the client's words to help them explore their feelings and thoughts. In this scenario, the nurse is reflecting the client's question back to them, encouraging self-exploration. Observation (A) involves stating what the nurse sees or hears without interpretation. Summarizing (C) involves condensing information. Validating (D) involves confirming the client's feelings or experiences. The nurse's response does not align with the other options, making reflection the best choice.
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A nurse is caring for an in-patient client in the hospital who is from another country and who fasts for temporary periods in order to promote his own spiritual growth. The nurse responds by saying, 'You need to eat something while you are here. Food and proper nutrition are extremely important for your health.' What social philosophy is the nurse demonstrating?
- A. Ethnocentrism
- B. Relativism
- C. Stereotyping
- D. Xenocentrism
Correct Answer: A
Rationale: The correct answer is A: Ethnocentrism. Ethnocentrism is the belief in the inherent superiority of one's own culture or ethnic group. In this scenario, the nurse is imposing their own cultural beliefs about food and nutrition onto the patient, without considering or respecting the patient's cultural or spiritual practices. This demonstrates a lack of cultural sensitivity and understanding, as the nurse is prioritizing their own cultural norms over the patient's beliefs.
Summary of other choices:
B: Relativism - Relativism would involve acknowledging and respecting the patient's cultural practices and beliefs, which the nurse is not doing in this case.
C: Stereotyping - Stereotyping involves making assumptions about individuals based on their cultural background, which is not explicitly demonstrated in this scenario.
D: Xenocentrism - Xenocentrism is the opposite of ethnocentrism, where one believes that other cultures are superior to their own. This is not evident in the nurse's behavior.
A nurse walks into a client's room to find the nursing assistant yelling, 'Sit back down or I won't help you eat, and then you will starve!' This type of behavior is known as:
- A. Psychological abuse
- B. Abandonment
- C. Material exploitation
- D. Physical abuse
Correct Answer: A
Rationale: The correct answer is A: Psychological abuse. This behavior involves verbal threats and emotional manipulation, causing fear and distress to the client. It violates the client's rights and dignity. Abandonment (B) refers to deserting a client in need. Material exploitation (C) involves misuse of a client's property or resources. Physical abuse (D) involves causing harm through physical force.
Which method is most appropriate for managing moral distress in the workplace?
- A. Recognizing that life is unfair and nurses cannot meet every need of every client
- B. Declining to act when clients or visitors make requests that are not justifiable
- C. Developing a new policy that would address the problematic situation
- D. Both A and B
Correct Answer: C
Rationale: The correct answer is C. Developing a new policy is the most appropriate method for managing moral distress in the workplace because it addresses the root cause of the problematic situation. By creating a policy, organizations can provide clear guidelines and procedures to handle ethical dilemmas, thus empowering healthcare professionals to navigate moral challenges effectively.
Choice A is incorrect as it encourages acceptance of unfairness and could lead to moral disengagement. Choice B is also incorrect as declining to act in unjustifiable situations can compromise patient care and violate ethical principles. Choice D is incorrect as it combines two flawed approaches that do not effectively address moral distress. Developing a new policy is the most proactive and systematic approach to managing moral distress in the workplace.
A client is admitted with the diagnosis of pulmonary embolism. While taking a history, the client tells the nurse he was admitted for the same thing twice before, the last time just 3 months ago. The nurse would anticipate the healthcare provider ordering:
- A. Pulmonary embolectomy
- B. Vena caval interruption
- C. Increasing the coumadin therapy to achieve an INR of 3-4
- D. Thrombolytic therapy
Correct Answer: B
Rationale: The correct answer is B: Vena caval interruption. In this scenario, the client has a history of recurrent pulmonary embolism, indicating a high risk for further episodes. Vena caval interruption, such as with an inferior vena cava filter, is a preventive measure to reduce the risk of pulmonary embolism recurrence by trapping blood clots before they reach the pulmonary circulation. This intervention is indicated when anticoagulation alone is not sufficient to prevent further emboli. Pulmonary embolectomy (A) is a surgical procedure to remove a clot from the pulmonary artery and is typically reserved for massive, life-threatening embolisms. Increasing coumadin therapy (C) to achieve a higher INR may increase bleeding risk without necessarily preventing future emboli. Thrombolytic therapy (D) is reserved for acute, large emboli causing hemodynamic instability.
Which of the following may be a cultural barrier that impacts a healthcare provider's ability to provide care or education to the client?
- A. A healthcare provider offers educational materials to a client that are written at an 8th-grade reading level
- B. A Vietnamese woman wants to use steaming in addition to her prescription antibiotics
- C. A healthcare provider uses pantomime to explain a procedure to a deaf client
- D. A Native American client requests a healing ritual before considering surgery
Correct Answer: C
Rationale: The correct answer is C because using pantomime to explain a procedure to a deaf client is a cultural barrier. Deaf individuals may use sign language or have different communication preferences, so relying solely on pantomime may not effectively convey the necessary information. This can lead to misunderstandings or incomplete communication, impacting the quality of care provided.
Choice A is incorrect as offering materials at an 8th-grade reading level is a best practice in health literacy and not a cultural barrier. Choice B may reflect cultural preferences but does not necessarily impede the provider's ability to provide care. Choice D involves a client's spiritual beliefs but does not directly hinder the provider's ability to provide care.